bluuebunny/crossref_metadata_2025_split huggingface dataset:
Torque Teno Virus in Nasopharyngeal Aspirate of Children With Viral Respiratory Infections
Authors: del Rosal Teresa , García-García Mª Luz , Casas Inmaculada , Iglesias-Caballero María , Pozo Francisco , Alcolea Sonia , Bravo Blanca , Rodrigo-Muñoz José M. , del Pozo Victoria , Calvo Cristina 
Published: February 2023

Background:
Torque teno virus (TTV) is a ubiquitous anellovirus responsible for persistent infections and is considered a marker of immune function. The role of TTV as a facilitator of respiratory infections (RIs) is unknown.

Objectives:
Our aim was to estimate, in a prospective study, the prevalence of TTV in the nasopharyngeal aspirate (NPA) of hospitalized children <5 years old, with RIs and correlate them with outcomes and immune response.

Patients and Methods:
NPA was taken for testing of 16 respiratory viruses by reverse transcription-polymerase chain reaction (PCR), TTV PCR, and immunologic study.

Results:
Sixty hospitalized children with an RI were included. A total of 51/60 patients had positive common respiratory viral (CRV) identification. A total of 23/60 (38.3%) children were TTV+ in NPA. TTV+ patients had other CRVs in 100% of cases versus 78.3% in TTV− (P = 0.029). The TTV+ patients tended to be older, have fever, and to need pediatric intensive care unit admission more often than TTV− patients. Abnormal chest radiograph was more frequent in the TTV+ patients, odds ratios 2.6 (95% CI: 1.3–5.2). The genetic expression of filaggrin (involved in epithelial barrier integrity) was lower in TTV+ patients; however, the levels of filaggrin in the NPA were increased.

Conclusions:
TTV infection is common in children with RI and could be associated with abnormal imaging in radiograph, greater severity and an alteration in filaggrin gene expression and protein release.
Comparison of Pediatric Patients With and Without Multisystem Inflammatory Syndrome Associated With COVID-19: Retrospective Cohort From Ecuador
Authors: Legarda Eliana M. , Martínez Jenny , Sisa Ivan 
Published: February 2023

Background:
Multisystem inflammatory syndrome in children (MIS-C) has been associated with severe acute respiratory syndrome coronavirus 2 infection in the pediatric population cared for in the pediatric intensive care unit. We aimed to compare patients with pediatric acute respiratory distress syndrome (PARDS) with those who also present a MIS-C diagnosis (PARDS vs. PARDS + MIS-C).

Methods:
One hundred and sixty-seven children (0–15 years) admitted to the pediatric intensive care unit COVID-19 ward of a national reference children’s hospital in Quito, Ecuador, from June 2020 to June 2021 who developed PARDS with or without MIS-C. To diagnose PARDS, the criteria of the Pediatric Acute Lung Injury Consensus Conference Group were used, and to diagnose MIS-C, the criteria of the Centers for Disease Control and Prevention were used. Additionally, the PRISM score was used to calculate the mortality risk of study patients on admission.

Results:
Of the 167 patients with PARDS, ~59% also developed MIS-C. Patients with PARDS + MIS-C had higher risks than patients without MIS-C in the following: frequency of associated bacterial infections (81.6% vs. 55.1%), mortality risk (36.7% vs. 11.6%), use of respiratory support (invasive mechanical ventilation: 92% vs. 86%), use of vasopressors/inotropes (90.8% vs. 30.4%), renal complications (36.7% vs. 8.7%), septic shock (84.7% vs. 20.3%), multiorgan failure (39.8% vs. 1.4%) and mortality at discharge (39.8% vs. 4.3%). Logistic regression failed to find an association between MIS-C and age, race, sex, ≥3 signs/symptoms and ≥2 comorbidities.

Conclusions:
Patients with PARDS + MIS-C had a more severe clinical picture than patients without MIS-C. The findings provide useful information to improve the management of PARDS patients with and without MIS-C in Ecuador.
Vision and patient-reported outcomes with nondiffractive EDOF or neutral aspheric monofocal intraocular lenses
Authors: Pantanelli Seth M. , O'Rourke Tara , Bolognia Olga , Scruggs Kathleen , Longenecker Amy , Lehman Erik 
Published: February 2023

