bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Case for Advance Care Planning in the NICU
Authors: Lin Matthew , Sayeed Sadath , DeCourcey Danielle D , Wolfe Joanne , Cummings Christy 
Published: November 2022

Many NICUs have reached an inflection point where infant deaths following limitation of life-sustaining treatments outnumber those following unsuccessful resuscitations, and many infants who survive continue to require intensive supports. Families of such infants with serious illness may benefit from a standardized, process-oriented approach in decisional-support. Advance care planning (ACP), or communication that supports patients, or their surrogate decision-makers, in sharing values, goals, and preferences for future medical care, is recognized as a valuable strategy in supporting adults with serious and chronic illness. Although the role of ACP in older children and adolescents is evolving, its utility has not been systematically explored in the perinatal context. This article builds a case for formalizing a role for ACP in the NICU by defining ACP and appraising recent outcomes research, reviewing the current state of parental needs for decisional support and serious illness in the NICU, and describing how ACP may address current limitations in primary and specialty pediatric palliative care and challenges for decision-making in the newborn period.
Rituximab in the Management of a Child with Pemphigus Vulgaris: Case Study
Authors: Murashkin Nikolay N. , Opryatin Leonid A. , Vasilenko Anastasiya A. , Ambarchian Eduard T. , Epishev Roman V. , Materikin Alexander I. , Ivanov Roman A. 
Published: November 2022

Background. Pemphigus vulgaris is an autoimmune bullous dermatosis. Its management generally involves lifelong administration of maintenance dose of systemic glucocorticosteroids, that leading to serious adverse effects especially in children.Clinical case description. Patient is the 16 years old boy with severe course of pemphigus vulgaris. The diagnosis was confirmed by the results of cell smear study from fresh erosions (> 50 acantholytic cells were revealed), histological examination of the skin biopsy from the lesion with the vesicle element (suprabasal vesicle was localized in the center, it included fibrin, neutrophil granulocytes, and acantholytic cells), skin biopsy from the area near the lesion (visually healthy skin), via direct immunofluorescence methods (IgG deposition was detected on keratinocytes’ surface throughout the epidermis), and enzyme-linked immunosorbent assay (desmoglein 1 IgG autoantibodies — 121 U/mL (reference value < 20 U/mL) and desmoglein 3 — > 200 U/mL (reference value < 20 U/mL)). Genetically engineered biologic drug, rituximab, and systemic glucocorticosteroid, methylprednisolone, were prescribed as first-line therapy with gradual dose reduction to permanent discontinuation in 8 months. Complete remission maintained after the completion of therapy course and discontinuation of systemic glucocorticosteroid.Conclusion. Combined therapy with systemic glucocorticosteroids and rituximab can be considered as first-line therapy in pediatric patients with pemphigus vulgaris due to relatively low risk of recurrence after rather rapid and complete drugs’ discontinuation.
A certeza delirante no discurso psicótico e seus atravessamentos no contexto familiar
Authors: Fonsêca Marcos Aurélio , De Laurentiis Sabino Lígia 
Published: November 2022

O discurso de conteúdo delirante se manifesta com frequência na psicose. A Reforma Psiquiátrica Brasileira propõe o cuidado em liberdade e a intervenção compartilhada com as famílias. Objetivo: discutir como as intervenções com a família repercutiram no projeto terapêutico, além de questionar acerca do papel da família e da equipe na condução do cuidado e do preparo e disponibilidade das instituições e equipes para acolher e orientar as famílias. Método: abordagem qualitativa, com objetivo descritivo-exploratório, a partir do relato de caso único, baseado na revisão de prontuário de uma mulher diagnosticada como psicótica, com a manifestação do transtorno delirante e que apresentou contexto familiar bastante conflituoso. Resultados: com as intervenções, foi atingida a redução do investimento afetivo nas certezas delirantes, com menor impacto no desempenho funcional e na dinâmica familiar da usuária. Conclusão: sem a abordagem familiar, promovendo a responsabilização dos integrantes do núcleo, as intervenções dos profissionais têm grande chance de serem pouco resolutivas.
Gastric dilatation volvulus in dogs: utility of lactate as a predictor of survival
Authors: Mackenzie David 
Published: November 2022

PICO question
In dogs presenting with gastric dilatation volvulus, is an admission or pre-operative lactate level a reliable predictor of survival to discharge?

