bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of postweaning supplementation of immunomodulatory feed ingredient on circulating cytokines and microbial populations in programmed fed beef heifers
Authors: McCarty Keelee J , Tipton Jessie E , Ricks Ralph E , Danielo Jessica , Thompson Jesse S , Block Elliot , Pratt Scott L , Long Nathan M 
Published: December 2021

Abstract
The objective was to determine the effects of an immunomodulatory feed ingredient following weaning on cytokine expression and fecal microbial populations of heifers. Commercial Angus heifers (n = 72) were weaned (227 ± 7 d of age), blocked by BW (n = 9 blocks), and randomly assigned to one of two pens per block. Pens within weight block (four heifers per pen) were then randomly assigned to treatments. Heifers were fed twice daily from days 0 to 60 (to gain 0.75 kg/d) and top dressed with either 18 g/heifer/d of the immunomodulatory feed ingredient (Celmanax; Arm and Hammer Animal Nutrition, Princeton, NJ; CEL) or corn-germ meal (CON). Blood samples were collected on days 0, 15, 30, 45, 60 and fecal grab samples on day 0 of the feeding trial. After day 60, two heifers per pen (n = 32) were randomly selected for a transportation challenge. Serum samples were collected at hours 0, 4, 8, 12 and fecal grab samples at hours −24, 0, 24 and 7 d postchallenge. Blood samples were analyzed for interferonγ (IFNγ), interleukin-8 (IL-8), and haptoglobin (HP) using commercially available ELISA kits and qRT–PCR for genes of interest associated with cytokine expression. Fecal samples were enumerated for Clostridia and E. coli using selective media (≤5 isolates from each media/sample), tested to determine whether they were Clostridium perfringens or pathogenic E. coli, and then enriched for detection of Salmonella. Data were analyzed via ANOVA. During the feeding trial, HP was reduced (P = 0.018) in CEL compared with CON at days 15, 45, and 60, whereas IFNγ and IL-8 did not differ (P &gt; 0.080) between treatments. All cytokines were decreased (P &lt; 0.001) in CEL compared with CON during the challenge. During the feeding trial, HP mRNA was increased (P = 0.045) in CEL compared with CON at days 30 and 60. Similarly, IFNγ mRNA was increased (P = 0.040) in CEL compared with CON; however, other genes of interest did not differ (P &gt; 0.172). Both C. perfringens and total E. coli counts were decreased (P = 0.036) in CEL compared with CON at 24 h after the start of the transportation challenge. Clostridia and pathogenic E. coli counts did not differ (P = 0.941) between treatments. Total Clostridia and E. coli counts were increased (P &lt; 0.014) 24 h postchallenge. All microbial populations, except pathogenic E. coli, observed decreased (P ≤ 0.009) counts from 24 h to 7 d postchallenge. Overall, Celmanax supplementation decreased circulating cytokines, and altered microbial populations and gene expression, thus, may serve a role in preparing animals to better cope with immunological challenges.
Evaluation of quality and reliability of musculoskeletal ultrasound videos on YouTube
Authors: Cüzdan Nihan , Türk İpek 
Published: December 2021

ABSTRACTObjectivesTo evaluate musculoskeletal ultrasound (MSUS) video contents on YouTube, regarding their quality, reliability, and educational value.MethodThe first three pages for the keywords ‘Musculoskeletal Ultrasound’, ‘joint ultrasound’, and ‘articular ultrasound’ were searched through YouTube website. The quality of the videos was assessed according to the European League Against Rheumatism (EULAR) Guidelines and EULAR Competency Assessment in MSUS. The reliability was evaluated with modified DISCERN tool.ResultsAfter the exclusion criteria applied, 58 videos were evaluated. The video quality analysis showed that probe holding (68.9%; median: 5, range: 0–5), scanning technique (63.8%; median: 4, range: 0–5), identification of anatomic structures (72.4%; median: 4, range: 0–5), and description of ultrasound findings (65.5%; median: 4, range: 0–5) were found to be sufficient, whereas ultrasound machine settings adjustments (1.7%; median: 0, range: 0–4) and final ultrasound diagnosis (12.1%; median: 0, range: 0–5) were insufficient. The total median value of the modified DISCERN scale was 2 (percentile: 2–2, range: 0–3).ConclusionMSUS video contents on YouTube are insufficient for educational purposes on MSUS training. There is a need for affordable, easily accessed, standardized, and peer-reviewed online training programmes on MSUS and MSUS-guided injections.
Thyroid hormone dependent transcriptional programming by TRβ requires SWI/SNF chromatin remodelers
Authors: Gillis Noelle E , Boyd Joseph R , Tomczak Jennifer A , Frietze Seth , Carr Frances E 
Published: December 2021

