bluuebunny/crossref_metadata_2025_split huggingface dataset:
Stigma, Intrusiveness, and Distress in Parents of Children with a Disorder/Difference of Sex Development
Authors: Traino Katherine A. , Roberts Caroline M. , Fisher Rachel S. , Delozier Alexandria M. , Austin Paul F. , Baskin Laurence S. , Chan Yee-Ming , Cheng Earl Y. , Diamond David A. , Fried Allyson J. , Kropp Bradley , Lakshmanan Yegappan , Meyer Sabrina Z. , Meyer Theresa , Buchanan Cindy , Palmer Blake W. , Paradis Alethea , Reyes Kristy J. , Tishelman Amy , Williot Pierre , Wolfe-Christensen Cortney , Yerkes Elizabeth B. , Mullins Larry L. , Wisniewski Amy B. 
Published: March 2022

ABSTRACT:

Objective:
The impact of parent-reported stigma due to their child's disorder/difference of sex development (DSD) on parent psychosocial adjustment is poorly understood. In other pediatric populations, perceived interference of medical conditions into daily activities (i.e., illness intrusiveness) mediates the relationship of stigma to adjustment. This study assessed relationships between parent-focused and child-focused stigma → illness intrusiveness → depressive and anxious symptoms. Exploratory analyses sought to identify patient characteristics associated with stigma.

Method:
Caregivers (59 women and 43 men) of 63 children diagnosed with a DSD up to age 4 years completed measures of demographics, parent-focused and child-focused stigma, illness intrusiveness, and depressive and anxious symptoms.

Results:
Increased parent-focused and child-focused stigma were associated with increased illness intrusiveness, which, in turn, was associated with increased depressive and anxious symptoms for parents nested within dyads. Among children with DSD family histories, parents reported greater child-focused stigma.

Conclusion:
Parents who experience DSD-related stigma report greater interference of their child's DSD into their daily activities, which is associated with poorer psychosocial adjustment. Findings support developing clinical interventions related to parents' perceptions of stigma and illness intrusiveness to improve parent adjustment.
Efficacy of corticosteroids in reducing the renal scarring in acute pyelonephritis in children
Authors: Al-Amri Mohamad , Helal Mahmoud , Almaslamani Thuraya , Allah Hani Khalaf , Syyed Rafah , Bakir Ibrahim , Almoustafa Malek , Shikhmous Mosab , Haik Waddah , Alyafei Tahiya , Syed Ghulam , Abounahla Emad , Hammoudeh Samer 
Published: March 2022

Abstract

Background:
Renal scarring is a serious and chronic consequence of acute pyelonephritis in children, which may cause late complications in young adults, such as hypertension, chronic renal failure, and preeclampsia. Urinary tract infection is the most common serious infection in childhood, accounts for 5% to 14% of all pediatric emergency centers. This study aimed to evaluate the effect of dexamethasone in reducing or preventing renal scarring in children who were treated with antibiotics for acute urinary tract infection.

Methods:
This is a multicenter, randomized, placebo-controlled, double-blind clinical trial, which evaluates the efficacy of dexamethasone in preventing or reducing renal scarring in febrile children (2 months to 14 years) with a first-diagnosed urinary tract infection. A total of 120 participants will be enrolled over a 3-year period from 6 sites in Qatar. Participants will be randomized into a therapy arm and a placebo arm; each arm will comprise 60 participants. Participants were allocated to the therapy arm and received dexamethasone, while those who were allocated to the placebo arm received a placebo, orally in the same regime, twice daily for 3 days. Blood and urine investigations will be performed at presentation and after 3 days from beginning antibiotics, renal ultrasonography will be performed over the first month and DMSA scan will be performed 6 months after enrolment. Study medication will be administered in the first 48 hours of starting antibiotics. The DMSA scan for all participants will be read by 3 reference radiologists without knowledge of clinical features or trial arms.

Discussion:
The formation of renal scarring will be compared between participants in both arms, the severity of renal scars and all adverse events of the therapy is determined.

Trial registration:
This trial has been registered at ClinicalTrials.gov: NCT04654507 (December 4, 2020), https://clinicaltrials.gov/ct2/show/NCT04654507.
Atypical characteristics of COVID-19 infection on CT imaging with preexisting combined pulmonary fibrosis and emphysema: A case report
Authors: Zhang Wei , Wei Xiong , Li Yonghui , Chen Yong 
Published: March 2022

Abstract

Introduction:
Combined pulmonary fibrosis and emphysema (CPFE) complicating Coronavirus Disease 2019 (COVID-19) is a challenging clinical scenario.

