bluuebunny/crossref_metadata_2025_split huggingface dataset:
Opioid Consumption After Arthroscopic Meniscal Procedures and Anterior Cruciate Ligament Reconstruction
Authors: Lovecchio Francis , Premkumar Ajay , Uppstrom Tyler , Stepan Jeffrey , Ammerman Brittany , McCarthy Moira , Stein Beth Shubin , Pearle Andrew , Taylor Samuel , Kumar Kanuypria , Albert Todd , Hannafin Jo 
Published: April 2020

Background: Procedure-specific opioid-prescribing guidelines have the potential to decrease the number of unused pills in the home without compromising patient satisfaction. However, there is a paucity of data on the minimum necessary quantity to prescribe for outpatient orthopaedic surgeries. Purpose: To prospectively record daily opioid use and pain levels after arthroscopic meniscal procedures and anterior cruciate ligament reconstruction (ACLR) at a single institution. Study Design: Case series; Level of evidence, 4. Methods: A total of 95 adult patients who underwent primary arthroscopic knee surgery (meniscectomy, repair, or ACLR) were enrolled. Patients with a history of opioid dependence were ineligible. Daily opioid consumption and Numeric Rating Scale pain scores were collected through an automated text-messaging platform starting on postoperative day 1 (POD1). At 6 weeks or at patient-reported cessation of opioid use, final survey questions were asked. Patients who failed to complete data collection were excluded. Opioid use was converted into “pills” (oxycodone 5-mg equivalents) to facilitate comparisons and clinical applications. Factors associated with high and low opioid use were compared. Results: Of the 95 patients enrolled, 71 (74.7%) were included in the final analysis. Of these, 40 (56.3%) underwent meniscal surgery and 31 (43.7%) underwent ACLR. After outpatient arthroscopic meniscectomy or repair, the total median postdischarge opioid use was 0.3 pills (oxycodone 5-mg equivalents), with 75% of patients consuming 3.3 or fewer pills (range, 0-19 pills). For ACLR, the median postdischarge consumption was 7 pills (75th percentile, 23.3 pills; range, 0-41 pills). Almost one-third of patients (32.3%) took no opioids after surgery (3 ACLR, 20 meniscus). All meniscus patients and 71% of ACLR patients ceased opioid consumption by postoperative day 7. Conclusion: Opioids may not be necessary in all patients, particularly after meniscal surgery and in comparison with ACLR. For patients requesting opioids for pain relief, reasonable prescription quantities are 5 oxycodone 5-mg pills after arthroscopic meniscal procedures and 20 5-mg pills after ACLR. Slowing the current opioid epidemic and preventing future crises is dependent on refining prescribing habits. Clinicians should strongly consider patient education regarding expected pain as well as pain management strategies.
The impact of the DWI-FLAIR-mismatch in the ECASS-4 trial – A post hoc analysis
Authors: Pfaff Johannes AR , Bendszus Martin , Donnan Geoffrey , Molina Carlos , Leys Didier , Schellinger Peter D , Schwab Stefan , Toni Danilo , Wahlgren Nils , Hacke Werner , Ringleb Peter Arthur 
Published: April 2020

Introduction To investigate the impact of a mismatch between diffusion-weighted imaging (DWI) and fluid attenuated inversion recovery (FLAIR) on functional outcome in patients with acute stroke in a prolonged time window or unknown time of symptom onset randomized to intravenous thrombolysis or placebo. Patients and Methods We performed a post-hoc analysis of the European Cooperative Acute Stroke Study-4 (ECASS-4) trial. ECASS-4 was an investigator driven, phase 3, multi-center, double-blind, placebo-controlled study which randomized ischemic stroke patients presenting within 4.5 and 9h of stroke onset or unknown time-window to either rt-PA or placebo after MR-imaging. Two subgroups “no mismatch” (nMM) and “any mismatch” (aMM) were created by applying a DWI-FLAIR-mismatch criterion. We calculated frequency of nMM and aMM and performed a univariate analysis (Fisher's Test) for excellent clinical outcome (mRS 0-1) and mortality (mRS=6). Results MR-Imaging of n=111/119 (93.2%) patients was suitable for this analysis. DWI-FLAIR mismatch was found in 49 patients (44.1%). Proportions of mismatch nMM and aMM were comparable in treatment-groups (aMM: Placebo 46.3%, Alteplase 42.1%; p=0.70). Patients with nMM showed no benefit of rt-PA-treatment (OR (95%CI) mRS 0-1: 0.95 (0.29-3.17)). Patients with aMM showed a point estimate of the odds ratio in favour of a treatment benefit of rt-PA (mRS 0-1: OR (95%CI) 2.62 (0.68-11.1)). Mortality within 90 days was not different in patients treated with rt-PA if nMM (15.2%) or aMM (12.5%) was present. Discussion In this analysis no significant evidence, but subtle indication towards patients treated with rt-PA in a prolonged time window reaching an excellent clinical outcome if a DWI-FLAIR-mismatch is present on initial stroke MR-imaging. Conclusion A DWI-FLAIR mismatch in the region of ischemia as imaging based surrogate parameter for patient selection for i.v. rt-PA should be strongly pursued.
Online Pornography Seeking Behavior and Its Relation to Literacy Rate and Financial Status of Indian States
Authors: Mondal Shaikat , Mondal Himel 
Published: April 2020

