bluuebunny/crossref_metadata_2025_split huggingface dataset:
Status and influential factors of vitamin D among children aged 0 to 6 years in a Chinese population
Authors: Zhang Heng , Li Zhijuan , Wei Yarong , Fu Jinyan , Feng Yaling , Chen Daozhen , Xu Dexiang 
Published: April 2020

AbstractBackgroundVitamin D insufficiency and deficiency in childhood are common. However, the status and influential factors of vitamin D during different ages are not clear. This study aimed to survey vitamin D concentrations in children aged 0 to 6 years and explore its influential factors.MethodsA total of 6953 children were recruited in Wuxi City of East China from January to December in 2016. Enzyme-linked immunosorbent assay was used to determine the serum concentrations of 25-hydroxyvitamin D [25(OH)D].ResultsThe median vitamin D concentrations in the infant group (0–1 years of age) was 69.40 nmol/L, which were higher than that in both the toddlerhood group (1–3 years of age; 62.30 nmol/L) and the preschool group (3–6 years of age; 50.85 nmol/L). In addition, the median vitamin D concentrations were 71.70 nmol/L in summer, which was higher than that in spring (64.25 nmol/L), autumn (62.95 nmol/L) and winter (64.10 nmol/L). However, no difference was observed between genders (P = 0.974). Furthermore, the prevalence of vitamin D deficiency (< 50 nmol/L) was 48.1% in the preschool group (3–6 years of age), which was higher than the 21.2% vitamin D deficiency in the toddlerhood group (1–3 years of age) and the 17.9% vitamin D deficiency in the infant group (0–1 years of age). Interestingly, a nonlinear association between 25(OH) D and air temperature was observed.ConclusionsA high prevalence of vitamin D deficiency was common in a Chinese population of children 0–6 years old, especially in the preschool-aged children. Therefore, we suggested that we should pay more attention to vitamin D supplementation in Chinese young children.
Patient-reported quality indicators to evaluate physiotherapy care for hip and/or knee osteoarthritis- development and evaluation of the QUIPA tool
Authors: Teo Pek Ling , Hinman Rana S. , Egerton Thorlene , Dziedzic Krysia S. , Kasza Jessica , Bennell Kim L. 
Published: April 2020

Abstract
Background
There is no physiotherapy-specific quality indicator tool available to evaluate physiotherapy care for people with hip and/or knee osteoarthritis (OA). This study aimed to develop a patient-reported quality indicator tool (QUIPA) for physiotherapy management of hip and knee OA and to assess its reliability and validity.

Methods
To develop the QUIPA tool, quality indicators were initially developed based on clinical guideline recommendations most relevant to physiotherapy practice and those of an existing generic OA quality indicator tool. Draft items were then further refined using patient focus groups. Test-retest reliability, construct validity (hypothesis testing) and criterion validity were then evaluated. Sixty-five people with hip and/or knee OA attended a single physiotherapy consultation and completed the QUIPA tool one, twelve- and thirteen-weeks after. Physiotherapists (n = 9) completed the tool post-consultation. Patient test-retest reliability was assessed between weeks twelve and thirteen. Construct validity was assessed with three predefined hypotheses and criterion validity was based on agreement between physiotherapists and participants at week one.

Results
A draft list of 23 clinical guideline recommendations most relevant to physiotherapy was developed. Following feedback from three patient focus groups, the final QUIPA tool contained 18 items (three subscales) expressed in lay language. The test-retest reliability estimates (Cohen’s Kappa) for single items ranged from 0.30–0.83 with observed agreement of 64–94%. The intraclass correlation coefficient (ICC) and 95% confidence interval (CI) for the Assessment and Management Planning subscale was 0.70 (0.54, 0.81), Core Recommended Treatments subscale was 0.84 (0.75, 0.90), Adjunctive Treatments subscale was 0.70 (0.39, 0.87) and for the total QUIPA score was 0.80 (0.69, 0.88). All predefined hypotheses regarding construct validity were confirmed. However, agreement between physiotherapists and participants for single items showed large measurement error (Cohen’s Kappa estimates ranged from − 0.04-0.59) with the ICC (95% CI) for the total score being 0.11 (− 0.14, 0.34).

