bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluating the Use of Atenolol for the Treatment of Infantile Hemangiomas
Authors: Pathman Lydia , Simpson Jodie , Penington Anthony J , Phillips Roderic J 
Published: September 2022

Introduction:
Infantile hemangiomas are common vascular tumours in infants. Propranolol is currently accepted as the first choice if systemic treatment is needed. Propranolol has an excellent record of safety in young children, but some concerns have been raised about possible longer-term neurocognitive effects and five recent unexpected infant deaths have been reported. An alternative beta blocker, atenolol, may be as effective at hemangioma treatment and may have a better side effect profile.

Objectives:
To report the efficacy, safety, and side effect profile of oral atenolol for infantile hemangiomas.

Design:
We conducted a prospective observational study of 219 infants with infantile hemangiomas who were prescribed oral atenolol (1 mg/kg bd) as outpatients. The primary outcome measure was the response of the hemangioma.

Results:
The median age at commencement was 3.6 months. The median duration of treatment was 8.5 months. An excellent response was seen in 59.0% of patients, good response in 30.5%, and poor response in 10.5%. There was no significant difference in the response to atenolol with location or type of hemangioma or age at the commencement of atenolol. Possible side effects were reported in 8% of patients, and sleep disturbance in 3%. No infant had any reported hypoglycaemic or cardiovascular events attributable to atenolol.

Conclusion:
Atenolol is effective in treating infantile hemangiomas in an outpatient setting with 90% of patients having a good or excellent response to treatment. Atenolol appears to have a more favorable side effect profile than propranolol. It is reasonable to consider atenolol as first-line therapy for infantile hemangiomas needing oral treatment.
Caring for the Pediatric Patient Post-Nuss Procedure
Authors: Duque Carmen R. , Altares Sarik Danielle , Buscemi Charles , Garlesky Cindy 
Published: September 2022

Background Surgical correction for pectus excavatum (PE) is often performed during adolescence for patients exhibiting cardiac and respiratory problems. The surgery to correct PE is a thoracoscopic-assisted minimally invasive repair of PE or Nuss procedure. The postoperative clinical management is largely related to addressing pain from the constant pressure from the bar(s) on the sternum. A quality improvement project was developed to improve nurses' knowledge of appropriate postoperative care for the pediatric patient undergoing a Nuss procedure. Method A literature search was conducted using CINAHL and MEDLINE (ProQuest) to identify research studies that have evaluated nurses' knowledge of postoperative care for patients undergoing surgical correction for PE. Six studies were identified that investigated nurses' knowledge and attitudes of postoperative pain management in the pediatric patient and the effectiveness of enhanced recovery pathways to improve patient outcomes. A pretest and posttest were developed from the findings of the literature review along with an educational intervention. The educational presentation focused on the postoperative care of the pediatric patient who undergoes a Nuss procedure. A complete supplemental care plan is provided, which includes an enhanced recovery after surgery pathway, recommended pain treatment plan, exercises, medication recording sheet, home management tips for pain control, and patient discharge information. Results Implementation of a targeted educational program for the care of the pediatric patient who undergoes a Nuss procedure improved the clinician's knowledge and attitudes, resulting in a positive impact on pain management practice and patient outcomes. Conclusion Targeted educational interventions to improve pain management knowledge in nurses can result in increased understanding of appropriate postoperative pain management. This increased knowledge has the possibility to improve pain management and significantly improve the nurse and patient experience.
Differences in plasma lipoprotein profiles between patients with chronic peripheral neuropathic pain and healthy controls: an exploratory pilot study
Authors: Jönsson Mika , Bäckryd Emmanuel , Jonasson Lena , Gerdle Björn , Ghafouri Bijar 
Published: September 2022

Abstract

Introduction:
Little is still known about the underlying mechanisms that drive and maintain neuropathic pain (NeuP). Recently, lipids have been implicated as endogenous proalgesic ligands affecting onset and maintenance of pain; however, in the case of NeuP, the relationship is largely unexplored.

Objectives:
The aim of this study was to investigate the lipoprotein profile in patients with chronic peripheral NeuP compared with healthy controls.