Patient concerns:
We report the case of a 44-year-old Chinese man with a medical history of CPFE showing atypical characteristics of COVID-19 infection on computed tomography (CT) imaging.

Diagnoses:
The patient was reported to have had close contact with a COVID-19 patient, with 4 real-time reverse transcriptase-polymerase chain reaction tests for COVID-19 - all positive. CT imaging showed scattered mixed ground-glass nodules and small ground-glass lesions in the lower and posterior parts of the posterior segment of the left upper lobes.

Intervention:
The patient received antiviral therapy (ritonavir tablets twice-daily, Xiyanping injection, and oral delivery of Keke capsules).

Outcomes:
On follow-up, nodules near the hilar side of the lung showed shrinkage at 7th day and nearly disappeared after 15 days.

Conclusion:
Clinicians should be alert to the results of lung CT examination and atypical lesions should be diagnosed in time. Precise clinical evaluation, well-directed monitoring, and intervention can effectively improve prognosis.
A comparative study on nosocomial and community-acquired spontaneous bacterial peritonitis in patients with liver cirrhosis at a university hospital
Authors: ELshamy Rana M. , Oda Mervat S. , Saeed Maysaa A. , Ramadan Raghdaa A. 
Published: March 2022

Background
The serious nature of spontaneous bacterial peritonitis (SBP) in patients with cirrhosis and the need for timely effective empirical antibiotic therapy in the context of the global surge of antimicrobial resistance and changing epidemiology necessitate a periodic review of the local epidemiologic features of the disease.

Aim
The aim of the study is to investigate the differences in bacterial profile and antibiotic resistance between nosocomial and community-acquired SBP in patients with liver cirrhosis to guide empirical antibiotic choices for better outcomes.

Methods
This cross-sectional study included 95 ascitic cirrhotic patients diagnosed with SBP. According to the setting in which the infection was acquired, the patients were divided into two groups: nosocomial and community-acquired SBP. The bacterial profile and rates of multidrug resistance (MDR) phenotype and the extended-spectrum β-lactamase (ESBL) production among Gram-negative isolates in both groups were compared.

Results

Escherichia coli was the most frequently isolated bacteria (60% of all isolates) followed by Klebsiella pneumoniae (11.4%). Gram-positive bacteria were only isolated from nosocomial SBP cases; the most common was Staphylococcus aureus (11.4%) followed by coagulase-negative staphylococci (5.7%). High rates of resistance to third-generation cephalosporins, the first-line empirical treatment of SBP, were detected (76.6–100% in nosocomial isolates and 25–87% in community isolates). Carbapenems, amikacin and gentamycin showed good activity against Gram-negative bacilli in both nosocomial and community-acquired isolates. MDR bacteria, including ESBL-producing Enterobacteriaceae, were significantly associated with nosocomial SBP.

Conclusion
The significant increase in MDR phenotype and ESBL production among nosocomial isolates necessitates a change in the initial empirical therapy for nosocomial SBP and carbapenems seem good alternatives.
Building Awareness of Diagnosis Together: Ambiguity During Progression-Free Survival Experienced by Patients With Lung Cancer and Caregivers in China
Authors: Yao Hong , Zhang Xinqian , Hou Yajie , Lai Angel Hor Yan , Zhang Qianqian 
Published: March 2022

Background
Lung cancer, as a multistep and multifactorial disease, is among the most fatal cancers worldwide. As new therapies are developed and early screening increases, patients tend to experience progression-free survival (PFS) as a coexistence of living and dying simultaneously.

Objective
The aim of this study was to explore the awareness context experienced by Chinese elderly patients and family members.

Methods
Interviews were conducted with 20 interviewees, including 13 elderly patients with lung cancer and 7 caregivers that were recruited using purposive sampling. Semistructured, face-to-face, in-depth interviews were conducted using a qualitative descriptive approach.

Results
Ambiguity was commonly experienced by patients with lung cancer with PFS. Three themes emerged from the data analysis: “ambiguity in cancer diagnosis,” “ambiguity in prognostic awareness,” and “ambiguity in identity.” In this case, ambiguity refers to a situation or context in which patients are uncertain about whether there will be a recurrence of their cancer and when it might occur.

