bluuebunny/crossref_metadata_2025_split huggingface dataset:
Malnutrition and immune cell subsets in children undergoing kidney transplantation
Authors: Shaw Brian I. , Lee Hui‐Jie , Ettenger Robert , Grimm Paul , Reed Elaine F. , Sarwal Minnie , Stempora Linda , Warshaw Barry , Zhao Congwen , Martinez Olivia M. , MacIver Nancie J. , Kirk Allan D. , Chambers Eileen T. 
Published: August 2022

AbstractBackgroundMalnutrition, including obesity and undernutrition, among children is increasing in prevalence and is common among children on renal replacement therapy. The effect of malnutrition on the pre‐transplant immune system and how the pediatric immune system responds to the insult of both immunosuppression and allotransplantation is unknown. We examined the relationship of nutritional status with post‐transplant outcomes and characterized the peripheral immune cell phenotypes of children from the Immune Development of Pediatric Transplant (IMPACT) study.MethodsNinety‐eight patients from the IMPACT study were classified as having obesity, undernutrition, or normal nutrition‐based pre‐transplant measurements. Incidence of infectious and alloimmune outcomes at 1‐year post‐transplantation was compared between nutritional groups using Gray's test and Fine‐Gray subdistribution hazards model. Event‐free survival was estimated by Kaplan–Meier method and compared between groups. Differences in immune cell subsets between nutritional groups over time were determined using generalized estimating equations accounting for the correlation between repeated measurements.ResultsWe did not observe that nutritional status was associated with infectious or alloimmune events or event‐free survival post‐transplant. We demonstrated that children with obesity had distinct T‐and B‐cell signatures relative to those with undernutrition and normal nutrition, even when controlling for immunosuppression. Children with obesity had a lower frequency of CD8 Tnaive cells 9‐month post‐transplant (p < .001), a higher frequency of CD4 CD57 + PD1‐ T cells, and lower frequencies of CD57‐PD1+ CD8 and CD57‐PD1‐ CD8 T cells at 12‐month transplant (p < .05 for all).ConclusionsChildren with obesity have distinct immunophenotypes that may influence the tailoring of immunosuppression.
BK DNAemia in pediatric kidney transplant recipients: Predictors and outcomes
Authors: Schoephoerster Jamee , Jensen Chelsey , Jackson Scott , Plautz Emilee , Balani Shanthi , Kouri Anne , Kizilbash Sarah J. 
Published: August 2022

AbstractBackgroundPediatric data on risk factors and the clinical course of BK DNAemia are limited. We aimed to determine the effects of BK DNAemia on transplant outcomes and delineate the safety and efficacy of various treatment approaches.MethodsThis retrospective‐cohort study included 161 transplants (age ≤ 21 years) performed at a single center between 1/1/2012 and 1/1/2020. We used Cox proportional models to evaluate the effects of BK DNAemia on patient survival (PS), graft survival (GS), and acute rejection (AR), using BK as a time‐dependent covariate. We also assessed the effects of pharmacological intervention on BK DNAemia duration using intervention as a time‐dependent covariate.ResultsBK‐free survival was 69.1% at 1‐year and 54.6% at 3‐year posttransplant. After multivariate adjustment, BK DNAemia was associated with young age at transplant (aHR, age 5–<12 vs. ≥12 (years): 2.5 (1.4–4.5); p = .001) and steroid‐based immunosuppression (IS) (aHR: 2.2 [1.1–4.5]; p = .03). We found no effect of DNAemia on AR (aHR: 1.25; p = .5), PS (aHR: 2.85; p = .22), and GS (aHR: 0.56; p = .41). Of 70 patients with DNAemia, 22 (31.4%) received no treatment, 20 (28.6%) received IS reduction alone, and 28 patients (40%) received treatment with at least one pharmacological agent (leflunomide, IVIG, ciprofloxacin, cidofovir). Sixty‐three patients (90%) cleared DNAemia with median time to resolution of 2.4 months (IQR:1.4–5.6). We found no significant effect of BK‐directed pharmacological treatment on time to resolution (aHR: 0.64;p = .13). BK‐directed agents were well tolerated.ConclusionsBK DNAemia is associated with a young age at transplant and steroid‐based maintenance IS. We found no effect of BK DNAemia on AR, GS, and PS.
Resolving Ultrafast Photoinitiated Dynamics of the Hachimoji 5‐aza‐7‐deazaguanine Nucleobase: Impact of Synthetically Expanding the Genetic Alphabet†
Authors: Krul Sarah E. , Costa Gustavo J. , Hoehn Sean J. , Valverde Danillo , Oliveira Leonardo M. F. , Borin Antonio Carlos , Crespo‐Hernández Carlos E. 
Published: August 2022

