bluuebunny/crossref_metadata_2025_split huggingface dataset:
Patient and operative factors associated with unanticipated intensive care admission and outcomes following posterior fossa decompressions in children: A retrospective study
Authors: Benzon Hubert A. , Tantoco Anthony , Longhini Anthony , Hajduk John , Saratsis Amanda , Suresh Santhanam , McCarthy Robert J. , Jagannathan Narasimhan 
Published: May 2022

AbstractIntroductionPosterior fossa decompression for Chiari I Malformation is a common pediatric neurosurgical procedure. We sought to identify the impact of anesthesia‐related intraoperative complications on unanticipated admission to the intensive care unit and outcomes following posterior fossa decompression.MethodsMedical records of all patients <18 years who underwent surgery for Chiari I malformation between 1/1/09 and 1/31/21 at the Ann & Robert H. Lurie Children's Hospital of Chicago were included. Records were reviewed for patient characteristics, anesthesia‐related intraoperative complications, postoperative complications, and surgical outcomes. The primary outcome was the incidence of unanticipated admission to the intensive care unit, and the primary variable of interest was an anesthesia‐related intraoperative complication. Patient, surgical characteristics, and year of surgery were also compared between patients with and without an unanticipated admission to the intensive care unit, and a multi‐variable adjusted estimate of odds of unanticipated admission to the intensive care unit admission following an anesthesia‐related intraoperative complication was performed. Secondary outcomes included anesthesia factors associated with an anesthesia‐related intraoperative event, and postoperative complications and surgical outcomes between patients admitted to the intensive care unit and those who were not.ResultsTwo hundred ninety‐six patients with Chiari I Malformation were identified. Clinical characteristics associated with an unanticipated admission to the intensive care unit were younger age, American Society of Anesthesiologist (ASA) physical status >2 and an anesthesia‐related intraoperative complication. 29 anesthesia‐related intraoperative complications were observed in 25 patients (8.4%). Two of 25 patients (8%) with an anesthesia‐related intraoperative complication compared with 3 of 271 (1%) patients without anesthesia‐related intraoperative complication had an unanticipated admission to the intensive care unit, odds ratio 7.8 (95% CI 1.2–48.8, p = .010). When adjusted for age, sex, ASA physical status, presenting symptoms, concomitant syringomyelia, previous decompression surgery and year of surgery, the odds ratio for an unanticipated admission to the intensive care unit following an anesthesia‐related intraoperative complication was 5.9 (95% CI 0.51–59.6, p = .149). There were no differences in surgical outcomes between patients with or without an unanticipated admission to the intensive care unit.ConclusionOur study demonstrates that although anesthesia‐related intraoperative complications during posterior fossa decompression are infrequent, they are associated with an increased risk of an unanticipated admission to the intensive care unit.
Early post‐liver transplant thrombocytopenia in children: Clinical characteristics and significance
Authors: Tal Noa , Waisbourd‐Zinman Orith , Kaplan Eytan , Kadmon Gili , Gendler Yulia , Gurevich Michael , Nahum Elhanan , Weissbach Avichai 
Published: May 2022

AbstractBackgroundPost‐liver transplant thrombocytopenia is common and associated with worse outcome in adults. In children, however, the prevalence, course, and significance of post‐liver transplantation thrombocytopenia are not described. Therefore, we aimed to assess this phenomenon in children.MethodsA retrospective chart review of children who underwent liver transplantation at a single tertiary center between 2004 and 2021.ResultsOverall, 130 pediatric liver transplantations were reviewed. During the first 28 POD, thrombocytopenia was evident in 116 (89%, 95% CI 83%–94%). The median nadir platelet count was 54 K/μl (IQR: 37–99). Nadir platelet count was reached in half the patients by the third POD (IQR: 1–6). In multivariate analysis, preoperative platelet count (p = .024), volume of intraoperative packed cell transfusion (p = .045), and hypersplenism (p = .007) were associated with lower postoperative platelet counts. Patients with platelet count lower than the 50th centile on the first POD suffered from a more complicated course leading to a longer PICU admission (p = .039).ConclusionsEarly post‐liver transplant thrombocytopenia appears to be common in children and associated with preoperative thrombocytopenia, hypersplenism, and higher intraoperative blood transfusion volumes. A low first POD platelet count (<86 K/μl) was found to be independently associated with a more complicated postoperative course, suggesting the need for heightened surveillance.
The erosion of the administrative state under President Trump: Citizens' pushback against individual and institutional racism
Authors: Wright James E. , Thomas Michael Blair 
Published: May 2022

