bluuebunny/crossref_metadata_2025_split huggingface dataset:
#53 Morbidity and Mortality Associated with Respiratory Syncytial Virus (RSV) Among Pediatric Hematopoietic Cell (HCT) Recipients: Preliminary Results from a Multi-Site U.S. Study.
Authors: Ross Hailey S 
Published: June 2022

Abstract

Background
RSV is the most common lower respiratory tract infection (LRTI) among children. Serious adverse outcomes are more likely among immunocompromised patients, including progression to pneumonia, respiratory failure, and increased mortality rates. We present interim analysis results from a multi-site study to characterize morbidity and mortality associated with RSV infection among pediatric HCT patients.

Method
Pediatric (&lt; 18 years old at transplant) HCT recipients from 10 U.S. transplant centers part of the Pediatric Infectious Diseases Transplant Network (PIDTRAN) who underwent HCT between 2010 and 2019 and were RSV positive during pre-transplant conditioning or within 365 days of HCT were identified from medical records. Demographics, underlying condition, and clinical characteristics were abstracted and entered in an electronic REDCap survey. Descriptive statistics were used to characterize the clinical course and outcomes of RSV infection.

Results
In total, 108 HCT patients were eligible with 108 (96%) reporting 1 case of RSV within 365 days of transplant and 5 (4%) reported 2 episodes resulting in 113 RSV episodes included in the analysis. Approximately half (53.7%) were male, 53 (49.1%) were white/Caucasian, with a median age of 7 years at the time of RSV diagnosis. The majority only received 1 HCT (84%) prior to RSV diagnosis. The most common HCT was allogeneic type (77.8%), 63 (59%) received myeloablative conditioning, and 23 (22.3%) were t-cell depleted. Just over one third (38%) had received systemic steroids in the 2 weeks prior to RSV diagnosis. Among the 113 episodes, 3 (2.7%) received palivizumab and 34 (30%) received IVIG in the 4 weeks prior to RSV diagnosis. One fourth (25.6%) were hospitalized due to RSV and 13 (11.5%) were diagnosed with LRTI at presentation and 3 (2.7%) progressed to LRTI after initial diagnosis of a URTI. Fifteen (13.3%) received at least 4 hours of oxygen support each day (at least one day), including 2 (13.3%) requiring mechanical ventilation. A quarter (24.8%) were treated with ribavirin, 10 (9%) received IVIG, and 15 (13.4%) received palivizumab for treatment of RSV. Seven (6.3%) deaths related to RSV were reported.

Conclusion
Preliminary results from this continuing multi-site study demonstrate RSV is an ongoing concern among HCT recipients with 1 in 10 developing LRTI and a quarter requiring hospitalization. These data help our understanding of RSV infections in this population and inform future prospective study designs to better define RSV risk as well as help address optimal prophylaxis and treatment strategies for HCT recipients at risk for severe illness.
#25 The highly conserved stem-loop II RNA element (s2m) is critical for the lifecycle of astrovirus VA1 but is dispensable for SARS-CoV-2
Authors: Janowski Andrew B 
Published: June 2022

Abstract

Background
RNA viruses often contain important elements for the viral lifecycle in the untranslated regions (UTR) of the genome. The stem-loop II (s2m) element is a RNA structural motif in the 3’ UTR that is 39-43 nucleotides in length and is present in members of the Astroviridae, Caliciviridae, Picornaviridae, Reoviridae, and Coronaviridae viral families, including SARS coronavirus 1 and 2 (SARS-CoV-1 and -2). Despite the first description of this element twenty-five years ago, the functional significance of the s2m sequence to the viral lifecycle remains poorly understood. The conservation of the s2m in many viral genomes suggests some fitness benefit to viruses that maintain it.

Method
To test the significance of the s2m element, we developed reverse genetic systems for astrovirus VA1 (VA1) and SARS-CoV-2. For both viruses, we introduced deletions and mutations predicted to significantly disrupt the secondary structure of the s2m. Recombinant viruses were passaged and the infectious viral titer was measured. To evaluate the in vivo significance of the s2m, we used a hamster model of SARS-CoV-2 infection. Recombinant viruses were intranasally inoculated and viral RNA and infectious viral titers measured from the nasal washes and the lungs three and six days after infection. A clinical SARS-CoV-2 isolate containing a deletion of the s2m was also propagated and the viral titer measured in a multi-step growth curve.

