bluuebunny/crossref_metadata_2025_split huggingface dataset:
Toxicity evaluation in rats following 28 days of inhalation exposure to xylitol aerosol
Authors: Tian Yushan , Wang Hongjuan , Chen Huan , Li Xianmei , Lu Fengjun , Ma Shuhao , Wang Wenming , Wu Jia , Tang Jiayou , Feng Pengxia , Fu Yaning , Han Shulei , Liu Tong , Hou Hongwei , Hu Qingyuan 
Published: November 2021

Abstract
Xylitol has reported to decrease gingival inflammation and nasopharyngeal pneumonia, which indicated that xylitol may have potential application in respiratory diseases. Although some studies have reported the inhalation toxicity of xylitol, however, the longest period tested was only for 14 days. The inhalation toxicity of xylitol is insufficient. This work investigated the potential subacute toxicity of xylitol according to the OECD TG 412. Rats were randomly divided into a control group and different dosage groups (2 g/m3, 3 g/m3, 5 g/m3), and exposed for 6 hours/day, 5 days/week for 28 days. At the end of the exposure or recovery period, clinical signs, mortality, body weight, food consumption, hematology, blood biochemistry, gross pathology, organ weight, and histopathology were examined. Compared with the control group, rats of both sexes in the exposure groups exhibited no significant changes in body weight, organ mass, and food uptake. After the xylitol exposure, aspartate aminotransferase activity in the xylitol group (3 g/m3) was significantly higher than that in the control group, while other blood indicators and pathological changes of liver and the analysis of the recovery group showed no changes, suggesting that xylitol exerted no observable toxic effect on the liver. Finally, other observations including the histopathology of target organs and hematology also showed no alterations. These results indicated that xylitol had no significant inhalation toxicity at doses up to 5 g/m3. These subacute inhalation toxicity results of xylitol showed that its no-observed-adverse-effect concentration (NOAEC) in rats was determined to 5 g/m3.
In-vivo production of branched-chain amino acids, branched-chain keto acids, and β-hydroxy β-methylbutyric acid
Authors: Ten Have Gabriella A.M. , Engelen Marielle P.K.J. , Deutz Nicolaas E.P. 
Published: November 2021

Purpose of review
The branched-chain amino acids (BCAA), branched-chain keto acids (BCKA), and β-hydroxy β-methylbutyric acid (HMB) have regained interest as food ingredients in health and disease. To support nutritional strategies, it is critical to gain insight into the whole body and transorgan kinetics of these components. We, therefore, reviewed the most recent literature in this field on in vivo analysis of BCAA, BCKA, and HMB kinetics in health and disease.

Recent findings
With a new comprehensive metabolic flux analysis BCAA, BCKA, and HMB whole body production, interconversion and disposal rates can be measured simultaneously. Recent studies have provided us with a better understanding of whole-body and transorgan kinetics under postabsorptive, postprandial, hibernating, and lactating conditions. In human pathophysiological conditions like COPD, obesity, and diabetes, the added value of BCAA kinetic measurements over the commonly used concentration measurements only, is discussed.

Summary
This article highlights the importance of implementing BCAA, BCKA, and HMB kinetic studies to further advance the field by gaining more mechanistic insights and providing direction to the development of new targeted (nutritional) strategies.
Number of cells in parathyroid tissue in primary hyperparathyroidism cases and its relationship with serum calcium value
Authors: Javadov Mirkhalig , Karatay Emrah , Ulusan Kivilcim , Ozpek Adnan , Idiz Oğuz , Duren Mete , Sari Serkan , Demircan Firat , Demirel Gulderen , Dagdeviren Husniye , Yigit Ayse , Kelestimur Fahrettin , Aysan Erhan 
Published: November 2021

Abstract

Background:
The relationship between serum calcium (Ca) level to serum parathyroid hormone (PTH), phosphorus (P) levels and tissue properties of the parathyroid gland is unknown in primary hyperparathyroidism cases. Revealing this relationship may be useful for understanding the etiopathogenesis of primary hyperparathyroidism and determining the time of treatment.

Methods:
Ninety patients (71 females, 19 males, age range; 27–73 years, average age; 46) who underwent single gland excision with the diagnosis of primary hyperparathyroidism were studied. The patients were divided into 2 groups as serum Ca level <12 and serum Ca level ≥12. Age and sex of the patients, mean cell number of the gland, mean volume of the gland, serum levels of PTH, P, and histopathologic type of hyperplasia were evaluated.

