Search

Purpose: Phenomenology is a branch of philosophy that focuses on human lived experience. Illness including dental diseases can affect this living experience. Within the dental literature, there is very little reported on the use of phenomenology compared to other healthcare sciences. Hence, the aim was to review the literature and provide an overview of various applications of phenomenology in dental research. Methods: This study was a narrative review using literature in the last 10 years identified by web-based search on PubMed and Scopus using keywords. A total of 33 articles that were closely related to the field and application in dentistry were included. The methodology, main results, and future research recommendations, if applicable, were extracted and reviewed. Results: The authors in this study had identified several areas such as orofacial pain and pain control research, dental anxiety, dental education, oral healthcare perceptions and access, living with dental diseases and dental treatment experience in which the phenomenological method was used to gain an in-depth understanding of the topic. Conclusions: There are several advantages of using the phenomenological research method, such as the small sample size needed, the diverse and unique perspective that can be obtained and the ability to improve current understanding, especially from the first-person perspective. [ABSTRACT FROM AUTHOR]

Background: Postacute Covid‐19 patients commonly present with respiratory symptoms; however, a noninvasive imaging method for quantitative characterization of respiratory patterns is lacking. Purpose: To evaluate if quantitative characterization of respiratory pattern on free‐breathing higher temporal resolution MRI stratifies patients by cardiopulmonary symptom burden. Study Type: Prospective analysis of retrospectively acquired data. Subjects: A total of 37 postacute Covid‐19 patients (25 male; median [interquartile range (IQR)] age: 58 [42–64] years; median [IQR] days from acute infection: 335 [186–449]). Field Strength/Sequence: 0.55 T/two‐dimensional coronal true fast imaging with steady‐state free precession (trueFISP) at higher temporal resolution. Assessment: Patients were stratified into three groups based on presence of no (N = 11), 1 (N = 14), or ≥2 (N = 14) cardiopulmonary symptoms, assessed using a standardized symptom inventory within 1 month of MRI. An automated lung postprocessing workflow segmented each lung in each trueFISP image (temporal resolution 0.2 seconds) and respiratory curves were generated. Quantitative parameters were derived including tidal lung area, rates of inspiration and expiration, lung area coefficient of variability (CV), and respiratory incoherence (departure from sinusoidal pattern) were. Pulmonary function tests were recorded if within 1 month of MRI. Qualitative assessment of respiratory pattern and lung opacity was performed by three independent readers with 6, 9, and 23 years of experience. Statistical Tests: Analysis of variance to assess differences in demographic, clinical, and quantitative MRI parameters among groups; univariable analysis and multinomial logistic regression modeling to determine features predictive of patient symptom status; Akaike information criterion to compare the quality of regression models; Cohen and Fleiss kappa (κ) to quantify inter‐reader reliability. Two‐sided 5% significance level was used. Results: Tidal area and lung area CV were significantly higher in patients with two or more symptoms than in those with one or no symptoms (area: 15.4 cm2 vs. 12.9 cm2 vs. 12.8 cm2; CV: 0.072, 0.067, and 0.058). Respiratory incoherence was significantly higher in patients with two or more symptoms than in those with one or no symptoms (0.05 vs. 0.043 vs. 0.033). There were no significant differences in patient age (P = 0.19), sex (P = 0.88), lung opacity severity (P = 0.48), or pulmonary function tests (P = 0.35–0.97) among groups. Qualitative reader assessment did not distinguish between groups and showed slight inter‐reader agreement (κ = 0.05–0.11). Data Conclusion: Quantitative respiratory pattern measures derived from dynamic higher‐temporal resolution MRI have potential to stratify patients by symptom burden in a postacute Covid‐19 cohort. Level of Evidence: 3 Technical Efficacy: Stage 3 [ABSTRACT FROM AUTHOR]

