bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a single dose of vitamin D in septic children: a randomized, double-blinded, controlled trial
Authors: Wang Yu , Yang Zhongwen , Gao Li , Cao Zhenfeng , Wang Qianhan 
Published: June 2020

Objective To assess the effects of a single dose of vitamin D on 25-hydroxyvitamin D (25OHD) levels and clinical outcomes in children with vitamin D deficiency (VDD) and sepsis. Methods In this randomized, controlled trial, eligible children with VDD and sepsis were assigned to receive one dose of 150,000 IU of cholecalciferol or placebo. Serum concentrations of 25OHD, angiotensin-II (Ang-II), interleukin-6 (IL-6), and tumor necrosis factor-α (TNF-α) were assessed at baseline and 8 days after treatment. The cardiovascular Sequential Organ Failure Assessment (cv-SOFA) score, septic shock incidence, duration of ventilation, and mortality were also examined. Results One hundred nine participants fulfilled the study requirements. The two groups had comparable baseline characteristics. Ang-II, IL-6, and TNF-α concentrations were all reduced after vitamin D supplementation. Furthermore, the cv-SOFA score (1.76 ± 0.8 vs. 2.3 ± 1.1) and incidence of septic shock (7% vs. 20%) were lower in the treatment group than in the control group. The duration of ventilation and mortality rates did not differ between two groups. Conclusions A single dose of vitamin D improved 25OHD levels and the incidence of septic shock in children with VDD and sepsis.
Safety and efficacy of transperitoneal laparoscopic nephron sparing surgery in patients with previous abdominal surgery
Authors: Manno Stefano , Dell’Atti Lucio , Cicione Antonio , Spasari Angelo 
Published: June 2020

Objective: The aim of this study is to assess the safety and feasibility of the transperitoneal laparoscopic approach during nephron sparing surgery in patients with previous abdominal surgery. Patients and methods: We retrospectively analyzed patients undergoing transperitoneal laparoscopic partial nephrectomy for renal masses. All patients had received a diagnosis of cT1a renal exophytic mass (⩽5 cm). Patients were divided into two groups, those with and without previous abdominal surgery. Patients with solitary kidney or major previous abdominal surgery were excluded in this study. The operative time, estimated blood loss, length of stay, surgical complications, and positive surgical margins were recorded to compare outcomes among two groups. Results: Of the 157 patients who were included in our study, 71 (45.3%) had a history of abdominal surgery (Group 1), while the remaining 86 (54.7%) had not (Group 2). Cholecystectomy was the most common previous surgery performed near the renal fossa. Patients with previous abdominal surgery experienced increased operative time (111.5 vs 83.2 min; p = 0.001). However, no statistically significant difference was found in estimated blood loss (122.1 vs 114.4 mL; p = 0.363), length of stay (4.1 vs 3.8 days; p = 0.465), rate of conversion to open surgery (2.8% vs 2.3%; p = 0.234), and rate of complications ( p = 0.121). However, operative time ( p = 0.003) and length of stay ( p < 0.001) were greater in patients with versus those without previous open cholecystectomy. Conclusion: Our results suggest that laparoscopic partial nephrectomy after minor previous abdominal surgery is safe and feasible in selected patients affected by renal masses with low nephrometry score. However, previous cholecystectomy results in an increased risk of conversion to open surgery and longer hospital stay in patients undergoing right laparoscopic partial nephrectomy.
Associations Between Variations in Breast Anatomy and Early Breastfeeding Challenges
Authors: Ventura Alison K. , Lore Brittany , Mireles Olga 
Published: June 2020

