bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accuracy of pancreatic stone protein for the diagnosis of infection in hospitalized adults: a systematic review and individual patient level meta-analysis
Authors: Prazak Josef , Irincheeva Irina , Llewelyn Martin J. , Stolz Daiana , García de Guadiana Romualdo Luis , Graf Rolf , Reding Theresia , Klein Holger J. , Eggimann Philippe , Que Yok-Ai 
Published: May 2021

Abstract
Background
Accurate biomarkers to diagnose infection are lacking. Studies reported good performance of pancreatic stone protein (PSP) to detect infection. The objective of the study was to determine the performance of PSP in diagnosing infection across hospitalized patients and calculate a threshold value for that purpose.

Methods
A systematic search across Cochrane Central Register of Controlled Trials and MEDLINE databases (1966–March 2019) for studies on PSP published in English using ‘pancreatic stone protein’, ‘PSP’, ‘regenerative protein’, ‘lithostatin’ combined with ‘infection’ and ‘sepsis’ found 44 records. The search was restricted to the five trials that evaluated PSP for the initial detection of infection in hospitalized adults. Individual patient data were obtained from the investigators of all eligible trials. Data quality and validity was assessed according to PRISMA guidelines. We choose a fixed-effect model to calculate the PSP cut-off value that best discriminates infected from non-infected patients.

Results
Infection was confirmed in 371 of 631 patients. The median (IQR) PSP value of infected versus uninfected patients was 81.5 (30.0–237.5) versus 19.2 (12.6–33.57) ng/ml, compared to 150 (82.70–229.55) versus 58.25 (15.85–120) mg/l for C-reactive protein (CRP) and 0.9 (0.29–4.4) versus 0.15 (0.08–0.5) ng/ml for procalcitonin (PCT). Using a PSP cut-off of 44.18 ng/ml, the ROC AUC to detect infection was 0.81 (0.78–0.85) with a sensitivity of 0.66 (0.61–0.71), specificity of 0.83 (0.78–0.88), PPV of 0.85 (0.81–0.89) and NPV of 0.63 (0.58–0.68). When a model combining PSP and CRP was used, the ROC AUC improved to 0.90 (0.87–0.92) with higher sensitivity 0.81 (0.77–0.85) and specificity 0.84 (0.79–0.90) for discriminating infection from non-infection. Adding PCT did not improve the performance further.

Conclusions
PSP is a promising biomarker to diagnose infections in hospitalized patients. Using a cut-off value of 44.18 ng/ml, PSP performs better than CRP or PCT across the considered studies. The combination of PSP with CRP further enhances its accuracy.
Long-term and acute safety of a novel orally administered combination drug product containing milbemycin oxime and lotilaner (Credelio® Plus) in juvenile and adult dogs
Authors: Riggs Kari L. , Wiseman Scott 
Published: May 2021

AbstractBackgroundThe combination of milbemycin oxime (MO) and lotilaner (Credelio®Plus) is a novel systemic endectocide that provides month-long effectiveness in dogs after a single oral treatment. The safety of Credelio®Plus flavored chewable tablets was investigated in three target animal safety studies. Two studies (one in juveniles and one in adults) evaluated the long-term safety, and one study evaluated the acute safety of the product when administered orally at the upper end of the recommended dose range (0.75–1.53 mg/kg MO and 20–41 mg/kg lotilaner) and multiples of this dose.MethodsThe objectives of these studies were to determine the long-term and acute safety of MO and lotilaner flavored chewable tablets in healthy dogs. All three studies were randomized, blinded, parallel-group design studies in healthy Beagle dogs. In each of the two long-term studies, 32 dogs were randomized among four groups to untreated controls or to treated groups at target doses of 1X, 3X, or 5X. Treatment was administered on seven (adult dogs) or nine (juvenile dogs) occasions with dosing every 4 weeks. In the acute study, 48 dogs were randomized among four groups to untreated controls or to treated groups at 1X, 3X, or 6X. In all three studies, the control group was administered placebo tablets. All dogs were fed 30 to 45 min prior to treatment and the assessment of safety was based on health observations, complete physical/neurological examinations, and food consumption. For the long-term safety studies, safety assessments also included clinical pathology evaluations (hematology, clinical chemistry and urinalysis), body weight, pharmacokinetic blood collections, and macroscopic and microscopic examinations of collected tissues.ResultsMO and lotilaner did not induce any treatment-related adverse effects based on health observations, physical/neurological examinations, or food consumption in the long-term or acute studies. Additionally, in the long-term studies, MO and lotilaner did not induce any treatment-related effects on clinical pathology, body weight, and macroscopic and microscopic examinations.ConclusionsThese three studies demonstrate that Credelio®Plus has a wide safety margin when administered at monthly intervals to puppies and dogs at the high end of the commercial dose band.Graphical Abstract
Field study to investigate the effectiveness and safety of a novel orally administered combination drug product containing milbemycin oxime and lotilaner (Credelio® Plus) for the prevention of heartworm disease (Dirofilaria immitis) in client-owned dogs in the USA
Authors: Young Lisa M. , Wiseman Scott , Crawley Elizabeth , Wallace Kim , Snyder Daniel E. 
Published: May 2021