Background: Pornography has become widely accessible due to the popularization of smartphones and internet connectivity. Consuming pornography has multiple effects on an individual and on society. Our research question was if pornography-seeking behavior has any correlation with education and financial status in Indian states. Objective: To find the online pornography-seeking behavior of Indian internet users according to states and find its correlation with the literacy level and per capita net state domestic product (NSDP). Methods: Trends of internet search about pornography-related keywords (namely, porn, XXX, Xvideos, and sex) were obtained from a public domain https://trends.google.com/trends . State-wise relative search volumes were compared with the literacy rate and NSDP of the state. Pearson correlation coefficients were calculated with the help of GraphPad Prism 6.01 (GraphPad Software, Inc., California, USA). A P < .05 was considered statistically significant. Results: Northeastern states showed a higher volume of overall online pornography searches. There was no significant correlation between the literacy rate and relative search volumes of pornography-related keywords. Overall pornography-related search volume showed a significant negative ( r = –0.49, P = .003) correlation with NSDP. Conclusion: Online pornography seeking behaviors in Indian states are not related to the literacy rate of the state. A higher volume of searches is from states with lower NSDP. The underlying factors for this finding should be explored in a future study.
Small for gestational age is a risk factor for thyroid dysfunction in preterm newborns
Authors: Liu Chunhua , Wang Kaiyan , Guo Jizhong , Chen Jiru , Chen Mei , Xie Zhexi , Chen Pu , Wu Beiyan , Lin Niyang 
Published: April 2020

Abstract
Background
Thyroid hormones play an important role in the normal growth and maturation of the central nervous system. However, few publications addressed the altered thyroid hormone levels in preterm small for gestational age (SGA) newborns. We hypothesized preterm SGA infants have higher thyroid-stimulating hormone (TSH) concentrations than appropriate for gestational age (AGA) ones within the normal range and an increased incidence of thyroid dysfunction.

Methods
The study was designed to compare thyroid hormone levels within the normal range and the incidence of thyroid dysfunction in the SGA and AGA groups to test the hypothesis. The medical records of all preterm infants admitted to the neonatal intensive care unit (NICU) at the First Affiliated Hospital of Shantou University Medical College, Shantou, China, between January 1, 2015 and December 31, 2018, were reviewed. Blood samples were collected between 72 and 96 h of life and analyzed with TSH, free thyroxine (FT4) and free triiodothyronine (FT3) assays. Thyroid function test (TFT) results, and neonatal demographic and clinical factors were analyzed to identify the associations between SGA birth and altered thyroid concentrations and thyroid dysfunction.

Results
TSH and FT4 concentrations were significantly higher in the SGA group than the AGA group ((3.74(interquartile range (IQR):2.28 ~ 6.18) vs. 3.01(IQR: 1.81 ~ 5.41) mU/L, p = 0.018), and (17.76 ± 3.94 vs. 17.42 ± 3.71 pmol/L, p = 0.371), respectively). The higher TSH levels were associated with being SGA or Z-score of birth weight (BW) for GA after adjusting for potential confounders ((βSGA = 0.68 (95% confidence interval (CI) 0.15 ~ 1.21), p = 0.013) or (βZ-score = − 0.25 (95%CI -0.48 ~ − 0.03), p = 0.028), respectively). However, we did not find a significant association between SGA birth and altered FT4 concentrations. Furthermore, compared with the AGA group, the SGA group presented an increased incidence of transient hypothyroxinemia with delayed TSH elevation (dTSHe), a higher percentage receiving levothyroxine (L-T4) therapy, and a higher rate of follow-up within the first 6 months of life.