Multi-competitor races often feature complicated within-race strategies that are difficult to capture when training data on race outcome level data. Models which do not account for race-level strategy may suffer from confounded inferences and predictions. We develop a generative model for multi-competitor races which explicitly models race-level effects like drafting and separates strategy from competitor ability. The model allows one to simulate full races from any real or created starting position opening new avenues for attributing value to within-race actions and performing counter-factual analyses. This methodology is sufficiently general to apply to any track based multi-competitor races where both tracking data is available and competitor movement is well described by simultaneous forward and lateral movements. We apply this methodology to one-mile horse races using frame-level tracking data provided by the New York Racing Association (NYRA) and the New York Thoroughbred Horsemen's Association (NYTHA) for the Big Data Derby 2022 Kaggle Competition. We demonstrate how this model can yield new inferences, such as the estimation of horse-specific speed profiles and examples of posterior predictive counterfactual simulations to answer questions of interest such as starting lane impacts on race outcomes. [ABSTRACT FROM AUTHOR]

An editorial is presented that discusses the significance of timely diagnosis and treatment for anti-factor H antibody-associated aHUS, highlighting the effectiveness of eculizumab and the need for standardization in anti-FH antibody testing. It notes that while some studies advocate for its use as a primary treatment, further multicenter research is necessary to refine management strategies and establish effective treatment protocols.

Background: Autopsy has been a gold standard in cases of antenatal detected anomalies or fetal demise. This helped clinicians in getting insights into the future management. In current times, ultrasound and genomic testing has become extremely powerful in further refining the etiological basis; however, fetal autopsy still has its role even now. Material and Methods: We have discussed the utility of fetal autopsy in current times by diving the cases in seven groups. Results: Case based discussions to discuss the utility of fetal autopsy. Conclusions: We suggest that fetal autopsy should be the standard of care in case of any abnormal fetal outcomes alongwith fetal genomic testing. Fetal autopsy is complementary to the ultrasound assessment and genomic investigations in reaching the final diagnosis and provides invaluable information regarding recurrence risk which may not be available when couple plans next pregnancy. [ABSTRACT FROM AUTHOR]

Purpose: The paper aims to provide a career perspective on self-employment (SE) by focusing on how engaging in SE shapes the career experiences of MBA graduates in a distinct cultural and institutional context. Design/methodology/approach: We thematically analyse interviews with 29 Indian MBA graduates (including 10 women) who have engaged in both SE and salaried employment, using the conservation of resources (COR) theory as the theoretical framework. Findings: Participants took up SE in a challenging institutional and cultural environment. Resources such as financial stability, social networks and family support enabled participants to pursue SE. Participants noted that the SE experience boosted their psychological resources, providing them with greater confidence, perseverance and self-awareness. Participants observed that SE had a negative impact on subjective career success (SCS) dimensions of financial success and positive work relationships but positively impacted other SCS dimensions such as entrepreneurship, learning and development, positive (social) impact and work–life balance (particularly for women). Research limitations/implications: Participants were highly educated with strong social networks from past work experience in a developing economy, so the transferability of the findings to other contexts may be limited. Practical implications: Individuals could benefit from considering a broader career canvas that includes SE as a career option. Policymakers should work towards removing institutional barriers and changing cultural perceptions towards SE. Originality/value: Our study is distinct in that it comprises participants who had engaged in both SE and salaried employment during their careers. Few studies have looked at the impact of one employment episode on another. We show that SE episodes can contribute to career sustainability by developing psychological resources. [ABSTRACT FROM AUTHOR]