AbstractBackgroundDirofilaria immitis,a globally distributed filarial parasite of dogs, is known to cause serious or fatal cardiopulmonary disease. Client-owned dogs were enrolled in a clinical field study in the USA to evaluate the clinical effectiveness and field safety of an orally administered combination investigational product (IP) containing milbemycin oxime and lotilaner (Credelio®Plus) as compared to a control product (CP) for the prevention of heartworm disease when administered monthly for 11 consecutive months.MethodsIn this 11-month field study, 319 dogs ≥ 8 weeks old confirmed to be heartworm-negative were enrolled from eight geographically distinct US veterinary clinics, including sites in the southern USA and Mississippi River Valley. The dogs were treated with either the IP combination product at 0.75–1.53 mg/kg milbemycin oxime and 20–41.5 mg/kg lotilaner (n = 159) or the CP (Sentinel®Flavor Tabs®; milbemycin oxime/lufenuron) at the label-recommended dose rate (n = 158.) On day 330, effectiveness was evaluated in each dog using antigen and microfilarial (modified Knott’s) testing to assess the establishment of any patent adult heartworm infections.ResultsAll dogs treated with the IP combination product and the CP tested negative (100% prevention) for heartworm infection on day 330. The IP combination product tablets containing milbemycin oxime and lotilaner were well tolerated based on the safety assessments in all treated dogs.ConclusionsThis multi-site clinical study using client-owned dogs demonstrated that monthly use of flavored, chewable tablets containing a combination of milbemycin oxime and lotilaner administered orally under end use conditions is safe for dogs. None of the enrolled dogs developed heartworm infections. Eleven consecutive monthly treatments of the IP provided 100% prevention of heartworm disease caused byD. immitis.Graphical Abstract
Denosumab alleviates intervertebral disc degeneration adjacent to lumbar fusion by inhibiting endplate osteochondral remodeling and vertebral osteoporosis in ovariectomized rats
Authors: Sun Qi , Tian Fa-Ming , Liu Fang , Fang Jia-Kang , Hu Yun-Peng , Lian Qiang-Qiang , Zhou Zhuang , Zhang Liu 
Published: May 2021

Abstract
Background
Although adjacent segmental intervertebral disc degeneration (ASDD) is one of the most common complications after lumbar fusion, its exact mechanism remains unclear. As an antibody to RANKL, denosumab (Dmab) effectively reduces bone resorption and stimulates bone formation, which can increase bone mineral density (BMD) and improve osteoporosis. However, it has not been confirmed whether Dmab has a reversing or retarding effect on ASDD.

Methods
Three-month-old female Sprague-Dawley rats that underwent L4–L5 posterolateral lumbar fusion (PLF) with spinous-process wire fixation 4 weeks after bilateral ovariectomy (OVX) surgery were given Dmab 4 weeks after PLF surgery (OVX+PLF+Dmab group). In addition, the following control groups were defined: Sham, OVX, PLF, and OVX+PLF (n=12 each). Next, manual palpation and X-ray were used to evaluate the state of lumbar fusion. The bone microstructure in the lumbar vertebra and endplate as well as the disc height index (DHI) of L5/6 was evaluated by microcomputed tomography (μCT). The characteristic alterations of ASDD were identified via Safranin-O green staining. Osteoclasts were detected using tartrate-resistant acid phosphatase (TRAP) staining, and the biomechanical properties of vertebrae were evaluated. Aggrecan (Agg), metalloproteinase-13 (MMP-13), and a disintegrin and metalloproteinase with thrombospondin motifs 4 (ADAMTS-4) expression in the intervertebral disc were detected by immunohistochemistry and real-time polymerase chain reaction (RT-PCR) analysis. In addition, the expression of CD24 and Sox-9 was assessed by immunohistochemistry.

