bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of a blend of mannan and glucan on growth performance, apparent nutrient digestibility, energy status, and whole-blood immune gene expression of beef steers during a 42-d receiving period
Authors: Ogunade Ibukun M , Taiwo Godstime , Estrada-Reyes Zaira M , Yun Jiang , Pech-Cervantes Andres A , Peters Sunday O 
Published: December 2020

AbstractWe examined the effects of dietary supplementation of a blend of mannan and glucan on the growth performance, energy status, and whole-blood immune gene expression of newly weaned beef steers during a 42-d receiving period. Forty-eight newly weaned Angus crossbred steers (2-d post-weaning; 199 ± 13 kg of initial body weight [BW]) from a single source were stratified by BW and randomly assigned to one of the two treatments: basal diet with no additive (CON; n = 24) or a basal diet top-dressed with 5 g of a blend of mannan and glucan (MANGLU; n = 24). Average daily gain (ADG) and feed efficiency (FE) from days 1 to 14, 15 to 42, and 1 to 42 were calculated from daily dry matter intake (DMI) and weekly BW. Blood samples were collected on days 0, 14, and 42 for measurement of plasma glucose and nonesterified fatty acids (NEFA). Blood samples collected on days 14 and 42 were composited for each steer for untargeted carbonyl-metabolome analysis (measurement of carbonyl-containing metabolites). Expression of 84 immune-related genes was analyzed on blood samples collected on day 42. Beginning on days 37 to 42, total mixed ration, refusals, and fecal samples were collected once daily to determine apparent total tract digestibility of DM, CP, NDF, and ADF using indigestible NDF as an internal marker. Over the 42-d feeding trial, supplemental MANGLU tended to increase final BW (P = 0.07) and ADG (P = 0.06). Compared to CON, beef steers fed supplemental MANGLU had greater (P = 0.01) DMI during the first 14 d, greater DM digestibility (P = 0.03), and tended to have greater NDF digestibility (P = 0.09). No treatment effects (P &gt; 0.10) on plasma glucose and NEFA on days 14 and 42 were detected; however, carbonyl-metabolome analysis revealed increased (FDR ≤ 0.05) plasma concentrations of galactose and glyceraldehydes, and altered (FDR ≤ 0.05) concentrations of some microbiome-derived metabolites in beef steers fed MANGLU. Compared with CON, MANGLU increased (P ≤ 0.05) the expression of five immune-related genes involved in recognition of and mounting immune defense against microbial pathogens. In conclusion, the results of this study demonstrated that supplemental MANGLU enhances beef cattle immunocompetence and productivity during feedlot receiving period.
Guidelines for screening and managing hypertension in children
Authors: Garvick Sarah , Ballen Eliza , Brasher Danielle , St. Amand Elizabeth , Ray Olivia , Vera Natalie , Gregory Tanya 
Published: December 2020

ABSTRACT
Pediatric hypertension has risen to an overall prevalence of 16.3%. If left untreated, hypertension in children and adolescents can have significant implications for cardiovascular and renal health into adulthood, including stroke, coronary artery disease, kidney disease, and heart failure. In 2017, the American Academy of Pediatrics (AAP) released updated guidelines for the screening, evaluation, and management of pediatric hypertension. This article reviews the definition of pediatric hypertension, describes why the guidelines were updated, and defines treatment protocol. By familiarizing themselves with and applying these guidelines, clinicians will be able to appropriately screen and manage hypertension in children to prevent morbidity into adulthood.
Managing tumor lysis syndrome
Authors: Greguska Chloe 
Published: December 2020

ABSTRACT
Tumor lysis syndrome (TLS) is one of the most common oncologic emergencies, occurring when tumor cell contents are rapidly released into the bloodstream. This release of cellular contents, including uric acid, phosphate, and potassium, can rapidly overwhelm the body's homeostasis mechanisms, leading to renal failure, seizures, cardiac dysrhythmias, or death. With an estimated 1.8 million new diagnoses of cancer projected in 2020 and an increase in the use of targeted agents for treatment, healthcare providers must be able to recognize, diagnose, and manage patients presenting with TLS.
Regional anaesthesia in the elderly patient a current perspective
Authors: Corcoran Eva , Kinirons Brian 
Published: December 2020

Purpose of review
The world's population is ageing. Although regional anaesthesia is well established, it seems there is limited evidence to support its use over general anaesthesia in the elderly. This review aims to examine recent publications of regional anaesthesia in relation to this specific patient subgroup.