Conclusions
The QUIPA tool showed acceptable test-retest reliability for subscales and total score but inadequate reliability for individual items. Construct validity was confirmed but criterion validity for individual items, subscales and the total score was inadequate. Further research is needed to refine the QUIPA tool to improve its clinimetric properties before implementation.
Influence of trends in hospital volume over time on patient outcomes for high-risk surgery
Authors: Payet Cécile , Polazzi Stéphanie , Lifante Jean-Christophe , Cotte Eddy , Grinberg Daniel , Carty Matthew J. , Sanchez Stéphane , Rabilloud Muriel , Duclos Antoine 
Published: April 2020

Abstract
Background
The “practice makes perfect” concept considers the more frequent a hospital performs a procedure, the better the outcome of the procedure. We aimed to study this concept by investigating whether patient outcomes improve in hospitals with a significantly increased volume of high-risk surgery over time and whether a learning effect existed at the individual hospital level.

Methods
We included all patients who underwent one of 10 digestive, cardiovascular and orthopaedic procedures between 2010 and 2014 from the French nationwide hospitals database. For each procedure, we identified three groups of hospitals according to volume trend (increased, decreased, or no change). In-hospital mortality, reoperation, and unplanned hospital readmission within 30 days were compared between groups using Cox regressions, taking into account clustering of patients within hospitals and potential confounders. Individual hospital learning effect was investigated by considering the interaction between hospital groups and procedure year.

Results
Over 5 years, 759,928 patients from 694 hospitals were analysed. Patients’ mortality in hospitals with procedure volume increase or decrease over time did not clearly differ from those in hospitals with unchanged volume across the studied procedures (e.g., Hazard Ratios [95%] of 1.04 [0.93–1.17] and 1.08 [0.97–1.21] respectively for colectomy). Furthermore, patient outcomes did not improve or deteriorate in hospitals with increased or decreased volume of procedures over time (e.g., 1.01 [0.95–1.08] and 0.99 [0.92–1.05] respectively for colectomy).

Conclusions
Trend in hospital volume over time did not appear to influence patient outcomes based on real-world data.

Trial registration
NCT02788331, June 2, 2016.
Persistent postoperative pain and healthcare costs associated with instrumented and non-instrumented spinal surgery: a case-control study
Authors: Weir Sharada , Samnaliev Mihail , Kuo Tzu-Chun , Tierney Travis S. , Manca Andrea , Taylor Rod S. , Bruce Julie , Eldabe Sam , Cumming David 
Published: April 2020

Abstract
Purpose
To compare rates of persistent postoperative pain (PPP) after lumbar spine surgery—commonly known as Failed Back Surgery Syndrome—and healthcare costs for instrumented lumbar spinal fusion versus decompression/discectomy.

Methods
The UK population-based healthcare data from the Hospital Episode Statistics (HES) database from NHS Digital and the Clinical Practice Research Datalink (CPRD) were queried to identify patients with PPP following lumbar spinal surgery. Rates of PPP were calculated by type of surgery (instrumented and non-instrumented). Total healthcare costs associated with the surgery and covering the 24-month period after index hospital discharge were estimated using standard methods for classifying health care encounters into major categories of health care resource utilization (i.e., inpatient hospital stays, outpatient clinic visits, accident and emergency attendances, primary care encounters, and medications prescribed in primary care) and applying the appropriate unit costs (expressed in 2013 GBP).

Results
Increasing the complexity of surgery with instrumentation was not associated with an increased rate of PPP. However, 2-year healthcare costs following discharge after surgery are significantly higher among patients who underwent instrumented surgery compared with decompression/discectomy.

Conclusions
Although there is a not insubstantial risk of ongoing pain following spine surgery, with 1-in-5 patients experiencing PPP within 2 years of surgery, the underlying indications for surgical modality and related choice of surgical procedure do not, by itself, appear to be a driving factor.
Valgus stability is enhanced by flexor digitorum superficialis muscle contraction of the index and middle fingers
Authors: Hoshika Shota , Nimura Akimoto , Takahashi Norimasa , Sugaya Hiroyuki , Akita Keiichi 
Published: April 2020