Methods:
The concentrations of 112 lipoprotein fractions in plasma from patients with NeuP (n = 16) and healthy controls (n = 13) were analyzed using proton nuclear magnetic resonance spectroscopy. A multiplex immunoassay based on an electrochemiluminescent detection method was used to measure the concentration of 71 cytokines in plasma from patients with NeuP (n = 10) and healthy controls (n = 11). Multivariate data analysis was used to identify patterns of protein intercorrelations and proteins significant for group discrimination.

Results:
We found 23 lipoproteins that were significantly upregulated in patients with NeuP compared with healthy controls. When the influence of cytokines was included in a regression model, 30 proteins (8 cytokines and 22 lipoprotein fractions) were significantly upregulated or downregulated in patients with NeuP. Both conditions presented lipoprotein profiles consistent with inflammation. Body mass index did not affect lipoprotein profiles in either group. No relationship between age and lipoprotein pattern was found in NeuP, but a significant relationship was found in healthy controls.

Conclusion:
Patients with NeuP presented a lipoprotein profile consistent with systemic low-grade inflammation, like that seen in autoimmune, cardiometabolic, and neuroprogressive diseases. These preliminary results emphasize the importance of chronic low-grade inflammation in NeuP.
Maximum Diameter of the Gallbladder Determined Presurgically Using Computed Tomography as a Risk Factor for Difficult Emergency Laparoscopic Cholecystectomy in Patients With Mild to Moderate Acute Cholecystitis
Authors: Sasaki Atsushi , Sakata Kazuhito , Nakano Koji , Tsutsumi Satoshi , Fujishima Hajime , Futsukaichi Takuro , Terashi Takahiro , Ikebe Masahiko , Bandoh Toshio , Utsunomiya Tohru 
Published: September 2022

Background:
Early or emergency laparoscopic cholecystectomy (LC) was recommended in the 2018 Tokyo Guidelines for patients with mild to moderate acute cholecystitis (AC). Although surgical difficulty is frequently encountered during these surgeries, risk factors for predicting surgical difficulties have not been fully investigated, especially based on computed tomography (CT) findings.

Materials and Methods:
We investigated 72 patients who underwent emergency LC with mild (n=45) to moderate (n=27) AC. Patients who previously underwent presurgical percutaneous or endoscopic biliary drainage were excluded from this study. Difficult LC was defined using any of the following surgical factors: surgical duration ≥180 minutes, blood loss ≥300 g, or a conversion to open cholecystectomy. Subsequently, several presurgical clinical factors were analyzed, including sex, age at surgery, experience of the surgeon, interval between symptom onset and surgery, body mass index, diabetes history, presurgical white blood cell count, and C-reactive protein level. Moreover, stones in the cystic duct or perigallblader fluid and the maximum thickness and diameter of the gallbladders were evaluated via presurgical CT. Finally, logistic regression analysis was performed to compare the relationship between surgical difficulty and each clinical factor.

Results:
The average age at surgery of the included patients was 60.3 (range: 25 to 88 y), surgical duration was 112.2 (range: 29 to 296 min), and surgical blood loss was 55.2 (range: 0 to 530 g). Furthermore, 4 (5.6%) had to undergo open cholecystectomy, whereas postsurgical complications occurred in 5 (6.9%) patients. In addition, the mean postsurgical admission duration was 7 (range: 3 to 63 d). Thus, 12 patients experienced difficult LC, whereas 60 experienced nondifficult LC. Of the evaluated clinical factors, patients who experienced difficult LC showed higher presurgical C-reactive protein levels (10.78 vs. 6.76 mg/dL, P=0.01) and wider gallbladder diameters (48.4 vs. 41.8 mm, P<0.01) than those who experienced nondifficult LC. By univariate logistic regression analysis, results also showed that patients with a maximum gallbladder diameter had a higher risk of experiencing difficulty during emergency LC (P=0.02). Moreover, the gallbladder diameter’s cutoff value was 43 mm after the receiver operating characteristic curve analysis.