AbstractPresident Trump encouraged bad state actors within the administrative state to contribute to inequities for civilians. We highlight how Trump's actions and rhetoric led to increased individual, institutional, and systemic racism and violence. As a response to this increased violence and rhetoric, we discuss the role civilians (including professional athletes) played in engaging in protests and the 2020 election. Given that more individuals voted in that election cycle, we emphasize the importance for public administration to adapt, evolve, and engage with new actors concerned with administrative action or inaction.
Long‐term effects of chemotherapy and radiation received during early childhood on the developing dentition of pediatric cancer patients
Authors: Rahul Morankar , Atif Mohammad , Ganguly Shuvadeep , Pushpam Deepam , Tewari Nitesh , Mathur Vijay , Bakhshi Sameer 
Published: May 2022

AbstractIntroductionThe short‐term effects of chemotherapy and irradiation are well documented; however, there is paucity regarding their long‐term effects, especially in children and adolescents.Case DescriptionThis paper discusses the long‐term effects of chemotherapy and/or radiation received by the patients during their early childhood on the developing dentition. It comprises the compilation of 11 cases with alteration in the dental development screened from 138 cases of the childhood cancer patients who received the chemotherapy and/or radiation as a part of anticancer therapy.Results and ConclusionThe findings revealed that the age of initiation of anticancer therapy along with the synergistic effect of chemo‐irradiation, and the dose of radiation used were the principal determinants for the dental abnormalities. The root‐related abnormalities were found to be varied and more common as compared to the missing teeth and defects related to the tooth crown.
Defining upstream enhancing and inhibiting sequence patterns for plant peroxisome targeting signal type 1 using large‐scale in silico and in vivo analyses
Authors: Deng Qianwen , Li He , Feng Yanlei , Xu Ruonan , Li Weiran , Zhu Rui , Akhter Delara , Shen Xingxing , Hu Jianping , Jiang Hangjin , Pan Ronghui 
Published: May 2022

SUMMARYPeroxisomes are universal eukaryotic organelles essential to plants and animals. Most peroxisomal matrix proteins carry peroxisome targeting signal type 1 (PTS1), a C‐terminal tripeptide. Studies from various kingdoms have revealed influences from sequence upstream of the tripeptide on peroxisome targeting, supporting the view that positive charges in the upstream region are the major enhancing elements. However, a systematic approach to better define the upstream elements influencing PTS1 targeting capability is needed. Here, we used protein sequences from 177 plant genomes to perform large‐scale and in‐depth analysis of the PTS1 domain, which includes the PTS1 tripeptide and upstream sequence elements. We identified and verified 12 low‐frequency PTS1 tripeptides and revealed upstream enhancing and inhibiting sequence patterns for peroxisome targeting, which were subsequently validated in vivo. Follow‐up analysis revealed that nonpolar and acidic residues have relatively strong enhancing and inhibiting effects, respectively, on peroxisome targeting. However, in contrast to the previous understanding, positive charges alone do not show the anticipated enhancing effect and that both the position and property of the residues within these patterns are important for peroxisome targeting. We further demonstrated that the three residues immediately upstream of the tripeptide are the core influencers, with a ‘basic‐nonpolar‐basic’ pattern serving as a strong and universal enhancing pattern for peroxisome targeting. These findings have significantly advanced our knowledge of the PTS1 domain in plants and likely other eukaryotic species as well. The principles and strategies employed in the present study may also be applied to deciphering auxiliary targeting signals for other organelles.
First multigene phylogeny of Cumacea (crustacea: Peracarida)
Authors: Gerken Sarah , Meland Kenneth , Glenner Henrik 
Published: May 2022