Conclusions
The findings highlighted that patients experienced ambiguity in response to unclear diagnoses, uncertain prognoses, and identity crises during PFS.

Implications for Practice
Healthcare teams should be equipped with psychosocial knowledge and communication skills to manage ambiguity in diagnosis and prognosis for patients with PFS.
The Association of Psychological Stressors With Cannabis Use During Pregnancy
Authors: Vadukapuram Ramu , Chaudhari Gaurav , Trivedi Chintan , Vora Darshini , Memon Aksha , Giri Deepali , Tazin Faria , Reddy Preetam , Mansuri Zeeshan , Jain Shailesh Bobby 
Published: March 2022

Abstract
Even though marijuana is illegal on the federal level, it is one of the most used drugs in the United States during pregnancy. Our study investigates the relationship between numerous socioeconomic, demographic, and mental health risk variables and substance use during pregnancy. We examined data from the National Survey on Drug Use and Health from 2017 to 2019. Compared with the no serious psychological distress (SPD) group, the odds of using cannabis were higher in pregnant women with past-month SPD. In this study, in comparison with unmarried pregnant women, married pregnant women had a 67% lower chance of currently using cannabis. Racially, Hispanic pregnant women had 3 to 4 times higher odds for current use of cannabis as compared with the other races. Preventing cannabis use and its adverse effects by screening pregnant women could be part of the current strategy for reducing cannabis use.
Racial and Ethnic Differences in Ondansetron Use for Acute Gastroenteritis in Children
Authors: Dickerson-Young Tavis , Uspal Neil G. , Prince William B. , Qu Pingping , Klein Eileen J. 
Published: March 2022

Objectives
There is limited research examining racial/ethnic disparities in antiemetic use for acute gastroenteritis (AGE). We assessed racial/ethnic differences in the care of children with AGE.

Methods
The Pediatric Health Information System was used to conduct a retrospective cohort study of children 6 months to 6 years old with AGE seen in participating emergency departments from 2016 to 2018. Cases were identified using International Classification of Diseases, Tenth Revision codes. The primary outcome was administration of ondansetron, secondary outcomes were administration of intravenous (IV) fluids and hospitalization, and primary predictor was race/ethnicity. Multivariable logistic regression followed by a mixed model adjusted for sex, age, insurance, and hospital to examine the association of race/ethnicity with each outcome.

Results
There were 78,019 encounters included; 24.8% of patients were non-Hispanic White (NHW), 29.0% non-Hispanic Black (NHB), 37.3% Hispanic, and 8.9% other non-Hispanic (NH) race/ethnicity. Compared with NHW patients, minority children were more likely to receive ondansetron (NHB: adjusted odds ratio, 1.36 [95% confidence interval, 1.2–1.55]; Hispanic: 1.26 [1.1–1.44]; other NH: 1.22 [1.07–1.4]). However, minority children were less likely to receive IV fluids (NHB: 0.38 [0.33–0.43]; Hispanic: 0.44 [0.36–0.53]; other NH: 0.51 [0.44–0.61]) or hospital admission (NHB: 0.37 [0.29–0.48]; Hispanic: 0.41 [0.33–0.5]; other NH: 0.52 [0.41–0.66]). Ondansetron use by hospital ranged from 73% to 95%.

Conclusions
This large database analysis of emergency departments around the nation found that NHW patients were less likely to receive ondansetron but more likely to receive IV fluids and hospital admission than minority patients. These findings are likely multifactorial and may represent bias, social determinants of health, access to care, or illness severity among other possible causes.
Using Quality Improvement to Improve Identification and Documentation of Malnutrition in Hospitalized Pediatric Patients
Authors: Osburn Shea T. , Towne-Merritt Mary , Baranda Roberta , Keosheyan Rhonda M. 
Published: March 2022

Introduction:
Recent publications have highlighted the importance and impact of recognizing malnutrition in hospitalized children. After noting that patients with malnutrition frequently went unrecognized in our facility, we implemented an interprofessional intervention comprising hospital medicine physicians, dietitians, and the clinical documentation improvement team to improve recognition and documentation of malnutrition in these patients, thereby facilitating earlier intervention.

