bluuebunny/crossref_metadata_2025_split huggingface dataset:
SHBG levels in primary infertile men: a critical interpretation in clinical practice
Authors: Boeri Luca , Capogrosso Paolo , Cazzaniga Walter , Pozzi Edoardo , Candela Luigi , Belladelli Federico , Oreggia Davide , Ventimiglia Eugenio , Schifano Nicolò , Fallara Giuseppe , Pontillo Marina , Abbate Costantino , Montanari Emanuele , Montorsi Francesco , Salonia Andrea 
Published: June 2020

Objective:
We aimed to test the association between age, BMI and sex-hormone–binding globulin (SHBG) in a homogenous cohort of white-European men presenting for primary couple’s infertility.

Design:
Retrospective study.

Methods:
Data from 1547 infertile men were analysed. Health-significant comorbidities were scored with the Charlson comorbidity index (CCI). Fasting serum hormones were measured in every patient. Age was considered according to quartile groups (<33, 33-41, >41 years) and BMI as normal weight (18.5–24.9 kg/m2), overweight (25.0–29.9 kg/m2) and obesity (>30 kg/m2). Descriptive statistics and linear regression analysis tested the associations between age, BMI and SHBG.

Results:
Median SHBG levels increased across quartiles of age and decreased along with BMI increases (all P < 0.001). For each year increase in age, SHBG increased 0.32 nmol/L; conversely, for each unit increase in BMI, SHBG decreased by 1.1 nmol/L (all P < 0.001). SHBG levels decline with increasing BMI was greater than SHBG progressive increase with age. Overall, BMI explained 3.0 times more of the variability in SHBG than did ageing. At multivariate linear model, age and BMI were the most significant factors influencing SHBG concentration (all P < 0.001), after accounting for CCI, albumin levels and smoking status.

Conclusions:
We found a wide distribution of SHBG concentrations across age and BMI values in primary infertile men. The association between BMI and lowered SHBG levels seems to be greater than the association of ageing with increased SHBG.
Interleukin-2 drives cortisol secretion in an age-, dose-, and body composition-dependent way
Authors: Roelfsema Ferdinand , Liu Peter Y , Yang Rebecca , Takahashi Paul , Veldhuis Johannes D 
Published: June 2020

Background:
Interleukin-2 (IL-2), one of the proinflammatory cytokines, is used in the treatment of certain malignancies. In some studies, transient increases in cortisol and ACTH secretion occurred. Thus, this agent may be used as an experimental probe of adrenal cortisol secretion.

Objective:
This study quantifies the effects of low and moderate doses of IL-2 on cortisol secretion and assesses the modulation by age, dose and body composition.

Site:
Mayo Clinical Translational Research Unit.

Subjects:
Study comprised 35 healthy men, 17 young and 18 older.

Methods:
Randomized prospective double-blind saline-controlled study of IL-2 administration in two doses with concurrent 10-min blood sampling for 24 h.

Outcome measures:
Deconvolution analysis and approximate entropy of cortisol secretion.

Results:
Low-dose IL-2 administration increased nocturnal pulsatile cortisol secretion from 1460 ± 160 to 2120 ± 220 nmol/L/8 h in young subjects and from 1680 ± 105 to 1960 ± 125 nmol/L/8 h (treatment P < 0.0001, but more in young than older, P = 0.02). Comparable results were obtained for total cortisol secretion (P treatment <0.0001, age effect P = 0.005). The higher IL-2 dose caused a large increase in young (P < 0.0001), but not in older (P = 0.90) subjects. This dose also increased approximate entropy from 0.877 ± 0.041 to 1.024 ± 0.049 (P = 0.008), pointing to reduced secretory orderliness. Incremental cortisol (nocturnal) secretion correlated negatively with visceral fat mass (R = −0.41, P = 0.019).

