bluuebunny/crossref_metadata_2025_split huggingface dataset:
KRASMutation Variants and Co-occurring PI3K Pathway Alterations Impact Survival for Patients with Pancreatic Ductal Adenocarcinomas
Authors: Diehl Adam C , Hannan Lindsay M , Zhen David B , Coveler Andrew L , King Gentry , Cohen Stacey A , Harris William P , Shankaran Veena , Wong Kit M , Green Steven , Ng Natasha , Pillarisetty Venu G , Sham Jonathan G , Park James O , Reddi Deepti , Konnick Eric Q , Pritchard Colin C , Baker Kelsey , Redman Mary , Chiorean E Gabriela 
Published: September 2022

AbstractBackgroundKRAS variant alleles may have differential biological properties which impact prognosis and therapeutic options in pancreatic ductal adenocarcinomas (PDA).Materials and MethodsWe retrospectively identified patients with advanced PDA who received first-line therapy and underwent blood and/or tumor genomic sequencing at the University of Washington between 2013 and 2020. We examined the incidence of KRAS mutation variants with and without co-occurring PI3K or other genomic alterations and evaluated the association of these mutations with clinicopathological characteristics and survival using a Cox proportional hazards model.ResultsOne hundred twenty-six patients had genomic sequencing data; KRAS mutations were identified in 111 PDA and included the following variants: G12D (43)/G12V (35)/G12R (23)/other (10). PI3K pathway mutations (26% vs. 8%) and homologous recombination DNA repair (HRR) defects (35% vs. 12.5%) were more common among KRAS G12R vs. non-G12R mutated cancers. Patients with KRAS G12R vs. non-G12R cancers had significantly longer overall survival (OS) (HR 0.55) and progression-free survival (PFS) (HR 0.58), adjusted for HRR pathway co-mutations among other covariates. Within the KRAS G12R group, co-occurring PI3K pathway mutations were associated with numerically shorter OS (HR 1.58), while no effect was observed on PFS.ConclusionsPatients with PDA harboring KRAS G12R vs. non-G12R mutations have longer survival, but this advantage was offset by co-occurring PI3K alterations. The KRAS/PI3K genomic profile could inform therapeutic vulnerabilities in patients with PDA.
Eschatology in Christian Feminist Theologies
Authors: Ruether Rosemary Radford 
Published: September 2022

Abstract
Christian eschatology is a complex combination of ideas and themes that synthesizes three ancient traditions of eschatological hope: Jewish futurism, Zoroastrian apocalyptic, and the Greco-Oriental soul journey. This article examines these three historical roots of eschatology and their synthesis in Judaism and Christianity. It points out the gender and class biases found in these classical patterns of eschatology, looks at the revision of Christian eschatology in nineteenth-century progressive millennialism, and shows how early feminist theology adapted both millennialist hope and belief in personal immortality. The article then examines the critique and revision of eschatological hope in several major feminist theologians of the late twentieth and early twenty-first centuries: Marjorie Suchocki, Catherine Keller, Ivone Gebara, Delores Williams, and Rosemary Ruether. It also considers the ancient Near East roots of Christian eschatological thought, the development of Christian eschatology, crises and reinterpretation of Christian eschatology in modern Western thought, and feminist theology and eschatology in the late twentieth century.
Old Testament Eschatology and the Rise of Apocalypticism
Authors: Arnold Bill T. 
Published: September 2022

Abstract
Eschatology does not appear to play a prominent role in the scriptures of ancient Israel, the “Old Testament” of Christian tradition, at least not at first glance. Understood broadly enough, however, and properly associated with other formulations of Israel's theological expressions, it will become clear that eschatology eventually evolved into a prominent role indeed. Israel's theology was intensely grounded in time and space, and especially in the events of its own history. This article considers the eschatology of the Old Testament. First, it discusses the emergence and development of eschatological themes in Israel's scriptures. Second, it examines how prophecy in ancient Israel relates to that of the ancient Near East and the degree to which Israel's eschatological impulses were unique. Finally, the article assesses the complicated and disputed relationship between Old Testament eschatology and the rise of apocalypticism.
Eschatology and Theodicy
Authors: Peterson Michael L. 
Published: September 2022