Abstract
Transcriptional regulation in response to thyroid hormone (3,5,3′-triiodo-l-thyronine, T3) is a dynamic and cell-type specific process that maintains cellular homeostasis and identity in all tissues. However, our understanding of the mechanisms of thyroid hormone receptor (TR) actions at the molecular level are actively being refined. We used an integrated genomics approach to profile and characterize the cistrome of TRβ, map changes in chromatin accessibility, and capture the transcriptomic changes in response to T3 in normal human thyroid cells. There are significant shifts in TRβ genomic occupancy in response to T3, which are associated with differential chromatin accessibility, and differential recruitment of SWI/SNF chromatin remodelers. We further demonstrate selective recruitment of BAF and PBAF SWI/SNF complexes to TRβ binding sites, revealing novel differential functions in regulating chromatin accessibility and gene expression. Our findings highlight three distinct modes of TRβ interaction with chromatin and coordination of coregulator activity.
Comparison of Invasive Arterial Blood Pressure Monitoring vs. Non-Invasive Blood Pressure Monitoring in Preterm Infants &lt; 37 Weeks in the Neonatal Intensive Care Unit— A Prospective Observational Study
Authors: Shah Sachin , Kaul Amita , Khandare Jayant , Dhalait Saleha 
Published: December 2021

Abstract

Background
Accurate measurement of blood pressure (BP) is extremely important in the management of sick preterm newborns. The primary objective of this study was to compare non-invasive blood pressure measurement (NIBP) with invasive blood pressure measurement (IBP) using peripheral arterial cannulation (PAC) in preterm neonates &lt; 37 weeks in the neonatal intensive care unit.

Methods
Preterm neonates needing PAC were prospectively enrolled in the study. NIBP measurements were taken in the same limb as that of peripheral arterial line. Initially IBP was recorded followed by NIBP within 1 min using the same monitor. These were called as paired measurements since they are taken within 1 min of each other.

Results
Seventy-three preterm infants with 1703 paired measurements were included in the final analysis (median gestational age 32 weeks, IQR 30–34 weeks, median birth weight 1540 g, IQR 1160–2100 g). In preterm infants not receiving vasoactive agents (n = 51, 1428 paired measurements, Bland–Altman analysis for agreement between invasive mean blood pressure (MBP) and non-invasive mean BP revealed a bias of −2.9123 mmHg (SD 7.8074). The 95% limits of agreement were from −18.2157 to 12.3893 mmHg. In preterm infants with hypotension, we detected a bias of −3.9176 mmHg (SD 5.1135) between invasive MBP and non-invasive MBP. The 95% limits of agreement were from −13.9401 to 6.1048 mmHg. In normotensive preterm infants receiving vasoactive agents, we detected a bias of −0.7629 mmHg (SD 8.0539) between invasive MBP and non-invasive MBP. The 95% limits of agreement were from −16.5485 to 15.02274 mmHg.

Conclusions
There is poor level of agreement between IBP and NIBP measurements in sick preterm neonates, leading to overestimation or underestimation of blood pressure. The bias was less for mean BP measurements as compared with systolic BP measurements and also for normotensive neonates as compared with hypotensive neonates. Hence, NIBP may be used as a screening method in haemodynamically stable preterm infants, but infants who are haemodynamically unstable and need to be commenced on vasoactive agents should have IBP monitoring.
Proposal for a Treatment-oriented Classification System for Congenital Kyphosis in Children
Authors: Yao Ziming , Guo Dong , Zhang Xuejun , Cao Jun , Liu Haonan , Gao Rongxuan 
Published: December 2021

Study Design.
Proposal of a new classification system for pediatric congenital kyphosis.

Objective.
To propose a new treatment-oriented classification system for pediatric congenital kyphosis based on radiographic findings and evaluates the reliability of this new classification system.

Summary of Background Data.
The classification of congenital kyphosis described by Winter is the one most commonly used. However, this classification of congenital kyphosis cannot direct the surgical options and the treatment choices remain controversial.

Methods.
For each type of congenital kyphosis, we propose a set of radiological criteria that are suggestive for diagnosis as well as the corresponding surgical options. To evaluate the reliability of this new classification system, 35 patients with congenital kyphosis were reviewed and classified by four attending spine surgeons and five spine fellows.