Conclusion:
In healthy men, IL-2 injection drives pulsatile cortisol secretion in a dose-dependent way in young, but not older, individuals and erodes cortisol secretory orderliness at a higher dose in young subjects. Cortisol responses are diminished with increasing abdominal visceral fat mass.
Estimation of the Genome-Wide Mutation Rate and Spectrum in the Archaeal Species Haloferax volcanii
Authors: Kucukyildirim Sibel , Behringer Megan , Williams Emily M , Doak Thomas G , Lynch Michael 
Published: June 2020

Abstract
Organisms adapted to life in extreme habitats (extremophiles) can further our understanding of the mechanisms of genetic stability, particularly replication and repair. Despite the harsh environmental conditions they endure, these extremophiles represent a great deal of the Earth’s biodiversity. Here, for the first time in a member of the archaeal domain, we report a genome-wide assay of spontaneous mutations in the halophilic species Haloferax volcanii using a direct and unbiased method: mutation accumulation experiments combined with deep whole-genome sequencing. H. volcanii is a key model organism not only for the study of halophilicity, but also for archaeal biology in general. Our methods measure the genome-wide rate, spectrum, and spatial distribution of spontaneous mutations. The estimated base substitution rate of 3.15 × 10−10 per site per generation, or 0.0012 per genome per generation, is similar to the value found in mesophilic prokaryotes (optimal growth at ∼20–45°). This study contributes to a comprehensive phylogenetic view of how evolutionary forces and molecular mechanisms shape the rate and molecular spectrum of mutations across the tree of life.
ANALISIS KEMAMPUAN KONEKSI MATEMATIS SISWA SMK PADA MATERI TRIGONOMETRI
Authors: Widiyawati Widiyawati , Septian Ari , Inayah Sarah 
Published: June 2020

Kemampuan koneksi matematis merupakan salah satu kemampuan yang sangat penting dan merupakan salah satu standar proses pembelajaran matematika yang dirumuskan oleh NCTM. Apabila siswa tersebut mampu mengaitkan ide-ide yang ada dalam matematika maka pemahaman terhadap matematikanya akan bertahan lama dan semakin mendalam. Begitu pentingnya kemampuan koneksi matematis terhadap suatu pembelajaran, maka dilakukanlah sebuah penelitian dengan tujuan untuk mengetahui kemampuan koneksi matematis siswa serta kesalahan apa saja yang sering dilakukan oleh siswa terkait soal koneksi matematis terhadap materi trigonometri. Penelitian ini menggunakan metode deskriptif kualitatif dengan subjek penelitiannya adalah siswa kelas X OTKP 3 SMK Bunga Persada Cianjur sebanyak 29 orang. Bentuk pengambilan datanya yaitu dengan pemberian soal tes uraian tertulis sebanyak 5 butir soal. Berdasarkan hasil analisisnya, didapatkan bahwa kemampuan koneksi matematis siswa di jenjang sekolah menengah kejuruan (SMK) Bunga Persada Cianjur kelas X OTKP 3 pada materi trigonometri tergolong rendah. Hal ini terlihat dari rata-rata kemampuan koneksi matematis siswa dari setiap indikatornya. Rendahnya kemampuan koneksi matematis tersebut karena ada beberapa kesalahan yang sering dilakukan oleh siswa diantaranya yaitu kesalahan konsep, kesalahan keterampilan komputasi, dan kesalahan interpretasi bahasa.
Group Evaluations of Individual Faculty Hospitalists
Authors: Alliston Deborah , Kelt Matthew J. , Nehme Grace , Wittler Robert 
Published: June 2020

Introduction
Faculty evaluations are important tools for improving faculty-to-resident instruction, but residents in our pediatric and internal medicine/pediatric residency programs would seldom evaluate individual pediatric faculty hospitalists. Our objectives were to: (1) increase the percentage of completed evaluations of individual pediatric hospitalists to greater than 85%, (2) improve the quality of pediatric hospitalist feedback as measured by resident and faculty satisfaction surveys, and (3) to reduce the resident concern of lack of anonymity of evaluations.
Methods
Members of the resident inpatient team (pediatric and internal medicine/pediatric residents) completed group-based evaluations of individual pediatric hospitalists. A survey to evaluate this change in process was distributed to the pediatric hospitalists (n = 6) and another survey was distributed to residents, both based on a 5-point Likert-type scale. Surveys were completed before and four months after implementation of the changes. Pre- and post-survey data of resident and hospitalist responses were compared using the Mann-Whitney test and probability proportion test.
Results
The percent of completed evaluations increased from 0% to 86% in one month and to 100% in two months. Thereafter, the percent of completed evaluations remained at 100% through the end of the data collection period at seven months. Hospitalists reported (n = 6, 100% participation) their satisfaction regarding the feedback they received from residents significantly increased for all survey questions. Resident satisfaction (n = 24, 89% participation in postintervention surveys) increased significantly with regards to the evaluation process.
Conclusions
For hospitalists, group-based resident evaluations of individual hospitalists led to an increased percentage of completed evaluations, improved the quality and quantity of feedback to hospitalists, and increased satisfaction with evaluations. For residents, these changes led to increased satisfaction with the evaluation process.
Significance of New, Isolated T-wave Inversion in Multiple Electrocardiogram Leads with Regadenoson Injection in Patients with Normal Myocardial Perfusion Imaging
Authors: Tung Robert T 
Published: June 2020