Results:
The mean cell number per cubic centimeter is 22.9 (10–220 range) million in all glands. Serum Ca level was <12 in 82 (91.1%) of the patients, and ≥12 in 8 (8.9%) cases. Mean cell number of the gland, mean volume of the gland, existence of cystic hyperplasia of the gland, serum levels of PTH and P were statistically significant between the 2 groups (P < .001, P < .001, P < .05, P < .001, P < .05 respectively).

Conclusion:
In primary hyperparathyroidism cases serum Ca level is not related to age and sex but directly related to proportionals to the cell number and volume of the gland and serum levels of PTH, inversely related to cystic hyperplasia and serum levels of P. Early surgical intervention should be planned since the serum Ca level will be high in large adenomas with a noncystic radiological appearance.
Outcomes of septic cirrhosis patients admitted to the intensive care unit
Authors: Chebl Ralphe Bou , Tamim Hani , Sadat Musharaf , Qahtani Saad , Dabbagh Tarek , Arabi Yaseen M. 
Published: November 2021

Abstract
The aim of this study is to examine the outcome of septic patients with cirrhosis admitted to the intensive care unit (ICU) and predictors of mortality.
Single center, retrospective cohort study.
The study was conducted in Intensive care Department of King Abdulaziz Medical City, Riyadh, Saudi Arabia.
Data was extracted from a prospectively collected ICU database managed by a full time data collector. All patients with an admission diagnosis of sepsis according to the sepsis-3 definition were included from 2002 to 2017. Patients were categorized into 2 groups based on the presence or absence of cirrhosis.
The primary outcome of the study was in-hospital mortality. Secondary outcomes included ICU mortality, ICU and hospital lengths of stay and mechanical ventilation duration.
A total of 7906 patients were admitted to the ICU with sepsis during the study period, of whom 497 (6.29%) patients had cirrhosis. 64.78% of cirrhotic patients died during their hospital stay compared to 31.54% of non-cirrhotic. On multivariate analysis, cirrhosis patients were at greater odds of dying within their hospital stay as compared to non-cirrhosis patients (Odds ratio {OR} 2.53; 95% confidence interval {CI} 2.04 – 3.15) independent of co-morbidities, organ dysfunction or hemodynamic status. Among cirrhosis patients, elevated international normalization ratio (INR) (OR 1.69; 95% CI 1.29-2.23), hemodialysis (OR 3.09; 95% CI 1.76-5.42) and mechanical ventilation (OR 2.61; 95% CI 1.60–4.28) were the independent predictors of mortality.
Septic cirrhosis patients admitted to the intensive care unit have greater odds of dying during their hospital stay. Among septic cirrhosis patients, elevated INR and the need for hemodialysis and mechanical ventilation were associated with increased mortality.
The effect and safety of ropinirole in the treatment of Parkinson disease
Authors: Zhu Jiali , Chen Min 
Published: November 2021

Abstract

Background:
It is necessary to conduct a meta-analysis of the clinical randomized controlled trials (RCTs) on ropinirole in the treatment of Parkinson disease (PD), to explore the effects and safety of ropinirole, and to provide a theoretical basis for clinically safe and rational drug use.

Methods:
RCTs on the effectiveness and safety of ropinirole in the treatment of PD were searched. We searched Dutch medical literature database, Pubmed, Cochrane Library, China National Knowledge Infrastructure, Wanfang Knowledge Service Platform up to December 15, 2020. The Cochrane risk bias assessment tool was used to evaluate the quality of the included literature, and the RevMan5.3 software was used for meta-analysis.

Results:
A total of 12 RCTs with 3341 patients were included. The changes of Parkinson Disease Rating Scale Part II score (mean difference = –2.23, 95% confidence interval [CI] –2.82 to –1.64) and Parkinson Disease Rating Scale Part III scores (mean difference = –4.93, 95%CI –5.25 to –4.61) in the ropinirole group was significantly lower than that in the control group. The incidence of dizziness (odd risk [OR] = 1.85, 95%CI 1.50–2.28), nausea (OR = 2.17, 95%CI 1.81–2.59), vomiting (OR = 2.73, 95%CI 1.47–5.09), and lethargy (OR = 2.19, 95%CI 1.39–3.44) in the ropinirole group was significantly higher than that in the control group (all P < .05), and there were no significant differences in the incidence of headache (OR = 1.14, 95%CI 0.79–1.65) and insomnia (OR = 1.06, 95%CI 0.72–1.55) were found between 2 groups (all P > .05).