AbstractCumaceans are small peracarid crustaceans that can be remarkably diverse and important benthic organisms. Despite their ubiquitous presence in soft sediments, no well‐resolved phylogeny currently exists, which impedes ecological and evolutionary studies of the group. We present a phylogeny based on Bayesian inference of six markers (18S, 28S, 12S, 16S, CytB and COI), which recovers monophyly of the order, a deep split between telson and pleotelson bearing groups, and monophyly of four of the seven included families, including monophyletic Pseudocumatidae, Lampropidae, Bodotriidae and Nannastacidae. The only species representing the family Gynodiastylidae in our dataset was positioned among members of Diastylidae in the phylogenetic analyses. However, this result is based on a single partial COI sequence; thus, we consider it doubtful, and the family Diastylidae are otherwise recovered as a monophyletic family. The family Leuconidae is split into two well‐supported clades, a clade containing Antarctic members of the genus Leucon and a separate clade containing non‐Antarctic members of the genera Leucon and Eudorella. The phylogeny is a great stride forwards, as it supports most families as monophyletic, making generic level phylogenies a plausible endeavour in the future.
Reinforcement Learning-Based Sequential Batch-Sampling for Bayesian Optimal Experimental Design
Authors: Ashenafi Yonatan , Pandita Piyush , Ghosh Sayan 
Published: May 2022

AbstractEngineering problems that are modeled using sophisticated mathematical methods or are characterized by expensive-to-conduct tests or experiments are encumbered with limited budget or finite computational resources. Moreover, practical scenarios in the industry, impose restrictions, based on logistics and preference, on the manner in which the experiments can be conducted. For example, material supply may enable only a handful of experiments in a single-shot or in the case of computational models one may face significant wait-time based on shared computational resources. In such scenarios, one usually resorts to performing experiments in a manner that allows for maximizing one’s state-of-knowledge while satisfying the above-mentioned practical constraints. Sequential design of experiments (SDOE) is a popular suite of methods that have yielded promising results in recent years across different engineering and practical problems. A common strategy that leverages Bayesian formalism is the Bayesian SDOE, which usually works best in the one-step-ahead or myopic scenario of selecting a single experiment at each step of a sequence of experiments. In this work, we aim to extend the SDOE strategy, to query the experiment or computer code at a batch of inputs. To this end, we leverage deep reinforcement learning (RL)-based policy gradient methods, to propose batches of queries that are selected taking into account the entire budget in hand. The algorithm retains the sequential nature, inherent in the SDOE while incorporating elements of reward based on task from the domain of deep RL. A unique capability of the proposed methodology is its ability to be applied to multiple tasks, for example, optimization of a function, once its trained. We demonstrate the performance of the proposed algorithm on a synthetic problem and a challenging high-dimensional engineering problem.
High-Resolution Thermal Profiling of a Combustor in a Non-Dedicated Test Using Thermal History Coatings
Authors: Peral David , Zaid Ahmed , Benninghoven Christoph , Araguás-Rodríguez Silvia , Kluß David , Karagiannopoulos Solon , Krewinkel Robert , Feist Jörg P. 
Published: May 2022