AbstractThe guanine derivative, 5‐aza‐7‐deazaguanine (5N7CG) has recently been proposed as one of four unnatural bases, termed Hachimoji (8‐letter) to expand the genetic code. We apply steady‐state and time‐resolved spectroscopy to investigate its electronic relaxation mechanism and probe the effect of atom substitution on the relaxation mechanism in polar protic and polar aprotic solvents. Mapping of the excited state potential energy surfaces is performed, from which the critical points are optimized by using the state‐of‐art extended multi‐state complete active space second‐order perturbation theory. It is demonstrated that excitation to the lowest energy 1ππ* state of 5N7CG results in complex dynamics leading to ca. 10‐ to 30‐fold slower relaxation (depending on solvent) compared with guanine. A significant conformational change occurs at the S1 minimum, resulting in a 10‐fold greater fluorescence quantum yield compared with guanine. The fluorescence quantum yield and S1 decay lifetime increase going from water to acetonitrile to propanol. The solvent‐dependent results are supported by the quantum chemical calculations showing an increase in the energy barrier between the S1 minimum and the S1/S0 conical intersection going from water to propanol. The longer lifetimes might make 5N7CG more photochemically active to adjacent nucleobases than guanine or other nucleobases within DNA.
Takotsubo syndrome after a minimally invasive tooth extraction in a patient without dental phobia: A case report
Authors: Takuma Shigeru , Asaka Takuya , Kitagawa Yoshimasa , Fujisawa Toshiaki 
Published: August 2022

AbstractTakotsubo syndrome (TTS) is a rare, stress‐induced acute cardiac disorder. Its precipitating factors include emotionally or physically stressful events and exogenous and endogenous adrenaline. In this report, we describe a case of atypical TTS in a 73‐year‐old woman who reported no dental fear and required acute cardiac care in an outpatient setting. She underwent routine extraction of an upper left premolar under local anesthesia. She reported heart palpitations after the injection, and the procedure was completed in 15 min. After presenting symptoms of sweating, pale skin, vomiting, low blood pressure, and ST‐segment elevation, cardiologists ordered echocardiography, coronary angiography, and ventriculography. Upon receiving a TTS diagnosis, the patient was hospitalized and administered an intra‐aortic balloon pump and beta‐blocker. Her symptoms resolved, and she was discharged with no sequelae. We found no precipitating factors in the progression of TTS in this case, which suggests that TTS can develop in the absence of precipitating factors. All general dentists and oral surgeons should recognize the possible risk of TTS, even during minimally invasive dental procedures, such as routine extractions in patients without dental phobia.
The physical environment is essential, but what does the design and structure of stroke units look like? A descriptive survey of inpatient stroke units in Sweden
Authors: Anåker Anna , Morichetto Hanna , Elf Marie 
Published: August 2022

AbstractBackgroundThe design of the physical environment is a critical factor in patient care and is known to influence health, well‐being, clinical efficiency, and health‐related outcomes. To date, there has been no general review of the physical environment of modern Swedish stroke units.AimTo explore the physical environment of inpatient stroke units in Sweden and describe the design and structure of these units.MethodsThis was a cross‐sectional study. Data were collected in Sweden from April to July 2021 via a survey questionnaire.ResultsThe layout of the stroke units varied broadly, such as the number of single‐bed and multi‐bed rooms. More than half the stroke units comprised spaces for rehabilitation and had an enriched environment in the form of communal areas with access to computers, games, books, newspapers, and meeting places. However, they offered sparse access to plants and/or scenery.ConclusionsHealthcare environments are an essential component of a sustainable community. From a sustainability perspective, healthcare facilities must be built with high architectural quality and from a long‐term perspective. Research on the physical environment in healthcare should contribute to improved quality of care, which can be achieved through building healthcare facilities that support the performance of care and recovery. Therefore, mapping of areas of interest for further investigation is crucial.
Strategy‐proof size improvement: is it possible?*
Authors: Afacan Mustafa Oğuz , Dur Umut 
Published: August 2022