Conclusions:
In patients with mild to moderate AC, emergency LC can safely be performed. However, performing LC might be technically difficult in patients with AC after the identification of severe gallbladder swelling during presurgical CT.
Identifying vulnerable populations with symptomatic cholelithiasis at risk for increased health care utilization
Authors: Shenoy Rivfka , Kirkland Patrick , Jackson Nicholas , DeVirgilio Michael , Zingmond David , Russell Marcia M. , Maggard-Gibbons Melinda 
Published: September 2022

BACKGROUND
Gallstones are a common problem in the United States with many patients suffering from symptomatic cholelithiasis (SC). Patients with SC may first present to the emergency department ED) and are often discharged for elective follow-up; however, it is unknown what system and patient factors are associated with increased risk for ED revisits. This study aimed to assess longitudinal ED utilization and cholecystectomy for patients with SC and identify patient, geographic, and hospital characteristics associated with ED revisits, specifically race/ethnicity and insurance status.

METHODS
Patients discharged from the ED with SC between July 1, 2016, and December 31, 2017, were identified from California administrative databases and followed for 1 year. Emergency department revisits and cholecystectomy after discharge were examined using logistic regression, clustering standard errors by hospital. Models adjusted for patient, geographic, and hospital variables using census and hospital administrative data.

RESULTS
Cohort included 34,427 patients who presented to the ED with SC and were discharged. There were 18.8% of the patients that had one or more biliary-related ED revisits within 1 year. In fully adjusted models, non-Hispanic Black patients had higher odds for any ED revisit (adjusted odds ratio 1.23; 95% confidence interval, 1.09–1.39) and for two more ED revisits (adjusted odds ratio 1.48; 95% confidence interval, 1.20–1.82). Insurance type was also associated with ED revisits.

CONCLUSION
Non-Hispanic Black patients experienced higher utilization of health care resources for SC after adjusting for other patient, geographic and hospital variables. Strategies to mitigate these disparities may include the development of standardized protocols regarding the follow-up and education for SC. Implementation of such strategies can ensure equitable treatment for all patients.

LEVEL OF EVIDENCE
Prognostic and Epidemiological; Level III.
The Impact of Nutritional Supplementation on Donor Kidneys During Oxygenated Ex Vivo Subnormothermic Preservation
Authors: Bhattacharjee Rabindra N. , Jackson Ashley , Ruthirakanthan Aushanth , Juriasingani Smriti , Levine Max A. , Jiang Larry , Patel Ram , Richard-Mohamed Mahms , Forrest Sheryl , Ravichandran Sevanthi , Sener Alp , Luke Patrick P. 
Published: September 2022

Background.
Evidence suggests that nutritional supplementation during normothermic ex vivo perfusion improves organ preservation. However, it is unclear whether the same benefit is observed during room temperature (subnormothermic) oxygenated perfusion. In this study, we tested the impact of providing complete nutrition during subnormothermic perfusion on kidney outcomes.

Methods.
Porcine kidneys were recovered after 30 min of cross clamping the renal artery in situ to simulate warm ischemic injury. After flushing with preservation solution, paired kidneys were cannulated and randomly assigned to perfusion with either (1) hemoglobin-carrier hemoglobin-based oxygen carrier or (2) hemoglobin-based oxygen carrier + total parenteral nutrition (TPN) for 12 h at 22 °C. To mimic reperfusion injury, all kidneys were reperfused with whole blood for an additional 4 h at 37 °C. Kidney function and damage were assessed.

Results.
Kidneys preserved with or without TPN performed equally well, showing similar renal function postreperfusion. Histological findings indicated similar levels of damage from apoptosis staining and acute tubular necrosis scores in both groups. Additionally, markers of renal damage (KIM-1) and inflammation (IL-6; high-mobility group box 1) were similar between the groups.