Background Mothers with anatomic variability (e.g., shorter, wider nipples; denser areolas) may experience breastfeeding challenges disproportionately. Research aim To examine whether variations in breast anatomy are associated with risk for early breastfeeding challenges. Methods Participants included mothers < 6 weeks postpartum. Nipple base width, nipple length, and areolar density were measured on the right and left breast separately. Experiences with early breastfeeding challenges were determined through a combination of maternal report and clinical assessment. Results Participants ( N = 119) had an average nipple diameter of 23.4 ( SD = 3.0) mm for left nipples and 23.5 ( SD = 3.0) mm for right nipples (range = 10–34 mm). Average nipple length was 8.5 ( SD = 3.2) mm for left breasts and 9.1 ( SD = 3.2) mm for right breasts (range = 5–20 mm); 35% of participants had dense areolas on the left breast and 36% had dense areolas on the right breast. The combination of wider and longer nipples was associated with greater risk for difficulties with latch; the combination of wider nipples and denser areolas was associated with greater risk for sore nipples. For participants with more dense areolas, shorter and wider nipples were associated with greater risk for low milk supply and slow infant weight gain. For participants with less dense areolas, longer and wider nipples were associated with greater risk for low milk supply and slow infant weight gain. Conclusion Further research is needed to understand how measures of breast anatomy can be used to guide targeted intervention efforts.
Fourth Industrial Revolution, Technological Advancement and Youth Employment: A South Asian Perspective
Authors: Khatun Fahmida , Saadat Syed Yusuf 
Published: June 2020

Technological advancement can displace workers with machines, but also create new jobs. Hence, at the crux of the matter lies a race between the rate of technological advancement and the pace at which educational institutions can empower workers with the right skills. For the countries of the South Asian region, generating jobs for youth will prove to be a challenge in the backdrop of the Fourth Industrial Revolution. This paper investigates the impact of technological advancement on youth unemployment in the context of six South Asian countries, namely, Bangladesh, Bhutan, India, Nepal, Pakistan and Sri Lanka. The results of the panel instrumental variables model estimations show that lower secondary completion rate has a negative relationship and capital–labour ratio has a positive relationship with the share of youth not in employment, education or training. However, since the magnitude of the coefficient of the lower secondary completion rate is greater than the magnitude of the coefficient of the capital–labour ratio, it is concluded that education will win the race against technology in South Asia, as long as the educational attainment rates are high enough to offset the impact of technical progress. JEL: E24, J01, J13, J64
Patterns of Failure in Patients With Head and Neck Squamous Cell Carcinomas of Unknown Primary Treated With Chemoradiotherapy
Authors: Dhouib Fatma , Bertaut Aurélie , Maingon Philippe , Siala Wicem , Daoud Jamel , Aubignac Léone , Lestrade Laetitia , Crehange Gilles , Vulquin Noemie 
Published: June 2020

Background: To evaluate the patterns of failure in patients treated for head and neck carcinoma of unknown primary and to discuss treatment practices concerning radiotherapy target volumes definition and dose prescription. Methods: Eleven patients presenting a locoregional recurrence after head and neck carcinoma of unknown primary treatment with curative-intent radiochemotherapy performed between 2007 and 2017 in the departments of radiation oncology of 2 French cancer institutes. Images of the computed tomography scan or the magnetic resonance imaging performed at the time of the recurrence were fused with those of the simulation computed tomography scan to delimit a volume corresponding to the recurrence and to define the area of relapse compared to the volumes treated. Results: Irradiation was unilateral in 6 cases and bilateral in 5 cases. The median time to onset of recurrence was 7.24 months (extreme 3-67.7 months). Six patients had only a neck node recurrence, 3 had a neck node and subsequent primary recurrence, and 1 had only a median subsequent primary recurrence. Only 1 patient had synchronous distance progression to local recurrence. All neck node recurrences were solitary and ipsilateral. The subsequent primary recurrences were in the oropharynx in 3 cases and in the contralateral oral cavity in one case. All neck node recurrences were into the irradiated volume. The subsequent primary recurrences were either within or in border of the irradiated volumes. The median of the mean dose, received by neck node recurrences, was 69.9 Gy and that of the mean dose, minimum dose, maximum dose, and dose received by 95% of the volume of recurrence was 66.7 Gy. For the primary relapses, the median of the mean dose was 52.1 Gy and that of the mean dose, minimum dose, maximum dose, and dose received by 95% of the volume of recurrence was 39.9 Gy. Conclusions: All local nodal recurrences occurred at sites that received high radiotherapy doses and doses received by sites of eventual failure did not vary significantly from sites that remain in control.
Electroencephalographic Grading of Neuronal Dysfunction in Various Etiologies of Encephalopathy
Authors: Alkhamis Fahad , Nazish Saima 
Published: June 2020