AbstractThe number of assigned agents (i.e., size) is an important parameter in object allocations. While size maximality clashes with individual rationality and strategy‐proofness, it can still be possible to increase the size over a mechanism while keeping these properties. To pursue this research, we devise a size comparison criterion to investigate the possibility of size increase. A mechanism size‐wise dominates another mechanism if the latter never assigns more agents than the former, and at some problem, assigns more agents than . We obtain arguably mild conditions for a mechanism to not be dominated size‐wise by an individually rational and strategy‐proof mechanism. Moreover, whenever there are at least as many objects as the total number of agents, we find conditions, different from those previously mentioned, for a mechanism to not be dominated size‐wise by an individually rational and group strategy‐proof mechanism. These results have implications for deferred‐acceptance, top trading cycles, efficiency‐adjusted deferred‐acceptance, serial dictatorship, and Boston mechanisms.
Time Trends of Step-Determined Physical Activity Among Adolescents With Different Activity Levels in Czech Republic
Authors: Frömel Karel , Mitáš Josef , Tudor-Locke Catrine 
Published: August 2022

Background: This study aimed to present step-determined physical activity trends in adolescents with different activity levels over a period of 10 years. Methods: Pedometers were used to monitor weekly physical activity in 1855 boys and 2648 girls aged 15–19 years recruited from 155 schools in the Czech Republic between 2009 and 2018. Trends for average steps/day and percent of accumulating various levels of steps/day (<10,000, 10,000–13,000, and >13,000 steps/d) were analyzed by sex. Results: There was a statistically significant decrease in average steps/day between 2009–2010 and 2017–2018 in boys from 12,355 (3936) steps/d to 10,054 (3730) steps/d and girls from 11,501 (3278) steps/d to 10,216 (3288) steps/d. The percent accumulating <10,000 steps/d increased by 21% in boys and 12% in girls. The percent achieving >13,000 steps/d decreased by 17% in boys and 10% in girls. Conclusions: Objectively collected evidence indicates an overall decrease in Czech adolescents’ steps/day over a 10-year period concurrent with an increase in the percent of boys and girls accumulating <10,000 steps/d. These trends are concerning as they portend a decline in physical activity as adolescents transition to adulthood and continue to age, which also may have major health implications.
Is Myofascial Decompression Effective at Increasing Hamstring Flexibility in the Athletic Population? A Critically Appraised Topic
Authors: Spellman Julia , Eldredge Rachel , Nelson Melissa , Ostrowski Jennifer , Concannon Jennifer 
Published: August 2022

Clinical Scenario: There are a variety of therapeutic modalities used to treat flexibility issues in athletes, which can be the main cause of hamstring injuries. Myofascial decompression is one modality used to treat these patients. Focused Clinical Question: Is myofascial decompression effective at increasing hamstring flexibility in the athletic population? Summary of Search, “Best Evidence” Appraised, and Key Findings: The literature was searched for studies of level 2 evidence or higher that investigated the use of myofascial decompression to increase hamstring flexibility, that were published in the last 5 years. Two high-quality randomized controlled trials were included and one cohort study. Clinical Bottom Line: There is not enough consistent, clinically significant, high-level evidence to support the use of myofascial decompression to increase hamstring flexibility. Strength of Recommendation: There is level B evidence to support that myofascial decompression is effective at increasing hamstring flexibility.
Factors influencing the safety of outpatient coronary CT angiography: a clinical registry study
Authors: Andre Florian , Fortner Philipp , Emami Mostafa , Seitz Sebastian , Brado Matthias , Gückel Friedemann , Sokiranski Roman , Sommer André , Frey Norbert , Görich Johannes , Buss Sebastian J 
Published: August 2022