Abstract
The requirement for reduced emissions and the growing demand for gas turbine efficiency are in part met through increasing firing temperatures. However, development budgets leave only limited time for dedicated thermal testing. Consequently, manufacturers are seeking novel temperature measurement technologies to validate new engine designs. This paper will demonstrate how a new temperature mapping technology can be utilized for non-dedicated (multi-cycling) testing while still delivering high-resolution temperature data in a non-dedicated test on a combustor of an industrial gas turbine. Typically, thermocouples are used to monitor the temperature during tests, but they only provide one data point. Color-changing thermal paints are used to deliver measurements over complete surfaces, but they require dedicated testing with short-duration exposure, necessitating dismantling and re-assembling the engine for further testing. Thermal History Coatings (THC) present an alternative solution to providing high-density temperature information. This coating permanently changes consistent with the maximum temperature of exposure during the test. A laser-based instrumentation technique is then used to obtain temperatures. The maximum temperature profile of the surface can be determined through a customized calibration. Given the complex cooling system of a combustor, the high temperatures, and the long-time exposure, this case offers a unique possibility for the testing of the coating under real engine conditions. The coated region covered the external surface of the can. Highly significant is the number of measurement points above 7000 (2 × 2 mm resolution), which enables advanced analysis. This provides insight into the impact of local features, e.g., the region adjacent to a cooling hole. The temperature profile is compared to a computational fluid dynamics-conjugate heat transfer model and thermocouple measurements for the calibration of cooling pre-design methods.
Vestibular and balance dysfunction in children with congenital CMV: a systematic review
Authors: Shears Annalie , Yan Georgina , Mortimer Harriet , Cross Elizabeth , Sapuan Shari , Kadambari Seilesh , Luck Suzanne , Heath Paul T , Walter Simone , Fidler Katy J 
Published: May 2022

ObjectiveThis systematic review evaluates vestibular and balance dysfunction in children with congenital cytomegalovirus (cCMV), makes recommendations for clinical practice and informs future research priorities.DesignMEDLINE, Embase, EMCARE, BMJ Best Practice, Cochrane Library, DynaMed Plus and UpToDate were searched from inception to 20 March 2021 and graded according to Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria.PatientsChildren with cCMV diagnosed within 3 weeks of life from either blood, saliva and/or urine (using either PCR or culture).InterventionStudies of vestibular function and/or balance assessments.Main outcome measuresVestibular function and balance.Results1371 studies were identified, and subsequently 16 observational studies were eligible for analysis, leading to an overall cohort of 600 children with cCMV. All studies were of low/moderate quality. In 12/16 studies, vestibular function tests were performed. 10/12 reported vestibular dysfunction in ≥40% of children with cCMV. Three studies compared outcomes for children with symptomatic or asymptomatic cCMV at birth; vestibular dysfunction was more frequently reported in children with symptomatic (22%–60%), than asymptomatic cCMV (0%–12.5%). Two studies found that vestibular function deteriorated over time: one in children (mean age 7.2 months) over 10 months and the other (mean age 34.7 months) over 26 months.ConclusionsVestibular dysfunction is found in children with symptomatic and asymptomatic cCMV and in those with and without hearing loss. Audiovestibular assessments should be performed as part of neurodevelopmental follow-up in children with cCMV. Case–controlled longitudinal studies are required to more precisely characterise vestibular dysfunction and help determine the efficacy of early supportive interventions.PROSPERO registrationCRD42019131656.
Short-course intravenous antibiotics for young infants with urinary tract infection
Authors: Lawrence Jolie , Pittet Laure F , Hikmat Samar , Silvester Eloise J , Clifford Vanessa , Hunt Rodney , Gwee Amanda 
Published: May 2022

ObjectiveShorter courses of intravenous antibiotics for young infants with urinary tract infection (UTI) have myriad advantages. As practice shifts toward shorter intravenous treatment courses, this study aimed to determine the safety of early intravenous-to-oral antibiotic switch and identify risk factors for bacteraemia with UTI.MethodsRetrospective audit of infants aged ≤90 days with a positive urine culture at a quaternary paediatric hospital over 4 years (2016–2020). Data were collected from the hospital electronic medical record and laboratory information system. Short-course intravenous antibiotic duration was defined as <48 hours for non-bacteraemic UTI and <7 days for bacteraemic UTI. Multivariate analysis was used to determine patient factors predicting bacteraemia.ResultsAmong 427 infants with non-bacteraemic UTI, 257 (60.2%) were treated for <48 hours. Clinicians prescribed shorter intravenous courses to infants who were female, aged >30 days, afebrile and those without bacteraemia or cerebrospinal fluid pleocytosis. Treatment failure (30-day UTI recurrence) occurred in 6/451 (1.3%) infants. All had non-bacteraemic UTI and one received <48 hours of intravenous antibiotics. None had serious complications (bacteraemia, meningitis, death). Follow-up audiology occurred in 21/31 (68%) infants with cerebrospinal fluid pleocytosis, and one had sensorineural hearing loss. Bacteraemia occurred in 24/451 (5.3%) infants, with 10 receiving <7 days intravenous antibiotics with no treatment failure. Fever and pyelonephritis were independent predictors of bacteraemia.ConclusionShort-course intravenous antibiotics for <48 hours for young infants with non-bacteraemic UTI should be considered, provided meningitis has been excluded. Treatment failure and serious complications were rare in young infants with UTI.
Changes in adolescents’ planned hospital care during the COVID-19 pandemic: analysis of linked administrative data
Authors: Mc Grath-Lone Louise , Etoori David , Gilbert Ruth , Harron Katie L , Woodman Jenny , Blackburn Ruth 
Published: May 2022