Conclusions:
Ropinirole can help improve the ability of daily living and exercise function of PD patients, but it will increase the incidence of related adverse reactions, which needs to be further confirmed by subsequent large-scale, high-quality RCTs.
Effects of respiratory training on ventilation potential and extubation time in patients with tracheotomy
Authors: Hu Tingting , Jiang Jianmei , Deng Xiaoling , Xiang Wei , Tan Chuan 
Published: November 2021

Abstract

Background:
In the early treatment of critical patients, tracheotomy is often performed to improve ventilation. Clinical practices usually start respiratory training after the artificial airway is removed. It is still controversial whether respiratory training during tube occlusion has effects on patients’ ventilation potential and tube occlusion time. Therefore, this study used Meta-analysis to evaluate the effects of respiratory training on patients’ ventilation potential and tube occlusion time during tracheotomy in patients with tube occlusion, so as to provide evidence for rehabilitation treatment.

Methods:
Wanfang, Chinese Biomedical Literature Database, Chinese National Knowledge Infrastructure, the Chongqing VIP Chinese Science and Technology Periodical Database, PubMed, Embase, and Web of Science were searched through the computer and the randomized controlled trials of respiratory training on ventilation potential and extubation time in patients experiencing tracheotomy were collected as well. The searching time is limited to October 2021. The language restrictions are Chinese and English. Meta-analysis is performed by using RevMan5.4.

Results:
The results of this meta-analysis will be submitted to a peer-reviewed journal for publication.

Conclusion:
This study will provide the latest evidence for the rehabilitation training of patients who underwent tracheotomy.

OSF Registration Number:
DOI 10.17605/OSF.IO/6UCQF.
Pazopanib-induced severe acute liver injury
Authors: Choi Jin-Wook , Yoo Jeong-Ju , Kim Sang Gyune , Kim Young Seok , Chin Susie 
Published: November 2021

Abstract

Rationale:
Drug-induced liver injury (DILI) is the most common cause of acute liver failure in the United States. Painkillers and fever antipyretics are the most common cause of DILI. Hepatic injury can be provoked by DILI as hepatocellular or cholestatic type.

Patient concerns:
A 48-year-old woman presented jaundice accompanied by nausea and vomiting. The patient was an inactive hepatitis B carrier with low viral titer and was diagnosed renal cell carcinoma (RCC) with hepatic metastasis requiring pazopanib treatment. Prior to administration of pazopanib, tenofovir administration was started to prevent exacerbation of hepatitis B. The patient was referred to clinic of gastroenterology department due to sudden elevation of bilirubin after 5 weeks of pazopanib treatment.

Diagnoses:
Abdominal ultrasound and computed tomography showed non-specific finding other than metastatic nodule in the liver and liver cirrhosis. After then, the patient was performed liver biopsy, and the biopsy result was acute cholestatic hepatitis with centrilobular area necrosis and portal inflammation. Therefore, considering the clinical history and biopsy results, the patient was diagnosed as DILI due to pazopanib.

Interventions:
After the biopsy, empirical steroid therapy was initiated and after 7 weeks of pazopanib discontinuation.

Outcomes:
The total bilirubin level returned to normal from peak level of 24.61 to 1.52 mg/dL.

Lessons:
In patients with renal cell carcinoma, pazopanib treatment requires clinical caution as it causes rare complications such as severe jaundice and acute cholestatic hepatitis.
Prevalence of refractive errors and color vision deficiency in a population of industry-workers in Abhar, Iran
Authors: Ahadi Masoumeh , Ebrahimi Afsaneh , Rahmani Saeed , Baghban Alireza Akbarzadeh 
Published: November 2021