AbstractBackgroundFlexor digitorum superficialis (FDS) muscle provides dynamic stabilization and medial elbow support for ulnar collateral ligament (UCL). The FDS contraction significantly affects the medial joint distance (MJD) through grip contraction. However, it remains unclear whether FDS activity alone contributes to medial elbow stability, or together with the activation of the flexor digitorum profundus during grip contraction, and which finger’s FDS is the main contributor to elbow stability. We investigated the resistive effects of isolated FDS contraction in individual fingers against valgus stress in the elbow joint using stress ultrasonography (US).MethodsWe investigated 17 healthy males (mean age, 27 ± 5 years). Valgus stress US was performed using the Telos device, with the elbow at 30° flexion. MJD was measured for each arm during 3 separate conditions: at rest (unloaded), under valgus load (50 N) (loaded), and under valgus load with FDS contracted in individual fingers (loaded-contracted).ResultsMJD was significantly longer when loaded (5.4 ± 0.4 mm) than unloaded (4.1 ± 0.2 mm,P= 0.007) or loaded-contracted (4.6 ± 0.3 mm,P= 0.003) for each finger. When loaded-contracted, MJD differed statistically between the index and ring fingers (P= 0.03) and between the middle and ring fingers (P= 0.04). However, the difference between the index and middle fingers was not statistically significant (P= 0.08).ConclusionsIndividual FDS contraction, particularly of the index and middle fingers, contributes most to stabilization against valgus stress. Thus, injury care programs should incorporate FDS exercises of these fingers.
Drug-induced lung disease adverse effect with Ledipasvir Acetonate/Sofosbuvir
Authors: Omotani Sachiko , Ishizaka Toshihiko , Inoue Miki , Nishida Koji , Yasui Yukako , Hatsuda Yasutoshi , Mukai Junji , Myotoku Michiaki 
Published: April 2020

Abstract
Background
Interferon and ribavirin have been used as therapeutic agents for chronic hepatitis C infection or C-compensated cirrhosis in the conventional treatment. Hepatitis C virus (HCV) -specific direct-acting antiviral agents that directly inhibit the growth process of HCV have been approved since 2011. However, in the early post-marketing vigilance phase of ledipasvir acetonate/sofosbuvir (LDV/SOF), there were reports of interstitial lung disease in 4 out of 32,700 cases with death in 1 case; the onset mechanism is unknown.

Case presentation
Treatment for hepatitis C was deemed to be necessary, and the patient was referred to our hospital. Oral administration of LDV/SOF was started. On day 8 of administration, a fever of 38–39 °C and coughing were observed followed by the gradual appearance of shortness of breath. As there was no improvement, the patient visited her primary care physician on day 16 of administration and the patient was brought urgently to our hospital on the same day. Blood tests and imaging tests were conducted at our hospital on the day of emergency transport; inflammatory response markers showed abnormal values, and sialylated carbohydrate antigen Krebs von den Lungen-6 was within the normal value range at 303 U/mL. Because the possibility of infection was low based on results of imaging and bronchoalveolar lavage, drug-induced lung disease was suspected, LDV/SOF administration was discontinued, and steroid administration was started. Following steroid pulse therapy, treatment with oral prednisolone tablets was gradually tapered. The patient’s symptoms were relieved and she was discharged.

Conclusions
The patient’s medication history in this case indicated that there were no drugs taken before or after administration of LDV/SOF until the adverse reaction occurred, and there were no supplements or dietary supplements taken. Therefore, LDV/SOF has been proposed as the cause of the suspected adverse effect. Pharmacists should try to collect adverse effect reports to identify adverse effects early.
Effect of lemongrass (Cymbopogon citratus Stapf) tea in a type 2 diabetes rat model
Authors: Garba Husaina Anchau , Mohammed Aminu , Ibrahim Mohammed Auwal , Shuaibu Mohammed Nasir 
Published: April 2020

Abstract
Background
Lemongrass (Cymbopogon citratus Stapf) tea is a widely consumed beverage for nourishment and the remedy of diabetes mellitus (DM) in Africa locally. The aim of the present study was to investigate the antidiabetic action of lemongrass tea (LGT) in a type 2 diabetes (T2D) model of rats.

Methods
The fructose-streptozotocin (STZ) animal model for T2D was used and the LGT was prepared by boiling for 10 min in water, allowed to cool and administered at 0.25 or 0.5% (ad libitum), for 4 weeks to the T2D rats.

Results
The LGT showed higher phytochemical contents compared to the cold-water extract. The diabetic untreated animals exhibited significantly (p < 0.05) higher serum glucose and lipids, insulin resistance (HOMA-IR) index with a significantly lower (p < 0.05) levels of serum insulin, β-cell function (HOMA-β) and liver glycogen compared to the normal animals. Oral supplemented of LGT for 4 weeks improved these changes comparable to the metformin treated group.

