bluuebunny/crossref_metadata_2025_split huggingface dataset:
#6910 PREDICTORS OF KIDNEY FUNCTION DECLINE IN LIVING KIDNEY TRANSPLANTATION DONORS
Authors: Trajcheska Lada , Bushljetik Irena Rambabova- , Nikolov Igor , Andreevska Galina Severova- , Filipovski Stefan , Markovska Zhaklina Shterjova- , Taneska Aleksandra Canevska , Milenkova Mimoza , Vasilova Adrijana Spasovska , Spasovski Goce 
Published: June 2023

Abstract

Background and Aims
After nephrectomy kidney transplant donors lose 50% of their renal mass. Shortage of donors and long waiting list for deceased donor transplantation expanded the living donor criteria. The aim of this study to identify pretransplant donor related factors associated with renal function decline.

Method
We retrospectively studied LDKT donors from one transplant center in the period 2013 -2022. Data was retrieved from medical history charts and national electronic database system. Demographic characteristics as age, gender and relation to the recipient, patients preference to donate the kidney with higher measured split GFR, the presence of diabetes, hypertension, hyperlipidemia and BMI &gt;30kg/m2 were analysed. Estimated GFR by CKD EPI was notified prior donation, one and two years afterwards. In a multivariate regression analysis the reduction ratio of CKD EPI was explored as dependent variable.

Results
We studied 121 donors. The average age at time of transplant was 59.18 ± 10.99 years. Donors’ average eGFR was 91.53 ± 18.62 mL/min. Donor's age and eGFR were significantly correlated (p &lt; 0.0001, r=r−0.529). Male donors were 37 (30%), 11 (9%) were unrelated to recipients, 9(7%) had BMI&gt;30, 17 (14%) diabetes, 53 (44%) hypertension 5 (4% hyperlipidemia), and 65 (52%) had more then one comorbidity combined. Eight of donors (7%) decided to donate the better kidney. CKD EPI declined to 68.17±18.62 ml/min at first and 66.01±21.29 ml/min at the second year. The RR of 24.53 ± 20.60 % and 27.62±18.76% raised on yearly bases, respectively. In the univariate analysis of the GFR declination at the first year BMI&gt;30 kg/m2 was associated with higher reduction of GFR (β=0.318, P = .003). At the second year the presence of diabetes emerged as worsening factor of GFR (β=0.227, P = .034) and BMI&gt;30 kg/m2 kept its significance (β=0.426, P = .000). All the other parameters showed no significant associations to the GFR decline. In the multivariate analysis BMI&gt;30 kg/m2 remained as most powerful predictor at 12 months reduction of eGFR.

Conclusion
Patients with diabetes and especially with obesity are at higher risk of rapid decline in kidney function after kidney donation. Careful assessment prior kidney donation should weight the risks.
#6930 TOO ELDERLY FOR A KIDNEY BIOPSY?
Authors: Medeiros Joana , Carvalho Renata , Bastos José Mário , Viana Johanna Rodrigues , Marques Sofia Homem Melo , Vaz Raquel , Costa Rui 
Published: June 2023

Abstract

Background and Aims
As we age, we lose kidney function and accumulate risk factors and comorbidities that predispose to kidney damage. However, kidney disease can develop at any time. Life expectancy continues to improve worldwide. For that reason, more elderly patients are undergoing diagnostic kidney biopsies (KB). There is a general reluctance in performing KB in those patients. It is important to know if a diagnosis KB in elderly patients can have a positive therapeutic impact.

Method
In this retrospective cohort study, we analyzed the medical charts of all patients aged ≥ 80years who underwent a native kidney biopsy (KB) between January and December 2021, in a central hospital in Portugal.