Background: Lupus nephritis (LN) is a very severe manifestation of lupus. There is no consensus on which treatment goals should be achieved to protect kidney function in children with LN. Methods: We retrospectively analyzed trends of commonly used laboratory biomarkers of 428 patients (≤ 18 years old) with biopsy-proven LN class ≥ III. We compared data of patients who developed stable kidney remission from 6 to 24 months with those who did not. Results: Twenty-five percent of patients maintained kidney stable remission while 75% did not. More patients with stable kidney remission showed normal hemoglobin and erythrocyte sedimentation rate from 6 to 24 months compared to the group without stable kidney remission. eGFR ≥ 90 ml/min/1.73m2 at onset predicted the development of stable kidney remission (93.8%) compared to 64.7% in those without stable remission (P < 0.00001). At diagnosis, 5.9% and 20.2% of the patients showed no proteinuria in the group with and without stable kidney remission, respectively (P = 0.0001). dsDNA antibodies decreased from onset of treatment mainly during the first 3 months in all groups, but more than 50% of all patients in both groups never normalized after 6 months. Complement C3 and C4 increased mainly in the first 3 months in all patients without any significant difference. Conclusions: Normal eGFR and the absence of proteinuria at onset were predictors of stable kidney remission. Significantly more children showed normal levels of Hb and erythrocyte sedimentation rate (ESR) from 6 to 24 months in the group with stable kidney remission. [ABSTRACT FROM AUTHOR]

The correlational marker technique by Lindell and Whitney for controlling method variance by adding an unrelated variable in the study is gaining a rage of debate and demands analysis study. This article explores common method variance in HR analytics research made in the Indian context. The study makes a comparative study upon common method variance with three known techniques. In our study, we test the biases in the HR analytics data using Harman's single-factor test, the common latent factor technique and the comprehensive confirmatory factor analysis marker approach. Common method variance was tested through Analysis of Moment Structures, version 21.0, by adding an unrelated variable. This article explains the implementation and testing of a marker variable and its impact in comparison to other practices for bias testing. The article also discusses the importance of selecting a marker variable in the questionnaire while collecting data. [ABSTRACT FROM AUTHOR]

This article focuses on the Swedish context of upper and post-upper secondary education provided in two sectors, universities and the Swedish Folk High School. The article is centred on the analysis of the support services offered by fifty-five university and Swedish Folk High School institutional websites to individuals and groups designated as being 'peripheral'. Taking as a point of departure a 'practiced policies' theoretical position, the study focuses on the 'situated nature' of institutional policies, that is, how policies become operationalised in local institutional contexts. Of interest is the nature of expectations placed on participants in the provision of support, and the ways in which different target groups are conceptualised and categorised. The findings of this national scale mapping, that build on two ongoing projects concerning equity and social justice, are discussed in terms of fundamental dimensions of democracy that shape students' opportunities to access upper and post-upper secondary education.

Aim/Purpose: The aim of the study is to explore students' encounters with digital tools and how they account for their experiences of using digital tools within formal education. Background: While computers have a long history in educational settings, research indicates that digital tools function both as affordances and constraints, and that the role of digital tools in schools continues to be debated. Taking into consideration student perspectives can broaden the understanding of knowledge formation practices. Methodology: The study is part of a larger ethnographic project, focusing on agency at all levels with respect to digitalization in schools. The present exploratory study is built primarily on interviews with 31 secondary school students at five different schools (15 girls and 16 boys). The analytical framework was a Nexus Analysis, focusing on discourses in place. Contribution: The paper shows how digital tools are conceptualized as being formed by and fitted into the traditions and habits of the institution, rather than acting as a transformative force to change knowledge formation practices in schools. Findings: From the students' narrative accounts, the following key themes emerge: (1) Action in contexts, (2) Agency in contexts, and (3) Equality in contexts. The first deals with the use of digital tools in school and the interaction order as it is accounted for in the use of digital tools in schools. The second frames human agency with regards to usage of digital tools and how agency fluctuates in interaction. The third deals with the compensating role digital tools are supposed to play for students who are identified with special needs and for students with divergent backgrounds, especially socioeconomic standards. Recommendations for Practitioners: For teachers, the recommendation is to engage in dialogue with the stu-dents on how and when to use digital tools and the affordances and con-straints involved from a student's point of view. For school leaders, the recommendation is to review how organizational structures, culture, and processes hinder or support the development of new practices in digitalization processes. Recommendation for Researchers: The three key themes that emerged in this study emphasize the need to reflect upon how a panopticon view of contemporary classrooms can be challenged. Involving students in this work is recommended as a means to anchor ideas and results. Impact on Society: This study is part of a larger project at Jönköping University, focusing on agency at all levels with respect to digitalization in schools. The overall goal is to increase our understanding of how to improve digitalization and implementation processes in schools. Future Research: Future studies that address digital technologies in schools need to pay special attention to the interaction between students, teachers, and various kinds of tools to map the nature of the education process, with the aim of challenging the panopticon view of the classroom. Future studies need to focus upon processes themselves, rather than accounts of processes.