Results
Manual palpation showed clear evidence of the fused segment’s immobility. Compared to the OVX+PLF group, more new bone formation was observed by X-ray examination in the OVX+PLF+Dmab group. Dmab significantly alleviated ASDD by retaining disc height index (DHI), decreasing endplate porosity, and increasing vertebral biomechanical properties and BMD. TRAP staining results showed a significantly decreased number of active osteoclasts after Dmab treatment, especially in subchondral bone and cartilaginous endplates. Moreover, the protein and mRNA expression results in discs (IVDs) showed that Dmab not only inhibited matrix degradation by decreasing MMP-13 and ADAMTS-4 but also promoted matrix synthesis by increasing Agg. Dmab maintained the number of notochord cells by increasing CD24 but reducing Sox-9.

Conclusions
These results suggest that Dmab may be a novel therapeutic target for ASDD treatment.
Microbial dynamic and growth potential of selected pathogens in Ethiopian traditional fermented beverages
Authors: Nemo Reda , Bacha Ketema 
Published: May 2021

Abstract
Purpose
The patterns of microbial succession and the associated physicochemical changes in the course of beverage fermentation determine the safety status of the final product against foodborne pathogens. In this study, the microbial dynamics during fermentation of three Ethiopian traditional fermented beverages (namely, borde, tej, and grawa) and the growth potential of selected foodborne pathogens in ready-to-consume beverages were assessed.

Methods
The raw materials used for lab-scale fermentation of the beverages were bought from open markets of Jimma and Anfilo towns. During fermentation, samples were drawn every 6 h (borde fermentation) and 12 h (grawa and tej fermentation). The dominant microbes of the fermentation phases were determined following standard microbiological methods. The growth potential of Escherichia coli, Salmonella typhimurium, Staphylococcus aureus, Listeria monocytogenes, and Candida albicans in the ready-to-consume beverages were assessed by microbial enumeration over defined storage period.

Result
Early fermentation period of all beverages was dominated by aerobic mesophilic bacteria, staphylococci, and Enterobacteriaceae with highest mean counts (Log CFU/ml) of 6.42 ± 0.10, 5.44 ± 0.08, and 5.40 ± 0.11, respectively. At the end of fermentation, yeast counts (Log CFU/ml) dominated in tej (9.41 ± 0.06) and grawa (7.88 ± 0.02) samples, while lactic acid bacteria dominated in borde sample (7.33 ± 0.07). During fermentation, pH dropped for borde (4.58 ± 0.03 to 4.22 ± 0.01), and grawa (4.18 ± 0.10 to 3.62 ± 0.02), but increased for tej (5.26 ± 0.01 to 5.50 ± 0.03) during the first 24 h, though it dropped later down to 3.81 ± 0.02 at 144th h. All reference pathogens were unable to reach infective dose in grawa and tej samples. However, borde sample supported their growth to infective dose within 24 h. Thus, grawa and tej beverages had the capability of inhibiting growth of pathogens while borde needs basic safety control measures during preparation and storage.

Conclusion
With further safety evaluation of the products, the production processes of the three beverages could be scaled up for commercial purposes using defined starter cultures originated from the same beverages. However, the safety status of borde calls for further evaluation for alternative shelf-life extension mechanisms including the introduction of organic preservatives from local products such as medicinal plants.
Intrabiliary and abdominal rupture of hepatic hydatid cyst leading to biliary obstruction, cholangitis, pancreatitis, peritonitis and septicemia: a case report
Authors: Aghajanzadeh Manouchehr , Ashoobi Mohammad Taghi , Hemmati Hossein , Samidoust Pirooz , Delshad Mohammad Sadegh Esmaeili , Pourahmadi Yousha 
Published: May 2021

Abstract
Background
Hydatid cysts are fluid-filled sacs containing immature forms of parastic tapeworms of the genus Echinococcus. The most prevalent and serious complication of hydatid disease is intrabiliary rupture, also known as cystobiliary fistulae. In this study, a sporadic case of biliary obstruction, cholangitis, and septicemia is described secondary to hydatid cyst rupture into the common bile duct and intraperitoneal cavity.