ObjectivesSince the safety of coronary CT angiography (CTA) is of great importance, especially with regard to widening indications and increasing morbidity, the aim of this study was to assess influencing factors.MethodsPatients undergoing coronary CTA in a third-generation dual-source CT in a radiological centre were included in a clinical registry. Up to 20 mg metoprolol was administered intravenously to attain a heart rate ≤65/min. Glyceryl trinitrate (GTN) was administered in doses of 0.8 mg and 0.4 mg. Blood pressure was measured before the administration and after the CTA.ResultsOut of 5500 consecutive patients (3194 men, 62.3 (54.9–70.0) years), adverse events occurred in 68 patients (1.2%) with mild anaphylactoid reactions (0.4%), vasovagal symptoms (0.3%) and extravasation (0.3%) being most frequent. Anti-allergic drugs were given in 17 patients, atropine in 3 patients and volume in 1 patient. Drug administration resulted in a significant mean arterial pressure decline (96.0 (88.3–106.0) vs 108.7 (99.7–117.3) mmHg; p<0.001). Patients who suffered systolic blood pressure drops >20 mmHg or >40 mmHg were older (66.5 (58.6–73.3) vs 60.5 (53.6–68.3) years; 70.2 (63.3–76.5) vs 62.1 (54.7–69.6) years), more often male (65.1% vs 54.4%; 68.9% vs 57.3%) and had higher Agatston score equivalents (83.0 (2.0–432.0) vs 15.0 (0.0–172.0); 163.0 (16.3–830.8) vs 25.0 (0.0–220.0); all p<0.001). GTN dose reduction lowered the fraction of patients suffering from blood pressure drops >20 mmHg or >40 mmHg from 34.5% to 27.4% and from 6.1% to 3.5% (both p<0.001), respectively. The proportion of coronary segments with impaired image quality did not differ significantly.ConclusionsCoronary CTA with intravenous beta-blocker administration is a safe procedure in an outpatient setting as adverse events are rare and mostly mild. Reduced GTN doses can further improve safety by lowering the rate of significant blood pressure drops, which occurred especially in elderly men with increased plaque burden.Trial registration numberNCT03815123.
Interventions for and experiences of shared decision-making underpinning reproductive health, family planning options and pregnancy for women with or at high risk of kidney disease: a systematic review and qualitative framework synthesis
Authors: Mc Laughlin Leah , Neukirchinger Barbara , Noyes Jane 
Published: August 2022

ObjectiveTo determine intervention effects and synthesise qualitative research that explored women with or at high risk of kidney disease experiences of shared decision-making in relation to their reproductive health, family planning options and pregnancy.DesignA systematic review of interventions and a qualitative evidence synthesis.Data sourcesWe searched Cochrane, CINAHL, MEDLINE, Scopus, ProQuest, Elsevier, PubMed, ScienceDirect and Web of Science.Eligibility criteriaShared decision-making interventions and qualitative studies related to reproductive health involving women with or at high risk of kidney disease published from 1980 until January 2021 in English (clinical settings, global perspective).Data extraction and synthesisTitles were screened against the inclusion criteria and full-text articles were reviewed by the whole team. Framework synthesis was undertaken.ResultsWe screened 1898 studies. No evidence-based interventions were identified. 18 qualitative studies were included, 11 kidney disease-specific studies and 7 where kidney disease was a common comorbidity. Women frequently felt unprepared and uninformed about their reproductive options. Conversations with healthcare professionals were commonly described as frustrating and unhelpful, often due to a perceived loss of autonomy and a mismatch in preferences and life goals. Examples of shared decision-making were rare. Kidney disease exacerbated societal expectations of traditional gender roles (eg, wife, mother, carer) including capability to have children and associated factors, for example, parenting, (sexual) relationships, body image and independent living (including financial barriers to starting a family). Local interventions were limited to types of counselling. A new health system model was developed to support new interventions.ConclusionThere is a clear need to establish new interventions, test those already in development and develop new clinical guidance for the management of women with or at high risk of kidney disease in relation to their reproductive health, including options to preserve fertility earlier. Other health conditions with established personalised reproductive care packages, for example, cancer, could be used to benchmark kidney practice alongside the new model developed here.
Differences in opioid prescription rates between patients with musculoskeletal disorders enrolled in coordinated ambulatory healthcare and patients receiving usual care: a retrospective observational cohort study
Authors: Müller Angelina , Amberger Olga Anastasia , Glushan Anastasiya , Klaaßen-Mielke Renate , Witte Claudia , van den Akker Marjan , Brünn Robin , Gerlach Ferdinand M , Beyer Martin , Karimova Kateryna 
Published: August 2022