Results
The s2m in VA1 was critical to the viral lifecycle as deletion of the s2m resulted in recombinant virus that could not be rescued and propagated. Introduction of one or two nucleotide mutations that disrupt predicted G-C binding pairs in the s2m element also resulted in recombinant virus that was not viable. Compensatory mutations that restored G-C base pairings in the s2m element supported recovery and propagation of the virus with similar viral titers compared to wild-type (WT) VA-1. In contrast, the s2m in SARS-CoV-2 was dispensable. SARS-CoV-2 genomes containing a deletion or mutation of the s2m could be rescued and propagated in cell culture and had similar viral titers compared to the WT SARS-CoV-2 in multi-step growth curves. In the hamster model, there was also no difference in the amount of viral RNA and infectious virus in the lung and nasal washes of infected animals. We also identified a clinical SARS-CoV-2 isolate that contained a deletion of the s2m and it showed no differences in the growth in a multi-step growth curve compared to a SARS-CoV-2 virus with an intact s2m.

Conclusion
The s2m is essential for the lifecycle of astrovirus VA1 but dispensable for SARS-CoV-2, suggesting differing functions of the s2m that is virus dependent. Future experiments will identify the mechanistic basis for the divergent role of the s2m in each viral lifecycle.
#31 Bloodstream Infections and Microbiology during Induction Chemotherapy over a Decade at a Community Pediatric Cancer Center
Authors: Vandenheuvel Julia 
Published: June 2022

Abstract

Background
Bloodstream infections (BSIs) remain a significant cause of morbidity and mortality in children with leukemia. They are at an increased risk of infectious complications secondary to intense chemotherapeutic regimens during induction resulting in prolonged and profound neutropenia. To our knowledge, there is limited literature regarding pathogens and antibiotic resistance from smaller institutions similar to ours. The primary objective of this review was to describe the microbiology of BSIs, and second to evaluate our rates of BSIs during induction chemotherapy as compared to larger institutions.

Method
Retrospective chart review of 82 eligible patients between the age of 1 and 21 years with newly diagnosed leukemia between May 1, 2010 and May 31, 2020. Patients who did not complete the entirety of induction chemotherapy at our hospital were excluded. A microbiologically documented infection was defined as a causative pathogen isolated from the blood in the setting of fever and/or neutropenia. Neutropenia was defined as an absolute neutrophil count (ANC) of less than 0.5x109 cells/L.

Results
Of the 82 patients, 12 (14.6%) patients had a BSI during induction chemotherapy. The most common organisms identified were Gram-positive cocci (75%), Gram-negative bacilli (16.6%), and Gram-negative cocci (8.3%). Methicillin-susceptible Staphylococcus aureus (MSSA) was the most frequently isolated organism (42%) overall. No methicillin-resistant Staphylococcus aureus (MRSA) was identified. Of the Gram-negative bacteria isolated, Escherichia coli (8%) and Pseudomonas aeruginosa (8%) were identified. No extended spectrum beta-lactamase (ESBL) or multi-drug resistant organisms were identified. No fungi were isolated.

Conclusion
The incidence of BSIs in children during induction chemotherapy at our institution is similar to what is reported from larger, academic centers. Gram-positive cocci comprise 75% of BSIs with no MRSA isolates in 10 years. Our antibiogram shows no resistant Gram-negative bacteria. This is in contrast to what is reported to larger pediatric cancer centers. Therefore, current empiric monotherapy with a fourth generation cephalosporin at the onset of febrile neutropenia remains adequate for our pediatric oncology patients.
#47 RESULTS OF AN EDUCATIONAL COMPONENT OF DECREASING TIME TO THERAPY (DoTT) IN PEDIATRIC CANCER PATIENTS WITH FEBRILE NEUTROPENIA IN PERU
Authors: Mendieta Ana Luisa 
Published: June 2022

Abstract

Background
In low-and middle-income countries, a limitation for optimal treatment of children with fever and neutropenia (FN) due to chemotherapy is the delay in administering the first dose of antibiotics. DoTT is a quality improvement project implemented in Peru and aligned to the WHO Global Initiative of Childhood Cancer. A component of DoTT is an educational intervention of health care providers to decrease the time to antibiotics (TTA) in pediatric patients presenting to the emergency room (ER) with FN.