Conclusion
The data suggests that LGT intake had excellent antidiabetic effect in a T2D model of rats attributed to the higher content of the ingredients.
Using maize wastes, fermented by co-cultures of Trichoderma harzianum and Pseudomonas fluorescens, as grain dressing against m maize diseases under field conditions
Authors: Atalla Sherien M. M. , Abdel-Kader Mokhtar M. , El-Gamal Nadia G. , El-Mougy Nehal S. 
Published: April 2020

AbstractMaize (Zea mays L.) is one of the most economic crops in Egypt. Production of amylase from the waste of maize is the most economic and cheap renewable and most abundant raw materials present in environment. Biosynthesis of Cu-chitosan nanoparticles for amylase production by co-culturing between Trichoderma harzianum and Pseudomonas fluorescens at different ratios compared to free conditions was the main purpose of this study. The optimum ratio 8:2, recorded between P. fluorescens: T. harzianum, was the most promising for production of amylase produce 22.47 and 28.60 U/ml for free and nano, respectively. The UV visible spectral analysis Cu-chitosan NPs was 220 nm, while the mean diameter, using transmission electron microscopy was 0.5 μm. Application of fermented maize wastes by co-cultivation of P. fluorescence and T. harzianum, as a grain dressing before sowing declared the reduction in both root and foliar diseases during the maize growing season, starting from germination up to 70 days of its vegetative growth under field conditions. A promising approach is the creation and use of environmentally safe products, whose protective effect is based on the induction of hydrolase inhibitors in plants.
Bacillus thuringiensis Cry1C resistance development and its processing pattern in Egyptian cotton leaf worm: Spodoptera littoralis (Boisd.) (Lepidoptera:Noctuidae)
Authors: Moussa Saad , Biaomy Fatian , Aiad Kahled , Khalil Hager , Abd El-latif Ashraf Oukasha 
Published: April 2020

AbstractBiopesticides based on the entomopathogenic bacterium, Bacillus thuringiensis toxins, have shown high ability to control several pests belonging to order Lepidoptera. Egyptian cotton leaf worm, Spodoptera littoralis (Boisd.) (Lepidoptera:Noctuidae), is a major pest that attacks various crops in Egypt, and Cry1C toxin-based formulations are heavily used to its control. A laboratory investigation was conducted to study the resistance development in S. littoralis against Cry1C toxin. Thus, a field strain of S. littoralis was selected and maintained under laboratory conditions for 12 generations. The selection pressure resulted in 32.12-fold of resistance ratio after 12 generations. The hydrolysis of Cry1C toxin by the midgut extracts of the susceptible line, and the resistant line was compared. Results revealed that Cry1C toxin was hydrolyzed more rapidly in the resistant line than the susceptible one. The Cry1C toxin was processed till 1 hour after incubation in the susceptible line; but in case of resistant line, the Cry1C toxin was degraded in 1 hour after incubation.
A novel mutation in ITGB4 gene in a newborn with epidermolysis bullosa, pyloric atresia, and aplasia cutis congenita
Authors: Okulu Emel , Durmaz Ceren D. , Tunc Gaffari , Guzel Adil , Kutlay Nuket Y. , Erdeve Omer , Atasay Begum , McGrath John A. , Liu Lu , Arsan Saadet 
Published: April 2020

Abstract
Background
Epidermolysis bullosa with pyloric atresia (EB-PA), also known as Carmi syndrome, is an uncommon, autosomal recessive genodermatosis that typically affects the skin and gastrointestinal tract. EB-PA is caused by homozygous or compound heterozygous mutations in the integrin alpha 6 (ITGA6) gene on chromosome 2q31.1 or in the integrin beta 4 (ITGB4) gene on 17q25.1.

Case presentation
A male premature infant was born with aplasia cutis, atresia of the pylorus, and bilateral hydronephrosis. His clinical and imaging findings were compatible with EB-PA. A novel, small deletion of the last two bases in exon 6 and the first two nucleotides of intron 6 (c.565_566+2del) in ITGB4 gene was identified.

Conclusion
EB-PA-aplasia cutis congenita is known to be a non-treatable condition with a poor prognosis as the reported case. The novel mutation reported in this patient may lead to the lethal form of this disease. Identification of underlying genetic abnormality is critical to give genetic counseling.
Assessment of the toxicity effects of nicotine on sperm and IVF and the potential protective role of silymarin—an experimental study in mice
Authors: Rahimi-Madiseh Mohammad , Mohammadi Mohsen , Hassanvand Amin , Ahmadi Reza , Shahmohammadi Maasume , Rostamzadeh Ayoob 
Published: April 2020

Abstract
Background
Male infertility is usually caused via the inability to produce adequate quantities of healthy and active sperms. Nicotine (NIC) is an alkaloid organic compound, predominantly found in the leaves of the tobacco plant. The major part of the nicotine is not ionized, so it can easily pass through cell membranes. Meanwhile, most of the disorders are caused by oxidative stress due to oxygen free radicals and other reactive species. Antioxidant supplements and antioxidant-rich foods can reduce induced oxidative stress without becoming destabilized themselves. This study aimed to examine spermato-protective potential of silymarin (SIL), on sperm and in vitro fertility (IVF) rate in nicotine-treated mice.

