bluuebunny/crossref_metadata_2025_split huggingface dataset:
Correlation between PCT, 25(OH)D, PTX-3, AMS levels and the severity of diabetic ketoacidosis complicated by pancreatitis
Authors: Lu Songtao , Wei Dongmei , Yin Chao , Xiong Juwen , Zhu Lishuang , Yan Shaoru , Meng Rui 
Published: June 2021

Abstract
Background
This study aims to explore the correlation between procalcitonin (PCT), 25-hydroxyvitamin D3 (25(OH)D), pentraxin-3 (PTX-3), amylase (AMS) levels and severity of diabetic ketoacidosis complicated by pancreatitis.

Methods
A retrospective analysis of 198 patients with diabetic ketoacidosis admitted to our hospital from January 2015 to February 2020 were included. According to whether the patients with pancreatitis, subjects were divided into diabetic ketoacidosis with pancreatitis (DKA-AP) group and diabetic ketoacidosis (DKA) group. Healthy controls admitted to the hospital for physical examinations were included as a control group. Clinical outcomes were collected.

Results
On the first day after admission, the levels of PCT, PTX-3, and AMS in DKA-AP group were significantly higher than those in DKA group and control group, and 25(OH)D levels in DKA-AP group were lower than those in DKA group and control group. PCT, PTX-3, and AMS levels were significantly increased, and 25(OH)D levels were decreased in the DKA group compared with the control group. Furthermore, the levels of PCT, 25(OH)D, PTX-3, and AMS in the DKA-AP group were correlated with the disease severity of of diabetic ketoacidosis complicated by pancreatitis. The levels of PCT, PTX-3, and AMS in the DKA-AP group on day 1 were significantly higher and 25(OH)D levels were significantly lower than those on days 3–7 after admission. The levels of PCT, PTX-3, and AMS in the DKA group on day 1 were significantly higher and 25(OH)D levels were significantly lower than those on days 2–7 after admission. The levels of these indicators returned to normal levels on day 3 or day 7 in DKA or DKA-AP group, respectively. PCT, PTX-3, and AMS levels in the DKA-AP group were significantly increased, while 25(OH)D levels in the DKA-AP group were decreased compared with DKA group on days 1–6 after admission. The duration of hospital stay, patients of ICU care, duration of ICU stay, and cost in DKA-AP group were all higher than those in the DKA group.

Conclusion
Blood levels of PCT, 25(OH)D, PTX-3, and AMS were correlated with diabetic ketoacidosis complicated by pancreatitis, and have certain application value in assessment of the disease severity.
Decision aids linked to evidence summaries and clinical practice guidelines: results from user-testing in clinical encounters
Authors: Heen Anja Fog , Vandvik Per Olav , Brandt Linn , Achille Frankie , Guyatt Gordon Henry , Akl Elie A. , Treewek Shaun , Agoritsas Thomas 
Published: June 2021

AbstractBackgroundTools for shared decision-making (e.g. decision aids) are intended to support health care professionals and patients engaged in clinical encounters involving shared decision-making. However, decision aids are hard to produce, and onerous to update. Consequently, they often do not reflect best current evidence, and show limited uptake in practice. In response, we initiated the Sharing Evidence to Inform Treatment decisions (SHARE-IT) project. Our goal was to develop and refine a new generation of decision aids that are generically produced along digitally structured guidelines and evidence summaries.MethodsApplying principles of human-centred design and following the International Patient Decision Aid Standards (IPDAS) and GRADE methods for trustworthy evidence summaries we developed a decision aid prototype in collaboration with the Developing and Evaluating Communication strategies to support Informed Decisions and practice based on Evidence project (DECIDE). We iteratively user-tested the prototype in clinical consultations between clinicians and patients. Semi-structured interviews of participating clinicians and patients were conducted. Qualitative content analysis of both user-testing sessions and interviews was performed and results categorized according to a revised Morville’s framework of user-experience. We made it possible to produce, publish and use these decision aids in an electronic guideline authoring and publication platform (MAGICapp).ResultsDirect observations and analysis of user-testing of 28 clinical consultations between physicians and patients informed four major iterations that addressed readability, understandability, usability and ways to cope with information overload. Participants reported that the tool supported natural flow of the conversation and induced a positive shift in consultation habits towards shared decision-making. We integrated the functionality of SHARE-IT decision aids in MAGICapp, which has since generated numerous decision aids.ConclusionOur study provides a proof of concept that encounter decision aids can be generically produced from GRADE evidence summaries and clinical guidelines. Online authoring and publication platforms can help scale up production including continuous updating of electronic encounter decision aids, fully integrated with evidence summaries and clinical practice guidelines.
Impact of dietary Chlorella vulgaris and carbohydrate-active enzymes incorporation on plasma metabolites and liver lipid composition of broilers
Authors: Coelho Diogo Francisco Maurício , Alfaia Cristina Maria Riscado Pereira Mate , Assunção José Miguel Pestana , Costa Mónica , Pinto Rui Manuel Amaro , de Andrade Fontes Carlos Mendes Godinho , Lordelo Madalena M. , Prates José António Mestre 
Published: June 2021