Introduction
The pharmacologic (regadenoson) stress myocardial perfusion imaging (MPI) is used widely in patients who cannot exercise for detecting coronary artery disease (CAD). The interpretation of these studies depends primarily on the imaging results because the sensitivity of electrocardiograms (ECG) in this setting is poor. Prior study showed that effects of regadenoson on ST-segment occurred infrequently and had low sensitivity for detecting CAD. The significance of T-wave inversion in multiple ECG leads without ST-segment depression with regadenoson injection in patients with normal MPI is described and reported.

Methods
ECGs were reviewed retrospectively in 64 patients who had regadenoson MPI and coronary angiography for evaluation of CAD from June 1, 2016 to August 31, 2018. Five cases were identified with new, isolated T-wave inversion in multiple ECG leads.

Results
All five cases had new and isolated T-wave inversion in multiple leads without ST segment depression with regadenoson injection and normal MPI. At coronary angiography, three of the five cases showed obstructive coronary artery disease who received coronary percutaneous intervention. One case had nonobstructive coronary artery disease and one had a normal coronary artery.

Conclusions
Despite nonspecific ST-T changes on baseline ECGs and normal MPI in all patients, three of five cases had obstructive CAD by coronary angiography. New, isolated T-wave inversion in multiple ECG leads with regadenoson injection were observed in our patients with normal MPI. These ECG findings may be associated with false negative MPI. Therefore, careful observation and scrutiny of all ECG changes, especially new, isolated T-wave inversion in multiple ECG leads during regadenoson MPI is advisable to identify potential obstructive CAD despite normal MPI findings.
Comparing the Influence of Different Overhand/Underhand Stacking Combinations of Reversing Half-Hitches on Alternating Posts on Arthroscopic Knot Security
Authors: Bilden Tyler T. , Evin Heather A. , Noonan Benjamin C. , Chong Alexander C.M. 
Published: June 2020

Introduction
Previous literature demonstrated the importanceof stacking at least three reversing half-hitches on alternating posts(RHAPs) following arthroscopic knot placement. However, RHAPsconstruction involves looping the suture in either an “overhand” or an“underhand” manner as it relates to the post, which may affect knotsecurity. This study investigated the presently unidentified influenceof different stacking combinations of three RHAPs and suture materialon arthroscopic knot security.
Methods
Four different RHAPs stacking combinations were tiedwith three different suture materials. Ten knots of each configurationwere tied using each suture material, resulting in 120 evaluated knots.A single load-to-failure test was performed. The mode of failure andmean ultimate clinical failure load were recorded.
Results
Different overhand/underhand stacking combinations ofthree RHAPs had a statistically significant effect on arthroscopicknot strength and security; however, all combinations surpassed theminimum ultimate clinical failure threshold. Knots constructed witheither Force Fiber® or braided fishing line had mean ultimate clinicalfailure loads of greater than 200 N and most commonly failed due tosuture material breakage (100%, 60 - 80% respectively). Conversely,FiberWire® demonstrated lower mean ultimate clinical failure loadsand had a higher incidence of elongated but intact failure (60 - 90%).
Conclusion
Different overhand/underhand stacking combinationsof three RHAPs yielded an arthroscopic knot capable of secure tissuefixation. A significant effect was observed for suture materials on theknot strength. This study increases our understanding of suitableRHAPs construction following arthroscopic knot placement that canlead to improving the ultimate clinical failure loads of constructedarthroscopic knots observed between orthopedic surgeons.
Patient’s Knowledge and Use of Oral Non-Steroidal Anti-Inflammatory Drugs in a Rheumatology Clinic
Authors: Arain Abeer , Rasheed Mehmoodur , Sallam Nader , Sarwar Zoona , Khan Mehwish 
Published: June 2020