Results
Our results show a significant increase in the number of abnormal sperm morphology after nicotine exposure, when compared to control groups (p < 0.05). On the other hand, SIL had a significant effect on the sperm count at each of the treated doses. Further, in the mice that received nicotine plus silymarin, the viable sperm percentage and the progressive sperm motility were significant (p < 0.05). Also, a significant reduction in the number of two-cell embryos and blastocyst-derived embryo was seen with increment in the number of dead embryos in mice receiving nicotine alone (p < 0.05).

Conclusions
In conclusion, SIL could support prevention of the adverse reproductive effects of nicotine. Moreover, SIL200 mg/kg may be therefore considered as a spermato-protective agent in dietary and herbal supplements.
Effect of Arginine on the Hypothalamic–Pituitary–Adrenal Axis in Individuals With and Without Vasopressin Deficiency
Authors: Bologna Katja , Cesana-Nigro Nicole , Refardt Julie , Imber Cornelia , Vogt Deborah R , Christ-Crain Mirjam , Winzeler Bettina 
Published: April 2020

Abstract

Context
Arginine stimulates pituitary hormones, like growth hormone and vasopressin, but its effect on the hypothalamic–pituitary–adrenal (HPA) axis is unknown. Arginine may also stimulate the HPA axis, possibly through a mechanism involving vasopressin.

Objective
To investigate the effect of arginine on adrenocorticotropic hormone (ACTH) and cortisol in subjects with and without vasopressin deficiency.

Design
Prospective study, University Hospital Basel.

Participants
38 patients with central diabetes insipidus, 58 patients with primary polydipsia, and 50 healthy controls.

Intervention
Arginine infusion with measurement of ACTH, cortisol and copeptin at baseline and 30, 45, 60, 90, and 120 minutes.

Results
We found different response patterns to arginine: in patients with diabetes insipidus (and low stimulated copeptin levels) median (interquartile range [IQR]) ACTH and cortisol increased from 22.9 (16.8, 38.7) to 36.6 (26.2, 52.1) ng/L and from 385 (266, 463) to 467 (349, 533) nmol/L, respectively. In contrast, median (IQR) ACTH and cortisol levels decreased in patients with primary polydipsia (despite high stimulated copeptin levels): ACTH from 17.3 (12.3, 23) to 14.8 (10.9, 19.8) ng/L and cortisol from 343 (262, 429) to 272 (220.8, 360.3) nmol/L; likewise, in healthy controls: ACTH from 26.5 (17.6, 35.7) to 14.8 (12.1, 22.7) ng/L and cortisol from 471 (393.3, 581.8) to 301.5 (206.5, 377.8) nmol/L.

Conclusion
Diabetes insipidus is associated with increased responsiveness of ACTH/cortisol to arginine. In contrast, arginine does not stimulate the HPA axis in healthy controls or in primary polydipsia.
The investigation and management of unilateral nipple discharge
Authors: Clark SE , Agrawal A , Laws S , Graja T , Sheehan LA , Laban C , Scutt F 
Published: April 2020

Introduction Between 16,000 and 48,000 women are estimated to present to UK breast clinics with nipple discharge each year. The incidence of malignancy in these women is 2.7–24.2%. Currently, there is no consensus on the best way to investigate and manage these women. The aim of this study was to assess the rate of malignancy in women presenting with unilateral nipple discharge, and to evaluate the role of examination, imaging and cytology in reliably predicting outcome. Methods Breast units were asked to prospectively collect data on all new patients with unilateral nipple discharge. Data collected included discharge colour, whether it was uniductal or multiductal, examination and imaging findings, cytology results and outcome. Results Complete datasets were submitted by 5 units on 228 patients. The incidence of malignancy was 4.4%. Clinical examination was valuable in detecting malignancy and multiductal discharge was not related to malignancy. The positive predictive value for detecting malignancy for an abnormality found on mammography was 53.5% and for ultrasonography, it was 65.2%. The role of cytology in detecting malignancy was inconclusive with positive predictive values of the presence of red blood cells and epithelial cells at 6.1% and 10.7% respectively. Conclusions A large number of women are investigated for nipple discharge (with huge resource implications) but there is little reliable evidence on the best way to investigate and manage these patients. A larger study is needed to evaluate the role of investigations in nipple discharge to produce guidelines on optimal management.