Results
Between January and December 2021, 59 patients underwent a native KB, 6 of them over 80 years of age (10% of all patients). Between those elderly patients, the median age was 82 years. The indications for KB were chronic kidney disease with a nephrotic range proteinuria in 3 patients, nephrotic syndrome, acute glomerulonephritis and acute kidney injury in 1 patient each. Median serum creatinine was 2.27 mg/dL (minimum 0.8 and maximum 5.4 mg/dL) and median protein-to-creatinine ratio was 5.7g/g (minimum 3.3 and maximum 13g/g). The pathological diagnoses found were focal and segmental glomerulosclerosis (FSGS) (n=2), pauci-immune crescentic glomerulonephritis (n=1), membranous nephropathy in a patient with a follicular lymphoma (n=1), acute interstitial nephritis (AIN) (n=1), and diabetic glomerulosclerosis in a patient with a monoclonal gammopathy of undetermined significance (n=1). 3 patients have received a kidney-specific treatment – the patient with AIN started corticosteroids, one patient with FSGS was submitted to corticosteroids plus tacrolimus, and the patient with pauci-imune crescentic glomerulonephritis to corticosteroids plus rituximab. The patient with membranous nephropathy and follicular lymphoma received a specific chemotherapy regimen according with lymphoproliferative disease. An improvement in kidney function occurred only in one patient and the other three developed adverse effects (particularly corticosteroids induced diabetes and infections). One year later, one of patients who received treatment was dead, another one was on hemodialysis, and the other two patients had a glomerular filtration rate lower than 15mL/min/1.73 m2.

Conclusion
Elderly patients have a higher risk of adverse effects from the kidney-specific treatment. It is important to assess the therapeutic risk/benefit when considering performing a renal biopsy in these patients.
#6931 TWO CASES OF PREGNANCY IN PATIENTS WITH TUBEROUS SCLEROSIS COMPLEX
Authors: Knezevic Tamara , Ivkovic Vanja , Prlic Margareta Fistrek , Ivandic Ema , Brinar Ivana Vukovic 
Published: June 2023

Abstract

Background and Aims
Tuberous sclerosis complex (TSC) is a rare autosomal dominant genetic disorder that is characterized by formation of benign tumors of the brain, kidney, eyes, heart, lung, liver and skin. The disease is frequently associated with adverse pregnancy outcomes. Our aim is to present two cases of Tuberous sclerosis complex in pregnancy which might be illustrative in the management of these patients.

Method
The first patient was a 32-year-old woman with a history of renal angiomyolipoma (AML) and pulmonic lymphangiomyomathosis (LAM) due to Tuberous sclerosis complex diagnosed at a young age. In the 35th gestational week she had an emergency Cesarean section due to acute retroperitoneal bleeding from angiomyolipoma of the right kidney and gave birth to a preterm male infant (birth mass 2077 g, Apgar 4/6). The patient did not take any medications during the course of pregnancy. Since 2015 she is being treated with everolimus (5 mg/day) due to complications for pulmonic lymphangiomyomathosis, subependymomas and epilepsy and AMLs. After eight years of treatment renal AMLs and LAM and subependymomas show no dynamic in size or number. The second patient was a 29-year-old nulliparous woman who has presented with seizures at the age of 2 and was diagnosed with TSC. At 37th gestational week of a twin pregnancy she gave birth to one male neonate (birth mass 2660 g, Apgar 8/9), while the other fetus died in utero. During the course of the pregnancy she was treated with phenobarbital, folic acid and iron supplementation. Her epilepsy is well-controlled and AMLs show no dynamic in size or number.

Results:

Conclusion
We have showed two cases with relatively good outcomes which have long-term stable disease. Female patients with TSC have increased risk of hemorrhagic complications of AMLs during pregnancy and it can be complicated by intrauterine growth restriction. A multidisciplinary approach is needed in the planning and monitoring pregnancies in these patients to achieve optimal outcomes.
Inequality and Stratification in East Asia
Authors: Park Hyunjoon , Ishida Hiroshi , Su Kuo-Hsien 
Published: June 2023

Abstract
Over the last few decades, three East Asian societies—Japan, South Korea, and Taiwan—have experienced an extraordinary degree of educational expansion, to the extent that their young adults are among the most educated population in the world. The roles of education in intergenerational social mobility in East Asia may show different patterns from those reported in Western societies, where educational expansion has been on much smaller scales. This chapter brings together various studies for each pair of the origin-education-destination stratification triangle in East Asia, along with recent studies that explicitly model the roles of education in modifying intergenerational social mobility. To contextualize empirical findings, this chapter also offers a description of structural features of educational systems, evolution of educational expansion, and changes in class structure in East Asia over time.
Modernization and Long-Term Trends in Social Mobility
Authors: Maas Ineke , van Leeuwen Marco H. D. 
Published: June 2023