Introduction
We evaluated the knowledge of non-steroidal antiinflammatorydrugs (NSAIDs) including their dosage, side effects,contraindications, and drug interactions among the patients in anoutpatient rheumatology clinic.
Methods
Patients in a rheumatology clinic completed a short surveyassessing their knowledge of over-the-counter NSAIDs.
Results
The survey was provided to 400 participants and 275(68.5%) were using over-the-counter (OTC) NSAIDs. The majorityof the participants identified their commonly used NSAID. Almost athird were unaware of the contraindication of NSAIDs such as pepticulcer disease, chronic kidney disease, and hypertension. Nearly 53.9%participants denied having any discussion of OTC medications withtheir providers. Two-thirds of the respondents reported seeing onlythe medication packaging for the dose determination (67.8%).
Conclusions
The gap in patient knowledge of the potential sideeffects and the lack of discussion of OTC medications by the providersmay be predisposing the patients to preventable side effects fromNSAIDs.
Short-Term Radiographic Evaluation of a Tri-Tapered Femoral Stem in Direct Anterior Total Hip Arthroplasty
Authors: Messamore William , Vopat Matthew , Helsper Elizabeth , Bachinskas Andrew , Nentwig Michelle , Bhargava Tarun 
Published: June 2020

Introduction. Direct anterior approach (DAA) total hip arthroplasty (THA) has become increasingly popular, largely due to utilization of a true internervous and intermuscular plane. However, recent literature has demonstrated an increased rate of femoral implant subsidence with this approach. Hence, different femoral implants, such as the tri-tapered femoral stem, have been developed to facilitate proper component insertion and positioning to prevent this femoral subsidence. The purpose of this study was to evaluate the subsidence rate of a tri-tapered femoral stem implanted utilizing a DAA, and to determine if the proximal femoral bone quality affects the rate of subsidence.
Methods. A retrospective analysis of 155 consecutive primary THAs performed by a single surgeon was conducted. Age, gender, primary diagnosis, and radiographic measurements of each subject were recorded. Radiological evaluations, such as bone quality, femoral canal fill, and implant subsidence, were measured on standardized anteroposterior (AP) and frog-leg lateral radiographs of the hip at 6-week and 6-month postoperative follow-up evaluations.
Results. The average subsidence of femoral stems was 1.18 ± 0.8 mm. There was no statistical difference in the amount of subsidence based on diagnosis or proximal femora quality. The tri-tapered stem design consistently filled the proximal canal with an average of 91.9 ± 4.9% fill. Subsidence was not significantly associated with age, canal flare index (CFI), or experience of the surgeon.
Conclusion. THA utilizing the DAA with a tri-tapered femoral stem can achieve consistent and reliable fit regardless of proximal femoral bone quality.
Biomechanical Evaluation of the Accuracy in Radiographic Assessment of Femoral Component Migration Measurement after Total Hip Arthroplasty
Authors: Forness Mikayla , Podoll Zachary , Noonan Benjamin , Chong Alexander 
Published: June 2020

Introduction: Implant subsidence is one criteria utilized to monitor for prosthesis loosening after total hip arthroplasty (THA) with initial implant subsidence assessment often done utilizing plain radiographs. The specific aim of this study was to identify the most reliable references when using plain radiographs to establish an image magnification with the goals being easy to use, inexpensive, reliable, and accurate.
Methods: Two femoral stem implants (stem lengths: 127mm, 207mm) were utilized to simulate hemiarthroplasty of the hip with composite femurs. Different combinations of femoral stem distances from the radiographic film (ODD), source-detector differences (SDD), hip rotation, and hip flexion were elected. Standardized anterior-posterior pelvis for each parameter combination setup were taken. Radiographic measurements (head diameter, stem length, stem seating length) were undertaken five times by three examiners. Radiographic image magnification factors were generated from two references (head diameter and stem length). Radiograph measurement reproducibility and stem seating length errors using these magnification factors were evaluated.
Results: High level of repeated measurements reliability was found for head diameter (99 ± 0%) and stem length (90 ± 7%) measurements, whereas seating length measurements were less reliable (76 ± 6%). Stem length error using the femoral head magnification factor yielded 11% accuracy. Stem seating length error using both magnification factors were not reliable (< 7% accuracy). All parameters, except SDD, showed significant effect on calibrated measurement error.
Conclusions: Current methods of assessing implant subsidence after THA using plain radiographs are inaccurate or reliable. Clinicians should recognize these limitations and be cautious when diagnosing implant stability using plain radiographs alone.
A Survey of County Health Departments of Kansas Regarding COVID-19
Authors: Raghuveer Talkad , Zackula Rosey , Wittler Robert 
Published: June 2020