Recent Findings
There is a paucity of evidence specifically relating to regional anaesthesia in the elderly patient. Studies tend to be small, retrospective and can combine assessment of multiple surgical and anaesthetic techniques in single studies. Surgical stimulus and the associated stress response are linked with an increased risk of morbidity in elderly patients. Regional anaesthesia is associated with reduced morbidity, improved pain scores, improved patient satisfaction and reduced resource allocation. Regional anaesthesia can potentially offset some of the surgical stress response and should be considered as part of a multimodal and, where possible, the primary approach to anaesthesia and analgesia in the elderly patient.

Summary
Undoubtedly, peripheral nerve blocks improve analgesia and reduce opioid consumption and their associated side effects. This is beneficial in the perioperative care of elderly patients who may have less physiologic reserve to withstand these side effects. Future large prospective trials are required to evaluate the duration of action and safety profile of local anaesthetic agents and adjunct agents in the older patient.
COVID in obstetrics: labor analgesia and cesarean section
Authors: Guasch Emilia , Brogly Nicolas , Gilsanz Fernando 
Published: December 2020

Purpose of review
This review is based on the latest evidence to provide a good standard of care for COVID-19 parturients and protection to healthcare givers.

Recent findings
COVID-19 by itself is not an indication for cesarean section. Different publications demonstrated the efficacy of neuraxial analgesia/anesthesia for delivery. Although SARS-CoV-2 was associated with a certain neurotropism, neuraxial block was not associated with neurological damage in COVID-19 parturients, and seems as safe and effective as in normal situations. It permits to avoid a general anesthesia in case of intrapartum cesarean section. Epidural failure is a concern: it may lead to a general anesthesia in case of emergency cesarean section. Local protocols and well-trained anesthesiologists will be helpful. COVID-19 patients require special circuits and every step (transfer to and from theatre, recovery, analgesia, and so on) should be planned in advance. For cesarean section under general anesthesia, personal protection equipment must be enhanced. Postoperative analgesia with neuraxial opioids, NSAIDs, or regional blocks are recommended. COVID-19 and pregnancy increase the risk of thrombosis, so thromboprophylaxis has to be considered and protocolized.

Summary
Anesthetic care for delivery in COVID-19 parturients should include neuraxial blocks. Special attention should be paid on the risk of thrombosis.
Determining the Effect of Transcranial Direct Current Stimulation on Depression and Anxiety in Methadone Consumers: A Randomized Controlled
Authors: Naeim Mahdi , Rezaeisharif Ali , Bagvand Samira Ghobadi 
Published: December 2020

Background:
Preliminary evidence suggests transcranial direct current stimulation (tDCS) has antidepressant and antianxiety efficacy. Because its effects have not been tested on methadone consumers, we investigated its efficacy.

Objectives:
This research is aimed at determining the effect of tDCS on depression and anxiety in methadone consumers.

Methods:
The present study was conducted in a pretest-posttest design. In this research, 40 people were studied as a group. These people took a test before and after the 8 days of tDCS. After the primary test, people received device simulation for 8 consecutive days at a specific time. Kolmogorov-Smirnov and Wilcoxon tests were used for analyzing the data.

Results:
The results show that with the score of 1.69 for the first variable, the patients’ anxiety level is much lower at the time of the electric stimulation. Also, regarding the score of 1.62 in the second hypothesis, it can be stated that the depression level was much lower at the time of performing the simulation.

Conclusions:
It seems that tDCS can improve the severity of depression and anxiety symptoms. It can be used as an effective treatment.
The Hidden Cost of the Opioid Epidemic in the United States: Drug Screening in Insurance Claims
Authors: Day-Storms Jeremy J. , Kren Erin M. , Bush Jason , Souslova Tatiana , Kerr William , Baird Geoffrey S. 
Published: December 2020

Background:
The opioid crisis has had a substantial financial impact on the health care system in the United States. This study evaluates how health plans have been affected financially and shows how a laboratory benefit management (LBM) program can be used to address related drug testing in an outpatient setting.