Conclusions.
Unlike other studies using normothermic oxygenated perfusion platforms, nutritional supplementation does not appear to provide any additional benefit during ex vivo kidney preservation over 12 h evaluated by whole blood-based reperfusion method at subnormothermic temperature. Further study should include a kidney autotransplant model to assess the role of TPN in vivo.
Advances in the gut microbiome and mood disorders
Authors: Mörkl Sabrina , Butler Mary I. , Lackner Sonja 
Published: September 2022

Purpose of review
The gut microbiome is in constant bidirectional communication with the brain through the microbiota-gut-brain-axis. Mood disorders are among the most common psychiatric disorders and include major depressive disorder and bipolar disorder. The gut microbiome is altered in individuals with mood disorders and has a role in its inflammatory pathophysiology. In this article, we performed a narrative review of clinical studies, randomized controlled trials and meta-analyses addressing advances in gut microbiome research in mood disorders and included articles that were published between 2021 and 2022.

Recent findings
Studies highlight transdiagnostic alterations of microbiota in mood disorders, with reductions of butyrate-producing bacteria. Participants with major depressive disorder showed altered beta-diversity, while participants with bipolar disorder showed reduced alpha-diversity. Both disorders exhibit alterations in the metabolome. Early pilot studies addressed the possibility of using the gut microbiome for the prediction of treatment response and the blood microbiome for the diagnosis of psychiatric disorders. Findings from clinical trials support the use of probiotics as an add-on therapy for major depressive disorder. The second published case report in the literature reported a favourable outcome of a patient with bipolar disorder after faecal microbiota transplantation.

Summary
Gut microbiome modulations allow new treatment strategies including the use of psychobiotics for the treatment and prevention of mood disorders. Well designed clinical trials aiming for personalized medicine are needed to investigate the efficacy and safety of psychobiotic interventions.
Multimorbidity and its associated factors in Indonesia through universal health coverage scheme: A cross-sectional study based on national claims data
Authors: Mahmudah Noor Afif , Tessma Mesfin Kassaye , Mahendradhata Yodi 
Published: September 2022

AbstractMultimorbidity has been increasing globally and is usually associated with higher health care utilization and costs. Indonesia has been implementing Universal Health Coverage (UHC) program since 2014. However, there is a limited study of the prevalence of multimorbidity and its impact on health care utilization and costs through the UHC scheme in Indonesia. This study aimed to determine the prevalence of multimorbidity and its associated factors, particularly the health care utilization and costs of patients with multimorbidity compared to patients with one chronic condition in the hospitals in Indonesia based on the UHC scheme. The study was a comparative cross-sectional design. The data was collected from the Social Security Agency for Health/Badan Penyelanggara Jaminan Sosial Kesehatan (BPJS Health) National Sample Data 2015-2016. All patients ≥60 years of age and have at least one chronic condition in the hospital were included. Descriptive statistics, bivariate analysis, and multivariable regression analysis were conducted to analyze the data. In a sample of 23,460 patients, the prevalence of multimorbidity was 44.4% among patients with chronic conditions in the hospital. We observed significant difference in gender, marital status, and membership segmentations between patients with multimorbidity and one chronic condition (p<0.05). Health care utilization and costs were significantly higher in multimorbid patients (p<0.001). This positive association between multimorbidity and health care utilization (OR: 1.70, 95% CI: 1.61-1.79) and health care costs (unstandardized coefficient 0.483, 95% CI: 0.443-0.524, p<0.001) remains significant after adjusting for age and gender. The analysis found that the prevalence of multimorbidity was high and positively associated with higher health care utilization and costs through the UHC scheme in Indonesia. Therefore, health policymakers and healthcare professionals need to consider the burden of multimorbidity more when structuring health care.
Computer generation of fruit shapes from DNA sequence
Authors: Pérez-Enciso M. , Pons C. , Granell A. , Soler S. , Picó B. , Monforte A.J. , Zingaretti L.M. 
Published: September 2022