AbstractBackgroundChlorella vulgarishas been proposed as a sustainable green feedstock in poultry nutrition due to its ease of cultivation, minimal environmental impact and balanced nutritional composition. However, the majority of studies documents the use ofC. vulgarisas a dietary supplement in broilers instead of a feed ingredient. To the best of our knowledge, no report has shown the effect of a high-level incorporation (>2 % in the diet) ofC. vulgarison plasma metabolites and hepatic lipid composition of broilers. One hundred and twenty Ross 308 male birds were housed in 40 wired-floor cages and randomly distributed by the following experimental diets at 22 days of age (n = 10) during 15 days: (1) a corn-soybean meal based diet (control); (2) based diet with 10% ofC. vulgaris; (3) diet2supplemented with 0.005% Rovabio®Excel AP; and (4) diet2supplemented with 0.01% of a pre-selected four-CAZyme mixture.ResultsThe inclusion ofC. vulgarisat 10% in the diet, regardless of the presence of exogenous CAZymes, changed plasma metabolites but did not compromise broilers growth. Plasma total lipids increased in broilers fedC. vulgariscombined with the two feed CAZymes (p< 0.001) compared with the control diet. Moreover, the supplementation with Rovabio®increased total cholesterol and LDL-cholesterol, while the addition of the four-CAZyme mixture increased triacylglycerols, VLDL-cholesterol and ALP activity. In opposition, HDL-cholesterol levels decreased in broilers fed microalga alone (p = 0.002). Regarding hepatic composition, the inclusion ofC. vulgarisin broiler diets, individually or combined with exogenous CAZymes, had a minor effect on fatty acids but improved then-6/n-3 ratio and total carotenoids.ConclusionsIn summary, the inclusion of a high level (10%) ofC. vulgarisin broiler´s diet, regardless of the presence of exogenous CAZymes, improved hepatic antioxidant composition and did not impair broiler’s performance. In addition, the feed supplementation with CAZymes increased broilers lipemia. Therefore, dietaryC. vulgarisat this incorporation level seems to be safe for animal health and do not compromise performance traits, with no need of CAZymes supplementation.
Klebsiella sp.-related infectious spondylitis in a bearded dragon (Pogona vitticeps)
Authors: Vetere Alessandro , Bertocchi Mara , Pelizzone Igor , Moggia Emanuele , Gerosa Sebastiano , Di Ianni Francesco 
Published: June 2021

Abstract
Background
Spondylitis is an inflammation of the vertebrae that leads to a destructive process with exuberant new bone formation. Osteomyelitis can produce a distortion of the bone architecture, degenerative joint changes and ankyloses of adjacent vertebrae. In reptiles, intervertebral discs are absent, so the term discospondylitis is not used. In lizards, vertebral lesions have not been well studied. The present paper describes the first case of Klebsiella sp.-related spondylitis in a pet lizard (Pogona vitticeps).

Case presentation
A 2-year-old, female bearded dragon (Pogona vitticeps) was presented for clinical examination due to a decreased activity level, decreased appetite and constipation. Blood tests showed no remarkable alterations. The haemogram showed normal parameters with relative lymphocytosis, although the absolute number of lymphocytes did not differ from the reference values. A computed tomography scan revealed a mixed osteolytic-proliferative bone lesion diffusing to the first and last tracts of the pre-sacral vertebrae together. A small amount of material obtained from the spinal swelling was sampled with an aseptic technique for bacterial culture, which was positive for Klebsiella sp. The antibiogram revealed sensitivity to enrofloxacin, marbofloxacin, and chloramphenicol and intermediate sensitivity to gentamicin. Complete return to spontaneous feeding was achieved 15 days after the beginning of antibiotic and anti-inflammatory therapy.