Results.
Our new classification system divides congenital kyphosis into five types. The overall Fleiss kappa coefficient (κ) value for the new classification system was 0.755, which indicates significant agreement. The interobserver and intraob-server κ values were 0.755 and 0.828, respectively, and there were no significant differences in the k values between the attending spine surgeons and spine fellows.

Conclusion.
The proposed classification system provides clear descriptions and surgical options for various types of pediatric congenital kyphotic deformities. The reliability study confirmed that the classification system is both simple and consistent, although further research may be needed to validate the system.
Automated Differentiation Between Osteoporotic Vertebral Fracture and Malignant Vertebral Fracture on MRI Using a Deep Convolutional Neural Network
Authors: Yoda Takafumi , Maki Satoshi , Furuya Takeo , Yokota Hajime , Matsumoto Koji , Takaoka Hiromitsu , Miyamoto Takuya , Okimatsu Sho , Shiga Yasuhiro , Inage Kazuhide , Orita Sumihisa , Eguchi Yawara , Yamashita Takeshi , Masuda Yoshitada , Uno Takashi , Ohtori Seiji 
Published: December 2021

Study Design.
Retrospective study of magnetic resonance imaging (MRI).

Objectives.
To assess the ability of a convolutional neural network (CNN) model to differentiate osteoporotic vertebral fractures (OVFs) and malignant vertebral compression fractures (MVFs) using short-TI inversion recovery (STIR) and T1-weighted images (T1WI) and to compare it to the performance of three spine surgeons.

Summary of Background Data.
Differentiating between OVFs and MVFs is crucial for appropriate clinical staging and treatment planning. However, an accurate diagnosis is sometimes difficult. Recently, CNN modeling—an artificial intelligence technique—has gained popularity in the radiology field.

Methods.
We enrolled 50 patients with OVFs and 47 patients with MVFs who underwent thoracolumbar MRI. Sagittal STIR images and sagittal T1WI were used to train and validate the CNN models. To assess the performance of the CNN, the receiver operating characteristic curve was plotted and the area under the curve was calculated. We also compared the accuracy, sensitivity, and specificity of the diagnosis made by the CNN and three spine surgeons.

Results.
The area under the curve of receiver operating characteristic curves of the CNN based on STIR images and T1WI were 0.967 and 0.984, respectively. The CNN model based on STIR images showed a performance of 93.8% accuracy, 92.5% sensitivity, and 94.9% specificity. On the other hand, the CNN model based on T1WI showed a performance of 96.4% accuracy, 98.1% sensitivity, and 94.9% specificity. The accuracy and specificity of the CNN using both STIR and T1WI were statistically equal to or better than that of three spine surgeons. There were no significant differences in sensitivity based on both STIR images and T1WI between the CNN and spine surgeons.

Conclusion.
We successfully differentiated OVFs and MVFs based on MRI with high accuracy using the CNN model, which was statistically equal or superior to that of the spine surgeons.

Level of Evidence: 4
Clinical Features and Prognoses of Middle-Aged Women With ST-Elevation Myocardial Infarction With a Focus on Spontaneous Coronary Artery Dissection
Authors: Almasi Aliasghar , Mansouri Pejman , Jameie Mana , Yadangi Somayeh , Parapary Saeed Haghighi , Mohsenizadeh Seyed Abolfazl , Jamshidi Peiman , Jenab Yaser 
Published: December 2021

Background:
Spontaneous coronary artery dissection (SCAD) has become an increasingly recognized cause of acute coronary syndrome, particularly in young women, over the last decade. The goal of this study was to determine the prognoses and characteristics of adult women with SCAD who presented with ST-elevation myocardial infarction (STEMI).

Methods:
This retrospective cohort study enrolled all adult women under the age of 60 who had undergone coronary artery angiography in the setting of STEMI. The patients were divided into 3 groups based on their angiographic characteristics: STEMI-SCAD (STEMI due to SCAD), STEMI-ATH (STEMI caused by an atherosclerotic lesion), and STEMI-others (STEMI due to other etiologies including Takotsubo cardiomyopathy and myopericarditis, as well as STEMI despite a normal epicardial coronary angiography).