Case presentation
A 21-year-old Iranian man was admitted to the emergency ward with 5 days of serious sickness and a history of right upper quadrant abdominal pain, fatigue, fever, icterus, vomiting, and no appetite. In the physical examination, abdominal tenderness was detected in all four quadrants and in the scleral icterus. Abdominal ultrasound revealed intrahepatic and extrahepatic biliary duct dilation. Gallbladder wall thickening was normal but was very dilated, and large unilocular intact hepatic cysts were detected in segment IV and another one segment II which had detached laminated membranes and was a ruptured or complicated liver cyst.

Conclusion
Intrabiliary perforation of the liver hydatid cyst is an infrequent event but has severe consequences. Therefore, when patients complain of abdominal pain, fever, peritonitis, decreased appetite, and jaundice, a differential diagnosis of hydatid disease needs to be taken into consideration. Early diagnosis of complications and aggressive treatments, such as endoscopic retrograde cholangiopancreatography and surgery, are vital.
Opioid-free anesthesia—dexmedetomidine as adjuvant in erector spinae plane block: a case series
Authors: Coviello Antonio , Esposito Danilo , Galletta Roberta , Maresca Alfredo , Servillo Giuseppe 
Published: May 2021

AbstractBackgroundLaparoscopic pain is related to the stretching of the peritoneum and peritoneal irritation caused by insufflation of the parietal peritoneum with carbon dioxide. In 2017, erector spinae plane block (ESPB) was described for management of postoperative pain following open and laparoscopic abdominal surgery. The use of multimodal anesthesia reduces both intraoperative and postoperative opioid use and improves analgesia. The addition of dexmedetomidine to the anesthetic mixture significantly prolongs analgesia, without clinically significant side effects.Case PresentationWe describe a series of three Caucasian women cases that illustrate the efficacy of bilateral ESPB performed at the level of the T7 transverse process to provide intraoperative and postoperative analgesia for laparoscopic gynecological surgery.ConclusionFurther investigation is recommended to establish the potential for ESPB with dexmedetomidine as adjuvant as an opioid-free anesthetic modality in laparoscopic gynecological surgery.
Proteus mirabilis thoracic vertebral osteomyelitis: a case report
Authors: Chiang Ming-Hsiu , Lee Mei-Hui , Liu Yung-Ching , Lee Chi-Hung 
Published: May 2021

Abstract
Background
Proteus mirabilis is the second most common pathogen that causes urinary tract infections after Escherichia coli. In rare cases, it is associated with vertebral osteomyelitis. The underlying mechanism of this relationship may be related to the retrograde dissemination of bacteria through the paravertebral venous plexus.

Case presentation
We report a case of an 80-year-old Taiwanese woman who had recurrent episodes of fever and chronic back pain for 1 year. All blood cultures were positive for P. mirabilis. Inflammation scans and magnetic resonance imaging revealed a previously undetected vertebral lesion between the seventh and eighth thoracic vertebra. She responded well to treatment with antibiotics, reporting considerable relief of back pain and no fever recurrence at the 4-month follow-up.

Conclusions
Chronic back pain is a common but often dismissed symptom among the older population; osteomyelitis should be considered in patients with recurrent fever or neurological symptoms. Old age, chronic renal failure, and diabetes mellitus are possible predisposing factors for osteomyelitis. Our findings suggest that long-term treatment with antibiotics is effective for osteomyelitis caused by P. mirabilis,, although surgery is required for abscess formation or serious vertebral destruction.
Residual feedback suppression with extended model-based postfilters
Authors: Gimm Marco , Bulling Philipp , Schmidt Gerhard 
Published: May 2021

AbstractWhen designing closed-loop electro-acoustic systems, which can commonly be found in hearing aids or public address systems, the most challenging task is canceling and/or suppressing the feedback caused by the acoustic coupling of the transducers of such systems. In many applications, feedback cancelation based on adaptive filters is used for this purpose. However, due to computational complexity such a feedback canceler is often limited in the length of the filter’s impulse response. Consequently, a residual feedback, which is still audible and may lead to system instability, remains in most cases. In this work, we present enhancements for model-based postfilters based on a priori knowledge of the feedback path which can be used cooperatively with the adaptive filter-based feedback cancelation system to suppress residual feedback and improve the overall feedback reduction capability. For this, we adapted an existing reverberation model such that our model additionally considers the presence and the performance of the adaptive filter. We tested the effectiveness of our approach by means of both objective and subjective evaluations.
Assessing sustainability factors of farmer seed production: a case of the Good Seed Initiative project in Tanzania
Authors: Kansiime M. K. , Bundi M. , Nicodemus J. , Ochieng J. , Marandu D. , Njau S. S. , Kessy R. F. , Williams F. , Karanja D. , Tambo J. A. , Romney D. 
Published: May 2021