Methods:
Monthly claims data from private health plans were collected from June 1, 2016 to February 29, 2020. The total number of claims (units) for definitive and presumptive drug testing were calculated and the number of paid claims recorded. Claims distribution by laboratory type and medical code billed, the paid rate and compound annual growth rate, and the test distribution and paid rate of rendering providers who had submitted a minimum of 1000 claims were determined.

Results:
In total, 2,004,230 drug testing claims were submitted. After the LBM program was implemented, the percentage of paid claims for definitive drug testing (Healthcare Common Procedure Coding System code G0483) decreased and the paid rate for the low-cost tests (HCPCS code G0480) in physician office and independent laboratory settings increased. The compound annual growth rate for G0483 claims submitted indicated a 70.5% and 31.9% decrease in payments to physician offices and independent laboratories, respectively, for the period ending February 2020.

Conclusions:
An LBM program can positively address policy enforcement while reducing unnecessarily complex tests and limiting potential fraud, waste, and abuse by directing testing toward laboratories amenable to cost-efficient contractual savings. Moreover, for definitive drug testing, the enforcement of the use of Healthcare Common Procedure Coding System codes and a move toward more cost-efficient tests (G0480), when clinically applicable, supported by clinical practice guidelines, or evidence-based medicine, is an approach to providing medical benefits while maintaining health costs.
Targeting persistent normal left ventricular geometry in the general population: a 25-year follow-up study
Authors: Cuspidi Cesare , Facchetti Rita , Seravalle Gino , Tadic Marijana , Mancia Giuseppe , Grassi Guido 
Published: December 2020

Aim:
Findings regarding the extent of persistence over time of normal left ventricular (LV) geometry, a reference healthy echocardiographic phenotype, in the community are scanty. We sought to assess this issue in members of the general population enrolled in the Pressioni Arteriose Monitorate e Loro Associazioni study.

Methods:
The study included 433 participants who attended the second and third survey of the Pressioni Arteriose Monitorate e Loro Associazioni study performed after 10 and 25 years from the initial evaluation. Data collection included medical history, anthropometric parameters, office, home, ambulatory blood pressure, routine blood examinations and echocardiography.

Results:
During 25-year follow-up 167 participants showed persistently normal LV mass (LVM) and LV geometry pattern, whereas 266 participants exhibited LV hypertrophy or LV concentric remodelling at any point during study. Compared with participants developing, maintaining or regressing from LV hypertrophy and LV concentric remodelling those with a persistently normal LVM index and geometry were younger (−8 years) and more frequently female (63 vs. 45%), exhibited baseline (and follow-up) lower office and out-of-office blood pressure, BMI, serum creatinine, fasting blood glucose total serum cholesterol and rate of antihypertensive treatment. In multivariate regression analysis age [odds ratio (OR): 0.93, confidence interval (CI): 0.91–0.96, P < 0.0001] BMI (OR: 0.90, CI: 0.83–0.97, P = 0.008), office SBP (OR: 0.97, CI: 0.95–0.99, P = 0.005) and fasting blood glucose (OR: 0.96, CI: 0.93–0.99, P = 0.007) were independently associated with persistent normal LVM index and geometry.

Conclusion:
The current long-term longitudinal study suggests that persistence of normal LV geometry is associated with normal/optimal SBP, BMI and blood glucose. Thus, a closer control of these risk factors in midlife may increase the likelihood of maintaining normal ventricular geometry and, in turn, reduce the burden of subclinical cardiac organ damage and related complications in advanced age.
Software Tools for the Evaluation of Clinical Signs and Symptoms in the Medical Management of Acute Radiation Syndrome—A Five-year Experience
Authors: Port Matthias , Haupt Julian , Ostheim Patrick , Majewski Matthäus , Combs Stephanie E. , Atkinson Mike , Abend Michael 
Published: December 2020