Abstract
Eschatology and theodicy are both intimately and importantly related. The Christian creeds conclude with the affirmation of the resurrection of the dead and the life of the world to come, and classical eschatology is concerned with the doctrine of “the consummation of all things.” The inveterate problem of evil identifies basic theistic commitments—about God's knowledge, power, and goodness—that must be squared with the facts of evil in any plausible vision of the eschatological future. So, theodicy is necessary to the task of eschatology. This article examines the reciprocal relationship between eschatology and theodicy by surveying the major strands of discussion of the problem of evil in contemporary philosophy. It traces how both the argument from evil and responses to it have evolved, setting the stage for why current discussions have turned to eschatological themes. It also discusses John Hick's soul-making theodicy, Richard Swinburne's theodicy of providence, Marilyn Adams's theodicy of divine goodness, open theism's theodicy of divine risk, and theodicy and Christian hope.
Eschatology in Pop Culture
Authors: Jewett Robert , Lawrence John Shelton 
Published: September 2022

Abstract
Popular culture embraces diverse arenas of expression, such as mythic narratives, news story archetypes, advertising, songs, games, political campaigns, public rituals, toys, comic books, films, television series, sports, celebrities, sermons, web sites, music, and biblical commentaries for lay readers. The label “popular” carries no pejorative flavor—as it did in mid-twentieth-century discussions of “mass culture”—nor does it imply consensus about popular culture's valuation by those who experience it. Compared to more mature fields, the scholarly study of religion and popular culture lacks a single disciplinary home. Inspiration for academic study with interdisciplinary texts and courses came from the Popular Culture Association, which originated at Bowling Green State University in Ohio. This article deals with eschatology in popular culture, focusing on early forms of popular eschatology, Bible-influenced popular culture in the United States, postmillennialism in civil religion, millennialism in superheroic fictions, the millennial vision and the video game, and premillennial fictions at the turn of the century.
Eschatology in the Early Church Fathers
Authors: Daley Brian 
Published: September 2022

Abstract
Early Christian theology developed in a climate of strong, although fluid, eschatological expectations. The degree to which Jesus' own preaching was dominated by themes of the imminent end of human history is still hotly debated, but it is unquestionable that both his own disciples and the authors of the New Testament canon lived in a religious world animated by Jewish apocalyptic images and the hopes they implied. This article discusses patristic eschatology, not simply the use made of the apocalyptic genre by early Christian authors, but their sense of constantly living in history's final age, of facing, amid persecutions and natural disasters, the end of society and the more immediate end of individual human life. It examines Christian apocalyptic in the second century, along with early Christian homiletics, the Greek apologists, gnostic Christianity and the Orthodox response, gnostic literature, Irenaeus, Tertullian and Hippolytus, Alexandrian theology in the third century, Clement of Alexandria, Origen, fourth- and fifth-century eschatology, and later apocalypticism.
The Effects of High Frequency Oscillatory Ventilation (HFOV) with Volume Guarantee (VG) on Left Ventricular Function, Systemic and Regional Oxygenation, and Ventilation When Compared to HFOV and Conventional Mechanical Ventilation (CMV) in A Newborn Piglet Model of Respiratory Distress Syndrome (RDS)
Authors: Bhogal J , Solevag AL , O'Reilly M , Lee TF , Lu M , Joynt C , Hornberger L , Schmolzer G , Cheung PY 
Published: September 2022