AbstractVisual impairment due to refractive errors and color vision deficiency (CVD) can affect the visual abilities of workers in workplace. Identifying the prevalence of common visual problems helps us to prevent and treat occupational ocular problems.This study was conducted on 2600 males referring from companies for a routine medical exam to Occupational Medicine Center. In all subjects, visual acuity and refraction were measured. Assessment of color vision was performed by Ishihara color test. In present study, right eyes of subjects were selected to statistical analysis.The mean spherical equivalent was –0.19 ± 1.39 diopter with a range of –11.00 to +10.00 diopter. Whereas 71% of persons were emmetropic, 20% and 9% of them were myopic and hypermetropic, respectively. From a total subjects, 164 of them had CVD with prevalence of color blindness of 6.3%. In comparison with normal subjects, CVD had no significant effect on refractive findings of our subjects (P > .05).Our data present the prevalence of refractive errors and color blindness among Iranian industry-workers. Compared with other studies, our subjects have a lower prevalence of refractive errors, and similar rate of prevalence of color blindness.
The self-rated health status and key influencing factors in middle-aged and elderly
Authors: Zhang Yu-Ling , Wu Bin-Jiang , Chen Pei , Guo Ying 
Published: November 2021

AbstractTo evaluate the self-rate health (SRH) status and explore influence factors of middle-aged and elderly in China.China Health and Retirement Longitudinal Survey was conducted in 2011, 2013, 2015 and 2018. Data of the China Health and Retirement Longitudinal Survey in 2018 was used in our study and a total of 17898 participants were included. SRH status was graded as “very good, good, average, bad, very bad.” Participants who answered “very good” and “good” were regarded as self-rated good health and who answered “average,” “bad” and “very bad” were regarded as self-rated poor health. Odds ratio and 95% confidence interval of Logistics regression were calculated to evaluate the correlation between SRH and chronic diseases, demographic characteristics and lifestyle of middle-aged and elderly participants.A total of 4476 (25.01%) participants reported they had good health, and 13422 (74.99%) reported they had poor health. 9975 participants self-rated they had no chronic disease (55.73%), and 7923 (44.27%) participants self-rated they suffered from one and above chronic diseases. The prevalence of chronic diseases showed significant odds ratio and trend with SRH poor rate of participants. The more kinds of chronic diseases they suffered from, the poorer SRH was reported in middle-aged and elderly participants. Except for the chronic diseases, participants with higher age, living in rural, with high Center for Epidemiological Survey-Depression Scale score of depression and fewer time of physical activities also correlated with higher SRH (poor) rate.The SRH (good) rate was very low in middle-aged and elderly, participants who accompanied with more kinds of chronic diseases, fewer physical activities, higher age and living in the rural had a worse health status. A more comprehensive and integrated health framework should be strengthened to improve the health of middle-aged and elderly in China.
A petroclival glioma mimicking trigeminal schwannoma
Authors: Xie Hui-Min , Richard Seidu A. , Lan Zhigang 
Published: November 2021

Abstract

Rationale:
Glioma in the petroclival region is very rare. Also, very few cases of primary gliomas have been reported to have radiographic as well as intraoperative features of extra-axial lesions resulting in diagnostic dilemma in the literature. We present a rare case of petroclival glioma mimicking trigeminal schwannoma in a young female.

Patient concerns:
We present a 21-years old female with a 3-month history of pain in the right eye with no visual impairment. Cranial nerves examination revealed mild deficits in the trigeminal nerve, facial nerve, auditory nerve, oculomotor as well as the trochlear nerve.

Diagnoses:
Magnetic resonance imaging detected an extra-axial mass with mixed signal intensities in the right petroclivus area. Immunohistochemical established glioma with world health organization (WHO) grade II.

Interventions:
The lesion was resected via 2 successive operations in 6 months interval. The patient was further treated with radiotherapy and post-radiotherapy temozolamide.

Outcomes:
Two years follow-up revealed no recurrence of the lesions and she is well. Nevertheless, he is still being followed diligently to uncover any recurrence.

Lessons:
The extra-axial nature as well as petroclival location of the glioma makes our case very unique and very rare. The imaging characteristics were very extraordinary for a glioma which resulted in diagnostic dilemma. Thus, the definitive diagnosis was based on the histopathological evaluation of the excised tumor.
Community-based point-of-care testing to identify new HIV infections
Authors: Mamulwar Megha , Prasad V. Sam , Nirmalkar Amit , Goli Sarita , Jadhav Sachin , Kumbhar Shamali , Kale Varsha , Michael Elizabeth , Ford Teresa Marie , Nazarov Denys , Honig Lyle , Gangakhedkar Raman , Thakar Madhuri 
Published: November 2021