AbstractThe generation of realistic plant and animal images from marker information could be a main contribution of artificial intelligence to genetics and breeding. Since morphological traits are highly variable and highly heritable, this must be possible. However, a suitable algorithm has not been proposed yet. This paper is a proof of concept demonstrating the feasibility of this proposal using ‘decoders’, a class of deep learning architecture. We apply it to Cucurbitaceae, perhaps the family harboring the largest variability in fruit shape in the plant kingdom, and to tomato, a species with high morphological diversity also. We generate Cucurbitaceae shapes assuming a hypothetical, but plausible, evolutive path along observed fruit shapes of C. melo. In tomato, we used 353 images from 129 crosses between 25 maternal and 7 paternal lines for which genotype data were available. In both instances, a simple decoder was able to recover expected shapes with large accuracy. For the tomato pedigree, we also show that the algorithm can be trained to generate offspring images from their parents’ shapes, bypassing genotype information. Data and code are available at https://github.com/miguelperezenciso/dna2image.
Characterizing subgroup performance of probabilistic phenotype algorithms within older adults: A case study for dementia, mild cognitive impairment, and Alzheimer’s and Parkinson’s diseases
Authors: Banda Juan M. , Shah Nigam H. , Periyakoil Vyjeyanthi S. 
Published: September 2022

ABSTRACTObjectiveBiases within probabilistic electronic phenotyping algorithms are largely unexplored. In this work, we characterize differences in sub-group performance of phenotyping algorithms for Alzheimer’s Disease and Related Dementias (ADRD) in older adults.Materials and methodsWe created an experimental framework to characterize the performance of probabilistic phenotyping algorithms under different racial distributions allowing us to identify which algorithms may have differential performance, by how much, and under what conditions. We relied on rule-based phenotype definitions as reference to evaluate probabilistic phenotype algorithms created using the Automated PHenotype Routine for Observational Definition, Identification, Training and Evaluation (APHRODITE) framework.ResultsWe demonstrate that some algorithms have performance variations anywhere from 3 to 30% for different populations, even when not using race as an input variable. We show that while performance differences in subgroups are not present for all phenotypes, they do affect some phenotypes and groups more disproportionately than others.DiscussionOur analysis establishes the need for a robust evaluation framework for subgroup differences. The underlying patient populations for the algorithms showing subgroup performance differences have great variance between model features when compared to the phenotypes with little to no differences.ConclusionWe have created a framework to identify systematic differences in the performance of probabilistic phenotyping algorithms specifically in the context of ADRD as a use case. Differences in subgroup performance of probabilistic phenotyping algorithms are not widespread nor do they occur consistently. This highlights the great need for careful ongoing monitoring to evaluate, measure, and try to mitigate such differences.
Generalization of contextual fear is sex-specifically affected by high salt intake
Authors: Beaver Jasmin N. , Weber Brady L. , Ford Matthew T. , Anello Anna E. , Ruffin Kaden M. , Kassis Sarah K. , Gilman T. Lee 
Published: September 2022

AbstractA hallmark symptom of many anxiety disorders, and multiple neuropsychiatric disorders more broadly, is generalization of fearful responses to non-fearful stimuli. Anxiety disorders are often comorbid with cardiovascular diseases. One established, and modifiable, risk factor for cardiovascular diseases is salt intake. Yet, investigations into how excess salt consumption affects anxiety-relevant behaviors remains little explored. Moreover, no studies have yet assessed how high salt intake influences generalization of fear. Here, we used adult C57BL/6J mice of both sexes to evaluate the influence of two or six weeks of high salt consumption (4.0% NaCl), compared to controls (0.4% NaCl), on contextual fear acquisition, expression, and generalization. Further, we measured osmotic and physiological stress by quantifying serum osmolality and corticosterone levels, respectively. Consuming excess salt did not influence contextual fear acquisition nor discrimination between the context used for training and a novel, neutral context when training occurred 48 prior to testing. However, when a four week delay between training and testing was employed to induce natural fear generalization processes, we found that high salt intake selectively increases contextual fear generalization in females, but the same diet reduces contextual fear generalization in males. These sex-specific effects were independent of any changes in serum osmolality nor corticosterone levels, suggesting the behavioral shifts are a consequence of more subtle, neurophysiologic changes. This is the first evidence of salt consumption influencing contextual fear generalization, and adds information about sex-specific effects of salt that are largely missing from current literature.