ObjectiveTo describe changes in planned hospital care during the pandemic for vulnerable adolescents receiving children’s social care (CSC) services or special educational needs (SEN) support, relative to their peers.DesignObservational cohort in the Education and Child Health Insights from Linked Data database (linked de-identified administrative health, education and social care records of all children in England).Study populationAll secondary school pupils in years 7–11 in academic year 2019/2020 (N=3 030 235).Main exposureReceiving SEN support or CSC services.Main outcomesChanges in outpatient attendances and planned hospital admissions during the first 9 months of the pandemic (23 March–31 December 2020), estimated by comparing predicted with observed numbers and rates per 1000 child-years.ResultsA fifth of pupils (20.5%) received some form of statutory support: 14.2% received SEN support only, 3.6% received CSC services only and 2.7% received both. Decreases in planned hospital care were greater for these vulnerable adolescents than their peers: −290 vs −225 per 1000 child-years for outpatient attendances and −36 vs −16 per 1000 child-years for planned admissions. Overall, 21% of adolescents who were vulnerable disproportionately bore 25% of the decrease in outpatient attendances and 37% of the decrease in planned hospital admissions. Vulnerable adolescents were less likely than their peers to have face-to-face outpatient care.ConclusionThese findings indicate that socially vulnerable groups of children have high health needs, which may need to be prioritised to ensure equitable provision, including for catch-up of planned care postpandemic.
Local nitroglycerin to facilitate peripheral arterial cannulation in children: systematic review and meta-analysis
Authors: Wagh Deepika , Pawale Dinesh , Tan Jason Khay Ghim , Rao Shripada C 
Published: May 2022

BackgroundNeonates and children admitted to intensive care units require peripheral arterial cannulation to monitor their blood pressures and for blood sampling, but many times it is unsuccessful.ObjectiveTo conduct a systematic review and meta-analysis to evaluate the efficacy and safety of local nitroglycerin (NTG) to facilitate peripheral artery cannulation in neonates and children.Review methodsPubMed, EMBASE, CINAHL, Emcare and Cochrane library were searched till August 2021. Grey literature was searched through Mednar. Data were extracted by two reviewers independently using a prespecified form and the risk of bias was assessed. Meta-analysis was conducted using a random-effects model. The I2statistic was used to quantify statistical heterogeneity. Certainty of evidence was assessed using the criteria of inconsistency, imprecision, indirectness, publication bias and size of effect as per the Grading of Recommendations, Assessment, Development and Evaluations (GRADE) guidelines.ResultsTwo randomised controlled trials (RCTs) were included in this meta-analysis (n=153). One was conducted in children 2–8 years of age and the other was in children <2 years. Both trials found increased success rates with the use of local NTG. Pooling of the two studies found that the first-attempt success rate was significantly higher in the NTG group (risk difference: 0.44, 95% CI 0.05 to 0.83; I2=89%). Overall procedure time was significantly lower in the NTG group (mean difference: −100.28 s, 95% CI −136.74 to –63.82; I2=0%). No major complications secondary to the use of NTG were noted. The GRADE of evidence was very low.ConclusionLocal NTG may be useful in facilitating peripheral arterial cannulation in children. Adequately powered RCTs are needed to confirm these findings.