AbstractBackgroundQuality seed is at the core of the technological packages needed to increase crop production, nutrition, and rural wellbeing. However, smallholder farmers in Tanzania have limited access to affordable quality seeds, and over 90% of seed sown is saved by farmers from previous harvests, though its quality is often poor. The Good Seed Initiative (GSI) aimed to enhance access to quality African indigenous vegetable (AIV) seed in Tanzania, through the promotion of farmer seed production, using two models—contract farming and Quality Declared Seed (QDS). This study assessed post-GSI project sustainability factors and explored the prospects for replicating the approach in a wider regional context.MethodsThe study was conducted in Arusha and Dodoma, targeting locations where the GSI project was implemented. Qualitative tools employing focus group discussions (73 men, 69 women), and key informant interviews were used for data collection.ResultsFarmer seed production under both models continued to thrive, creating avenues for income diversification and contributing over 50% to household incomes. Farmer seed production contributed to increased availability of quality seed for vegetable growers, especially in central Tanzania that is less served by the formal sector. However, QDS production was challenged by a lack of access to foundation seed, inspections, and seed testing services, which are key for quality seed production.ConclusionsResults reveal unequivocally that farmer seed production offers a potentially sustainable solution to the problem of seed supply while providing income benefits for seed producers. The market-based approach used by the project and partnerships with the formal sector, coupled with stimulation of demand through nutritional awareness campaigns, were strong contributory factors to the survival of farmer seed production. Farmer-led seed systems, especially QDS, deserve support from the government to develop a tailored and appropriate seed system that meets the ever-evolving needs of smallholder farmers. Adoption gender-inclusive approaches, particularly in contract farming is paramount to benefit women as much as men.
The association between obesity and weight loss after bariatric surgery on the vaginal microbiota
Authors: Raglan Olivia , MacIntyre David A. , Mitra Anita , Lee Yun S. , Smith Ann , Assi Nada , Nautiyal Jaya , Purkayastha Sanjay , Gunter Marc J. , Gabra Hani , Marchesi Julian R. , Bennett Phillip R. , Kyrgiou Maria 
Published: May 2021

AbstractBackgroundObesity and vaginal microbiome (VMB) dysbiosis are each risk factors for adverse reproductive and oncological health outcomes in women. Here, we investigated the relationship between obesity, vaginal bacterial composition, local inflammation and bariatric surgery.MethodsVaginal bacterial composition assessed by high-throughput sequencing of bacterial 16S rRNA genes and local cytokine levels measured using a multiplexed Magnetic Luminex Screening Assay were compared between 67 obese and 42 non-obese women. We further assessed temporal changes in the microbiota and cytokines in a subset of 27 women who underwent bariatric surgery.ResultsThe bacterial component of the vaginal microbiota in obese women was characterised by a lower prevalence of aLactobacillus-dominant VMB and higher prevalence of a high diversity (Lactobacillusspp., andGardnerella- spp. depleted) VMB, compared with non-obese subjects (p<0.001). Obese women had higher relative abundance ofDialisterspecies (p<0.001),Anaerococcus vaginalis(p=0.021), andPrevotella timonensis(p=0.020) and decreased relative abundance ofLactobacillus crispatus(p=0.014). Local vaginal IL-1β, IL-4, IL-6, IL-8, IFNγ, MIP-1α and TNFα levels were all higher among obese women, however, only IL-1β and IL-8 correlated with VMB species diversity. In a subset of obese women undergoing bariatric surgery, there were no significant overall differences in VMB following surgery; however, 75% of these women remained obese at 6 months. Prior to surgery, there was no relationship between body mass index (BMI) and VMB structure; however, post-surgery women with aLactobacillus-dominant VMB had a significantly lower BMI than those with a high diversity VMB.ConclusionsObese women have a significantly different vaginal microbiota composition with increased levels of local inflammation compared to non-obese women. Bariatric surgery does not change the VMB; however, those with the greatest weight loss 6-month post-surgery are most likely to have aLactobacillus-dominant VMB.