Conclusions
In veterinary medicine, spondylitis represents a well-known disease in small companion animals. In mammals, the most common aetiologic agents are fungi and bacteria. Antibiotic therapy was set based on the antibiogram, and marbofloxacin was chosen at a dosage of 10 mg/kg subcutaneously (SC) once per day (SID). After only 7 days of antibiotic therapy, the clinical condition improved significantly; the patient started feeding and drinking spontaneously and gained weight. This case should remind clinicians of the importance of always performing antibiograms before choosing any antibiotic therapy. Considering reptiles, there have been few papers about spinal diseases, mostly regarding snakes and a few about Iguana iguana. Relative to other species of saurians, the literature remains lacking.
Redirection of the central metabolism of Klebsiella pneumoniae towards dihydroxyacetone production
Authors: Sun Shaoqi , Wang Yike , Shu Lin , Lu Xiyang , Wang Qinghui , Zhu Chenguang , Shi Jiping , Lye Gary J. , Baganz Frank , Hao Jian 
Published: June 2021

Abstract
Background
Klebsiella pneumoniae is a bacterium that can be used as producer for numerous chemicals. Glycerol can be catabolised by K. pneumoniae and dihydroxyacetone is an intermediate of this catabolism pathway. Here dihydroxyacetone and glycerol were produced from glucose by this bacterium based a redirected glycerol catabolism pathway.

Results
tpiA, encoding triosephosphate isomerase, was knocked out to block the further catabolism of dihydroxyacetone phosphate in the glycolysis. After overexpression of a Corynebacterium glutamicum dihydroxyacetone phosphate dephosphorylase (hdpA), the engineered strain produced remarkable levels of dihydroxyacetone (7.0 g/L) and glycerol (2.5 g/L) from glucose. Further increase in product formation were obtained by knocking out gapA encoding an iosenzyme of glyceraldehyde 3-phosphate dehydrogenase. There are two dihydroxyacetone kinases in K. pneumoniae. They were both disrupted to prevent an inefficient reaction cycle between dihydroxyacetone phosphate and dihydroxyacetone, and the resulting strains had a distinct improvement in dihydroxyacetone and glycerol production. pH 6.0 and low air supplement were identified as the optimal conditions for dihydroxyacetone and glycerol production by K, pneumoniae ΔtpiA-ΔDHAK-hdpA. In fed batch fermentation 23.9 g/L of dihydroxyacetone and 10.8 g/L of glycerol were produced after 91 h of cultivation, with the total conversion ratio of 0.97 mol/mol glucose.

Conclusions
This study provides a novel and highly efficient way of dihydroxyacetone and glycerol production from glucose.
Healthcare provider and pregnant women’s perspectives on the implementation of intermittent screening and treatment with dihydroartemisinin–piperaquine for malaria in pregnancy in western Kenya: a qualitative study
Authors: Hoyt Jenna , Hill Jenny , Achieng Florence , Ouma Peter , Kariuki Simon , Desai Meghna , Webster Jayne 
Published: June 2021

Abstract
Background
In malaria endemic regions in Kenya, pregnant women are offered long-lasting insecticidal nets and intermittent preventive treatment (IPTp) with sulfadoxine–pyrimethamine (SP) at antenatal care (ANC) to prevent the adverse effects of malaria. Fears of growing SP resistance have heightened the search for alternative strategies. The implementation feasibility of intermittent screening and treatment (ISTp) with dihydroartemisinin–piperaquine (DP) in routine ANC settings was evaluated using qualitative and quantitative methods, including the exploration of healthcare provider and pregnant women’s perceptions.

Methods
Qualitative methods included data from 13 focus group discussions (FGDs) with pregnant women and 43 in-depth interviews with healthcare providers delivering ANC services. FGDs were conducted with women who had received either ISTp-DP or current policy (IPTp-SP). Thematic analysis was used to explore experiences among women and providers and findings were used to provide insights into results of the parallel quantitative study.

Results
Women were accepting of testing with rapid diagnostic tests (RDTs) and receiving treatment if malaria positive. Providers perceived DP to be an effective drug and well tolerated by women. Some providers indicated a preference for test and treat strategies to reduce unnecessary exposure to medication in pregnancy, others preferred a hybrid strategy combining screening at every ANC visit followed by IPTp-SP for women who tested negative, due to the perception that RDTs missed some infections and concerns about the growing resistance to SP. Testing with RDTs during ANC was appreciated as it was perceived to reduce wait times. The positive attitude of healthcare providers towards ISTp supports findings from the quantitative study that showed a high proportion (90%) of women were tested at ANC. There were concerns about affordability of DP and the availability of sufficient RDT stocks.