Abstract
The World Health Organization recommends point-of-care testing (POCT) to detect human immunodeficiency virus (HIV) infected individuals in the community. This will help improve treatment coverage through detection of HIV infection among those who are unaware of their status.
This study was planned with an objective to investigate the feasibility and acceptability of POCT for HIV in the community.
A community-based cross-sectional study was conducted in rural and peri-urban areas of Pune, India. These sites were selected based on the distance from the nearest HIV testing center. Testing locations were identified in consultation with the local stakeholders and grass-root health workers to identify and capture the priority population. The POCT was performed on blood samples collected by the finger-prick method.
The proportion of participants seeking HIV tests for the first time was 79.6% that signifies the feasibility of POCT. The acceptability in the peri-urban and rural areas was 70.2% and 69.7%, respectively. POCT was performed at construction sites (24.9%), nearby industries (16.1%) and parking areas of long-distance trucks (8.1%) in the peri-urban area. Three newly diagnosed HIV-infected participants (0.1%) were detected from the peri-urban areas but none from the rural areas. Two of the newly diagnosed participants and their spouses were linked to care.
There was a high acceptability of POCT and wider coverage of priority population with a strategy of testing at places preferable to the study population. Therefore, we believe that community-based POCT is a promising tool for improving HIV testing coverage even in low prevalence settings with the concentrated HIV epidemic.
Saliva testing as noninvasive way for monitoring exercise-dependent response in teenage elite water polo players
Authors: Ferlazzo Nadia , Currò Monica , Saija Caterina , Naccari Francesco , Ientile Riccardo , Di Mauro Debora , Trimarchi Fabio , Caccamo Daniela 
Published: November 2021

Abstract
Excessively increased training volume and/or intensity and competition can lead to development of overtraining syndrome, causing a performance decrement in athletes. Tracking individual response to exercise intensity is crucial for establishing recovery strategies.
We assessed the exercise intensity-dependent variability of stress response biomarkers, namely cortisol (C), testosterone (T), s-IgA, and advanced oxidation protein products (AOPP), in saliva samples of teenage elite water polo players. Saliva was collected on a day of training match (T1) and a day of competitive match (T2), at morning, before and after match.
Cortisol/proteins and testosterone/proteins concentrations decreased throughout day T1, whereas increased throughout day T2. The highest values were measured after match on day T2 (2.5 ± 0.5 vs 14.6 ± 6.3 ng/mg; 0.061 ± 0.024 vs 0.371 ± 0.15 ng/mg, respectively). sIgA/proteins and AOPP/proteins concentrations increased throughout both days, and were higher after T2 match than T1 one (respectively, 1073.0 ± 438.2 vs 71.0 ± 17.3 μg/mg; 78.05 ± 24.2 vs 15.98 ± 3.16 nmol/mg, P = .003). Significant differences between concentrations of different biomarkers recorded on T1 and T2 were found only for AOPP, suggesting an increased oxidative stress on day T2. Free testosterone/cortisol ratio on day T2 was lower than that at morning (0.053 ± 0.021 vs 0.107 ± 0.031), indicating an increased catabolic response after competitive match.
A highly significant positive correlation was found between Cortisol/Proteins and Testosterone as well as s-IgA/Proteins on day T1, and between Cortisol/Proteins and AOPP on day T2.
In conclusion, we found that different types of activities, such a training or competitive session can affect the hormonal response, immunity, and oxidative stress, thereby modulating athletic performance.
Our findings also confirm the usefulness of saliva testing as noninvasive way for monitoring the individual response to changes in exercise intensity in teenage elite water polo players.
A didactic unit for the evaluation of the use of assistive technology for access to computers in occupational therapy
Authors: Pousada Thais , Jiménez Estíbaliz , Díez Emiliano 
Published: November 2021

Abstract
Assistive technology (AT) is an umbrella term that refers to different devices that facilitate the performance of activity for people. Future occupational therapists (OT) must acquire specific competencies to undertake the correct selection of such devices, specifically for those that facilitate access and use the computer.
To create a didactic unit to improve the competencies of OT students about assessment of AT to access computers.
The didactic unit was implemented with 95 students in OT Bachelor's degree, involving teachers from 2 Spanish universities. The procedure included: definition of competencies and learning results; determination of evidence; didactic unit design, and implementation.
The main result was the didactic unit, which included 4 content blocks, each one with several activities defined. The evaluation of the students was continuous, where 48.6% of them achieved a score of between 1.9 and 2.00 (the maximum).
The application of the didactic unit allowed to check that students have improved their competencies and knowledge about assessment and prescription of AT for access to a computer.
The selection of competencies and learning results helped in determining and embedding expertise and professional skills concerning AT for computer access.