Purpose:To compare outcomes in patients who underwent cataract extraction with implantation of nondiffractive extended depth-of-focus (ND-EDOF; Alcon AcrySof Vivity) or neutral aspheric monofocal (Bausch & Lomb enVista) intraocular lenses (IOLs).Setting:Academic medical center.Design:Prospective single-center double-arm patient- and assessor-masked randomized controlled trial.Methods:Patients were randomized to receive either a ND-EDOF or monofocal IOL in both eyes, targeted for emmetropia. Uncorrected and corrected (CDVA) distance visual acuities, distance-corrected intermediate visual acuity (DCIVA), distance-corrected near visual acuity (DCNVA), level of spectacle independence, and severity of photic phenomena were assessed at 3 months postoperatively.Results:56 patients were enrolled, of which 24 in the ND-EDOF group and 27 in the monofocal group completed follow-up. The binocular mean CDVA, DCIVA, and DCNVA were 20/20, 20/19, and 20/21 for the ND-EDOF IOL and 20/18 (P= .188), 20/31 (P< .001), and 20/30 (P= .004) for the monofocal IOL, respectively. At intermediate, 88% of the ND-EDOF vs 30% of the monofocal patients had a binocular DCIVA of 20/25 or better (P< .001). Moderate or severe glare occurred in 20.8% of ND-EDOF vs 7.4% of monofocal patients (P= .228), whereas moderate or severe halos occurred in 16.7% of ND-EDOF vs 11.1% of monofocal patients (P= .697).Conclusions:The ND-EDOF and monofocal IOLs provided similarly excellent distance vision. Patients implanted with the ND-EDOF IOL had 2 more lines of vision at both intermediate and near, and a greater proportion reported spectacle independence. Most patients in both groups reported low severity of photic phenomena.
Emergence of nociceptive functionality and opioid signaling in human induced pluripotent stem cell–derived sensory neurons
Authors: Röderer Pascal , Belu Andreea , Heidrich Luzia , Siobal Maike , Isensee Jörg , Prolingheuer Jonathan , Janocha Elke , Valdor Markus , Hagendorf Silke , Bahrenberg Gregor , Opitz Thoralf , Segschneider Michaela , Haupt Simone , Nitzsche Anja , Brüstle Oliver , Hucho Tim 
Published: February 2023

AbstractInduced pluripotent stem cells (iPSCs) have enabled the generation of various difficult-to-access cell types such as human nociceptors. A key challenge associated with human iPSC-derived nociceptors (hiPSCdNs) is their prolonged functional maturation. While numerous studies have addressed the expression of classic neuronal markers and ion channels in hiPSCdNs, the temporal development of key signaling cascades regulating nociceptor activity has remained largely unexplored. In this study, we used an immunocytochemical high-content imaging approach alongside electrophysiological staging to assess metabotropic and ionotropic signaling of large scale–generated hiPSCdNs across 70 days of in vitro differentiation. During this period, the resting membrane potential became more hyperpolarized, while rheobase, action potential peak amplitude, and membrane capacitance increased. After 70 days, hiPSCdNs exhibited robust physiological responses induced by GABA, pH shift, ATP, and capsaicin. Direct activation of protein kinase A type II (PKA-II) through adenylyl cyclase stimulation with forskolin resulted in PKA-II activation at all time points. Depolarization-induced activation of PKA-II emerged after 35 days of differentiation. However, effective inhibition of forskolin-induced PKA-II activation by opioid receptor agonists required 70 days of in vitro differentiation. Our results identify a pronounced time difference between early expression of functionally important ion channels and emergence of regulatory metabotropic sensitizing and desensitizing signaling only at advanced stages of in vitro cultivation, suggesting an independent regulation of ionotropic and metabotropic signaling. These data are relevant for devising future studies into the development and regulation of human nociceptor function and for defining time windows suitable for hiPSCdN-based drug discovery.
Feasibility and reliability of a quantitative sensory testing protocol in youth with acute musculoskeletal pain postsurgery or postinjury
Authors: Li Rui , Holley Amy L. , Palermo Tonya M. , Ohls Olivia , Edwards Robert R. , Rabbitts Jennifer A. 
Published: February 2023