Plain English summary Developing medicines involves multiple stages, all essential for pharmaceutical companies. However, this approach is becoming increasingly costly and patients are rarely involved in defining treatment outcomes. Patient insight is important for everyone involved in medicinal development and required by authorities reviewing new treatments. To identify best practices, the difference (‘impact’) made by engaging with patients must be measured continuously throughout the treatment development process. Possible impact measures have been proposed (for example, the PARADIGM initiative), but problems remain. This study aimed to work with patients and adapt standard measuring approaches that can be used to provide ongoing insight into the impact of patient engagement activities for companies and patients. Researchers interviewed 13 patient organisation (PO) representatives to explore their experiences of impact measures. Thematic analysis was conducted, and data used to adapt 23 potential impact measures in collaboration with patients. This study identified that PO representatives view impact as being positive, tangible, and useful outcomes, achieving a deep sense of accomplishment and ownership for those patients and representatives involved. The authors created the term ‘value-impact’ to describe how patients perceive such achievements. Furthermore, measures should be adapted to: 1) include greater context such as descriptions, patients quotes and satisfaction; 2) capture patient influence; and 3) use language that is understandable for all parties. Examples and suggestions for engagement at different stages and revised impact measures are presented in this report. It is our hope that this study will encourage more frequent and effective use of patient engagement strategies as medicines are developed.

Abstract Background Pantothenate kinase (PANK) is the first and rate-controlling enzymatic step in the only pathway for cellular coenzyme A (CoA) biosynthesis. PANK-associated neurodegeneration (PKAN), formerly known as Hallervorden–Spatz disease, is a rare, life-threatening neurologic disorder that affects the CNS and arises from mutations in the human PANK2 gene. Pantazines, a class of small molecules containing the pantazine moiety, yield promising therapeutic effects in an animal model of brain CoA deficiency. A reliable technique to identify the neurometabolic effects of PANK dysfunction and to monitor therapeutic responses is needed. Methods We applied 1H magnetic resonance spectroscopy as a noninvasive technique to evaluate the therapeutic effects of the newly developed Pantazine BBP-671. Results 1H MRS reliably quantified changes in cerebral metabolites, including glutamate/glutamine, lactate, and N-acetyl aspartate in a neuronal Pank1 and Pank2 double-knockout (SynCre + Pank1,2 dKO) mouse model of brain CoA deficiency. The neuronal SynCre + Pank1,2 dKO mice had distinct decreases in Glx/tCr, NAA/tCr, and lactate/tCr ratios compared to the wildtype matched control mice that increased in response to BBP-671 treatment. Conclusions BBP-671 treatment completely restored glutamate/glutamine levels in the brains of the mouse model, suggesting that these metabolites are promising clinically translatable biomarkers for future therapeutic trials.

Introduction: Depression in elderly population is a serious public health concern but is often undetected and ignored as a medical problem, leading to poor quality of life. Aim and Objectives: The objectives of this study were to estimate the prevalence and degree of depression among the elderly population using a Geriatric Depression Scale (GDS-15) Short Form and to study some correlates associated with depression in them. Materials and Methods: A community-based cross-sectional study was conducted with a sample size of 100 elderly subjects using systematic random sampling technique. After getting informed consent, information was collected using GDS-15 Marathi version. Results: Of 100 respondents interviewed, 52 were 70 years and above and 54 were male. The prevalence of depression among the elderly was 84.0%. Sixteen (8 males and 8 females) were suffering from severe depression. Age, sex, death of spouse, education, occupation, and morbidity status were found to be significantly associated with depression. Conclusions: The prevalence of depression among the urban elderly was very high. By identifying risk factors for depression among the elderly population and screening them on time, we can go a long way in adding life to their years instead of years to life of the elderly.

