bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of serum parameters to predict the dietary intake of calcium and available phosphorus in growing pigs
Authors: Vötterl Julia C , Klinsoda Jutamat , Hennig-Pauka Isabel , Verhovsek Doris , Metzler-Zebeli Barbara U 
Published: March 2021

Abstract
Adequate provision of calcium (Ca) and phosphorus (P) is essential for bone formation and high growth performance in pigs. Nevertheless, reliable serum biomarkers for pig’s Ca and P intake are still missing. Here, we used phytase supplementation to alter the dietary available P (aP) level in order to investigate the effect of differences in dietary aP levels on serum parameters related to the Ca and P homeostasis in pigs. Moreover, we assessed whether serum parameters can be used to predict the Ca, total P (tP), and aP intake in barrows and gilts throughout the fattening period. In total, 216 pigs (115 gilts and 101 barrows) were randomly allotted to one of the two diets in three replicate batches, each lasting 56 d (n = 108/diet). Pigs had free access to the diets without (Con) or with phytase (Phy; 650 phytase units/kg) via a transponder-based feeding system. Blood samples were collected on days 2, 23, and 52, and serum parameters were correlated with the daily Ca, tP, and aP intake. The intake of tP, aP, and Ca was overall 14.2%, 13.8%, and 14.2% higher in barrows compared with gilts, respectively (P &lt; 0.001). Concurrently, phytase decreased the intake of tP and Ca by 8.4% and 6.7%, respectively, whereas it raised the intake of aP by 16.3% compared with the Con diet (P &lt; 0.001). Serum levels of fibroblast growth factor 23, alkaline phosphatase (ALP), vitamin D (VitD), and osteocalcin (OCN) decreased with age (P &lt; 0.05). The higher aP intake of pigs fed the Phy diet increased serum P on days 2 and 23 but decreased it on day 52 compared with the Con diet (P = 0.004). Pigs fed the Phy diet had higher serum ALP compared with pigs fed the Con diet on days 23 and 52 (P &lt; 0.05). Correlation analysis between serum parameters and Ca, tP, and aP intake showed age- and sex-related associations. With 12 wk of age, serum P in both sexes, serum VitD in barrows, and serum OCN and ALP in gilts correlated with aP intake (|r| &gt; 0.38), whereas serum OCN correlated with Ca in both sexes’ intake (r &gt; 0.50). At 20 wk, serum Ca and ALP in gilts correlated with aP intake, whereas serum P, Ca, and VitD correlated with Ca intake in both sexes (|r| &gt; 0.39). In conclusion, the present results showed that the daily Ca and aP intake could be most reliably estimated from serum parameters for an approximate age of 12 and 20 wk. Serum P and the Ca:P ratio at 12 wk of age and serum VitD at 20 wk of age may be used to predict pig’s daily aP intake in both sexes.
New Adjuvant Drug for Lung Cancer
Authors: Aschenbrenner Diane S. 
Published: March 2021

A new adjuvant treatment, osimertinib (Tagrisso), has been approved for patients with non–small cell lung cancer whose tumors have certain mutations.The most common adverse effects of treatment are leukopenia, lymphopenia, thrombocytopenia, diarrhea, anemia, rash, musculoskeletal pain, nail toxicity, neutropenia, dry skin, stomatitis, fatigue, and cough.
Cable Tie Dynamic Wound Closure: Alternative Technique for Secondary Wound Closure
Authors: Singh Simmrat , Ch’ng Hwei Choo , Haseeb Amber , Chin Aun Low , Draman Mohd. Rusdi 
Published: March 2021

Background:
Wound closure by secondary intention has always been a norm in clinical practice for large infected wounds at our institution. The aim is to prevent recurrent infection while waiting for wound closure. This study investigates the use of cable tie for dynamic wound closure in infected wounds to accelerate healing process as an alternative technique.

Materials and Methods:
Ten patients with infected wounds were recruited. The time to wound closure, complications, length, and cost of treatment were evaluated over 4 to 6 weeks.

Result:
All infected wounds were closed within 9.9 days with no documented complications.

Conclusion:
Cable tie used for dynamic wound closure in infected wounds is cheap and an effective alternative to wound healing by secondary intention.