Conclusions
Preterm SGA newborns had significantly higher TSH concentrations within the normal range and an increased incidence of thyroid dysfunction. The SGA newborns with these features should be closely followed up with periodical TFTs and endocrinologic evaluation.
Can mathematical modelling solve the current Covid-19 crisis?
Authors: Panovska-Griffiths Jasmina 
Published: April 2020

AbstractSince COVID-19 transmission started in late January, mathematical modelling has been at the forefront of shaping the decisions around different non-pharmaceutical interventions to confine its’ spread in the UK and worldwide. This Editorial discusses the importance of modelling in understanding Covid-19 spread, highlights different modelling approaches and suggests that while modelling is important, no one model can give all the answers.
Improvement of sabinene tolerance of Escherichia coli using adaptive laboratory evolution and omics technologies
Authors: Wu Tong , Liu Jinfeng , Li Meijie , Zhang Ge , Liu Lijuan , Li Xing , Men Xiao , Xian Mo , Zhang Haibo 
Published: April 2020

AbstractBackgroundBiosynthesis of sabinene, a bicyclic monoterpene, has been accomplished in engineered microorganisms by introducing heterologous pathways and using renewable sugar as a carbon source. However, the efficiency and titers of this method are limited by the low host tolerance to sabinene (in both eukaryotes and prokaryotes).ResultsIn this study,Escherichia coliBL21(DE3) was selected as the strain for adaptive laboratory evolution. The strain was evolved by serial passaging in the medium supplemented with gradually increasing concentration of sabinene, and the evolved strain XYF(DE3), which exhibited significant tolerance to sabinene, was obtained. Then, XYF(DE3) was used as the host for sabinene production and an 8.43-fold higher sabinene production was achieved compared with the parental BL21(DE3), reaching 191.76 mg/L. Whole genomes resequencing suggested the XYF(DE3) strain is a hypermutator. A comparative analysis of transcriptomes of XYF(DE3) and BL21(DE3) was carried out to reveal the mechanism underlying the improvement of sabinene tolerance, and 734 up-regulated genes and 857 down-regulated genes were identified. We further tested the roles of the identified genes in sabinene tolerance via reverse engineering. The results demonstrated that overexpressions ofybcKgene of the DLP12 family, the inner membrane protein geneygiZ, and the methylmalonyl-CoA mutase genescpAcould increase sabinene tolerance of BL21(DE3) by 127.7%, 71.1%, and 75.4%, respectively. Furthermore, scanning electron microscopy was applied to monitor cell morphology. Under sabinene stress, the parental BL21(DE3) showed increased cell length, whereas XYF(DE3) showed normal cell morphology. In addition, overexpression ofybcK,ygiZorscpAcould partially rescue cell morphology under sabinene stress and overexpression ofygiZorscpAcould increase sabinene production in BL21(DE3).ConclusionsThis study not only obtained a sabinene-tolerant strain for microbial production of sabinene but also revealed potential regulatory mechanisms that are important for sabinene tolerance. In addition, for the first time,ybcK, ygiZ, andscpAwere identified to be important for terpene tolerance inE. coliBL21(DE3).
Enhanced rhamnolipids production using a novel bioreactor system based on integrated foam-control and repeated fed-batch fermentation strategy
Authors: Xu Ning , Liu Shixun , Xu Lijie , Zhou Jie , Xin Fengxue , Zhang Wenming , Qian Xiujuan , Li Min , Dong Weiliang , Jiang Min 
Published: April 2020

Abstract
Background
Rhamnolipids are the best known microbial-derived biosurfactants, which has attracted great interest as potential ‘‘green” alternative for synthetic surfactants. However, rhamnolipids are the major contributors to severe foam problems, which greatly inhibit the economics of industrial-scale production. In this study, a novel foam-control system was established for ex situ dealing with the massive overflowing foam. Based on the designed facility, foam reduction efficiency, rhamnolipids production by batch and repeated fed-batch fermentation were comprehensively investigated.