Method
This study was performed at Hospital Nacional Edgardo Rebagliati, a tertiary care National Hospital in Lima. We defined TTA as the time elapsed between patient′s arrival to the ER and administering the first dose of an antibiotic. Patient Time to Arrival, PTA, is the time elapsed between onset of symptoms and arrival to the hospital. The intervention consisted of a synchronous and asynchronous educational course on managing FN in children with cancer. Trainees were attending pediatricians and pediatric residents. We compared the TTA between 22 patients admitted from October to November 2021 with fever and neutropenia (after educational intervention) and baseline data of 99 patients from 2020 January and 2021 August (before intervention).

Results
The median age considering the two groups was 5 years, 55 patients were female and 66 were male. 104/121 patients had leukemia, and 17/121 patients had solid malignant tumors. No patients required admission to ICU or died of sepsis in the pre-intervention group, in the post-intervention group one patient required admission to ICU and one patient died of sepsis. In the pre-intervention group (97 patients), the median TTA was 171 minutes (IQR: 102–293), and in the post-intervention group, the median TTA was 60 minutes (IQR: 35–73). Early results indicate a statistically significant decrease in the TTA (p=0.001). A long PTA was observed before intervention (median= 1483 minutes) which was decreased (median=1290 minutes) in the post-intervention group (p=0.06).

Conclusion
This study suggests the potential impact of the educational intervention in pediatric health care professionals in to decrease of TTA in pediatric patients with cancer and FN, which encourages the team to continue with the intervention in other health care providers in the emergency room. The PTA was very high in both groups and indicated the need for an additional intervention to improve these results.
#58 Establishment of an antibiogram in paediatric Oncology unit in National Cancer Institute - Sri Lanka Samanmalee Gunasekara 1, Upeka Rathnayaka 1, Deepika Vidanage 1 1 Department of Microbiology, National Cancer Institute, Sri Lanka
Authors: Gunasekara Samanmalee 
Published: June 2022

Abstract

Background
Bacterial infection is a dreaded complication in cancer patients worldwide. In low resources setting where supportive care facilities are less than ideal this takes on even more greater significance. In recent years, the emergence of antimicrobial resistance has become a significant problem worldwide and cancer patients are among those most affected. Treatment of infections due to MDR (Multi Drug Resistant) bacteria represents a clinical challenge since the therapeutic options are limited. It is important to monitor emerging trends of antibiotic resistance in an institution to support clinical decision making and infection control interventions.

Method
Microbiology Laboratory received 4302 aerobic blood cultures from paediatric Oncology unit between 1st January and 31st December 2020. Aerobic bacterial blood cultures were performed in BD BACTEC automated blood culture system. All positive blood cultures were sub cultured onto blood agar and MacConkey agar. Bacterial isolates were identified and antibiotic susceptibility was tested using VITEK 2 automated system. Patient’s data, bacterial identification and sensitivity results were entered and analyzed using WHONET software. An antibiogram was developed for Gram- negative and Gram- positive organisms using analysed data.

Results
Seventy two blood cultures grew Gram- negative organisms including Klebsiella pneumoniae, Acinetobacter baumannii, Escherichia coli, Pseudomonas aeruginosa and Burkholderia cepacia. Klebsiella pneumoniae was the predominant isolate, 47 %( n= 34) and only 21.2% of them were sensitive to meropenem. Twenty three blood cultures grew Gram- positive organisms including, Staphylococcus aureus, Coagulase negative staphylococci, and Streptococcus pneumonia. Staphylococcus aureus was the predominant isolate, 78 %( n=18) and 55% of them were MRSA (Methicillin Resistant Staphylococcus aureus).