Clinical bottom line
Category of research question
Prognosis
The number and type of study designs reviewed
15 studies (12 retrospective and 3 prospective) were critically appraised
Strength of evidence
Moderate
Outcomes reported
At a population level, lower blood lactate concentration, or lactate concentration that decreases following fluid resuscitation, are associated with a better prognosis.
At a population level, higher blood lactate concentration, or lactate concentration that fails to decrease following fluid resuscitation, is associated with a worse prognosis. However, the lower sensitivity across studies means that a high lactate, or one that does not decrease following fluid therapy, should be interpreted more cautiously than a low lactate; i.e., low lactate predicts survival better than high lactate predicts non-survival.
In all studies, there was a significant overlap in individual blood lactate concentration between survivors and non-survivors
Conclusion
Blood lactate level should only be used to help guide broad, cautiously worded conversations with owners as described above. It should not be used to give a prognosis for individual patients. The overlap between survivors and non-survivors, and the high overall survival rate, means that exploratory laparotomy should be advised irrespective of the blood lactate level

How to apply this evidence in practice
The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.
Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.
Impacto en la salud mental de los niños y adolescentes de Lima Metropolitana en el contexto de la COVID-19
Authors: Alvarez Militza , Arias Jose-Pablo , Morón Giannina , Ramírez Rocio , Cayo Julissa , Pomalima Rolando 
Published: November 2022

Los problemas de salud mental en niños y adolescentes tienen una elevada incidencia en el Perú y a nivel mundial. Sin embargo, los estudios sobre las repercusiones psicológicas de la pandemia de Covid-19 en niños y adolescentes en el Perú son insuficientes. El objetivo general fue identificar la magnitud de los principales problemas de salud mental en la población infanto-juvenil de Lima (Perú) relacionados con la Covid-19. El estudio fue descriptivo-transversal. La muestra estuvo conformada por 2639 niños(as) y adolescentes. Se emplearon los siguientes instrumentos: Ficha demográfica y socioeconómica, Cuestionario sobre experiencias, conductas e impacto relacionadas a la Covid-19, Entrevista Neuropsiquiátrica Internacional para Niños y Adolescentes, Cuestionario de Violencia Familiar, Cuestionario “Como es tu Familia”, Escala Adolescent Family Process, Inventario de Conductas Parentales y Cuestionario sobre Determinantes del Acceso a los Servicios de Salud en el Perú. Entre los aspectos de la conducta parental percibidos por los adolescentes, se halló que alrededor de la mitad de ellos experimentaban rara vez un conflicto con sus madres o padres. El miedo a que algún ser querido enferme o muera por la Covid-19 fue el más frecuente en los niños(as) de 6 a 11 años y en los adolescentes (63% y 63.6% respectivamente). El 44.4% de los informantes de los niños de 1.5 a 5 años, refirieron que utilizaban el castigo físico, frente a un 60.3% en niños(as) de 6 a 11 años. Los adolescentes reportaron haberlo sufrido en un 59.3%. El miedo a separarse de una figura de apego se presentó en un 45.7% de niños(as) de 6 a 11 años. Más del 80% (n = 2227) de la muestra contaba con algún seguro de salud. La tercera parte de la muestra (n = 870) presentó problemas emocionales y/o de conducta, de los cuales 714 no recibieron atención. Se concluye que, en los seis meses previos a la encuesta, los principales trastornos clínicos, así como el maltrato físico y psicológico y el abuso sexual en la población infanto-juvenil se incrementaron en comparación con la época de pre-pandemia. La frecuencia de la comunicación entre padres y sus hijos de 1.5 a 11 años tuvo una cierta mejoría. El acceso a servicios es un punto crítico en la atención.
Rescate de peces aguas abajo de la presa Porce III (Colombia) para reducir su mortalidad
Authors: Restrepo-Santamaria Daniel , Valencia-Rodríguez Daniel , Galeano Andrés , Herrera Juliana , Jiménez-Segura Luz 
Published: November 2022