Results
An ex situ foam-control system was developed to control the massive overflowing foam and improve rhamnolipids production. It was found that the size of individual bubble in the early stage was much larger than that of late fermentation stage. The foam liquefaction efficiency decreased from 54.37% at the beginning to only 9.23% at the end of the fermentation. This difference of bubble stability directly resulted in higher foam reduction efficiency of 67.46% in the early stage, whereas the small uniform bubbles can only be reduced by 57.53% at the later fermentation stage. Moreover, reduction of secondary foam is very important for foam controlling. Two improved designs of the device in this study obtained about 20% improvement of foam reduction efficiency, respectively. The batch fermentation result showed that the average volume of the overflowing foam was reduced from 58–640 to 19–216 mL/min during the fermentation process, presenting a notable reduction efficiency ranging from 51.92 to 73.47%. Meanwhile, rhamnolipids production of batch fermentation reached 45.63 g/L, and the yield 0.76 g/g was significantly better than ever reported. Further, a repeated fed-batch fermentation based on the overall optimization was carried out. Total rhamnolipids concentration reached 48.67 g/L with the yield around of 0.67–0.83 g/g, which presented an improvement of 62% and 49% compared with conventional batch fermentation by using various kinds of defoamers, respectively.

Conclusions
The ex situ foam-control system presented a notable reduction efficiency, which helped greatly to easily solve the severe foaming problem without any defoamer addition. Moreover, rhamnolipids production and yield by repeated fed-batch fermentation obtained prominent improvement compared to conventional batch cultivation, which can further facilitate economical rhamnolipids production at large scales.
Higher efficacy of rupatadine 20 mg and 10 mg versus placebo in patients with perennial allergic rhinitis: a pooled responder analysis
Authors: Valero Antonio , Izquierdo Iñaki , Kowalski Marek L. , Scadding Glenis K. , Bousquet Jean , Mullol Joaquim 
Published: April 2020

Abstract
Background
The clinical efficacy of rupatadine in terms of responders has not been previously explored in perennial allergic rhinitis (PAR).

Methods
This pooled analysis included data from 6 randomised, double-blind, placebo-controlled trials conducted in PAR patients treated with rupatadine 10 mg or 20 mg, or placebo. Participants were aged ≥ 18 years, with diagnosis of PAR and a Total 4 Nasal Symptom Score (T4NSS) ≥ 5. We evaluated the T4NSS and Total 5 Symptom Score (T5SS) for 28 days of treatment, the responder proportion (50% and 75% response), and the time to response.

Results
Efficacy data from 1486 patients were analysed: 585 received placebo, 682 rupatadine 10 mg, and 219 rupatadine 20 mg. Compared with placebo, rupatadine promoted greater symptom improvements and higher responder proportions (50% and 75% response) for T4NSS and T5SS over 28 days. Symptom improvements and responder proportions were higher in the rupatadine 20 mg group vs the 10 mg group. The time to response was shorter in the rupatadine 20 mg group vs the 10 mg group for T4NSS (16 and 9 days for the 50% and 75% responses, respectively) and for T5SS (13 and 8 days for the 50% and 75% responses, respectively).

Conclusions
Rupatadine was efficacious in reducing allergic rhinitis symptoms, showing high responder proportions. The faster and stronger effect of rupatadine 20 mg may suggest its use in patients with severe PAR or not responding to the standard dose.
The impact of social, national and community-based health insurance on health care utilization for mental, neurological and substance-use disorders in low- and middle-income countries: a systematic review
Authors: Docrat Sumaiyah , Besada Donela , Cleary Susan , Lund Crick 
Published: April 2020

Abstract
Background
Whilst several systematic reviews conducted in Low- and Middle-Income Countries (LMICs) have revealed that coverage under social (SHI), national (NHI) and community-based (CBHI) health insurance has led to increased utilization of health care services, it remains unknown whether, and what aspects of, these shifts in financing result in improvements to mental health care utilization. The main aim of this review was to examine the impact of SHI, NHI and CBHI enrollment on mental health care utilization in LMICs.

Methods
Systematic searches were performed in nine databases of peer-reviewed journal articles: Pubmed, Scopus, SciELO via Web of Science, Africa Wide, CINAHL, PsychInfo, Academic Search Premier, Health Source Nursing Academic and EconLit for studies published before October 2018. The quality of the studies was assessed using the Effective Public Health Practice Project quality assessment tool for quantitative studies. The systematic review was reported according to the PRISMA guidelines (PROSPERO;2018; CRD42018111576).

