Oral Glucose-Lowering Agents vs Insulin for Gestational Diabetes: A Randomized Clinical Trial.

Importance: Metformin and glyburide monotherapy are used as alternatives to insulin in managing gestational diabetes. Whether a sequential strategy of these oral agents results in noninferior perinatal outcomes compared with insulin alone is unknown.

Objective: To test whether a treatment strategy of oral glucose-lowering agents is noninferior to insulin for prevention of large-for-gestational-age infants.

The clinical application of transcutaneous carbon dioxide monitoring during rigid bronchoscopy or microlaryngeal surgery in children.

Study Objective: During rigid bronchoscopies and microlaryngeal surgery (MLS) in children, there is currently no reliable method for managing ventilation strategies based on carbon dioxide (CO) levels. This study aimed to investigate the effects of the clinical implementation of transcutaneous CO (tcPCO) monitoring during rigid bronchoscopies or MLS.

Design: Prospective observational study.

Standard versus High Cardiopulmonary Bypass Flow Rate: A Randomized Controlled Subtrial Comparing Brain Injury Biomarker Release.

Objectives: To compare brain injury biomarker release levels between two different cardiopulmonary bypass (CPB) flow rates in elective cardiac surgery and to explore differences in postoperative delirium between groups and associations between age, sex, CPB time, oxygen levels, and near-infrared spectroscopy, and biomarker levels.

Design: A randomized controlled substudy trial SETTING: Sahlgrenska University Hospital, Sweden PARTICIPANTS: Forty patients undergoing elective cardiac surgery with CPB INTERVENTION: Patients were assigned at random to either a standard (2.4 L/min/m) or a high (2.

Sustainable energy solutions: Well retrofit analysis and emission reduction for a net-zero future in the Intermountain West, United States of America.

To achieve net-zero emissions by 2050, we need economic means of sequestering carbon dioxide (CO) and reducing greenhouse gas emissions (GHG). We analyze the sequestration potential of the Intermountain West (I-West) region, US, as a primary energy transition hub through analysis of wellbore retrofit potential and emission reduction in both fugitive gas abatement and flare gas. We selected the I-West region due to its abundant energy sources and oil and gas production legacy.

Bihormonal fully closed-loop system for the treatment of type 1 diabetes: a real-world multicentre, prospective, single-arm trial in the Netherlands.

Background: Management of insulin administration for intake of carbohydrates and physical activity can be burdensome for people with type 1 diabetes on hybrid closed-loop systems. Bihormonal fully closed-loop (FCL) systems could help reduce this burden. In this trial, we assessed the long-term performance and safety of a bihormonal FCL system.

Oxygenation during general anesthesia in pediatric patients: A retrospective observational study.

Study Objective: Protocols are used in intensive care and emergency settings to limit the use of oxygen. However, in pediatric anesthesiology, such protocols do not exist. This study aimed to investigate the administration of oxygen during pediatric general anesthesia and related these values to PaO, SpO and SaO.

Case report: Skin protective barrier cream interference in benzethonium chloride method for urine protein measurement in a 6-month-old girl.

This case report describes the positive interference of the commonly used skin protective barrier cream used together with urine collection bags on the benzethonium chloride method for urine protein measurements in a 6-month-old female baby, leading to falsely elevated results. The interference was identified by both artificially mixing urine samples with this cream and comparing the results obtained using the benzethonium chloride method with those obtained using the pyrogallol red method.

Levamisole Modulation of Podocytes' Actin Cytoskeleton in Nephrotic Syndrome.

Podocytes play a central role in glomerular diseases such as (idiopathic) nephrotic syndrome (iNS). Glucocorticoids are the gold standard therapy for iNS. Nevertheless, frequent relapses are common.

Efficient SARS-CoV-2 Surveillance during the Pandemic-Endemic Transition Using PCR-Based Genotyping Assays.

Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) variants of concern (VOC) pose an increased risk to public health due to higher transmissibility and/or immune escape. In this study, we assessed the performance of a custom TaqMan SARS-CoV-2 mutation panel consisting of 10 selected real-time PCR (RT-PCR) genotyping assays compared to whole-genome sequencing (WGS) for identification of 5 VOC circulating in The Netherlands. SARS-CoV-2 positive samples (N = 664), collected during routine PCR screening (15 ≤ ≤ 32) between May-July 2021 and December 2021-January 2022, were selected and analyzed using the RT-PCR genotyping assays.

Multi-population genome-wide association study implicates immune and non-immune factors in pediatric steroid-sensitive nephrotic syndrome.

Pediatric steroid-sensitive nephrotic syndrome (pSSNS) is the most common childhood glomerular disease. Previous genome-wide association studies (GWAS) identified a risk locus in the HLA Class II region and three additional independent risk loci. But the genetic architecture of pSSNS, and its genetically driven pathobiology, is largely unknown.

Rare Single Nucleotide and Copy Number Variants and the Etiology of Congenital Obstructive Uropathy: Implications for Genetic Diagnosis.

Significance Statement: Congenital obstructive uropathy (COU) is a prevalent human developmental defect with highly heterogeneous clinical presentations and outcomes. Genetics may refine diagnosis, prognosis, and treatment, but the genomic architecture of COU is largely unknown. Comprehensive genomic screening study of 733 cases with three distinct COU subphenotypes revealed disease etiology in 10.

Early Eculizumab Withdrawal in Patients With Atypical Hemolytic Uremic Syndrome in Native Kidneys Is Safe and Cost-Effective: Results of the CUREiHUS Study.