Background and Aims: An efficient neonatal airway management is peculiarly challenging even in the most experienced hands. Considering the recent interest in assessing the performance of various video-laryngoscopes (VL) in pediatric cohort, the prospective randomized study was contemplated to stage a comparative evaluation of C-MAC with Miller laryngoscope for neonatal endotracheal intubation. Material and Methods: 150 neonates were randomized to undergo intubation with either the C-MAC VL (n = 75) or the Miller laryngoscope (n = 75) performed by an experienced anesthesiologist in a tertiary care perioperative setting. The percentage of glottic opening (POGO), time to best glottic view (TTBGV), time to intubation (TTI), number of attempts, optimal external laryngeal manipulation (OELM) employed, and the complications were assessed and compared between the two groups. Results: C-MAC group demonstrated a significantly higher POGO, compared to the Miller group (88 ± 26.7%;76.8 ± 32.1%, respectively, P = 0.022). TTBGV was significantly lower in the C-MAC (7.7 ± 0.1s) group as opposed to the Miller group (11.3 ± 1.1s). The C-MAC group displayed higher TTI values compared to the Miller group (25.4 ± 1.6s; 19.7 ± 1.2s, respectively, P < 0.01).The first-attempt intubation success rate and the number of attempts were comparable in both the groups. OELM was required in 24% of the patients in the Miller group as opposed to 10.7% in the C-MAC group (P = 0.031).Higher patient percentage in the C-MAC group required the need of stylet for assisting a successful intubation, although the difference between the two groups was not statistically significant. Conclusion: Despite an improved view of the glottis, the TTI was higher for C-MAC compared to direct laryngoscopy with a comparable first-attempt success rate in the two techniques.

Introduction: The structural characteristics of unilaterally impacted maxillary canines and adjacent teeth were compared to the nonimpacted side. Three-dimensional (3D) cone-beam computed tomography (CBCT) was used to analyze and evaluate the various parameters. The aim of this study was a quantitative comparison of teeth adjacent to buccally and palatally impacted maxillary canines. Methods: CBCT records of 40 patients with unilateral impacted maxillary canine were allocated to this study. The morphological characteristics of teeth on the impaction and non-impaction sides of the same patient were examined. 3D reconstructed CBCT images were assessed using the OnDemand 3D program. Results: The dependent samples t test was used for data analysis with a level of statistical significance of 0.05. There was a significant increase in the size of the maxillary canine crown and a decrease in the maxillary lateral incisor root dimensions on the impacted side. No significant difference was observed in the morphology of the maxillary first premolar on either side. Conclusion: The impacted canine showed greater size compared to the eruption side. The decrease in root dimensions of the lateral incisor on the impacted side may indicate the possibility of root resorption.