Abstract
Quantitative sensory testing (QST) is increasingly used in pediatric chronic pain; however, assessment in youth with acute musculoskeletal (MSK) pain is limited. This study evaluated the feasibility, reliability, and sources of variability of a brief QST protocol in 2 clinical samples of youth with acute MSK pain. Participants were 277 youth (Mage = 14.5 years, SD = 2.0, range = 11-18 years, 59% female, 81% non-Hispanic) across 3 geographic study sites who completed a QST protocol assessing pressure and thermal pain sensitivity, temporal summation of pain, and conditioned pain modulation 8 weeks after MSK surgery (n = 100) or within 4 weeks after an acute MSK injury (n = 177). High feasibility was demonstrated by protocol completion rates ranging from 97.5% to 100% for each task, with 95.3% of youth completing all tasks. Reliability was high, with reliability coefficients of >0.97 for 7 out of 8 QST parameters and minimal influence of examiner or participating site effects. Younger youth had lower pressure and heat pain thresholds (11-12 vs 13-18 years, d = −0.80 to −0.56) and cold pain tolerance (d = −0.33). Hispanic youth had higher pressure and heat pain thresholds (d = 0.37-0.45) and pain ratings for cold pain tolerance (d = 0.54) compared with non-Hispanic youth. No significant differences were observed in QST values by sex or personal contextual factors at the time of assessment (momentary pain, menstrual period, use of pain medications). Overall findings demonstrate feasibility of a brief QST protocol with youth with diverse acute MSK pain and data provide initial support for the reliability of this QST protocol for multisite research studies.
Efficacy and Safety of Oral Hydration 1 Hour After Extubation of Patients Undergoing Cardiac Surgery
Authors: Liang Ting , Li Sai-Lan , Peng Yan-Chun , Chen Qi , Chen Liang-Wan , Lin Yan-Juan 
Published: February 2023

Background
Thirst is one of the most common and uncomfortable symptoms in patients after cardiac surgery. The postextubation time for early oral hydration (EOH) remains unclear, and there is a lack of studies on its safety and effectiveness.

Objective
The aim of this study was to investigate the effects of oral hydration 1 hour after extubation on thirst, salivary pH, salivary flow, oral mucosa, halitosis, gastrointestinal adverse reactions, aspiration pneumonia, and satisfaction in patients undergoing cardiac surgery.

Methods
Eighty-four patients who underwent cardiac surgery were randomly assigned into 2 groups, for either conventional oral hydration (COH) or EOH. The EOH group drank 30 mL of warm water 1 hour post extubation and thereafter 50 mL hourly for 4 hours. The COH group had nil per os for 4 hours after extubation. If no dysphagia was evident after 4 hours, the patients were instructed to slowly drink water. Thirst intensity was evaluated every hour before the intervention. Nausea and vomiting were recorded after drinking water. The salivary pH, unstimulated salivary flow rate, oral odor, and oral mucosal moisture were evaluated at 1 hour post extubation, immediately before the intervention, and at 4 hour post intervention. Aspiration pneumonia data were collected within 72 hours post intervention. Satisfaction was assessed before leaving the intensive care unit.

Results
The scores for thirst (3.38 ± 1.04; F = 306.21, P < .001), oral mucosa (2.03 ± 0.74; P < .001), and halitosis (2.77 ± 0.63; P < .001) in the EOH group were significantly lower than those in the COH group. The EOH group had significantly higher salivary pH (6.44 ± 1.06; P < .001), unstimulated salivary flow rates (0.18 ± 0.08; P < .001), and patient satisfaction (4.28 ± 0.45; P < .001) than the COH group. Nausea and vomiting did not differ significantly between groups (P = .60). Aspiration pneumonia was not observed in either group.

Conclusions
Oral hydration 1 hour after extubation significantly alleviated thirst and stabilized the oral environment without gastrointestinal adverse reactions or aspiration pneumonia, and with increased patient satisfaction.
Correlation of whole blood zinc levels, CD4 cell count, HIV disease stage, and dermatologic manifestations among diagnosed HIV patients in a tertiary hospital
Authors: Sarne Riza I. , Gabriel Ma. Teresita G. , Vista Emmerson Gale S. , Aguado Maria Jenina P. , Karim Cynthia Angela 
Published: February 2023

Objectives:
Zinc deficiency is the most common micronutrient abnormality seen in human immunodeficiency virus (HIV) infection. Depletion of CD4 cells is a hallmark of HIV infection. The study aims to determine the association between whole blood zinc levels and CD4 cell count and stage of HIV infection among patients in a tertiary hospital in the Philippines.

Methods:
Sixty-five newly diagnosed HIV positive patients of the institution were recruited. Demographic profile, whole blood zinc levels, CD4 cell count level, HIV Disease Stage, and presence of any dermatologic manifestations were noted. Prevalence of zinc deficiency and orrelation between whole blood zinc levels and CD4 cell count were determined.

Results:
Among the 65 patients, overall zinc deficiency was noted at 33.8%. Low CD4 count and HIV Disease Stage IV participants had the highest percentage of zinc deficiency at 54.6% and 50%, respectively. A correlation coefficient at r=0.3364 was noted between whole blood zinc levels and CD4 cell count (P<0.050). Twenty-nine patients presented with dermatologic manifestations, with 10 patients being zinc deficient.