Abstract
This chapter provides an overview of recent large-scale studies on historical trends in social mobility. The major findings are that intergenerational mobility increased and marital mobility showed a shift from ascription to achievement in the nineteenth century when industrialization and socioeconomic modernization took place. Most studies show trends in mobility, but only few analyze the association of mobility with indicators of modernization. Those that do so indicate that marital mobility was more clearly related to modernization than intergenerational mobility was. Studies are appearing that focus on women’s mobility and on non-Western countries, but these are still too few to draw general conclusions. Future research could benefit from better and more comparable measures of modernization. Alternative hypotheses on the causes of trends in intergenerational and marital mobility, related to societal inequality, political regimes, educational systems, culture, and religion, are also still awaiting testing.
PTC and DTC: a new perspective from Switzerland
Authors: Turato Filippo 
Published: June 2023

Abstract
This article analyses the use of private trust companies and dedicated trust companies (DTCs) in Switzerland. The Swiss trust industry has evolved steadily over the last few years, thanks to the creation of a solid regulatory framework. Professional trustees are now qualified as financial institutions, subject to licensing requirements and placed under the supervision of the Swiss Financial Market Supervisory Authority. This regulation introduced Swiss DTCs as a type of private trust company. DTCs are independent of the family, being held and supervised by a licensed trustee, and allow full flexibility in terms of governance evolving in the concept of a Swiss single-family office.
A comparison of the Newly Reformed German and the Liechtenstein Foundation Law against the background of the competition between the legal systems
Authors: Butterstein Alexandra 
Published: June 2023

Abstract
An European legal framework for foundation practice is still missing. Even the proposal for a regulation on the statute of the Fundatio Europaea has not yet been implemented. Meanwhile, the civil law regulations of the various foundation law systems are manifold. At the same time, competition between European legal systems not only affects civil, corporate and tax law, but has also reached foundation law. Moreover, the social and international environment of foundations is changing. In addition to a new generation of young founders, the demographic change in society and the mobility of legal forms in the European environment are also having an impact on foundations. Due to current reforms in the traditional foundation law systems of Germany and Switzerland, the question arises whether Liechtenstein should react to the competition between foundation law systems and whether the Liechtenstein legislator should become active once again. For this reason, this article deals in detail with the most important changes in German foundation law that are relevant for Liechtenstein foundation law. The article also looks at the regulations in Liechtenstein foundation law in a comparative law perspective, highlighting the competition between foundation law systems.
Strategies for Incorporating Plant-Based Nutrition Into Nursing Curricula
Authors: Benavides Heidi , Christianson-Silva Paula 
Published: June 2023

Abstract
A whole-food, plant-based (WFPB) eating pattern has shown benefits in preventing and reversing chronic disease, yet nursing curricula rarely include content on nutrition as a primary modality for disease management. We implemented several undergraduate and graduate nursing and interprofessional teaching strategies to increase student knowledge of a WFPB diet and help nurses improve patient outcomes through assimilation. Students requested additional emphasis on WFPB diets and chronic illness in the curriculum.
How obesity affects the disposition of intravenous anesthetics
Authors: Obara Shinju , Yoshida Keisuke , Inoue Satoki 
Published: June 2023

Purpose of review
Understanding the changes in drug disposition of intravenous anesthetics in patients with obesity and administering appropriate doses are critical to avoid intraoperative awareness with recall because of underdosing and over-sedation and delayed emergence due to overdosing. Pharmacokinetic simulation or target-controlled infusion (TCI) using models that have been adapted to patients with obesity are necessary to select appropriate dosing regimens. This review aimed to describe the pharmacokinetic concepts underpinning the use of intravenous anesthetics, including propofol, remifentanil, and remimazolam, in patients with obesity.

Recent findings
In the last 5 years, a series of pharmacokinetic models for propofol, remifentanil, and remimazolam that were estimated from populations that included obese patients have been published. These new pharmacokinetic models can be considered ‘second generation’ compared with earlier models in that they expand the range of covariate effects (e.g. the extremes of body weight and age) accounted for by the models. The predictive performances of each pharmacokinetic model have been shown in the literature to be within clinically acceptable limits. Among them, the propofol model by Eleveld et al. has been externally validated and has shown reasonable predictive accuracy.