Abstract
BACKGROUND: RDS due to surfactant deficiency is commonly seen in preterm infants. These infants often require ventilatory support such as CMV and HFOV. HFOV with VG (HFOV+VG) is an alternative mode that delivers a set tidal volume. There is limited data on either HFOV mode regarding the effects on left ventricular (LV) function, systemic and regional oxygenation, and ventilation.
OBJECTIVES: We primarily compared the effects of CMV with VG, HFOV, and HFOV+VG on cardiac index (CI). Secondary parameters included heart rate (HR), mean arterial pressure (MAP), LV ejection fraction (EF), stroke volume (SV), dP/dt max, LV end-systolic volume and pressure (ESV, ESP), end-diastolic volume and pressure (EDV, EDP), and measures of oxygenation and ventilation. Oxygenation parameters included cerebral and renal near-infrared spectroscopy (NIRS), partial pressure of arterial oxygen (PaO2), and carotid artery flow index (CAFI). Ventilation parameters included partial pressure of arterial carbon dioxide (PaCO2) and minute ventilation (MV).
DESIGN/METHODS: Piglets (1.4-2.4 kg; 1-3 days old) were acutely anesthetized and instrumented with the placement of a right femoral arterial catheter for blood gas analysis, NIRS probes (Invos®), Transonic® flow probe on right common carotid artery, and Millar® catheter in the LV. Warm saline lung lavage was performed to achieve an AaDO2 of 300-450 mmHg to simulate moderate to severe RDS. Piglets were then block-randomized to CMV, HFOV or HFOV+VG for 4 hours using a Fabian HFO ventilator (Acutronic Medical Systems AG, Switzerland)(n=8 per group). Sham-operated piglets without RDS were monitored for the same duration under CMV (n=6). Two-way repeated measures ANOVA was used to analyze the data between modes or time points.
RESULTS: Piglets developed moderately severe RDS with comparable AaDO2 and Paw along with stable hemodynamic parameters. Both HFOV and HFOV+VG groups had similar PaCO2 whereas the CMV group had elevated PaCO2 when compared to that of the Sham (p&lt;0.01). Switching to HFOV resulted in a higher MV than its baseline. HFOV+VG but not HFOV or CMV groups had lower regional oxygenation and CAFI than its respective normoxic baseline (all p&lt;0.01). HFOV and HFOV+VG had higher CI, EF, and SV than CMV at 4 hours of recovery (p&lt;0.05) with similar HR, MAP, dP/dt max, ESV, ESP, EDV and EDP.
CONCLUSION: In our piglet model of RDS, HFOV shows benefits to LV function and ventilation when compared to CMV. HFOV+VG does not show benefits compared to HFOV.
A Randomized Controlled Trial on Oral Analgesic Utilization for Children Presenting With A Musculoskeletal Trauma in the Emergency Department
Authors: May S Le , Ali S , Plint A , Mâsse B , Neto G , Auclair M C , Drendel AL , Khadra C , Ballard A , Villeneuve E , Parent S , McGrath P , Gouin S 
Published: September 2022

Abstract
BACKGROUND: A single-agent approach to children’s moderate to severe pain is often inadequate. To date, no studies have evaluated the combined use of oral morphine and ibuprofen for optimal pain management of children presenting to an emergency department (ED) for muscu-loskeletal (MSK) trauma.
OBJECTIVES: To assess the efficacy of a combination of oral morphine and ibuprofen for pain management in children with MSK trauma in the ED.
DESIGN/METHODS: A double-blind, placebo-controlled, multi-centered, three-arm, randomized clinical trial of 500 patients was conducted at three pediatric tertiary care EDs. Patients were randomized (in a 2:1:1 ratio) to receive (orally): (a) morphine (0.2mg/kg) + ibuprofen (10mg/kg) (Group MOR + IBU) or (b) morphine (0.2 mg/kg) + placebo (Group MOR) or (c) ibuprofen (10mg/kg) + placebo (Group IBU). Patients 6 to 17 years of age, who presented to the ED with a MSK trauma, and a score &gt;30 mm on the 100mm visual analogue scale were eligible to participate. Primary outcome was pain intensity score under 30 mm (mild pain) at 60-minutes (T-60) after treatment administration.
RESULTS: A total of 456 patients were included in analyses: 177 (MOR + IBU), 188 (MOR), 91 (IBU). Mean age was 11.9±2.7 years, with a majority of boys (55.3%) and Soft tissue injuries (62%). There were no differences in baseline characteristics in the three groups. Baseline mean pain score was 60.9±16.2 mm. Only 30% (MOR + IBU), 29% (MOR) and 30% (IBU) of patients reached a pain score under 30 mm at T-60 (p=0.83). Mean pain scores at T-60 were 42.3±23.2 mm (MOR + IBU), 43.8 + 23.1 mm (MOR) and 42.3±23.3 mm (IBU) (p=0.83). No severe adverse events were observed in any of the groups, at any of the study measurement points.
CONCLUSION: Combination of morphine with ibuprofen did not provide any additional pain relief for children with MSK injuries, in the ED. None of the study medication provided optimal pain management, as the majority of children did not reach the WHO definition of mild pain. Alternative analgesic combinations should be investigated to optimize pain relief of children who present to the ED with MSK injuries.
Evaluation of An Oral Morphine Protocol for Treatment of Acute Pain Crisis in Sickle Cell Patients in the Outpatient Setting
Authors: Paquin H , . Trottier E D. , Pastore Y , Robitaille N , Doré Bergeron M-J , Bailey B 
Published: September 2022