En la cuenca del río Magdalena, las actividades de rescate de peces son una medida de manejo ambiental utilizada para reducir su mortalidad en el área próxima a los embalses. Cuando se realiza la apertura y posterior cierre de compuertas del vertedero, producto de la operación de la central hidroeléctrica Porce III, aguas abajo de la presa se crean hábitats acuáticos temporales en forma de pozas marginales de lecho rocoso, en donde se presentan atrapamientos de peces. El objetivo del rescate es reubicarlos al canal principal del río para reducir su mortalidad. Entre los años 2013 y 2020 se capturaron 4927 individuos, representantes de 28 especies, 12 familias y cinco órdenes. Reubicamos a 4704 individuos nuevamente en el río Porce, siendo las especies de los géneros Chaetostoma, Andinoacara, Astyanax y Rhamdia los de mayor captura. También se capturaron especies potamodromas de la familia Pochilodontidae, cuya presencia próxima a la presa se debe posiblemente a migraciones que realizan para llevar a cabo su reproducción. Estas acciones de rescate y reubicación, producto de la operación de las centrales hidroeléctricas, deben ser replicadas en la cuenca como estrategia para mitigar los impactos ambientales ocasionados por la fragmentación del hábitat.
Riqueza genérica y distribución de los efemerópteros (Insecta: Ephemeroptera) de la Colección Limnológica del Chocó
Authors: Murillo Zuleyma Mosquera , Córdoba Aragón Karen Everni , Mosquera Mosquera Mairin Minerva 
Published: November 2022

Se revisaron 1148 ejemplares del orden Ephemeroptera depositados en la Colección Limnológica del Chocó (CLCH), que abarcan 21 municipios (entre 5 y 3202 m s.n.m.), en 71 corrientes hídricas de diferente orden y 12 ecosistemas lénticos en las cuencas de los ríos Atrato, San Juan y Baudó. Se reportan siete familias y 25 géneros, de los cuales Ecuaphlebia, Ulmeritoides, Asthenopus, Mayobaetis y Choroterpes son registrados por primera vez para el Chocó. La familia Baetidae es la de mayor abundancia y la de más amplia distribución, mientras que Oligoneuriidae es la menos representativa. La mayor riqueza taxonómica la registran las familias Leptophlebiidae (9 géneros) y Baetidae (7 géneros). Thraulodes, Baetodes y Terpides son los géneros con mayor distribución altitudinal, y mayor riqueza específica se presenta en el sustrato piedra con 23 géneros. La cuenca del río Atrato presenta el mayor registro taxonómico. Los datos que se presentan es este estudio ponen en evidencia la gran diversidad del orden Ephemeroptera en el departamento del Chocó y la necesidad de adelantar nuevas investigaciones que amplíen el conocimiento de su riqueza y distribución en la región.
Role of Baricitinib in moderate to severe COVID-19, a case control study from a South Indian tertiary care setting
Authors: Kulirankal Kiran G , Mary Ann , Mehta Asmita Anilkumar , Razak M. Abdul , Abhinandh B. , Nair Chithira V , Hakeem Sai Chandra , Edathadathil Fabia , Chandra Subhash , Pillai Gopala Krishna , Sabarish B , P Shyam Sundar , Sathyapalan Dipu T , Moni Merlin 
Published: November 2022