Level of Evidence:
Level IV.
The elastic stable intramedullary nails as an alternative treatment for adult humeral shaft fractures
Authors: Tarng Yih-Wen , Lin Kai-Cheng , Chen Cheng-Fong , Yang Meng-Yin , Chien Yueh 
Published: March 2021

Background:
Plate and locked intramedullary nailing for humeral fractures are golden standard procedure, but the humerus is a nonweight-bearing bone and can tolerate a larger range of acceptable alignment. We believe the elastic stable intramedullary nails (ESINs) can provide enough relative stability for humeral shaft fractures in certain adult patients.

Methods:
There are four new indications for using ESINs: (1) patient could not tolerate a sugar-tong splint but was a high risk for general anesthesia, (2) intramedullary canal narrowing (<7 mm), (3) long spiral or oblique fracture over the metadiaphyseal junction, and (4) obesity. All patients received retrograde fixation with two titanium elastic nails, except for one patient with a long spiral fracture over the proximal metadiaphysis. Patients had routine follow-up plain radiographs until bone union, and we evaluated functional results of patients by Mayo Elbow Performance Score and asked to complete Quick Disabilities of the Arm, Shoulder and Hand score at the last outpatient clinic visit.

Results:
A total of 16 patients with a mean age of 54.4 years were included. The mean follow-up time was 14 ± 2.5 months, and the average time to bone union was 16 ± 4.3 weeks. There were no wound infections, loss of reduction, fracture nonunion, implant failure, or skin irritation expect for one nail back-out because of osteoporosis.

Conclusion:
We have reported good results using ESINs for the displaced fractures of the humerus in the four indication adults who would not be able to tolerate plate fixation or intramedullary nailing. The ESINs fixation method is a simple procedure that provides a small incision, minimal blood loss, short surgical time, and relative stability fixation.
SARS-Cov-2: The Relevance and Prevention of Aerosol Transmission
Authors: van der Valk Johanna P.M. , in ’t Veen Johannes C.C.M. 
Published: March 2021

Coronavirus disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2), has claimed many victims worldwide due to its high virulence and contagiousness.
The person-to-person transmission of SARS-Cov-2 when in close contact is facilitated by respiratory droplets containing the virus particles, and by skin contact with contaminated surfaces. However, the large number of COVID-19 infections cannot be explained only by droplet deposition or contact contamination. It seems very plausible that aerosols are important in transmitting SARS-Cov-2. It has been demonstrated that SARS-CoV-2 remains viable in aerosols for hours, facilitating rapid distribution of the virus over great distances. Aerosols may, therefore, also be responsible for so-called super-spreader events.
Indirect evidence points to a correlation between ventilation and the transmission and spread of SARS-Cov-2, supporting ventilation as an important factor in preventing airborne transmission. Further actions to avoid transmission of COVID-19 include social distancing, hygiene measures, and barrier measures, such as face-coverings. Professional masks offer better protection than cloth masks.
These protection measures are especially relevant to health care workers, when performing endotracheal intubation, but the risk from non-invasive ventilation and nebulizing treatment seems to be moderate.
Capacity Limitations and Workplace Problems in Patients With Mental Disorders
Authors: Muschalla Beate , Linden Michael 
Published: March 2021

Objectives:
According to the bio-psycho-social health model of the WHO, chronic illness should not only be described at the level of symptoms, but in respect to capacity limitations.

Methods:
Patients with common mental disorders (N = 1143, n = 808 employed, n = 581 workplace problems) were investigated concerning their self-rated capacities (Mini-ICF-APP-S).

Results:
Employed patients reported better capacities than unemployed patients. Among the employed patients, those without workplace problems reported better capacities than those with workplace-problems. Different types of workplace-problems were related with specific capacity levels, for example, problems with bullying or conflicts were associated with lower interactional capacities (assertiveness, group integration, dyadic relations), whereas patients with over-taxation problems perceived lower levels of flexibility, competency, structuring of tasks, proactivity and endurance.

Conclusions:
The capacity self-rating Mini-ICF-APP-S can depict differentiated capacity profiles that may be indicative for specific types of workplace problems.
Performance Evaluation of Coupling Variants for an Active Middle Ear Implant Actuator: Output, Conductive Losses, and Stability of Coupling With Ambient Pressure Changes
Authors: Gamm Ute A. , Prenzler Nils K. , Timm Max E. , Lenarz Thomas , Maier Hannes 
Published: March 2021

Introduction:
This study aims to investigate the performance of an active middle ear implant actuator for various coupling configurations. Actuator output and conductive losses were measured, and the stability of coupling was evaluated by challenging the link between actuator and ossicles through pressure events in magnitudes that occur in daily life.