Summary
Pharmacokinetic simulations or TCI using pharmacokinetic models that account for the influence of obesity on a drug's disposition are essential to predict plasma/effect-site concentrations of intravenous anesthetics and understand the temporal profile of drug concentrations and effect in patients with obesity, particularly severe obesity.
Regional anesthesia in the emergency department outside the operating theatre
Authors: Wolmarans Morné , Albrecht Eric 
Published: June 2023

Purpose of review
Moderate to severe pain is common and remains a significant problem in the emergency department and regional anesthesia provides optimal and safe pain relief. This review aims to discuss the benefits, indications of the most common ultrasound-guided regional anesthesia techniques that can be provided by clinicians in the emergency department as part of multimodal analgesia. We will also comment on the education and training for effective and safe ultrasound-guided regional anesthesia in the emergency department.

Recent findings
The emergence of multiple new fascial plane blocks that provide easier to learn alternatives, yet effective analgesia for specific patient groups can now safely be taught and utilized in the emergency department.

Summary
Emergency physicians are perfectly placed to utilize the advantages of ultrasound-guided regional anesthesia. Various techniques can now be employed to cover most of the painful injuries presenting to the emergency department, thus modifying the morbidity and outcomes of emergency patients. Some of the new techniques require minimal training, provide safe and effective pain relief with low risk of complications. Ultrasound-guided regional anesthetic techniques should form an integral part of the curriculum of emergency department physicians.
Provider and Caregiver Perspectives on Telehealth Assessments for Autism Spectrum Disorder in Young Children: A Multimethod DBPNet Study Exploring Equity
Authors: Kellom Katherine S. , Flaherty Carina M. , Cacia Jaclyn , Christiansen Audrey , Cordero Lucero , Hah Julia , Kennelly Annie , Ortiz Priscilla , Stefanski Kristen , Wozniak Sarah N. , Wallis Kate E. 
Published: June 2023

ABSTRACT:

Background:
Telehealth uptake increased dramatically during the COVID-19 pandemic, including for autism spectrum disorder (ASD) assessment by developmental-behavioral pediatric (DBP) clinicians. However, little is known about the acceptability of telehealth or its impact on equity in DBP care.

Objective:
Engage providers and caregivers to glean their perspectives on the use of telehealth for ASD assessment in young children, exploring acceptability, benefits, concerns, and its potential role in ameliorating or exacerbating disparities in access to and quality of DBP care.

Methods:
This multimethod study used surveys and semistructured interviews to describe provider and family perspectives around the use of telehealth in DBP evaluation of children younger than 5 years with possible ASD between 3/2020 and 12/2021. Surveys were completed by 13 DBP clinicians and 22 caregivers. Semistructured interviews with 12 DBP clinicians and 14 caregivers were conducted, transcribed, coded, and analyzed thematically.

Results:
Acceptance of and satisfaction with telehealth for ASD assessments in DBP were high for clinicians and most caregivers. Pros and cons concerning assessment quality and access to care were noted. Providers raised concerns about equity of telehealth access, particularly for families with a preferred language other than English.

Conclusion:
This study's results can inform the adoption of telehealth in DBP in an equitable manner beyond the pandemic. DBP providers and families desire the ability to choose telehealth care for different assessment components. Unique factors related to performing observational assessments of young children with developmental and behavioral concerns make telehealth particularly well-suited for DBP care.
Intraoperative Bleb Behavior in Subretinal Gene Augmentation Therapy for Inherited Retinal Diseases
Authors: Sisk Robert A. , Berger Tyler A. , Williams Eric R. , Riemann Christopher D. 
Published: June 2023

Abstract

Purpose:
In subretinal gene therapy for inherited retinal diseases (IRDs), blebs may not propagate predictably in the direction of the injection cannula. We evaluated factors that influenced bleb propagation among various IRDs.

Methods:
Retrospective review of all subretinal gene therapy procedures performed by a single surgeon between September 2018 and March 2020 for various IRDs. Main outcome measures were directional bias of bleb propagation and intraoperative foveal detachment. Secondary outcome was visual acuity.

Results:
Desired injection volumes and/or foveal treatment were successfully achieved in all 70 eyes of 46 IRD patients regardless of IRD indication. Bullous foveal detachment was associated with retinotomy closer to the fovea, posterior bleb bias, greater bleb volumes (p < 0.01). Blebs biased anteriorly or posteriorly based upon disease indication (p = 0.04) and age (p<0.001). Retinotomy location ≤ 3.7mm (approximately 2 disc diameters) from the fovea favored foveal detachment (p < 0.001). Multiple retinotomies and blebs allowed greater surface area coverage in some eyes, but intersecting blebs did not propagate further.