ObjectivesTo compare opioid prescription rates between patients enrolled in coordinated ambulatory care and patients receiving usual care.DesignIn this retrospective cohort study, we analysed claims data for insured patients with non-specific/specific back pain or osteoarthritis of hip or knee from 2014 to 2017.SettingThe study was based on administrative data provided by the statutory health insurance fund ‘Allgemeine Ortskrankenkasse’, in the state of Baden-Wurttemberg, Germany.ParticipantsThe intervention group consisted of patients enrolled in a coordinated ambulatory healthcare model; the control group included patients receiving usual care. Outcomes were overall strong and weak opioid prescriptions. Generalised linear regression models were used to analyse the effect of the intervention.ResultsOverall, 46 001 (non-specific 18 787/specific 27 214) patients with back pain and 19 366 patients with osteoarthritis belonged to the intervention group, and 7038 (2803/4235) and 963 patients to the control group, respectively. No significant difference in opioid prescriptions existed between the groups. However, the chance of being prescribed strong opioids was significantly lower in the intervention group (non-specific back pain: Odds Ratio (OR) 0.735, 95% Confidential Interval (CI) 0.563 to 0.960; specific back pain: OR 0.702, 95% CI 0.577 to 0.852; osteoarthritis: OR 0.644, 95% CI 0.464 to 0.892). The chance of being prescribed weak opioids was significantly higher in patients with specific back pain (OR 1.243, 95% CI 1.032 to 1.497) and osteoarthritis (OR 1.493, 95% CI 1.037 to 2.149) in the intervention group.ConclusionCoordinated ambulatory healthcare appears to be associated with a lower prescription rate for strong opioids in patients with chronic musculoskeletal disorders.Trial registration numberGerman Clinical Trials Register (DRKS00017548).
Long working hours, sedentary work, noise, night shifts and risk of ischaemic heart disease
Authors: Eng Amanda , Denison Hayley J , Corbin Marine , Barnes Lucy , 't Mannetje Andrea , McLean Dave , Jackson Rod , Laird Ian , Douwes Jeroen 
Published: August 2022

ObjectiveIschaemic heart disease (IHD) is a leading cause of death in Western countries. The aim of this study was to examine the associations between occupational exposure to loud noise, long working hours, shift work, and sedentary work and IHD.MethodsThis data linkage study included all New Zealanders employed and aged 20–64 years at the time of the 2013 census, followed up for incident IHD between 2013 and 2018 based on hospitalisation, prescription and death records. Occupation and number of working hours were obtained from the census, and exposure to sedentary work, loud noise and night shift work was assessed using New Zealand job exposure matrices. HRs were calculated for males and females using Cox regression adjusted for age, socioeconomic status, smoking and ethnicity.ResultsFrom the 8 11 470 males and 7 83 207 females employed at the time of the census, 15 012 male (1.9%) and 5595 female IHD cases (0.7%) were identified. For males, there was a modestly higher risk of IHD for the highest category (>90 dBA) of noise exposure (HR 1.19; 95% CI 1.07 to 1.33), while for females exposure prevalence was too low to calculate an HR. Night shift work was associated with IHD for males (HR 1.10; 95% CI 1.05 to 1.14) and females (HR 1.25; 95% CI 1.17 to 1.34). The population attributable fractions for night shift work were 1.8% and 4.6%, respectively. No clear associations with working long hours and sedentary work were observed.ConclusionsThis study suggests that occupational exposures to high levels of noise and night shift work might be associated with IHD risk.
Thermodynamically consistent entropic late-time cosmological acceleration
Authors: Zamora D. J. , Tsallis C. 
Published: August 2022

AbstractEntropic-force cosmology provides, in contrast with dark energy descriptions, a concrete physical understanding of the accelerated expansion of the universe. The acceleration appears to be a consequence of the entropy associated with the information storage in the universe. Since these cosmological models are unable of explaining the different periods of acceleration and deceleration unless a correction term is considered, we study the effects of including a subdominant power-law term within a thermodynamically admissible entropic-force model. The temperature of the universe horizon is obtained by a clear physical principle, i.e., requiring that the Legendre structure of thermodynamics is preserved. We analyze the various types of behaviors, and we compare the performance of thermodynamically consistent entropic-force models with regard to available supernovae data by providing appropriate constraints for optimizing alternative entropies and temperatures of the Hubble screen. The novelty of our work is that the analysis is based on a entropy scaling with an arbitrary power of the Hubble radius, instead of a specific entropy. This allows us to conclude on various models at once, compare them, and conserve the scaling exponent as a parameter to be fitted with observational data, thus providing information about the form of the actual cosmological entropy and temperature. We show that the introduced correction term is capable of explaining different periods of acceleration and deceleration in the late-time universe.