Background: Surgical site infections (SSIs) may be reduced by following SSI prevention measures. We assessed the SSI rate following caesarean section (CS) and gynaecologic surgery after implementing a simple SSI prevention bundle including preoperative bath and hair wash. Methods: The study was carried out in two hospitals in North India (Post Graduate Institute of Medical Education and Research [PGIMER] and Civil Hospital CH) from August 2018 to July 2019. The SSI rate during intervention period (9 months) was compared with baseline rate (3 months). Womens' knowledge about SSI was assessed preoperatively and after counselling, postoperatively. Results: The baseline SSI rate after CS (n = 165) was 11.1% at PGIMER and 8.5% at CH. After gynae surgery (n = 172), it was 13% at PGIMER and 11.5% at CH. During intervention, (CS = 585, gynae surgery = 503), SSI rate was reduced significantly at PGIMER (CS: 11.1% to 3.7%, P = 0.048; gynae surgery: 13% to 7.1%, P = 0.027), but not at CH (CS: 8.5% to 8.2%, P = 0.903; gynae surgery: 11.5% to 11.4%, P = 0.984). Three measures were followed more often at PGIMER than at CH: before CS, bath with hair-wash: 99.3% vs 78.5%, P = 0.00, hair-clipper vs razor: 100% vs 5.1%, P = 0.00 and antibiotic prophylaxis ≤120 min: 100% vs 92.4%, P = 0.00; and before gynae surgery, bath with hair-wash: 93.2% vs 71%, P = 0.00, hair-clipper vs razor: 93.6% vs 1.9%, P = 0.00 and antibiotic prophylaxis ≤120 min: 100% vs 80.8%, P = 0.00. Postoperatively, womens' knowledge about SSI prevention improved significantly at the two sites. Conclusion: The reduction in SSI at PGIMER was attributed to better compliance to SSI prevention measures listed above. Counselling women about simple SSI prevention method like preoperative bath with scalp hair wash increased their knowledge about these significantly.

Objectives: To evaluate if addition of an anti-anaerobic agent to standard drug-cefazolin for antimicrobial prophylaxis would further decrease postoperative infectious morbidity or not. This is relevant as most of the infections in gynecological surgeries are anaerobic but cefazolin does not protect against anaerobes. Materials and Methods: The study design was a parallel randomized controlled trial. Two hundred patients undergoing benign gynecological surgeries were divided into two groups of 100 each. Group A received 2 g cefazolin 30–60 min before incision and Group B received 2 g cefazolin 30–60 min and 1.6 g tinidazole 60–120 min before incision. The patients were followed for any infectious morbidity for 1 month postoperatively. The analysis was done separately for abdominal, laparoscopic, and vaginal surgeries. The analysis was also done for surgeries according to the wound category, i.e. clean and clean-contaminated. Results: The two groups were comparable for age and body mass index (BMI). The two groups were comparable for the factors affecting infectious morbidity such as duration of surgery, blood loss, blood transfusions, duration of hospital stay, and need for additional antibiotics. The postoperative infectious morbidity was analyzed in terms of fever, surgical site infection (SSI), and urinary tract infection (UTI). No patient in vaginal and laparoscopic groups suffered from infectious morbidity. In abdominal surgeries group, postoperative fever occurred in 6/74 (8.1%) and 11/74 patients (14.8%) in Groups A and B, respectively (P = 0.38). SSI occurred in 1/74 (1.3%) and 2/74 (2.7%) patients in Groups A and B, respectively (P = 1.0). UTI occurred in 5/74 patients (6.7%) and 2/74 patients (2.7%) in Groups A and B, respectively (P = 0.44). The data were also analyzed for infectious morbidity for clean and clean-contaminated wound categories, and the results were nonsignificant between both groups for each type of wound category (P > 0.05). Conclusion: Cefazolin alone is a sufficient antibiotic prophylaxis for benign gynecological procedures.