Methods:
Actuator coupling efficiency and the occurrence of conductive losses were measured in 10 temporal bones through laser Doppler vibrometry on the stapes footplate for various coupling types (incus short process with and without laser hole, incus long process, stapes head). To test the stability of coupling, actuator output was measured before and after daily-life pressure events that were simulated; Valsalva maneuvers (500 cycles of −40 to +60 hPa) and jumping into a swimming pool and diving 3 m deep (a step change of 300 hPa).

Results:
Actuator output was similarly high for all types of coupling to the incus (short process and long process) and most efficient for coupling to the stapes head. Conductive losses occurred in two temporal bones (TBs) for short process coupling but for seven TBs for coupling to the incus long process. All coupling types were stable and did not lose efficiency after pressure events in the low-frequency range (<1 kHz). Losses in output of 13 to 24 dB were observed in one TB at frequencies from 3 to 6 kHz.

Conclusion:
Actuator output was similarly high for all types of coupling to the incus but coupling to the incus long process led to a higher occurrence of conductive losses. All three coupling configurations connected the actuator securely to the ossicular chain, under variations of barometric pressure that can be expected in daily life.
Variation in Canalith Repositioning Procedure Use Among Medicare Beneficiaries: Understanding the Role of Geographic Region and Provider Specialty
Authors: Zuniga Steven A. , Marmor Schelomo , Adams Meredith E. 
Published: March 2021

Objective:
Clinical practice guidelines recommend canalith repositioning procedures (CRPs) for the management of benign paroxysmal positional vertigo (BPPV). As only 10 to 20% of affected individuals receive CRPs, there is concern for guideline adherence and knowledge dissemination to relevant medical specialties. This study aimed to characterize patterns of CRP utilization over time, across all United States regions, and by provider specialty.

Study Design:
Cross-sectional analysis with time trends of CRP claims in the Centers for Medicare and Medicaid Service Provider Utilization and Payment database, 2012 to 2017.

Setting:
National administrative claims data.

Patients:
Fee-for-service Medicare beneficiaries.

Interventions:
Canalith repositioning procedures.

Main Outcome Measures:
CRP utilization was analyzed by year, hospital referral region (HRR), and provider specialty.

Results:
From 2012 to 2017, 253,894 CRPs were performed on 146,139 Medicare beneficiaries and CRP utilization increased 80%. CRP use varied widely by geographic region. In 2017, CRP use per 100,000 beneficiaries varied 113-fold across HRRs (range, 6.0–701.8, interquartile range, 68.4, extremal ratio, 116.9). Most CRPs were performed by otolaryngologists (50.9%) and physical therapists (34.3%) with few by primary care providers (1.3%).

Conclusions:
CRP utilization increased substantially suggesting improved dissemination and implementation of BPPV management guidelines. Nevertheless, wide geographic and provider-level variation remained, signifying non-uniform provider practices and access to care. Care for BPPV may thus be improved through education and incentivization of a broader range of providers.
Formations of Host Fibers and Bacteria in Human Temporal Bones With Otitis Media
Authors: Tsuprun Vladimir , Shibata Dai , Paparella Michael M. , Cureoglu Sebahattin 
Published: March 2021

Hypothesis:
In temporal bones with otitis media, fibrin and neutrophil extracellular traps (NETs) form a fibrous network with bacteria, which is involved in growth of bacterial clusters/biofilms and chronicity of disease.

Background:
NETs and fibrin are important in host defense against pathogens; however, their role in otitis media is not well understood.

Methods:
Eight human temporal bones with serous otitis media, 30 with serous-purulent otitis media, 7 with mucoid otitis media, 23 with mucoid-purulent otitis media (OM), 30 with purulent OM, and 30 with chronic otitis media were selected based on histopathologic findings. Fibrous material with bacteria was detected with hematoxylin-eosin, Gram-Weigert, and propidium iodide stains; and its composition was analyzed with immunohistochemistry.