Conclusion
In ANC settings, healthcare providers and pregnant women found ISTp-DP to be an acceptable strategy for preventing malaria in pregnancy when compared with IPTp-SP. DP was considered an effective anti-malarial and a suitable alternative to IPTp-SP in the context of SP resistance. Despite providers’ lack of confidence in RDT results at current levels of sensitivity and specificity, the quantitative findings show their willingness to test women routinely at ANC.
Household air pollution, ultrasound measurement, fetal biometric parameters and intrauterine growth restriction
Authors: Dutta Anindita , Alexander Donee , Karrison Theodore , Morhasson-Bello Oludare , Wilson Nathaniel , Atalabi Omolola Mojisola , Adu Damilola , Ibigbami Tope , Adekunle Samuel , Adepoju Dayo , Olamijulo John , Akinwunmi Omolola , Afolabi Oluniyi S. , Deji-Abiodun Oluwafunmilade , Adedokun Babatunde , Aschebrook-Kilfoy Briseis , Ojengbede Oladosu , Olopade Christopher O. 
Published: June 2021

Abstract
Background
Low birthweight, intrauterine growth restriction (IUGR) and perinatal mortality have been associated with air pollution. However, intervention studies that use ultrasound measurements to assess the effects of household air pollution (HAP) on fetal biometric parameters (FBP) are rare. We investigated the effect of a cookstove intervention on FBP and IUGR in a randomized controlled trial (RCT) cohort of HAP-exposed pregnant Nigerian women.

Methods
We recruited 324 women early in the second trimester of pregnancy. Between 16 and 18 weeks, we randomized them to either continue cooking with firewood/kerosene (control group) or receive a CleanCook stove and ethanol fuel (intervention group). We measured fetal biparietal diameter (BPD), head circumference (HC), femur length (FL), abdominal circumference (AC) and ultrasound-estimated fetal weight (U-EFW) in the second and third trimesters. The women were clinically followed up at six regular time points during their pregnancies. Once during the women’s second trimester and once during the third, we made 72-h continuous measurements of their personal exposures to particulate matter having aerodynamic diameter < 2.5 μm (PM2.5). We adopted a modified intent-to-treat approach for the analysis. Differences between the intervention and control groups on impact of HAP on fetal growth trajectories were analyzed using mixed effects regression models.

Results
There were no significant differences in fetal growth trajectories between the intervention and control groups.

Conclusions
Larger studies in a setting of low ambient air pollution are required to further investigate the effect of transitioning to a cleaner fuel such as ethanol on intrauterine growth.

Trial registration
ClinicalTrials.gov NCT02394574; September 2012
Associations between exposure to perfluoroalkyl substances and body fat evaluated by DXA and MRI in 109 adolescent boys
Authors: Thomsen Mathilde Lolk , Henriksen Louise Scheutz , Tinggaard Jeanette , Nielsen Flemming , Jensen Tina Kold , Main Katharina M. 
Published: June 2021

Abstract
Background
Exposure to perfluoroalkyl substances (PFASs) has been associated with changes in body mass index and adiposity, but evidence is inconsistent as study design, population age, follow-up periods and exposure levels vary between studies. We investigated associations between PFAS exposure and body fat in a cross-sectional study of healthy boys.

Methods
In 109 boys (10–14 years old), magnetic resonance imaging and dual-energy X-ray absorptiometry were performed to evaluate abdominal, visceral fat, total body, android, gynoid, android/gynoid ratio, and total fat percentage standard deviation score. Serum was analysed for perfluorooctanoic acid, perfluorooctane sulfonic acid (PFOS), perfluorohexane sulfonic acid, perfluorononanoic acid, and perfluorodecanoic acid using liquid chromatography and triple quadrupole mass spectrometry. Data were analysed by multivariate linear regression.

Results
Serum concentrations of PFASs were low. Generally, no clear associations between PFAS exposure and body fat measures were found; however, PFOS was negatively associated with abdominal fat (β = -0.18, P = 0.046), android fat (β = -0.34, P = 0.022), android/gynoid ratio (β = -0.21, P = 0.004), as well as total body fat (β = -0.21, P = 0.079) when adjusting for Tanner stage.