Methods:
We implemented three separate plan-do-study-act cycles to improve the identification and documentation of malnutrition among patients hospitalized at our facility. The cycles consisted of identifying malnutrition using z-scores, educating providers, and implementing smart text within the medical record to help with consistent documentation. In addition, real-time communication between the disciplines (nutrition services, clinical documentation improvement providers, and hospitalists) was also employed to improve documentation quality. After completing the plan-do-study-act cycles, charts were reviewed to evaluate the nutritional interventions received.

Results:
Baseline data revealed that only 13% of patients with z-scores indicative of malnutrition were identified as such in attending physicians’ documentation. Upon implementation of our plan-do-study-act cycles, documentation of these patients increased to greater than 64%. Patients with documented malnutrition received nutritional interventions at least 81% of the time, increasing from 35% at baseline.

Conclusion:
Our findings demonstrate that an interprofessional approach can dramatically enhance the identification and documentation of malnutrition in hospitalized children, leading to earlier intervention.
A Pilot Quality Improvement Project to Reduce Intraoperative MRI Hypothermia in Neurosurgical Patients
Authors: Wong Becky J. , Rama Asheen , Caruso Thomas J. , Lee Charles K. , Wang Ellen , Chen Michael 
Published: March 2022

Introduction:
Intraoperative hypothermia increases patient morbidity, including bleeding and infection risk. Neurosurgical intraoperative magnetic resonance imaging (iMRI) can lead to hypothermia from patient exposure and low ambient temperature in the MRI suite. This quality improvement project aimed to reduce the risk of hypothermia during pediatric neurosurgery laser ablation procedures with iMRI. The primary aim was to increase the mean lowest core temperature in pediatric patients with epilepsy during iMRI procedures by 1 °C from a baseline mean lowest core temperature of 34.2 ± 1.2 °C within 10 months and sustain for 10 months.

Methods:
This report is a single-institution quality improvement project from March 2019 to June 2021, with 21 patients treated at a pediatric hospital. After identifying key drivers, temperature-warming interventions were instituted to decrease hypothermia among patients undergoing iMRI during neurosurgery procedures. A multidisciplinary team of physicians, nurses, and MRI technologists convened for huddles before each case. Interventions included prewarmed operating rooms (ORs), blanket coverings, MRI table and room; forced-air blanket warming, temperature monitoring in the OR and iMRI environments; and the MRI fan turned off.

Results:
Data were analyzed for five patients before and nine patients after the institution of the temperature-warming elements. The sustainment period included 15 patients. The mean lowest intraoperative temperature rose from 34.2 ± 1.3 °C in the preintervention period to 35.5 ± 0.6 °C in sustainment (P = 0.004).

Conclusion:
Hybrid OR and MRI procedures increase hypothermia risk, which increases patient morbidity. Implementation of a multidisciplinary, multi-item strategy for patient warming mitigates the risk.
A Recanalized Umbilical Vein Hypermetabolic Thrombosis Mimicked an Hepatocellular Carcinoma Recurrence
Authors: Fidani Thibault , Desmarets Guillaume , Goupil Jean , Pouget Jean-Pierre , Boudousq Vincent 
Published: March 2022

Abstract
A transarterial left hepatic artery radioembolization involving 90Y microspheres was performed on a cirrhotic man with hypermetabolic 18F-FDG segment III hepatocellular carcinoma. During the 18F-FDG PET/CT follow-up, the disappearance of the hypermetabolic lesion was initially observed. Then, a focal segment III hypermetabolism reappeared mimicking a recurrence before disappearing without any treatment. Finally, the hepatic MRI demonstrated that the transitory segment III hypermetabolism matched a thrombus of the dilated recanalized umbilical vein.
Orbital Metastasis
Authors: Morland David , Jallet Lucas , Deguelte Sophie , Cadiot Guillaume , Papathanassiou Dimitri 
Published: March 2022

Abstract
Orbital foci of increased uptake are sometimes visualized on 18F-FDOPA PET/CT, but the literature remains poor as to their nature. The orbit is indeed a rare site of metastatic involvement. Given this low probability of metastatic location, the question of an incidental benign finding may arise. We reviewed all 18F-FDOPA PET/CT examinations performed at our institution between January 2015 and May 2021: 4/149 patients presented at least 1 orbital focus of increased uptake, all of them presented a metastatic small intestine neuroendocrine tumor. Somatostatin receptor expression was confirmed using 68Ga-DOTATOC PET/CT supporting the hypothesis of genuine metastases.
Galectin-3 ablation does not affect infarct size or inflammatory cytokines after experimental stroke in 24-month-old female mice
Authors: Manouchehrian Oscar , Andersson Emelie , Eriksson-Hallberg Björn , Deierborg Tomas 
Published: March 2022

Background
The tissue damage following a focal stroke causes an inflammatory response that is thought to aggravate the disease state. Galectin-3 is a proinflammatory molecule that has been shown to play a significant role in the inflammatory responses in brain diseases and following experimental stroke. In most animal experiments, young animals are used, although attempts are often made to model diseases that affect the elderly. Therefore, in this project, we intended to investigate the role of Galectin-3 in experimental stroke in older mice.