Results:
Extensive formations of fibrous material with bacteria were observed in 30% of temporal bones with serous-purulent otitis media, 29% with mucoid otitis media, 50% with mucoid-purulent OM, 57% with purulent OM, and 67% of temporal bones with histological evidence of chronic otitis media. Some of these formations showed large bacterial clusters or biofilms. Immunohistochemical analysis showed that fibrous structures were composed of fibrin or NETs.

Conclusions:
Formations of fibrous material with bacteria were detected in human temporal bones with different types of otitis media. Inflammatory cells were observed mostly in areas with low presence of fibrous structures. The network of fibrous material seems to prevent clearance of bacteria by phagocytic cells and thus influences growth of bacterial clusters or biofilms. Fibrin and NETs may be important for the recurrences and chronicity of disease, and contribute to clogging of tympanostomy tubes in children.
Spontaneous Tegmen Tympani Dehiscence: Causes and Treatment of Conductive Hearing Loss
Authors: Heywood Rebecca L. , Goderie Thadé , Atlas Marcus D. 
Published: March 2021

Objective:
Conductive hearing loss (CHL) commonly arises in patients with spontaneous dehiscence of the tegmen of the temporal bone with meningoencephalocele (SME). The aim of this study was to further investigate 1) the potential mechanisms for CHL in this setting; 2) hearing outcomes following surgery to address SME, and 3) the possible causes of persistent CHL following surgery.

Study Design:
Retrospective case review.

Setting:
Tertiary referral center.

Patients and Intervention:
Seven patients (six female; nine ears) who underwent middle cranial fossa repair of SME and were found to have a tegmen tympani dehiscence from October 2010 to September 2014 were included in the study.

Main Outcome Measure(s):
Pre- and postoperative pure-tone audiometry.

Results:
Eight of nine ears (89%) had audiometric hearing loss at presentation. Seven ears (78%) had an air bone gap of ≥15 dB; all of these had an encephalocele traversing the tegmen tympani defect, four had a middle ear effusion, and three had a simultaneous superior semicircular canal dehiscence (SSCCD). The CHL resolved postoperatively in four of seven ears. Two of the three ears with persistent CHL had SSCCD. Attic ossicular fixation was identified in the other patient and the CHL resolved after ossiculoplasty.

Conclusions:
CHL associated with SME can be attributed preoperatively to ossicular chain fixation and synchronous SSCCD as well as the more commonly cited cerebrospinal fluid effusion and prolapse of meningoencephalocele onto the ossicular chain. Persistent postoperative CHL can also occur due to SSCCD and ossicular fixation by adhesions.
In Vivo Measurements of Middle Ear Temperature During Transcanal Endoscopic Ear Surgery
Authors: Beláková Petra , Salzman Richard , Hyravý Martin , Heřman Jan 
Published: March 2021

Objective:
The light emitted from the endoscope during transcanal endoscopic ear surgery (TEES) heats the intratympanic space. This heat may potentially be dangerous to nearby important structures, as documented by in vitro and by animal and cadaveric studies. The aim of our work was to monitor middle ear temperatures during TEES in vivo.

Study Design:
Cohort study.

Setting:
Tertiary referral hospital.

Patients:
Four patients (15–69 yrs old) underwent transcanal endoscopic tympanoplasties for chronic perforation or retraction.

Intervention:
After elevating the tympanomeatal flap, a thermocouple was placed in the middle ear to measure the heat generated by a 30° Hopkins rod telescope (11 cm long, 2.7 mm wide) and fiberoptic light emitting diode light source.

Main Outcome Measures:
Middle ear temperature in the retrotympanum was monitored under these conditions: at 50 and 100% light intensity, after removing and wiping the endoscope tip, during suctioning and following middle ear irrigation.

Results:
Maximum middle ear temperature ranged from 36.26–37.30°C. Pulling out and wiping the endoscope caused no change or minimal decrease of 0.16°C. Middle ear irrigation caused a temperature drop of 2.05°C to 5.11°C. Suctioning was associated with a drop from 0.24°C to 3.91°C that was dependent on the depth of the endoscopic tip.