Conclusions
Overall, we found no consistent associations between PFAS exposure and body fat. This could be due to our cross-sectional study design. Furthermore, we assessed PFAS exposure in adolescence and not in utero, which is considered a more vulnerable time window of exposure.
Increased levels of S100A8/A9, IL-1ß and IL-18 as a novel biomarker for recurrent tonsillitis
Authors: Spiekermann Christoph , Seethaler Alicia , McNally Annika , Stenner Markus , Rudack Claudia , Roth Johannes , Vogl Thomas 
Published: June 2021

Abstract
Background
Acute tonsillitis represents one of the most frequent reasons patients seek primary medical care and otorhinolaryngology consultation. Therefore, recurrent episodes of acute tonsillitis (RAT), also called chronic tonsillitis, exhaust a substantial amount of medical and financial resources. Diagnosis of tonsillitis depends on a physical examination, which therefore does not allow for a reliable differentiation between viral and bacterial infection. However, the frequency of bacterial infections during the previous three years is currently being used as the major deciding factor in patient selection for tonsillectomy. The aim of the present study was to determine an objective biomarker to help in the identification of patients suffering from recurrent tonsillitis.

Results
By analyzing a panel of cytokines and chemokines in serum and saliva of patients with RAT compared to healthy controls, increased levels of IL-1ß (153.7 ± 48.5 pg/ml vs 23.3 ± 6.6 pg/ml, p = 0.021), IL-18 (120.2 ± 16.5 vs 50.6 ± 9.3 pg/ml, p = 0.007) and/or S100A8/A9 (996 ± 102 ng/ml vs 546 ± 86 ng/ml, p = 0.042) could be observed in patients suffering from RAT. Cut-off values of these parameters were determined and combined to a new RAT-score allowing for reliable identification of patients suffering from recurrent tonsillitis with a sensitivity of 95% and a specificity of 88%.

Conclusion
The RAT-score represents the first objective criterion as a tool for the diagnosis of recurrent tonsillitis and it also improves patient selection for tonsillectomy.
Public availability of information from WFME-recognized accreditation agencies
Authors: Baniadam Kahlo , Arfeen Zakia , Rashid Mohammed Ahmed , Ho Ming-Jung , Tackett Sean 
Published: June 2021

AbstractThe World Federation for Medical Education (WFME) Recognition Programme was created to ensure the comparability of medical school accrediting agencies, so that the schools accredited by those agencies would have similar educational quality. WFME explicitly values transparency and has recognition criteria that relate to agencies making information publicly available. Our study examined 20 WFME-recognized agencies’ transparency by reviewing agency websites for 27 information elements related to accreditation standards, procedures, and processes. We contacted agencies as needed for information that we could not find on their websites. We were only able to retrieve additional information from 3 of the 12 agencies that we attempted to contact. We found that while 12 agencies had over 90% of expected information elements available, 6 agencies had less than 50%. Our findings illustrate barriers for those who wish to better understand medical school accreditation in some regions and raise questions about how comparable WFME-recognized agencies are.
Lack of impact of radiation on blood physiology biomarkers of Chernobyl tree frogs
Authors: Burraco Pablo , Bonzom Jean-Marc , Car Clément , Beaugelin-Seiller Karine , Gashchak Sergey , Orizaola Germán 
Published: June 2021

Abstract
Background
Human actions have altered natural ecosystems worldwide. Among the many pollutants released to the environment, ionizing radiation can cause severe damage at different molecular and functional levels. The accident in the Chernobyl Nuclear Power Plant (1986) caused the largest release of ionizing radiation to the environment in human history. Here, we examined the impact of the current exposure to ionizing radiation on blood physiology biomarkers of adult males of the Eastern tree frog (Hyla orientalis) inhabiting within and outside the Chernobyl Exclusion Zone. We measured the levels of eight blood parameters (sodium, potassium, chloride, ionized calcium, total carbon dioxide, glucose, urea nitrogen, and anion gap), physiological markers of homeostasis, as well as of liver and kidney function.

Results
Levels of blood physiology biomarkers did not vary in function of the current exposure of tree frogs to ionizing radiation within the Chernobyl Exclusion Zone. Physiological blood levels were similar in frogs inhabiting Chernobyl (both in areas with medium-high or low radiation) than in tree frogs living outside Chernobyl exposed only to background radiation levels.

Conclusions
The observed lack of effects of current radiation levels on blood biomarkers can be a consequence of the low levels of radiation currently experienced by Chernobyl tree frogs, but also to the fact that our sampling was restricted to active breeding males, i.e. potentially healthy adult individuals. Despite the clear absence of effects of current radiation levels on physiological blood parameters in tree frogs, more research covering different life stages and ecological scenarios is still needed to clarify the impact of ionizing radiation on the physiology, ecology, and dynamics of wildlife inhabiting radioactive-contaminated areas.