Background: Lower segment caesarean sections (LSCS) are commonly done under spinal anaesthesia. Although spinal anaesthetic techniques are relatively safe and associated with quick and uneventful recovery, post-operative pain is a major concern after effect of spinal anaesthesia weans off. Other than pain postoperative nausea and vomiting (PONV) is one of the important side effects of spinal anaesthesia. Steroids by virtue of their anti-inflammatory effect is expected to reduce pain consequent upon inflammation and many studies have shown their efficacy in reducing pain as well as PONV in post-operative patients. Aims and Objectives: Primary objective of the study was to evaluate efficacy of single-dose dexamethasone in reducing post-operative pain. The secondary objectives were to analyse effect of single-dose dexamethasone on hemodynamic stability as well as incidence of nausea and vomiting in patients undergoing LSCS under spinal anesthesia. Materials and Methods: This was a double-blind comparative study in which 60 patients undergoing LSCS under spinal anaesthesia were included on the basis of a predefined inclusion and exclusion criteria. Written informed consent was obtained from all patients. The patients were divided into two groups: Group D: 30 patients who received IV dexamethasone 8 mg (2 ml) intravenously just before giving spinal anesthesia. Group N: 30 patients who received Normal saline (2 ml) immediately before spinal anesthesia. In both groups, hemodynamic parameters, respiratory rate, severity of post-operative pain, and incidence of PONV was compared. P value less than 0.05 was taken as statistically significant. Results: Patients in Group D had significantly less severe post-operative pain (as assessed by the Visual analog scale) and incidence of PONV (P

Purpose of Review: Magnesium is an essential mineral for bone metabolism, but little is known about how magnesium intake alters fracture risk. We conducted a narrative review to better understand how magnesium intake, through supplementation, diet, or altering the concentration of dialysate magnesium, affects mineral bone disease and the risk of fracture in individuals across the spectrum of kidney disease. Sources of Information: Peer-reviewed clinical trials and observational studies. Methods: We searched for relevant articles in MEDLINE and EMBASE databases. The methodologic quality of clinical trials was assessed using a modified version of the Downs and Black criteria checklist. Key Findings: The role of magnesium intake in fracture prevention is unclear in both the general population and in patients receiving maintenance dialysis. In those with normal kidney function, 2 meta-analyses showed higher bone mineral density in those with higher dietary magnesium, whereas 1 systematic review showed no effect on fracture risk. In patients receiving maintenance hemodialysis or peritoneal dialysis, a higher concentration of dialysate magnesium is associated with a lower concentration of parathyroid hormone, but little is known about other bone-related outcomes. In 2 observational studies of patients receiving hemodialysis, a higher concentration of serum magnesium was associated with a lower risk of hip fracture. Limitations: This narrative review included only articles written in English. Observed effects of magnesium intake in the general population may not be applicable to those with chronic kidney disease particularly in those receiving dialysis.

BackgroundIn low and middle-income countries, reliable data on the epidemiology of childhood acute kidney injury (AKI) is lacking. The Global Snapshot, conducted by the ISN "0by25" AKI initiative, was a world-wide cross-sectional, observational study to evaluate AKI in hospitalized patients. Here we report the pediatric results of this study.Patients and methodsWe prospectively collected data on children who met the Kidney Disease Improving Global Outcomes AKI criteria during a 10-week window in late 2014. AKI risk factors, etiological factors, management and outcomes were recorded using standardized forms and protocols. Countries were classified according to their 2014 gross national income (GNI) per person into high-income countries (HIC), upper-middle income countries (UMIC) and low and low-middle income countries (LLMIC). Need for renal replacement therapy, mortality, and renal recovery were assessed 7 days after AKI diagnosis or at hospital discharge, whichever came first.Results92 centers from 41 countries collected data on 354 pediatric AKI patients; 53% of the children developed AKI while hospitalized and 47% in the community. The most common etiological factors for AKI differed across GNI categories as well as between patients with community-acquired vs. hospital-acquired AKI. Children from HIC were younger, and larger proportion of AKI in this group were due to post-surgical complications vs. other etiologies when compared to other income categories. In patients with hypotension as the cause of AKI, the adjusted risk of death was almost 10-fold higher compared to patients without hypotension as an etiological factor for AKI development. Mortality was similar within AKI stages in HIC and UMIC. In LLMIC, patients with the highest AKI level of severity had higher mortality than patients in higher income categories. Patients from LLMIC and UMIC had a 57-fold and 11 fold higher adjusted risk of death, respectively, compared to patients from HIC.ConclusionIn resource-limited countries, pediatric AKI-associated mortality is disproportionately higher when compared to high-resource areas, especially among patients with more severe AKI.