Conclusion
Use of antibiogram could help in the selection of empirical choice of treatment in patients with sepsis due to neutropenia. Also the antibiogram shows high degree of antibiotic resistance among both Gram- negative and Gram- positive organisms. Therefore implementation of antibiotic stewardship program and infection control measures is the cornerstone for controlling the development and spread of these MDR pathogens in the paediatric unit. Limitations: This antibiogram was developed using only the bacterial isolates grew in the blood cultures due to financial constraints (high cost of the VITEK identification and sensitivity cards).
Robotic-assisted resection of pelvic mesorectum lipoma during the COVID-19 pandemic: a case report
Authors: Macchini Daniele , Perano Vittoria , Celoria Valentina , Bombardieri Emilio , Goletti Orlando 
Published: June 2022

Abstract
Mesorectal lipoma is a rare, usually asymptomatic tumor. The best treatment is R0 resection but the previous literature reports different approaches. Robotic surgery allows for an accurate intervention, with a faster postoperative course, less risk of infection and need for transfusions, a faster return to normal daily activities and the best esthetic result. We describe a case of a 43-year-old female with a large lipoma with dislocation of the vagina, rectum and distal sigmoid colon, potentially malignant, successfully treated by robotic excision, which was safe, effective and well tolerated by the patient.
Flood syndrome: a rare case of spontaneous rupture of umbilical hernia in a cirrhotic patient
Authors: Gorji Leva , Brown Jordan 
Published: June 2022

AbstractFlood syndrome is a rare and potentially fatal complication of long-standing ascites resulting from a spontaneous rupture of an umbilical hernia. We present the case of a 67-year-old male with a medical history of diastolic heart failure, cocaine abuse, hepatitis C and cirrhosis secondary to daily alcohol consumption who presented to the emergency department with spontaneous rupture of an umbilical hernia with continuous, perfuse drainage of ascites from a 3 cm hernia defect. In this case report, we highlight the successful temporizing and definitive management of flood syndrome, as the patient presented to and was temporized a community hospital and was subsequently transferred to a tertiary care center for definitive management.
RIP kinases and necroptosis in aging and aging-related diseases
Authors: Yang Yuanxin , Li Xingyan , Zhang Tao , Xu Daichao 
Published: June 2022

Abstract
Aging is a natural process that is characterized by chronic, low-grade inflammation, which represents the primary risk factor in the pathogenesis of a variety of diseases, i.e. aging-related diseases. RIP kinases, in particular RIPK1 and RIPK3, have emerged as master regulators of proinflammatory responses that act either by causing apoptosis and necroptosis or by directly regulating intracellular inflammatory signaling. While, RIPK1/3 and necroptosis are intimately linked to multiple human diseases, the relationship among RIPK1/3, necroptosis, and aging remains unclear. In this review, we discuss current evidence arguing for the involvement of RIPK1/3 and necroptosis in the progression of aging. In addition, we provide updated information and knowledge on the role of RIPK1/3 and necroptosis in aging-related diseases. Leveraging these new mechanistic insights in aging, we postulate how our improved understanding of RIPK1/3 and necroptosis in aging may support the development of therapeutics targeting RIPK1/3 and necroptosis for the modulation of aging and treatment of aging-related diseases.
Exploratory methods for relation discovery in archival data
Authors: Giagnolini Lucia , Daquino Marilena , Mambelli Francesca , Tomasi Francesca 
Published: June 2022

AbstractIn this article, we propose a holistic approach to discover relations in art historical communities and enrich historians’ biographies and archival descriptions with graph patterns relevant to art historiographic enquiry. We use exploratory data analysis to detect patterns, we select features, and we use them to evaluate classification models to predict new relations, to be recommended to archivists during the cataloguing phase. Results show that relations based on biographical information can be addressed with higher precision than relations based on research topics or institutional relations. Deterministic and a priori rules present better results than probabilistic methods.
The scatter in the galaxy–halo connection: a machine learning analysis
Authors: Stiskalek Richard , Bartlett Deaglan J , Desmond Harry , Anbajagane Dhayaa 
Published: June 2022