Conclusion:
Middle ear temperatures during TEES using a Hopkins rod telescope and light-emitting diode light source reach values corresponding to physiological body temperature, and do not reach dangerous levels.
The possibility of use of the ketogenic diet and medium chain triglycerides supplementation in the support therapy of Alzheimer disease
Authors: Włodarek Dariusz 
Published: March 2021

Purpose of review
Diet-induced ketosis has a fasting-like effect and brings the body to increase the production of ketone bodies (KB). Works over the last decades have provided evidence of the therapeutic potential of the ketogenic diet (KD). This review focus on mainly clinical research on the effectiveness of the KD and medium-chain triglycerides (MCT) supplementation in ameliorating the severity of symptoms in Alzheimer disease (AD).

Recent findings
A limited number of clinical studies (short-time and with a small number of participants) evaluated the role of the KD and MCT supplementation in AD as a potential dietary intervention in the therapy of this disease. These studies report that the application of KD or/and MCT supplements to older people reduces symptoms of AD. MCT supplements allow achieving an increased level of KBs in the blood even with a greater supply of carbohydrates in the diet and without any drastic changes in the habitual diet of patients.

Summary
The recent literature highlights the potential benefit of using diet-induced ketosis as an additional element of therapy in AD. Since persons with AD are at risk of malnutrition, the use of KD raises certain concerns due to side effects, especially for long periods of time. MCT supplements to obtain similar clinical results without the need for drastic changes in the diet of patients.
Comparative risk for intracranial hemorrhage related to new oral anticoagulants
Authors: Ma Tao , Liu Chunbo , Jiang Tianwei , Qin Huaping , Wu Ruhong , Zhou Peng 
Published: March 2021

Abstract

Background:
The intracranial hemorrhage (ICH) risk of oral anticoagulants/non-vitamin K antagonist oral anticoagulants (NOACs) remains largely unknown. Patients who need oral anticoagulants such as aspirin or warfarin often suffer from obvious complications.

Methods:
This network meta-analysis intended to assess the ICH risk in patients taking NOACs. The data from PubMed, the Cochrane database, and Embase were reviewed. All phase III randomized controlled trials of NOACs (apixaban, edoxaban, dabigatran, rivaroxaban), aspirin and warfarin were reviewed.

Results:
Twenty-three trials involving 137,713 participants were included, involving 6 regimens. Warfarin had the first risk of ICH (surface under the cumulative ranking area: 0.82), followed by dabigatran, edoxaban, aspirin, apixaban, rivaroxaban, and placebo. Dabigatran had the lowest risk of all-cause mortality (surface under the cumulative ranking area: 0.63), followed by apixaban, edoxaban, warfarin, rivaroxaban, aspirin, and placebo.

Conclusion:
Warfarin significantly increased the risk of ICH in patients taking oral anticoagulants compared with 4 NOACs (dabigatran, edoxaban, apixaban, rivaroxaban) and aspirin. Apixaban is least likely to induce all-cause mortality.
Association of TNIP1 polymorphisms with hepatocellular carcinoma in a Northwest Chinese Han population
Authors: Shi Yuting , Zhang Lihua , Bao Yang , Wu Pengfei , Zhang Xiaoli 
Published: March 2021

Abstract
Study has demonstrated that TNIP1 polymorphisms are associated with an increased risk of HBV-induced hepatocellular carcinoma (HCC). The purpose of this study was to investigate the correlation between polymorphisms in TNIP1 and HCC risk in a Northwest Chinese Han population.
A case–control study was conducted including 473 Hepatocellular carcinoma patients and 564 healthy controls. Three SNPs (rs3792792, rs7708392, and rs10036748) were genotyped with Sequenom MassARRAY technology and their associations with HCC risk were analyzed. These data were evaluated using the Chi-square test/Fisher's exact test, genetic model analysis, and haplotype analysis. Odds ratios (ORs) with 95% confidence intervals (CIs) were used to assess the association.
Patients with the “G” allele of TNIP1 rs7708392 showed a significantly increased risk of HCC (OR = 1.24, 95%CI: 1.01–1.52, P = .042). Significant association was also shown between TNIP1 rs7708392 and HCC susceptibility in Additive model (OR = 1.25; 95% CI = 1.01–1.54; P = .040). Besides, we also found that the “GC” haplotype of rs7708392 and rs10036748 was significantly associated with higher occurrence of HCC (OR = 1.25, 95% CI: 1.01–1.54, P = .039).
These results demonstrate that TNIP1 polymorphisms are associated with increased HCC risk in a Northwest Chinese Han population for the first time, which warrants further investigation in the future.