Conclusion:
Bleb formation and propagation are predictable based upon patient age, retinotomy location, disease indication, and how tangentially fluid is directed into the subretinal space.
SARS-CoV-2 and Dengue Coinfection in Filipino Children: Epidemiology Profile, Clinical Presentation and Outcomes
Authors: Pantig Francesca Mae T. , Clemens Sue Ann Costa , Clemens Ralf , Maramba-Lazarte Cecilia C. , Madrid Mary Antonette C. 
Published: June 2023

Background:
The emergence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in dengue-endemic regions has raised concern on the possibility of coinfection, especially in children who bear the highest burden of illness. This study determined the incidence and described the profile of Filipino children with SARS-CoV-2 and dengue coinfection, and compared disease severity and outcome in children with coinfection to a matched group of children with SARS-CoV-2 monoinfection.

Methods:
This was a retrospective matched cohort study of pediatric patients 0–18 years old diagnosed with SARS-CoV-2 and dengue coinfection or SARS-CoV-2 monoinfection in the Philippines and reported to the Surveillance and Analysis of Coronavirus disease 2019 (COVID-19) in Children Nationwide registry from March 01, 2020 to June 30, 2022.

Results:
A total of 3,341 SARS-CoV-2 infections in children were reported. The SARS-CoV-2 and dengue coinfection incidence is 4.34% (n = 145). We matched 120 coinfections to monoinfections according to age, gender and timing of infection. More coinfection cases were classified as mild or moderate COVID-19, whereas more asymptomatic cases were seen in those with monoinfection. Rates were similar for severe and critical COVID-19 in both groups. Coinfections predominantly presented with typical dengue symptoms rather than COVID-19 symptoms and laboratory parameters. No differences in outcomes were observed between coinfection and monoinfection. The case fatality rates are 6.7% for coinfection and 5.0% for monoinfection.

Conclusions:
One in every 25 SARS-CoV-2 infections had a dengue coinfection. Continued surveillance is needed to establish the interaction of SARS-CoV-2 and dengue virus, evaluate the impact of COVID-19 and/or dengue vaccination on coinfection and monitor complications of coinfection.
Development and Preliminary Validity Study of a Modified Version of the Upper Extremity Fugl-Meyer Assessment for Use in Telerehabilitation
Authors: Carmona Carolina , Sullivan Jane E. , Arceo Riegele , Drogos Justin , Besser Sofie , Gutierrez Susana , Jeteric Zineyra , Wyman James , Yao Jun 
Published: June 2023

Background/Purpose:
The Upper Extremity Fugl-Meyer Assessment (UEFMA, maximum 66) is widely used in clinics and research studies to examine poststroke upper extremity (UE) impairment. This study aimed to develop and provide pilot data to support the validity of a remote version of the UEFMA to examine UE impairment after stroke through telerehabilitation.

Methods:
Team members developed a remote version of the UEFMA for telerehabilitation (tUEFMA, maximum 44) using subscales II to IV and VII of the UEFMA. Twenty-two participants with moderate to severe arm impairment (UEFMA, median = 19) and chronic stroke (>1 year post) were evaluated using the UEFMA (face-to-face) and the tUEFMA (remotely). A prediction equation was used to identify the function to predict the UEFMA based on the tUEFMA. Intraclass correlation (ICC) was used to test the absolute agreement between the subscales included in the UEFMA and the tUEFMA, and between their 2 normalized total scores.

Results:
A strong and significant agreement was found between the total scores of the UEFMA and the projected value based on the tUEFMA (ICC = 0.79, P < 0.05). The ICC test also reported a good agreement in subscales II to IV and a poor agreement in subscale VII between the UEFMA and the tUEFMA using a real-time video link.

Discussion and Conclusions:
The study findings suggest that the tUEFMA is a promising tool to remotely examine UE impairment in individuals with chronic stroke and moderate to severe arm impairment. Future research should evaluate additional psychometric properties and clinical utility of the tUEFMA across stroke participants with a broad range of arm impairments.

Video Abstract available for more insights from the authors (see the Video, Supplemental Digital Content 1, available at: http://links.lww.com/JNPT/A441).