Results
Eighteen studies were included in the review. Despite some heterogeneity across countries, the results demonstrated that enrollment in SHI, CBHI and NHI schemes increased utilization of mental health care. This was consistent for the length of inpatient admissions, number of hospitalizations, outpatient use of rehabilitation services, having ever received treatment for diagnosed schizophrenia and depression, compliance with drug therapies and the prescriptions of more favorable medications and therapies, when compared to the uninsured. The majority of included studies did not describe the insurance schemes and their organizational details at length, with limited discussion of the links between these features and the outcomes. Given the complexity of mental health service utilization in these diverse contexts, it was difficult to draw overall judgements on whether the impact of insurance enrollment was positive or negative for mental health care outcomes.

Conclusions
Studies that explore the impact of SHI, NHI and CBHI enrollment on mental health care utilization are limited both in number and scope. Despite the fact that many LMICs have been hailed for financing reforms towards universal health coverage, evidence on the positive impact of the reforms on mental health care utilization is only available for a small sub-set of these countries.
Exploration of isoxanthohumol bioconversion from spent hops into 8-prenylnaringenin using resting cells of Eubacterium limosum
Authors: Moens Esther , Bolca Selin , Van de Wiele Tom , Van Landschoot Anita , Goeman Jan L. , Possemiers Sam , Verstraete Willy 
Published: April 2020

AbstractHops is an almost unique source of the potent phytoestrogen 8-prenylnaringenin (8-PN). As hops contain only low levels of 8-PN, synthesis may be more attractive than extraction. A strain of the Gram-positive Eubacterium limosum was isolated previously for 8-PN production from more abundant precursor isoxanthohumol (IX) from hops. In this study, spent hops, an industrial side stream from the beer industry, was identified as interesting source of IX. Yet, hop-derived compounds are well-known antibacterial agents and the traces of a large variety of different compounds in spent hops interfered with growth and IX conversion. Critical factors to finally enable bacterial 8-PN production from spent hops, using a food and feed grade medium, were evaluated in this research. The use of bacterial resting cells and complex medium at a pH of 7.8–8 best fulfilled the requirements for 8-PN production and generated a solid basis for development of an economic process.
Synthesis, characterization and assessment of anti-quorum sensing activity of copper(II)-ciprofloxacin complex against Pseudomonas aeruginosa PAO1
Authors: Rafiee Farzaneh , Haghi Fakhri , Bikas Rahman , Heidari Azam , Gholami Mina , Kozakiewicz Anna , Zeighami Habib 
Published: April 2020

AbstractQuorum sensing (QS) inhibition by metal-antibiotic complexes is a promising strategy for the management and control of multidrug resistant Pseudomonas aeruginosa infections. We investigated the anti-quorum sensing activity of sub-minimum inhibitory concentration (sub-MIC) of copper(II) sulfate pentahydrate-ciprofloxacin (Cu-CIP) complex and free ciprofloxacin (free-CIP) against P. aeruginosa PAO1. Copper-CIP complex was synthesized and its characterization was assessed using spectroscopic methods and single crystal X-ray analysis. The effect of sub-MIC (1/4 and 1/16 MIC) concentrations of Cu-CIP and free-CIP on cell growth, biofilm formation, motility, alginate and pyocyanin production, H2O2 susceptibility and expression of QS circuit genes lasI and lasR in PAO1 was determined. Minimum inhibitory concentration of Cu-CIP complex and free-CIP was determined as 0.125 µg/ml. Copper-CIP complex did not show significant effect on the cell growth at concentrations of 1/4 and 1/16 MIC. However, sub-MIC concentrations (1/4 and 1/16 MIC) of Cu-CIP showed the significant reduction in violacein production, motility, biofilm formation, alginate and pyocyanin production and sensitivity to H2O2 in a concentration dependent manner (P < 0.001). Copper-CIP at the concentration of 1/4 MIC showed the greatest reduction in lasI and lasR transcriptional expression (89.5% and 96.2% respectively). Considering the biological effects of Cu-CIP complex and its inhibitory activity on QS related virulence traits at low concentrations (0.03 and 0.007 µg/ml), it may be used as an effective approach in the management of infections caused by P. aeruginosa.