Abstract
A suite of software tools has been developed for dose estimation (BAT, WinFRAT) and prediction of acute health effects (WinFRAT, H-Module) using clinical symptoms and/or changes in blood cell counts. We constructed a database of 191 ARS cases using the METREPOL (n = 167) and the SEARCH-database (n = 24). The cases ranged from unexposed (RC0), to mild (RC1), moderate (RC2), severe (RC3), and lethal ARS (RC4). From 2015–2019, radiobiology students and participants of two NATO meetings predicted clinical outcomes (RC, H-ARS, and hospitalization) based on clinical symptoms. We evaluated the prediction outcomes using the same input datasets with a total of 32 teams and 94 participants. We found that: (1) unexposed (RC0) and mildly exposed individuals (RC1) could not be discriminated; (2) the severity of RC2 and RC3 were systematically overestimated, but almost all lethal cases (RC4) were correctly predicted; (3) introducing a prior education component for non-physicians significantly increased the correct predictions of RC, ARS, and hospitalization by around 10% (p<0.005) with a threefold reduction in variance and a halving of the evaluation time per case; (4) correct outcome prediction was independent of the software tools used; and (5) comparing the dose estimates generated by the teams with H-ARS severity reflected known limitations of dose alone as a surrogate for H-ARS severity. We found inexperienced personnel can use software tools to make accurate diagnostic and treatment recommendations with up to 98% accuracy. Educational training improved the quality of decision making and enabled participants lacking a medical background to perform comparably to experts.
Analysis of Long-Term Quality Control Data for a 137Cs Dosimetry Calibration Source
Authors: Noey Jordan D. , Golduber Robert M. , Kearfott Kimberlee J. 
Published: December 2020

Abstract
Strict quality assurance programs are required for many radiological applications, but these seldom exist for verifying dosimetry calibration sources. After initial characterization of a dosimetry calibration facility, quality control procedures are recommended to ensure the early detection of any changes or malfunctions. These also result in refined knowledge about average dose rate and experimental variations in dose delivery. This paper describes the implementation of a phase I quality control protocol for a 137Cs dosimetry calibration source and includes an analysis of the resulting data collected over a 24-mo period. During this time, substantial data was collected to establish trial control limits. Air kerma rate measurements were obtained using an ion chamber and were adjusted for decay, corrected for ambient temperature, pressure and humidity, and then analyzed using quality control charts. Three variations of rational subgrouping methods were used in order to find assignable causes of error, and Nelson’s Rules were followed to detect any non-random statistical variations. Measurements were subgrouped according to same-day measurements in order to detect positional errors as well as atmospheric correction errors. Additionally, measurements were subgrouped according to analogous experimental setups in order to detect failure in equipment or incorrect settings. Both were analyzed using the X-bar and R chart method. Similarly, individuals and moving ranges charts were used to carefully examine each position in order to observe any situational errors that may occur which include timing, positional, or interference errors. Each method was successful in identifying unique out-of-control data points that occurred during the phase I application of forming control limits. Over the 24-mo period, enough data points were deemed in-control to establish reliable trial limits. Future experiments will include the phase II application of gaining more reliable measurements in order to fine-tune the limits, as well as performing a designed experiment, where variables are purposefully changed in order to test the variation of the data.
PERIPHERAL EXUDATIVE HEMORRHAGIC CHORIORETINOPATHY-A NEW ADDITION TO THE SPECTRUM OF PACHYCHOROID DISEASE?
Authors: Shroff Daraius , Sharma Minal , Chhablani Jay , Gupta Priyanka , Gupta Charu , Shroff Cyrus 
Published: December 2020

Purpose:
To demonstrate choroidal vascular changes and report a novel choroidal thickness contour in eyes with peripheral exudative hemorrhagic chorioretinopathy (PEHCR).

Methods:
Retrospective, observational, comparative case series. Fourteen eyes of nine patients with PEHCR and 14 eyes of 14 age-matched and sex-matched controls underwent swept-source optical coherence tomography. Choroidal thickness was measured from posterior edge of the retinal pigment epithelium–Bruch membrane to choroidoscleral interface at 11 points 1,000 µm apart. Large choroidal vessel thickness was also measured.

Results:
In PEHCR group, the choroid was thinnest at 3 mm nasal to fovea (mean 95.3 ± 33.5 µm) and thickest at 7 mm temporal to fovea (mean 272.7 ± 80.2 µm), with gradual increase in choroidal thickness from nasal to temporal periphery. The choroid was thickest subfoveally (259.7 ± 63.8 µm) in the control group. The choroid was significantly thicker in temporal periphery in PEHCR eyes as compared to controls (P = 0.0002). The mean large choroidal vessel thickness was 202.4 ± 50.8 µm in the PEHCR group and 160.6 ± 40.5 µm in the control group (P = 0.0235).