Conclusion:
A weak positive correlation was seen between zinc levels and CD4 count. There is an increasing frequency of zinc level deficiency with a higher HIV disease stage. Dermatologic manifestations of HIV may be present in both patients with normal and deficient zinc levels.
Self-reported hair-loss following COVID-19 infection
Authors: Alajlan Abdulmajeed , Aldihan Rema , Almana Lyan , Althnayan Rahaf , Awartani Hadeel , Alsuwaidan Sami 
Published: February 2023

Objectives:
This study was performed to estimate the prevalence of hair loss among patients with COVID-19 and to determine the correlation of the severity of COVID-19 with the severity of hair loss.

Methods:
Data were collected through a self-administered electronic questionnaire that was distributed among social media platforms. Participants were invited to complete the survey using a convenience sampling technique.

Results:
Among 420 participants who reported a positive polymerase chain reaction for SARS‐CoV‐2 infection, 77.6% reported hair loss after the development of COVID-19. Notably, the onset of hair loss was within 3 weeks of the development of COVID-19 in 29% of participants. Most of the participants reported that the duration of hair loss was up to 6 months, and hair regrowth was noticed within 1 year after the development of COVID-19. Patients who were admitted to the hospital, who experienced respiratory difficulties, who had lost weight due to COVID-19, and who experienced symptoms for longer than 10 days were significantly more prone to experience severe hair loss following COVID-19 (P < 0.001).

Conclusion:
This study demonstrated a high frequency of self-reported hair loss after the development of COVID-19. Interestingly, even patients with mild COVID-19 symptoms were significantly more prone to experience moderate hair loss. Unique to COVID-19 infection, the onset of hair loss following the development of COVID-19 was within 3 weeks in one-third of the participants.
Multiple Cutaneous Nodules as Clinical Harbinger of Gallbladder Adenocarcinoma: A Case Report
Authors: Tariq Hira , Fayyaz Afshan , Batool Saelah , Aman Shahbaz 
Published: February 2023

Introduction:
Cutaneous metastasis is defined as invasion of the skin by malignant cells originating elsewhere in the body. Cutaneous metastasis of adenocarcinoma gall bladder is extremely rare. The skin can be involved simultaneously or metachronously with the primary tumor.
Here, we reported a case of cutaneous metastases as a clinical harbinger to an otherwise difficult to diagnose primary adenocarcinoma gallbladder.

Case presentation:
A 46-year-old male presented with multiple nodules on scalp, trunk, and limbs along with fever, weight loss, and lymphadenopathy. Histopathologic examination of the nodule revealed a malignant infiltrating glandular neoplasm in dermis, consistent with metastatic adenocarcinoma with intestinal metaplasia on immunohistochemistry. Radiological investigations further confirmed the primary tumor in gall bladder with metastases in liver and lymph nodes. Unfortunately, the patient succumbed to his disease.

Discussion:
Gallbladder adenocarcinoma is the most commonly seen tumor of the biliary tract. Skin involvement in malignancy helps determine the treatment course and has inevitable prognostic significance.

Conclusion:
We reported multiple cutaneous nodules as a remote manifestation of gallbladder adenocarcinoma. Biopsy of the skin lesion was easy to perform and quite reliably guided us toward the diagnosis of the primary tumor which would have been very difficult to diagnose otherwise.
Large cell acanthoma in a 10-year-old child: A case report
Authors: Wu Hao , Chang Jian-Min 
Published: February 2023

Introduction:
Large cell acanthoma (LCA) is a rare benign tumor of epidermal origin. It is mainly seen on sun-exposed areas such as the head and extremities of older patients. Histopathologically, LCA is characterized by acanthosis and keratinocytes that are twice as large as normal cells.
We herein report a case involving a child diagnosed with LCA on an unexposed area of skin.

Case presentation:
A 10-year-old boy presented with a rough, painless light brown papule on his right chest that had been present for 11 months. He underwent surgical resection and pathological examination, and the histopathological findings were consistent with LCA.

Discussion:
LCA is common in adults but rare in children. It is difficult to differentiate from solar lentigo, actinic keratosis, or seborrheic keratosis because of its atypical clinical presentation. Dermoscopy, reflectance confocal microscopy, and cellular-resolution full-field optical coherence tomography can be used as auxiliary examinations, but pathological biopsy is still required to confirm the diagnosis.