Objective: The objective of this work was to study the electroencephalographic (EEG) grading of neuronal dysfunction in encephalopathy of various etiologies and assess their association with clinical outcomes. Subjects and Methods: This retrospective cross-sectional study was performed between June and November 2018 at the Neurology Department of King Fahd Hospital of University, Kingdom of Saudi Arabia (KSA) and involved a review and analysis of EEG and medical records pertaining to 222 patients in whom encephalopathy was diagnosed. Results: In patients suffering from encephalopathy, advanced age ( P = .01), low Glasgow Coma Scale (GCS) scores ( P = .00), and certain etiologies, namely hypoxic-ischemic encephalopathy (HIE) ( P = .00), septic encephalopathy ( P = .01), and other illnesses ( P = .00), were significantly associated with unfavorable clinical outcomes, whereas traumatic brain injury (TBI) ( P = .01) and GCS >7 ( P = .00) were associated with favorable outcomes. Among different etiologies, EEG grade I ( P = .02) and grade IV ( P = .04) neuronal dysfunction was significantly associated with TBI while grade III ( P = .05) and grade V ( P = .02) neuronal dysfunction was significantly associated with HIE. Grade I ( P = .03) neuronal dysfunction was mostly observed in septic encephalopathy cases, while patients suffering from other illnesses were also found to have grade I ( P = .04) and grade IV ( P = .05) neuronal dysfunction based on their EEG. Conclusion: EEG is being conducted routinely to determine the course and severity of various forms of encephalopathy. However, the clinical implications of EEG grading for neuronal dysfunction are largely dependent on underlying etiology and other clinical parameters, such as age and GCS score. Further larger prospective cohort studies involving other important prognostic parameters and continuous EEG monitoring are thus needed.
First-in-human phase I trial of anti-hepatocyte growth factor antibody (YYB101) in refractory solid tumor patients
Authors: Kim Seung Tae , Hong Jung Yong , Park Se Hoon , Park Joon Oh , Park Young Whan , Park Neunggyu , Lee Hukeun , Hong Sung Hee , Lee Song-Jae , Song Seong-Won , Kim Kyung , Park Young Suk , Lim Ho Yeong , Kang Won Ki , Nam Do-Hyun , Lee Jeong-Won , Park Keunchil , Kim Kyoung-Mee , Lee Jeeyun 
Published: June 2020

Background: YYB101, a humanized monoclonal antibody against hepatocyte growth factor (HGF), has shown safety and efficacy in vitro and in vivo. This is a first-in-human trial of this antibody. Materials and Methods: YYB101 was administered intravenously to refractory cancer patients once every 4 weeks for 1 month, and then once every 2 weeks until disease progression or intolerable toxicity, at doses of 0.3, 1, 3, 5, 10, 20, 30 mg/kg, according to a 3+3 dose escalation design. Maximum tolerated dose, safety, pharmacokinetics, and pharmacodynamics were studied. HGF, MET, PD-L1, and ERK expression was evaluated for 9 of 17 patients of the expansion cohort (20 mg/kg). Results: In 39 patients enrolled, no dose-limiting toxicity was observed at 0.3 mg/kg, and the most commonly detected toxicity was generalized edema ( n = 7, 18.9%) followed by pruritis and nausea ( n = 5, 13.5%, each), fatigue, anemia, and decreased appetite ( n = 4, 10.8%, each). No patient discontinued treatment because of adverse events. YYB101 showed dose-proportional pharmacokinetics up to 30 mg/kg. Partial response in 1 (2.5%) and stable disease in 17 (43.5%) were observed. HGF, MET, PD-L1, and ERK proteins were not significant predictors for treatment response. However, serum HGF level was significantly lowered in responders upon drug administration. RNA sequencing revealed a mesenchymal signature in two long-term responders. Conclusion: YYB101 showed favorable safety and efficacy in patients with refractory solid tumors. Based on this phase I trial, a phase II study on the YYB101 + irinotecan combination in refractory metastatic colorectal cancer patients is planned. Conclusion: ClinicalTrials.gov Identifier: NCT02499224
Weightbearing Radiography and MRI Findings in Ankle Fractures
Authors: Bäcker Henrik C. , Vosseller J. Turner , Bonel Harald , Cullmann-Bastian Jennifer , Krause Fabian , Attinger Marc C. 
Published: June 2020