Abstract
Background
Baricitinib is a Janus kinase inhibitor with known anti-inflammatory effects and has been explored for beneficial outcomes in COVID-19 therapeutic management however with paucity of data on its effects on secondary infections and thrombosis. We aimed to assess the efficacy and all-cause mortality among moderate to severe COVID − 19 on a retrospective cohort of patients who received adjunct baricitinib as compared to a matched cohort who received standard of care for moderate to severe Covid 19.
Methods
The retrospective case control study conducted at 1300-bedded South Indian tertiary care centre from April to October 2021 recruited moderate to severe Covid patients receiving baricitinib therapy for at-least 72 hours into case group. Age and severity matched Covid patients who received standard of care without baricitinib were enrolled as control arm in 1:1 ratio. Data of the study groups on baseline characteristics, medications including antivirals, steroids, antibiotics and outcome measures were obtained. Study outcomes included all-cause mortality, daily clinical improvement assessed by ≥ 1-point improvement in WHO Ordinal Scale scores, multi-organ dysfunction syndrome, incidence of thrombotic events and secondary infections.
Results
Among the 527 moderate to severe COVID 19 patients in the study period, 75 patients each were recruited into case and control groups respectively. Mean age of case and control groups were 60.82 ± 13.03 and 61 ± 13.48 years respectively. 28-day mortality rate was 33.3%(n = 25) in the case group and 48%(n = 36) in the control group (p = 0.24, RR = 0.79, CI 95%). An absolute risk reduction of 16.75% was observed (NNT = 6) between the groups. All-cause mortality was 42.7%(n = 64) with 27(n = 36%) and 37(n = 49.3%) deaths in the case and control groups respectively(p = 0.09). Kaplan-Meier survival analysis revealed survival distributions to be significantly different between case and control groups (Log rank: p = 0.048). Clinical improvement assessed by decrease in WOS ≥ 1 was demonstrated to be higher in cases (n = 35,47%) than controls (n = 28,37.7%)(p = 0.32).
Conclusion
Our retrospective case control study revealed lower mortality and higher proportion of patients attaining clinical improvement as measured by at least one-point improvement of WHO ordinal scale in patients admitted with moderate to severe Covid 19, which did not attain statistical significance.
Combined transcriptome and metabolome analysis reveals the effects of light quality on maize hybrids
Authors: Zhan Weimin , Guo Guanghui , Cui Lianhua , Rashid Muhammad Abdul Rehman , Jiang Liangliang , Sun Guanghua , Yang Jianping , Zhang Yanpei 
Published: November 2022

Abstract

Background Heterosis, or hybrid vigor, refers to the phenotypic superiority of an F1hybrid relative to its parents in terms of growth rate, biomass production, grain yield, and stress tolerance. Light is an energy source and main environmental cue with marked impacts on heterosis in plants. Research into the production applications and mechanism of heterosis has been conducted for over a century and a half, but little is known about the effect of light on plant heterosis. Results In this study, an integrated transcriptome and metabolome analysis was performed using maize (Zea maysL.) inbred parents, B73 and Mo17, and their hybrids, B73×Mo17 (BM) and Mo17×B73 (MB), grown in darkness or under far-red, red, or blue light. Most differentially expressed genes (73.72–92.50%) and differentially accumulated metabolites (84.74–94.32%) exhibited non-additive effects in BM and MB hybrids. Gene Ontology analysis revealed that differential genes and metabolites were involved in glutathione transfer, carbohydrate transport, terpenoid biosynthesis, and photosynthesis. The darkness, far-red, red, and blue light treatments were all associated with phenylpropanoid–flavonoid biosynthesis by Weighted Gene Co-expression Network Analysis and Kyoto Encyclopedia of Genes and Genomes enrichment analysis. Five genes and seven metabolites related to phenylpropanoid–flavonoid biosynthesis pathway were identified as potential contributors to the interactions between maize heterosis and light conditions. Consistent with the strong mid-parent heterosis observed for metabolites, significant increases in both fresh and dry weights were found in the MB and BM hybrids compared with their inbred parents. Unexpectedly, increasing light intensity resulted in higher biomass heterosis in MB, but lower biomass heterosis in BM. Conclusions Together, the transcriptomic and metabolomic results provide unique insights into the effects of light quality on gene expression patterns and genotype–environment interactions, and have implications for gene mining of heterotic loci to improve maize production.
Prediction of stent under-expansion in calcified coronary arteries using machine learning on intervascular optical coherence tomography images
Authors: Gharaibeh Yazan , Lee Juhwan , Zimin Vladislav N. , Kolluru Chaitanya , Dallan Luis A. P. , Pereira Gabriel T. R. , Vergara-Martel Armando , Kim Justin N. , Hoori Ammar , Dong Pengfei , Gamage Peshala T. , Gu Linxia , Bezerra Hiram G. , Al-Kindi Sadeer , Wilson David L. 
Published: November 2022