Conclusion:
LCA is not limited to adults and exposed areas. This case reminds us that LCA may occur in children and that close attention is required for its identification.
Successful Treatment of Generalized Pustular Psoriasis with Adalimumab in a Pediatric Patient: A Case Report
Authors: Iraqi Mohamed F. , Alhomida Faris A. , Masoud Hasan , AlRasheed Girnasah , Almahlasi Reema 
Published: February 2023

Introduction:
Generalized pustular psoriasis (GPP) is a rare life-threatening subtype of psoriasis and continues to be a therapeutic challenge. The first line therapies include acitretin, cyclosporin A, and methotrexate which have long-term side effects for children. Adalimumab has a favorable safety profile with low rates of adverse events, and has been described for successful treatment of adults with GPP in a few reports.
We herein describe a 3-year-old girl with a body weight of 14.2 kg in whom adalimumab was used to successfully treat GPP.

Case presentation:
A 3-year-old girl with a 10-day history of systemic symptoms of fever, malaise, and the onset of studded painful pustules overlying an erythematous base on the scalp, face, neck, trunk, and bilateral extremities, affecting a body surface area of 90%. Laboratory examination results were notable for leukocytosis and elevated inflammatory markers. Biopsy confirmed the diagnosis of GPP. After failure of conventional therapies including cyclosporine and methotrexate, the patient began off-label treatment with adalimumab and achieved complete lesion clearance. During 14-month follow-up, she remains in remission on maintenance adalimumab therapy.

Discussion:
No consensus on the standard treatment regimen for GPP has been reached. Unfortunately, all drugs that have been reported to be effective for GPP are off-label. These treatments include systemic immunomodulators such as cyclosporine and methotrexate, systemic retinoids such as acitretin and isotretinoin, and various biologics. Our findings lend weight to the scant evidence describing the effective use of adalimumab in the treatment of pediatric GPP.

Conclusion:
Off-label use of adalimumab may be an effective and safe therapeutic option for GPP.
Nurse Engagement in Antibiotic Stewardship Programs: A Scoping Review of the Literature
Authors: Thurman Johnson Cara , Ridge Laura J. , Hessels Amanda J. 
Published: February 2023

ABSTRACT

Introduction:
Hospital-based antibiotic stewardship programs (ASPs) are an important strategy in combating antibiotic resistance. Four antibiotic stewardship interventions are recommended by the CDC as particularly well-designed to engage nurses. However, there is limited information on whether and how existing hospital-based ASPs reflect these practices.

Purpose:
To describe how nurses are being engaged in hospital ASPs and to what extent this overlaps with the CDC framework.

Methods:
This scoping review included studies published in the last 10 years on engaging nurses in hospital-based ASPs. Three databases, PubMed, CINAHL, and Embase, were searched.

Results:
The search yielded 195 unique articles. Ten articles were retained for review detailing how nurses are engaged. One CDC recommended intervention, initiating discussion of antibiotic treatment, appeared in nine studies.

Conclusions:
Although hospitals are engaging nurses in antibiotic stewardship programs, their selected approaches do not reflect the full breadth of the opportunities identified by the CDC. More detail as to how exactly nurses engage would also be a useful addition to the literature.

Implications:
More research is needed on nurse engagement on culturing or testing and penicillin allergy evaluation. Standardized measures should be collected and reported to measure the impact of engaging nurses in ASPs.
HIV Continuum of Care Among People Who Inject Drugs in Iran: A Cross-sectional Study
Authors: Ghalekhani Nima , Mirzazadeh Ali , Tavakoli Fatemeh , Mousavian Ghazal , Khezri Mehrdad , Zamani Omid , Mehmandoost Soheil , Haghdoost Ali Akbar , Sharifi Hamid 
Published: February 2023

Abstract
People living with HIV who inject drugs may have lower access to treatment services. We aimed to assess the HIV continuum of care among people who inject drugs (PWID) in Iran. Data were collected from 2,663 PWID who were recruited via respondent-driven sampling from 11 cities of Iran between June 2019 and March 2020. Participants who tested positive for HIV infection were asked questions to calculate the status of HIV cascade of care. Of 95 PWID living with HIV, 67% were aware of their HIV status, 57% were linked to care service and initiated ART, 49% retained on ART, and only 15% had viral load less than 1,000 copies/ml. About half of the PWID diagnosed with HIV ever started ART and less than one in six were virally suppressed. Strategies to improve linkage to ART programs and ART retention may improve HIV care outcomes among PWID in Iran.