Results:
Fifteen women out of 311 female patients aged below 60 years with STEMI were diagnosed with SCAD (4.8%). There were no significant differences in body mass index, hypertension, dyslipidemia, smoking status, opium addiction status, family history, previous percutaneous coronary intervention, coronary artery bypass grafting, and cerebrovascular accidents between the STEMI-SCAD and STEMI-ATH groups. Nevertheless, the STEMI-SCAD and STEMI-others groups were more likely to be younger, less likely to be diabetic, and less likely to have 3 cardiovascular risk factors or more than was the STEMI-ATH group. The left anterior descending artery was the most common culprit lesion in the STEMI-SCAD group (80%) and the other 2 groups. Out of the 311 patients, 7 patients died during the index hospitalization: 1 patient in the STEMI-SCAD group, 6 patients in the STEMI-ATH group, and 0 patients in the STEMI-others group. None of the patients in the STEMI-others group experienced any major adverse cardiac events during the follow-up. In the other 2 groups, the most experienced outcomes were myocardial infarction and in-hospital cardiac death, followed by target lesion revascularization and target vessel revascularization.

Conclusions:
STEMI-SCAD is one of the known causes of STEMI in young women. Still, despite the complexity of revascularization in our patients with STEMI-SCAD, they had more favorable prognoses in both conservative and revascularization management modalities than our patients with STEMI-ATH.
Efficacy of Selective Laser Trabeculoplasty on Circadian Intraocular Pressure Following Trabeculectomy in Advanced Primary Open-angle Glaucoma
Authors: Pillunat Karin R. , Herber Robert , Wolfram Stephanie , Jasper Carolin S. , Waibel Soeren , Pillunat Lutz E. 
Published: December 2021

Précis:
In about 50% of post-trabeculectomy (TE) eyes, selective laser trabeculoplasty (SLT) is effective in further lowering intraocular pressure (IOP).

Purpose:
To investigate the efficacy and safety of SLT in post-TE eyes, uncontrolled on maximum tolerated medication, and/or with progression of visual field loss.

Patients and Methods:
This retrospective study consecutively included post-TE eyes of patients diagnosed with primary open-angle glaucoma who had been treated with 360 degrees SLT and had a follow-up after 12 months. Primary endpoints were the reduction of mean diurnal intraocular pressure (mdIOP, mean of 6 measurements), peak IOP, and diurnal IOP fluctuations. Secondary outcomes were factors influencing IOP reduction, SLT success, and failure rates.

Results:
Forty-three eyes of 43 patients were included. During the first year, 10 eyes (23%) needed additional procedures to reduce mdIOP and were accounted as failures and excluded from final analysis. Of the remaining 33 eyes (77%) mdIOP [Q25, Q75] dropped from 15.2 [12.2 to 16.5] to 13.2 [11.6 to 15.3] mm Hg (P=0.027), 23 eyes (54%) showed a sufficient mdIOP reduction, 1 year after SLT.

Conclusion:
SLT is effective and safe in lowering mdIOP to target IOP in about 50% of eyes after prior incisional glaucoma surgery.
Use of Benzodiazepines and Antipsychotic Drugs Are Inversely Associated With Acute Readmission Risk in Schizophrenia
Authors: Strømme Maria F. , Mellesdal Liv S. , Bartz-Johannesen Christoffer A. , Kroken Rune A. , Krogenes Marianne L. , Mehlum Lars , Johnsen Erik 
Published: December 2021

Abstract

Purpose
Little is known about the impact of different psychotropic drugs on acute readmission risk, when used concomitantly in a real-life setting. We aimed to investigate the association between acute readmission risk and use of antipsychotic drugs, antidepressants, mood stabilizers, and benzodiazepines in patients with schizophrenia.

Methods
A cohort study included all patients diagnosed with schizophrenia admitted to a psychiatric acute unit at Haukeland University Hospital in Bergen, Norway, during a 10-year period (N = 663). Patients were followed from discharge until first readmission or censoring. Cox multiple regression analyses were conducted using antipsychotic drugs, antidepressants, mood stabilizers, and benzodiazepines as time-dependent variables, and periods of use and nonuse were compared within individual patients. Adjustments were made for sex, age at index admission, and excessive use of alcohol and illicit substances.

Results
A total of 410 patients (61.8%) were readmitted during follow-up, and the mean and median times in days to readmission were 709 and 575, respectively. Compared with nonuse, the use of antipsychotic drugs was associated with reduced risk of readmission (adjusted hazards ratio, 0.20; P < 0.01; confidence interval, 0.16–0.24), and the use of benzodiazepines was associated with increased risk of readmission (adjusted hazards ratio, 1.51; P < 0.01; confidence interval, 1.13–2.02). However, no relation to readmission risk was found for the use of antidepressants and mood stabilizers.