Abstract

It can be difficult/impossible to fully expand a coronary artery stent in a heavily calcified coronary artery lesion. Under-expanded stents are linked to later complications. Here we used machine/deep learning to analyze calcifications in pre-stent intravascular optical coherence tomography (IVOCT) images and predicted the success of vessel expansion. Pre- and post-stent IVOCT image data were obtained from 110 coronary lesions. Lumen and calcifications in pre-stent images were segmented using deep learning, and lesion features were extracted. We analyzed stent expansion along the lesion, enabling frame, segmental, and whole-lesion analyses. We trained regression models to predict the post-stent lumen area and then computed the stent expansion index (SEI). Best performance (root-mean-square-error = 0.04 ± 0.02 mm2,r = 0.94 ± 0.04,p < 0.0001) was achieved when we used features from both lumen and calcification to train a Gaussian regression model for segmental analysis of 31 frames in length. Stents with minimum SEI > 80% were classified as “well-expanded;” others were “under-expanded.” Under-expansion classification results (e.g., AUC = 0.85 ± 0.02) were significantly improved over a previous, simple calculation, as well as other machine learning solutions. Promising results suggest that such methods can identify lesions at risk of under-expansion that would be candidates for intervention lesion preparation (e.g., atherectomy).
Matrix vesicle-inspired platelet membrane vesicles for biomineralization of dentin tubules
Authors: Shi Shijie , Zhen Li , Fan Menglin , Sun Lizhong , Tao Siying , Han Mingyue , Yu Zhaohan , Yang Jiaojiao , Li Jiyao 
Published: November 2022

Abstract
Objectives

This work aims to propose a kind of platelet membrane-derived vesicle (PMVs) to mimic matrix vesicles (MVs) and to verify their function in improving the stability of collagen and promoting biomineralization.

Methods

PMVs were prepared from natural platelet membrane fragments and then the morphology, particle size, protein retention of PMVs were characterized. Then the anti-enzymatic properties were reflected by testing the concentration of hydroxyproline after PMVs were in contact with collagen for 1 h. In addition, the demineralized dentins treated with PMVs were incubated in artificial saliva for 1 week or 3 weeks for remineralization. Finally, their mineralization effects were observed through SEM, EDS, XRD. The control group was treated with deionized water.

Results

PMVs can promote the cross-linking of collagen to inhibit the enzymatic hydrolysis of collagen and therefore could restrain the degradation of type I collagen from collagenase. Furthermore, the bioinspired nanovesicles can penetrate into the deep dentinal tubules due to their stable nanostructure, and provide nucleation sites and templates for nascent mineral crystals. The newly formed minerals can effectively seal the dentinal tubules.

Conclusions

PMVs can improve collagen stability by strengthening crosslinking and promote remineralization of dentin surfaces and deep inside dentin tubules, finally repairing damaged dentin effectively.

Significance

This strategy uses "artificial MVs" derived from platelet membranes for the biomineralization of dentin, bringing new prospects for hard tissue repair in clinical practice.
Numerical Simulation of Discontinuously Vegetated Open Channel Flow to Estimate Effects of Vegetation Condition on Flood Mitigation
Authors: Ahmed Nadim , Bangalee Zavid Iqbal 
Published: November 2022

Abstract
The velocity structure and turbulent characteristics of vegetated open channel flow were studied computationally using the computational fluid dynamics (CFD) code FLUENT to find logical distribution of vegetation in the flow to minimize flood disaster. A three‐dimensional Reynolds stress turbulence model was first validated with the experimental data and then used for investigating properties of flow through vertically double‐layered and discontinuous vegetation patches that occupy both sides of an open channel with different patch patterns— linear and staggered. Results indicate that the flow velocities within the gap zones are reduced by the sheltering effect of vegetation patches, which is observed to be significantly higher for the flow through staggered patch pattern than that through linear pattern. Flow velocities in non-vegetated main channel increased by 29 % and 36 % compared to that in vegetation sides of the channel—canopy and gap—for linear and staggered pattern, respectively. The findings indicate that the higher flow resistance on the channel's vegetation sides in staggered pattern is balanced by the faster flow in the main channel, which could be utilized effectively during higher flows like floods over the floodplains. Moreover, velocity magnitude as well as fluctuations and turbulent kinetic energy (TKE) in vegetation sides are lower in flow through staggered pattern than that in linear pattern, which satisfies a better feature for aquatic life in staggered pattern. Thus, this arrangement of staggered vegetation patches can be used as an effective measure for flood mitigation as well as providing positive feedback for aquatic life and sediment deposition.