Background. Static weightbearing radiography can be used to assess stability in ankle fractures by measuring lateral talar shift (medial clear space; MCS). However, the correlation of a stable ankle joint under weightbearing load and the structural integrity of the deltoid ligament has not been shown. In this study, we assessed deltoid ligament integrity on magnetic resonance imaging (MRI) and correlated that with weightbearing and gravity stress test radiography. Methods. Thirty-four patients with supination external rotation II-IV (SER) fractures underwent MRI, weightbearing radiography, and gravity stress test. On MRI, the deep anterior and posterior tibiotalar deltoid, tibionavicular and tibiocalcaneal ligaments, as well as the syndesmosis were assessed as intact, partial rupture, or complete rupture. The MCS was measured as the distance between the lateral border of the medial malleolus and the medial border of the talus at the level of the talar dome on the mortise view. Results. Twenty-three patients suffered a deep anterior tibiotalar ligament rupture (16 partial; 7 complete) and 2 a deep posterior tibiotalar ligament tear (1 partial; 1 complete). For MCS on weightbearing radiography, no statistically significant differences were identified between any of the individual groups. With gravity stress radiography, only a complete tear of the tibiocalcaneal ligament showed a significantly higher MCS than a partial tear or intact tibiocalcaneal ligament ( P < .005). No other ligament disruption showed a significant difference between the complete rupture versus intact or partial tear. Conclusion. Weightbearing radiography does not show much variation in terms of MCS even with ligamentous disruption and fibula fracture. The talus often centers itself underneath the tibia with weightbearing radiography. Levels of Evidence: Level III: Retrospective cohort study
Leisure time physical activity is associated with improved HDL functionality in high cardiovascular risk individuals: a cohort study
Authors: Hernáez Álvaro , Soria-Florido Maria Trinidad , Castañer Olga , Pintó Xavier , Estruch Ramón , Salas-Salvadó Jordi , Corella Dolores , Alonso-Gómez Ángel , Martínez-González Miguel Ángel , Schröder Helmut , Ros Emilio , Serra-Majem Lluis , Fiol Miquel , Lapetra José , Gomez-Gracia Enrique , Fitó Montserrat , Lassale Camille 
Published: June 2020

Abstract

Aims
Physical activity has consistently been shown to improve cardiovascular health and high-density lipoprotein-cholesterol levels. However, only small and heterogeneous studies have investigated the effect of exercise on high-density lipoprotein functions. Our aim is to evaluate, in the largest observational study to date, the association between leisure time physical activity and a range of high-density lipoprotein functional traits.

Methods
The study sample consisted of 296 Spanish adults at high cardiovascular risk. Usual leisure time physical activity and eight measures of high-density lipoprotein functionality were averaged over two measurements, one year apart. Multivariable linear regression models were used to explore the association between leisure time physical activity (exposure) and each high-density lipoprotein functional trait (outcome), adjusted for cardiovascular risk factors.

Results
Higher levels of leisure time physical activity were positively and linearly associated with average levels over one year of plasma high-density lipoprotein-cholesterol and apolipoprotein A-I, paraoxonase-1 antioxidant activity, high-density lipoprotein capacity to esterify cholesterol and cholesterol efflux capacity in individuals free of type 2 diabetes only. The increased cholesterol esterification index with increasing leisure time physical activity reached a plateau at around 300 metabolic equivalents.min/day. In individuals with diabetes, the relationship with cholesteryl ester transfer protein followed a U-shape, with a decreased cholesteryl ester transfer protein activity from 0 to 300 metabolic equivalents.min/day, but increasing from there onwards. Increasing levels of leisure time physical activity were associated with poorer high-density lipoprotein vasodilatory capacity.