Conclusions
We found that use of benzodiazepines and antipsychotic drugs are inversely associated with acute readmission risk in schizophrenia.
Leiomyomatosis-like lymphangioleiomyomatosis
Authors: Erginoz Ergin , Taskin Halit Eren , Cavus Gokce Hande , Zengin Abdullah Kagan 
Published: December 2021

Abstract

Introduction:
Tuberous sclerosis complex is an inherited multisystemic disorder with manifestations in various organ systems as a result of a mutation of 1 of 2 tumor suppressor genes, tuberous sclerosis complex-1 or tuberous sclerosis complex-2. Perivascular epithelioid cell tumors have been shown to be associated with these gene mutations and include a variety of tumors such as angiomyolipomas and lymphangioleiomyomatosis.

Patient concerns:
In this report, we present a case of a 28-year-old woman presenting with symptoms of severe abdominal pain and nausea with a medical history of cardiac rhabdomyoma, adenoma sebaceum, Ash leaf spots, bilateral renal angiomyolipomas, and retinal hamartoma, which are manifestations of tuberous sclerosis complex. The patient was operated twice for colonic perforations in the rectosigmoid and ileocecal regions where the pathologic examination revealed multiple tumoral lesions in both specimens.

Diagnosis:
The tumor consisted of a myomatous component where the nodules were composed of spindle cells with fascicular array, and a lymphangiomatous component where epithelioid cells could be observed. Immunohistochemically, smooth muscle markers (desmin and SMA) were positive and the epithelioid component showed HMB-45 positivity. A diagnosis of leiomyomatosis-like lymphangioleiomyomatosis was established due to its morphological and immunohistochemical features, the presence of the tumor in multiple foci, and widespread lymphovascular invasion.

Interventions:
The patient had a perforation in her bowel twice during the hospital stay and underwent Hartmann operation and ileocecal resection in 2 different surgical operations.

Outcomes:
After the second operation the patient developed fever and was diagnosed with SARS-CoV-2 infection. No other complication was observed during her stay and the patient's follow-up was unremarkable.

Conclusion:
Perivascular epithelioid cell tumors are associated with tuberous sclerosis and can rarely appear in the colon. Therefore, lymphangioleiomyomatosis should be in the differential diagnosis in a tuberous sclerosis patient presenting with a colonic tumor.
The role of virtual reality simulation in surgical training in the light of COVID-19 pandemic
Authors: Sommer Guillermo Marcos , Broschewitz Johannes , Huppert Sabine , Sommer Christina Gesine , Jahn Nora , Jansen-Winkeln Boris , Gockel Ines , Hau Hans-Michael 
Published: December 2021

Abstract

Introduction:
Due to the current COVID-19 pandemic, surgical training has become increasingly challenging due to required social distancing. Therefore, the use of virtual reality (VR)-simulation could be a helpful tool for imparting surgical skills, especially in minimally invasive environments. Visual spatial ability (VSA) might influence the learning curve for laparoscopic surgical skills. However, little is known about the influence of VSA for surgical novices on VR-simulator training regarding the complexity of different tasks over a long-term training period. Our study evaluated prior VSA and VSA development in surgical trainees during VR-simulator training, and its influence on surgical performance in simulator training.

Methods:
In our single-center prospective two-arm randomized trial, VSA was measured with a tube figure test before curriculum training. After 1:1 randomization, the training group (TG) participated in the entire curriculum training consisting of 48 different VR-simulator tasks with varying difficulty over a continuous nine-day training session. The control group (CG) performed two of these tasks on day 1 and 9. Correlation and regression analyses were used to assess the influence of VSA on VR-related surgical skills and to measure procedural abilities.

Results:
Sixty students (33 women) were included. Significant improvements in the TG in surgical performance and faster completion times were observed from days 1 to 9 for the scope orientation 30° right-handed (SOR), and cholecystectomy dissection tasks after the structured 9-day training program. After training, the TG with pre-existing low VSA scores achieved performance levels similar to those with pre-existing high VSA scores for the two VR simulator tasks. Significant correlations between VSA and surgical performance on complex laparoscopic camera navigation SOR tasks were found before training.

Conclusions:
Our study revealed that that all trainees improved their surgical skills irrespective of previous VSA during structured VR simulator training. An increase in VSA resulted in improvements in surgical performance and training progress, which was more distinct in complex simulator tasks. Further, we demonstrated a positive relationship between VSA and surgical performance of the TG, especially at the beginning of training. Our results identified pre-existing levels of VSA as a predictor of surgical performance.