Introduction. SARS-CoV-2 virus (severe acute respiratory syndrome coronavirus 2) causing COVID-19 (Coronavirus Disease 2019) initially was identified in China in December 2019. It has resulted in a pandemic with increasing spread of the virus in the US. The county health departments around US are spearheading the response to contain the spread of this virus.
Methods. This project was a survey of county health departments in the state of Kansas with data collection period from 4/15 to 4/24/2020. This study evaluated the staffing, resources, and funding of these health departments and how it was affecting the efforts to contain COVID-19. Descriptive statistics were used to summarize the responses.
Results. A total of 75% of the county health departments in Kansas responded to the survey. In 89% of locations, the staffing had not increased. Most health departments had an average of five people and the four largest ones had 30 to 98 staff working on COVID-19. Most locations used the Kansas Department of Health and Environment criteria for testing and used a combination of state or private laboratories. The results of the tests were available three days or longer in 62% and after five days in 14% of sites. All locations were active in contact tracing, but most had 1-3 people for this purpose and in 90% the contact tracing interview was via phone calls. There was no change in funding in 21% and decreased funding in 8.5% of health departments. Most locations had an average of five nasopharyngeal swabs on the day of the survey. The most common needs expressed were help to increase testing capability, more public education, more personal protective equipment, increased personnel, and assistance with contract tracing.
Conclusions. There is an urgent need in Kansas to increase support to county health departments for testing capability, personal protective equipment, increased number of staff, increased help with contact tracing, and especially increase support for public education.
Cuando la diversidad cultural lleva fonendo. Los «nuevos médicos» en la atención primaria de les Terres de l’Ebre
Authors: Franco López Lourdes 
Published: June 2020

Las migraciones forman parte de la historia de la humanidad, trasformando las sociedades en poliétnicas. Nos centraremos en el perfil de trabajadores altamente cualificados, concretamente médicos.Actualmente la situación laboral en el sistema sanitario público catalán es compleja; la falta de personal facultativo para cubrir las necesidades existentes y futuras ofrecerá oportunidades para la incorporación de médicos extranjeros, introduciendo una diversidad cultural que podría generar cambios en el funcionamiento de la institución. El objetivo principal es analizar los discursos y las prácticas que se generan en torno a estos procesos de incorporación en la atención primaria del sistema sanitario público en les Terres de l’Ebre. Especificar los factores que producen esta introducción, conocer las relaciones que se establecen con el resto de médicos autóctonos y las experiencias sentidas por las personas atendidas por estos profesionales. El porcentaje de médicos de familia extranjeros en el territorio estudiado es de 15,85%, siendo el perfil mayoritario mujeres jóvenes latinoamericanas con contratos eventuales. Se produce un efecto de etiquetaje social y de categorización jerárquica según el origen y el tipo de formación. El contexto laboral genera una atracción para este tipo de migración y una adaptación al fenómeno por parte de todos los actores implicados.
La professó que va per dins: un estudi antropològic de la Setmana Santa tarragonina a través dels portants a espatlles
Authors: Quetcuti i Ferrer Adolf 
Published: June 2020

Aquest article pretén analitzar els diferents elements que identifiquen un grup de persones que participen en les professons de la Setmana Santa de Tarragona i són coneguts amb el nom de portants . Majoritàriament amagats sota les faldilles dels anomenats misteris (representacions escultòriques de la passió i mort de Jesús de Natzaret), aquest col·lectiu abraça múltiples motivacions que van més enllà del caràcter religiós que se li pressuposa. En un món marcat per la transformació de la religiositat, la transmissió familiar, el gènere o la identitat local emergeixen com a elements importants que motiven i identifiquen la seva participació, que a la vegada s’emmarca sota una forta identitat de grup que s’adquireix a través d’uns rituals que actuen com a elements de socialització.