Conclusion:
Peripheral exudative hemorrhagic chorioretinopathy eyes showed progressively increasing choroidal thickness toward the temporal periphery, compared with age-matched and sex-matched controls. This gave rise to a club-shaped choroidal contour compared with the bowl-shaped contour seen in control eyes. Thicker choroid and pachyvessels favor inclusion of PEHCR in the pachychoroid disease spectrum.
Milestones in Oculofacial Plastic and Reconstructive Surgery: The Discovery of the Levator Palpebrae Superioris and Its Subsequent History
Authors: Reifler David M. 
Published: December 2020

Purpose:
This review aims to substantiate attributions of priority for the discovery and first description of the levator palpebrae superioris (LPS) muscle to Matteo Realdo Colombo [Columbus] (1516–1559), and to describe the history of this muscle from ancient to modern times.

Methods:
Relevant chapters on eyelid and eye muscles in Colombo’s De re anatomica (1559) were translated, and the work was further analyzed from a historical perspective. Literature on the anatomy of human eyelid and orbital striated muscles was reviewed from the publication of the Fabrica (1543) by Andreas Vesalius (1514–1564) through modern times. The discovery of the LPS was viewed in relation to other milestones along the road that led to the establishment of the subspecialty of oculofacial and orbital plastic surgery.

Results:
The first description of the LPS appeared in De re anatomica (1559) by Colombo who correctly identified the LPS as a retractor of the (upper) eyelid and the orbicularis oculi as its protractor. The current lack of recognition of the priority of Colombo’s description of the LPS stemmed from his lifelong rivalries with other anatomists, improved descriptions of the orbital muscles by Gabriele Falloppio (1523–1562) that soon followed, and historical controversies over other anatomical discoveries.

Conclusions:
Colombo discovered the LPS and described the antagonistic functions of retractors and protractors of the eyelid, just a portion of his broader contributions to anatomy. Colombo’s discoveries of such ophthalmologic and oculofacial plastic surgical importance should be added to the ongoing reappraisals of Colombo by medical historians.
What is in a Name? It is Time to Retire the Term “Asian Blepharoplasty”
Authors: Lorden Diana S. , Kim Angela , Tejawinata Felicia , Samimi David B. , Lo Christopher C. , Dresner Steven C. , Burnstine Michael A. 
Published: December 2020

Purpose:
This perspective explores the term “Asian blepharoplasty” and its socioemotional meaning to some patients.

Methods:
N/A.

Results:
Words have power. The term “Asian blepharoplasty” makes some patients uncomfortable. To our knowledge, it is the only medical descriptor that uses race.

Conclusions:
The use of the term “Asian Blepharoplasty” may unwittingly make patients uncomfortable and pathologize Asian features. Therefore, we suggest replacing the term “Asian Blepharoplasty” with “Double Eyelid Surgery.” For the subset of procedures which do not include the creation of an eyelid crease, “Blepharoplasty” is appropriate.
Vertical Lid Split to Aid Excision and Reconstruction of Conjunctival Tumors Involving the Fornices
Authors: Hickley Nicholas M. , McCormick Austin G. , Hsuan James D. 
Published: December 2020

Purpose:
To describe how a vertical lid split helps excision and reconstruction of conjunctival tumors.

Methods:
All patients with a limited view of conjunctival tumors involving the fornices underwent a vertical lid split procedure to improve access during resection and reconstruction.

Results:
There were 11 cases where vertical lid splits were performed to assist excision and reconstruction of conjunctival tumors on patients between 2015 and 2019. There were 4 male and 7 female patients, 50–85 years of age, mean age 67.2 years. Four patients had invasive malignant melanoma, 2 melanoma in situ, 3 invasive squamous cell carcinoma, and 2 squamous cell carcinoma in situ. The authors have had no local reoccurrences in 9 patients (follow-up 8–54 months, mean 18 months). One patient’s deep margins were involved and proceeded to exenteration, and 1 patient died from liver metastases.

Conclusions:
A vertical lid split incision of either or both eyelids, well away from the visible tumor edge splays the lid open allowing the whole conjunctival surface to be stretched out and viewed as a single flat sheet. This aids excision and reconstruction of the tumor, potentially reducing the risk of seeding and simplifying the reconstruction.