Methods
In this project, 24-month-old (aged) female mice were subjected to an experimental stroke (permanent middle cerebral artery occlusion) 7 days before sacrifice. We wanted to investigate whether the absence of the inflammatory protein Galectin-3 could affect motor phenotype, neuroinflammation and infarct size. Number of mice without Galectin-3 (Galectin-3 KO) = 9, number of wildtype controls of the same age = 6.

Results
In our aged female mice, we could not observe any significant differences between Galectin-3 KO and wildtype regarding the inclined plane test or cylinder test. We could not observe different infarct sizes between the two genotypes. In brain homogenates, we measured levels of 10 inflammatory cytokines, but we could not see any significant differences in any of them.

Conclusion
In summary, it can be said that the absence of the inflammatory mediator Galectin-3 does not seem to have a strong poststroke effect in aged females. Unfortunately, we could not analyze these mice with immunohistochemistry, which limited our study.
Neuroimaging within the Dominantly Inherited Alzheimer’s Network (DIAN): PET and MRI
Authors: McKay Nicole S. , Gordon Brian A. , Hornbeck Russ C. , Jack Clifford R. , Koeppe Robert , Flores Shaney , Keefe Sarah , Hobbs Diana A. , Joseph-Mathurin Nelly , Wang Qing , Rahmani Farzaneh , Chen Charles D. , McCullough Austin , Koudelis Deborah , Chua Jasmin , Ances Beau M. , Millar Peter R. , Nickels Mike , Perrin Richard J. , Allegri Ricardo F. , Berman Sarah B. , Brooks William S. , Cash David M. , Chhatwal Jasmeer P. , Farlow Martin R. , Fox Nick C. , Fulham Michael , Ghetti Berhadino , Graff-Radford Neill , Ikeuchi Takeshi , Day Gregg , Klunk William , Levin Johannes , Lee Jae-Hong , Martins Ralph , Masters Colin L. , McConathy Jonathan , Mori Hiroshi , Noble James M. , Rowe Christopher , Salloway Stephen , Sanchez-Valle Raquel , Schofield Peter R. , Shimada Hiroyuki , Shoji Mikio , Su Yi , Suzuki Kazushi , Vöglein Jonathan , Yakushev Igor , Swisher Laura , Cruchaga Carlos , Hassenstab Jason , Karch Celeste , McDade Eric , Xiong Chengjie , Morris John C. , Bateman Randall J. , Benzinger Tammie L.S. ,   Dominantly Inherited Alzheimer Network
Published: March 2022

AbstractThe Dominantly Inherited Alzheimer Network (DIAN) Observational Study is an international collaboration studying autosomal dominant Alzheimer disease (ADAD). This rare form of Alzheimer disease (AD) is caused by mutations in the presenilin 1 (PSEN1), presenilin 2 (PSEN2), or amyloid precursor protein (APP) genes. As individuals from these families have a 50% chance of inheriting the familial mutation, this provides researchers with a well-matched cohort of carriers vs non-carriers for case-control studies. An important trait of ADAD is that the age at symptom onset is highly predictable and consistent for each specific mutation, allowing researchers to estimate an individual’s point in their disease time course prior to symptom onset. Although ADAD represents only a small proportion (approximately 0.1%) of all AD cases, studying this form of AD allows researchers to investigate preclinical AD and the progression of changes that occur within the brain prior to AD symptom onset. Furthermore, the young age at symptom onset (typically 30-60 years) means age-related comorbidities are much less prevalent than in sporadic AD, thereby allowing AD pathophysiology to be studied independent of these confounds. A major goal of the DIAN Observational Study is to create a global resource for AD researchers. To that end, the current manuscript provides an overview of the DIAN magnetic resonance imaging (MRI) and positron emission tomography (PET) protocols and highlights the key imaging results of this study to date.