Abstract
BACKGROUND: Sickle cell vaso-occlusive crisis (VOC) is one of the most frequent causes of emergency visit and admission in children with this condition.
OBJECTIVES: To evaluate whether the implementation of an oral morphine protocol has led to improved care of sickle cell disease (SCD), translated by a reduced hospitalization rate, an increased oral administration rate and faster opiate administration time, comparing cohorts of patients presenting to the emergency department (ED) and hematology outpatient clinic (HOC) with VOC pre and post implementation.
DESIGN/METHODS: Retrospective chart review of patients with SCD followed at CHU Ste-Justine, who presented to the ED and HOC with VOC, in the year pre and post implementation of the protocol. Patients with a VOC diagnosis during the study periods were selected in each department’s database. The primary outcome was to evaluate the hospital-ization rate. The rate of oral administration, as well as the opiate administration time from inscription in the ED or arrival in the HOC were also calculated. We estimated that 35 patients per arm would be sufficiently powered to detect at least a 30% rate reduction of admissions, with a power of 80% and a significance of 0.05.
RESULTS: Over the two periods, a total of 105 patients (49 pre and 56 post) were included from the ED and 62 patients (36 pre and 26 post) from the HOC. Both departments showed a reduction in hospitalization rate: a difference of 48% (95% CI 32, 61) in ED and 38% (95% CI 13, 57) in HOC. Both showed an increase in the rate of oral administration: a difference of 36% (95% CI 19, 50) in ED and 33% (95% CI 8, 53) in HOC. There was a non-significant difference of 10 min (95% CI -10, 25) in the opiate administration time in ED, as opposed to HOC where a significant difference of -45 min (95% CI -71, -6) was found, with both presenting median times over the recommended 60 minutes post implementation. Both settings showed an increase in the percentage of patients without IVs; a difference of 17% (95% CI 4, 30) in ED and 55% (95% CI 72, 31) in HOC.
CONCLUSION: This study validates the use of our oral morphine protocol for the treatment of VOC, by showing a significant reduction in hospi-talization rates. Although delays remain in our opiate administration time, our protocol decreased the number of painful IV procedures.
Decreases in Rotavirus Hospitalizations: Impact Data Pre- and 3 Years Post- First Publically Funded Programs
Authors: Saux N Le , Halperin S , Vaudry W , Scheifele D , Bettinger J 
Published: September 2022

Abstract
BACKGROUND: Since January 2012, almost all Canadian provinces have implemented publically funded rotavirus immunization programs. IMPACT had been doing routine active surveillance for rotavirus hospital-izations at pediatric hospitals in 7 provinces since 2005.
OBJECTIVES: Determine changes in hospitalization for rotavirus infection pre and post vacination programs.
DESIGN/METHODS: Active, surveillance of patients hospitalized for rotavirus infections was conducted by IMPACT from January 1 2010 to December 2015 at 12 paediatric hospitals. Rotavirus hospitalization data was compared for periods pre (2010-2011) and post (2012-2014) implementation of publically funded immunization programs. Six sites were located in jurisdictions that had publically funded programs as of January 2012.
RESULTS: Initiation of rotavirus vaccine programs have resulted in a 43% overall reduction in hospitalizations for rotavirus infection in pediat-ric hospitals in Canada with the greatest decreases seen in provinces with programs that were established as of January 2012 where there was a 66% reduction in hospitalizations. Overall, the average yearly number of hospi-talizations for 2012-2014 was 279, compared to 490 in 2010-2011. Six sites with publically funded programs since 2012 had a yearly average of 121.3 cases identified in 2012-2014 compared to an average of 360 cases in 2010-2011. The average yearly number of hospital acquired cases decreased from 78 to 24.7 in sites with vaccine programs whereas sites without increased (26.5 to 33.7 average cases yearly). The proportion of cases occurring in children &lt;2 years was significantly lower in sites with programs (51.6% vs. 72.5%; p&lt;0.0001). In 2012-2014, 63.4% of children were &lt;2 years compared to the period 2010-2011 where 67.7% were &lt;2 years. The seasonal peak in infections has decreased over time, especially in the age groups 6-11 months and 12 to 24 months.
CONCLUSION: Publically funded rotavirus vaccine programs have resulted in important reductions in hospitalizations due to community acquired and hospital acquired rotavirus infections in pediatric hospitals in Canada with the greatest decreases seen in provinces with programs that were established as of January 2012. The proportion of children &lt; 2 years hospitalized with rotavirus infection is decreasing at sites with established programs. Given the &gt;85% efficacy of rotavirus vaccine, increasing uptake and delivery throughout Canada could potentially decrease admissions further.
Sexual Health of Adolescents Admitted to A Psychiatric Unit
Authors: Zanten S Van , Noel A , Gresham L , Boafo A , Norris M , Robinson A , Turner D , Harrison M , Chan J 
Published: September 2022