Conclusions
In a high cardiovascular risk population, leisure time physical activity was associated not only with greater circulating levels of high-density lipoprotein-cholesterol, but also with better markers of high-density lipoprotein functionality, namely cholesterol efflux capacity, the capacity of high-density lipoprotein to esterify cholesterol and paraoxonase-1 antioxidant activity in individuals free of diabetes and lower cholesteryl ester transfer protein activity in individuals with type 2 diabetes.
Examining the Otolaryngology Match and Relationships Between Publications and Institutional Rankings
Authors: Ryan Evan M. , Geelan‐Hansen Katie R. , Nelson Kari L. , Dowdall Jayme R. 
Published: June 2020

This study examines associations among publication number, National Institutes of Health (NIH) funding rank, medical school research rank, and otolaryngology department ranks of otolaryngology applicants during the 2018‐2019 match cycle. Information regarding 2018‐2019 otolaryngology applicants was collected from Otomatch.com and verified via department websites. Information was also collected regarding 2018 NIH funding rank and 2020 US News & World Report research rank of medical schools and otolaryngology departments. T tests and chi‐square analyses were performed. Top 40 NIH funding rank, top 40 medical school research rank, and home institution department rank were separately associated with more publications and higher rates of matching into highly reputed otolaryngology departments (all P <. 01). Furthermore, applicants who matched into ranked otolaryngology departments averaged significantly more publications (P <. 01). Prospective otolaryngology applicants should take into account NIH funding rank, medical school research rank, and otolaryngology department rank, as they are associated with matching into high‐ranking institutions.
Microplastic analysis using chemical extraction followed by LC-UV analysis: a straightforward approach to determine PET content in environmental samples
Authors: Müller Axel , Goedecke Caroline , Eisentraut Paul , Piechotta Christian , Braun Ulrike 
Published: June 2020

Abstract
Background
The ubiquitous occurrence of microplastic particles in marine and aquatic ecosystems was intensively investigated in the past decade. However, we know less about the presence, fate, and input paths of microplastic in terrestrial ecosystems. A possible entry path for microplastic into terrestrial ecosystems is the agricultural application of sewage sludge and solid bio-waste as fertilizers. Microplastic contained in sewage sludge also includes polyethylene terephthalate (PET), which could originate as fiber from textile products or as a fragment from packaging products (foils, bottles, etc.). Information about microplastic content in such environmental samples is limited yet, as most of the used analytical methods are very time-consuming, regarding sample preparation and detection, require sophisticated analytical tools and eventually need high user knowledge.

Results
Here, we present a simple, specific tool for the analysis of PET microplastic particles based on alkaline extraction of PET from the environmental matrix and subsequent determination of the monomers, terephthalic acid, using liquid chromatography with UV detection (LC-UV). The applicability of the method is shown for different types of PET in several soil-related, terrestrial environmental samples, e.g., soil, sediment, compost, fermentation residues, but also sewage sludge, suspended particles from urban water management systems, and indoor dust. Recoveries for model samples are between 94.5 and 107.1%. Limit of determination and limit of quantification are absolute masses of 0.031 and 0.121 mg PET, respectively. In order to verify the measured mass contents of the environmental samples, a method comparison with thermal extraction-desorption-gas chromatography–mass spectrometry (TED-GC/MS) was conducted. Both methods deliver similar results and corroborated each other. PET mass contents in environmental samples range from values below LOQ in agriculture soil up to 57,000 mg kg−1 in dust samples.

Conclusions
We demonstrate the potential of an integral method based on chemical extraction for the determination of PET mass contents in solid environmental samples. The method was successfully applied to various matrices and may serve as an analytical tool for further investigations of PET-based microplastic in terrestrial ecosystems.