ABSTRACT
We apply machine learning (ML), a powerful method for uncovering complex correlations in high-dimensional data, to the galaxy–halo connection of cosmological hydrodynamical simulations. The mapping between galaxy and halo variables is stochastic in the absence of perfect information, but conventional ML models are deterministic and hence cannot capture its intrinsic scatter. To overcome this limitation, we design an ensemble of neural networks with a Gaussian loss function that predict probability distributions, allowing us to model statistical uncertainties in the galaxy–halo connection as well as its best-fitting trends. We extract a number of galaxy and halo variables from the Horizon-AGN and IllustrisTNG100-1 simulations and quantify the extent to which knowledge of some subset of one enables prediction of the other. This allows us to identify the key features of the galaxy–halo connection and investigate the origin of its scatter in various projections. We find that while halo properties beyond mass account for up to 50 per cent of the scatter in the halo-to-stellar mass relation, the prediction of stellar half-mass radius or total gas mass is not substantially improved by adding further halo properties. We also use these results to investigate semi-analytic models for galaxy size in the two simulations, finding that assumptions relating galaxy size to halo size or spin are not successful.
On the peculiar long-term orbital evolution of the eclipsing accreting millisecond X-ray pulsar SWIFT J1749.4 − 2807
Authors: Sanna A , Burderi L , Salvo T Di , Riggio A , Altamirano D , Marino A , Bult P , Strohmayer T E , Guillot S , Malacaria C , Ng M , Mancuso G , Mazzola S M , Albayati A C , Iaria R , Manca A , Deiosso N , Cabras C , Anitra A 
Published: June 2022

ABSTRACT
We present the pulsar timing analysis of the accreting millisecond X-ray pulsar SWIFT J1749.4 − 2807 monitored by NICER and XMM–Newton during its latest outburst after almost 11 yr of quiescence. From the coherent timing analysis of the pulse profiles, we updated the orbital ephemerides of the system. Large phase jumps of the fundamental frequency phase of the signal are visible during the outburst, consistent with what was observed during the previous outburst. Moreover, we report on the marginally significant evidence for non-zero eccentricity (e ≃ 4 × 10−5) obtained independently from the analysis of both the 2021 and 2010 outbursts and we discuss possible compatible scenarios. Long-term orbital evolution of SWIFT J1749.4 − 2807 suggests a fast expansion of both the NS projected semimajor axis (x), and the orbital period (Porb), at a rate of $\dot{x}\simeq 2.6\times 10^{-13}\, \text{lt-s}\, \text{s}^{-1}$ and $\dot{P}_{\rm orb}\simeq 4 \times 10^{-10}\, \text{s}\, \text{s}^{-1}$, respectively. SWIFT J1749.4 − 2807 is the only accreting millisecond X-ray pulsar, so far, from which the orbital period derivative has been directly measured from appreciable changes on the observed orbital period. Finally, no significant secular deceleration of the spin frequency of the compact object is detected, which allowed us to set a constraint on the magnetic field strength at the polar caps of BPC &lt; 1.3 × 108 G, in line with typical values reported for AMXPs.
Machine-guided exploration and calibration of astrophysical simulations
Authors: Oh Boon Kiat , An Hongjun , Shin Eun-jin , Kim Ji-hoon , Hong (홍 성 욱) Sungwook E 
Published: June 2022

ABSTRACT
We apply a novel method with machine learning to calibrate sub-grid models within numerical simulation codes to achieve convergence with observations and between different codes. It utilizes active learning and neural density estimators. The hyper parameters of the machine are calibrated with a well-defined projectile motion problem. Then, using a set of 22 cosmological zoom simulations, we tune the parameters of a popular star formation and feedback model within Enzo to match observations. The parameters that are adjusted include the star formation efficiency, coupling of thermal energy from stellar feedback, and volume into which the energy is deposited. This number translates to a factor of more than three improvements over manual calibration. Despite using fewer simulations, we obtain a better agreement to the observed baryon makeup of a Milky Way (MW)-sized halo. Switching to a different strategy, we improve the consistency of the recommended parameters from the machine. Given the success of the calibration, we then apply the technique to reconcile metal transport between grid-based and particle-based simulation codes using an isolated galaxy. It is an improvement over manual exploration while hinting at a less-known relation between the diffusion coefficient and the metal mass in the halo region. The exploration and calibration of the parameters of the sub-grid models with a machine learning approach is concluded to be versatile and directly applicable to different problems.