Abstract
BACKGROUND: Research suggests an association between certain psychiatric conditions and high-risk adolescent sexual activity. In fact, pregnancy is three times more likely in adolescent girls with major mental health disorders in comparison to those without mental illness. Given a proportion of adolescents with mental health disorders will require admission to the hospital for acute psychiatric concerns, this could serve as a useful time point to screen for risky sexual behaviour in high-risk youth.
OBJECTIVES: Our objective was to review the history screening practices at admission and throughout an inpatient stay for adolescents on an inpatient psychiatry unit and to review any resulting referrals or treatment relating to sexual health.
DESIGN/METHODS: A chart review was conducted which included one hundred randomly selected adolescent patients admitted to an inpa-tient psychiatry unit over a 12 month period (January 2013-December 2013). Measures extracted from charts included demographic information, reason for admission, psychiatric diagnoses, documented sexual health related data and any investigations, co-morbidities, treatment and/or follow up booked related to sexual health. Ethics approval was obtained prior to study onset.
RESULTS: The majority of patients were female (79%) and the mean age of study subjects was 15.24 (SD=1.30). The majority of patients admitted received a discharge diagnosis of a major depressive disorder (57%) and the mean length of stay was 11.14 days (SD=7.75). Of the patients admitted, 85% did not appear to have sexual health questions asked on admission and 61% did not have any documented sexual health questions asked throughout their inpatient admission. 17% of patients had sexual activity information documented and very few patients had any STI screening or pregnancy testing (9 patients and 14 patients, respectively).
CONCLUSION: Adolescents with major mental health disorders may be at increased risk for risky sexual behaviours. We found that sexual health practices were only addressed in a minority of patients during their inpatient psychiatric admission. This interaction with the health care system represents an underutilized opportunity to provide counselling and anticipatory guidance to adolescents regarding their sexual health.
Association between Rome III Diagnostic Criteria and Treatment Failure in Children Brought for Emergency Department Care
Authors: Eltorki M , Martin E 
Published: September 2022

Abstract
BACKGROUND: Many children diagnosed with functional constipation (FC) in the ED in fact meet Rome III criteria for irritable bowel syndrome constipaion subtype (IBS-C). The frequency of this misdiagnosis and its relation to outcomes is unknown.
OBJECTIVES: To determine if treatment failure frequency differs based on Rome III diagnostic criteria classification in a cohort of ED children diagnosed by treating physicians as having constipation.
DESIGN/METHODS: We performed a prospective cohort study of children 1 month – 18 years of age who were diagnosed with or were treated as FC in a pediatric ED. ED chart data was abstracted and a follow-up call was performed 7 days post-ED visit to enable the completion of the ROME III functional intestinal disorder questionnaire, confirm treatments administered, and enable symptom resolution assessment. 'Adequate therapy' was defined in accordance with ESPGHAN/NASPGHAN consensus guidelines. Treatment failure was defined by ≥2 of the following: persistence of presenting symptom(s), bowel movement frequency &lt;1 every other day, pain or difficulty passing stools, abdominal pain between bowel movements, and/or persistence of the ED chief complaint.
RESULTS: 929 potentially eligible children were identified; 237 were excluded. We failed to contact 162 patients and 17 refused consent. 513 (74%) completed day 7 follow up – 227 (44%) met FC ROME III criteria, 119 (23%) met IBS-C criteria and 167 (33%) did not meet IBS-C or FC criteria and were classified as ‘other’. Mean age was 6.1±3.9 years. Treatment failure occurred in 69 (30%) FC patients, 50 (43%) of those with IBS-C, and 41 (25%) of ‘other’ group; P=0.007. These differences persisted when only those receiving ‘adequate therapy’ (n=308) were included: 41 (28%) of FC and 16 (22%) of those in the ‘other’ group had persistent symptoms compared to 37 (43%) of IBS-C patients; P=0.008. Kaplan-Meier analysis revealed greater symptom persistence in children with IBS-C compared to those with FC (P&lt;0.001). Those classified as FC were more likely to have abdominal distension (P=0.05) and tenderness (P=0.04) compared to the IBS-C.
CONCLUSION: Children diagnosed with constipation in an ED who fulfill ROME III irritable bowel syndrome (constipation subtype) criteria have a higher treatment failure rate at day 7 compared to functional constipation even when including only those who received adequate functinal constipation therapy. ROME III criteria can be employed to identify children with irritable bowel syndrome; such children might benefit from diagnosis specific therapy.