Introduction: The introduction of eculizumab has improved the outcome in patients with atypical hemolytic uremic syndrome (aHUS). The optimal treatment strategy is debated. Here, we report the results of the CUREiHUS study, a 4-year prospective, observational study monitoring unbiased eculizumab discontinuation in Dutch patients with aHUS after 3 months of therapy.

Circulating Permeability Factors in Focal Segmental Glomerulosclerosis: Detection.

Introduction: The recurrence of proteinuria after kidney transplantation in patients with focal segmental glomerulosclerosis (FSGS) is considered proof of the presence of circulating permeability factors (CPFs). The aim of this study is to demonstrate the presence of plasma CPFs using series of assays.

Methods: Podocytes and endothelial cells (glomerular microvascular endothelial cells [GMVECs]) were incubated with plasma from FSGS patients with presumed CPFs in relapse and remission and from steroid-resistant nephrotic syndrome (SRNS), steroid-sensitive nephrotic syndrome (SSNS), membranous nephropathy (MN), and healthy controls (hCtrls).

Uncovering risk factors for kidney injury in children with a solitary functioning kidney.

Children with a solitary functioning kidney (SFK) have an increased risk of kidney injury. The exact risk of and risk factors for kidney injury remain unknown, which impedes personalized care. Here, we recruited a nationwide multicenter cohort of 944 patients with SFK to get more insight into this by consenting patients born in 1993-2020 and diagnosed with congenital or acquired SFK before adulthood.

Identification and characterization of circulating immune complexes in IgA nephropathy.

The underlying pathology of immunoglobulin A (IgA) nephropathy (IgAN), the most common glomerulonephritis worldwide, is driven by the deposition of immune complexes containing galactose-deficient IgA1 [Tn(+)IgA1] in the glomerular mesangium. Here, we report that novel anti-Tn circulating immune complexes (anti-Tn CICs) contain predominantly IgM, representing large macromolecular complexes of ~1.2 megadaltons to several megadalton sizes together with Tn(+)IgA1 and some IgG.

A novel plating technique for Ideberg type 1 A glenoid fractures: a report of five patients.

Background: Glenoid rim fractures are uncommon and generally associated with high complication rates. The most common treatment techniques include screw or anchor fixation. Here, we introduce a new fixation method to treat Ideberg type 1 A fractures.

StrategyAtlas: Strategy Analysis for Machine Learning Interpretability.

Businesses in high-risk environments have been reluctant to adopt modern machine learning approaches due to their complex and uninterpretable nature. Most current solutions provide local, instance-level explanations, but this is insufficient for understanding the model as a whole. In this work, we show that strategy clusters (i.

The Role of Interactive Visualization in Fostering Trust in AI.

The increasing use of artificial intelligence (AI) technologies across application domains has prompted our society to pay closer attention to AI's trustworthiness, fairness, interpretability, and accountability. In order to foster trust in AI, it is important to consider the potential of interactive visualization, and how such visualizations help build trust in AI systems. This manifesto discusses the relevance of interactive visualizations and makes the following four claims: i) trust is not a technical problem, ii) trust is dynamic, iii) visualization cannot address all aspects of trust, and iv) visualization is crucial for human agency in AI.

Validation of a new combined transcutaneous tcPCO and tcPO sensor in children in the operating theater.

Background: Arterial blood gas analysis is the gold standard for monitoring of P CO and PaO during mechanical ventilation. However, continuous measurements would be preferred. Transcutaneous sensors continuously measure blood gases diffusing from the locally heated skin.

Long-term follow-up including extensive complement analysis of a pediatric C3 glomerulopathy cohort.

Background: C3 glomerulopathy (C3G) is a rare kidney disorder characterized by predominant glomerular depositions of complement C3. C3G can be subdivided into dense deposit disease (DDD) and C3 glomerulonephritis (C3GN). This study describes the long-term follow-up with extensive complement analysis of 29 Dutch children with C3G.

Clinical Management of Children with a Congenital Solitary Functioning Kidney: Overview and Recommendations.

Context: A congenital solitary functioning kidney (cSFK) is a common developmental defect that predisposes to hypertension and chronic kidney disease (CKD) as a consequence of hyperfiltration. Every urologist takes care of patients with a cSFK, since some will need lifelong urological care or will come with clinical problems or questions to an adult urologist later in life.

Objective: We aim to provide clear recommendations for the initial clinical management and follow-up of children with a cSFK.

Who wants 'the worst of the worst'? Rationales for and consequences of third country resettlement of Guantanamo Bay detainees.

Against the backdrop of countries increasingly being confronted with undesirable but unreturnable non-citizen terrorist suspects, this article describes the resettlement process of 150 cleared but unreturnable Guantanamo Bay detainees. Merely 13% of these detainees have been resettled in full democracies, compared to 52% in authoritarian regimes. Using Starkley et al.

Copy Number Variant Analysis and Genome-wide Association Study Identify Loci with Large Effect for Vesicoureteral Reflux.

Background: Vesicoureteral reflux (VUR) is a common, familial genitourinary disorder, and a major cause of pediatric urinary tract infection (UTI) and kidney failure. The genetic basis of VUR is not well understood.

Methods: A diagnostic analysis sought rare, pathogenic copy number variant (CNV) disorders among 1737 patients with VUR.

Practice variations in the management of childhood nephrotic syndrome in the Netherlands.

Nephrotic syndrome in childhood is a common entity in the field of pediatric nephrology. The optimal treatment of children with nephrotic syndrome is often debated. Previously conducted studies have shown significant variability in nephrotic syndrome management, especially in the choice of steroid-sparing drugs.