bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy of sheep as a digestibility model for cattle when fed concentrate-based or forage-based diets
Authors: Chishti Ghazanfar A , Carvalho Pedro H V , Pinto Ana Carolina , Silva Flavia A S , Felix Tara L 
Published: June 2019

AbstractThe objectives were to determine the efficacy of sheep as a digestibility model for cattle feeding two diets, forage or concentrate based, under current genetics. Twelve Suffolk wethers were blocked into two periods with six wethers in each period. Within each period, wethers were fed a forage-based diet (n = 3) or a concentrate-based diet (n = 3). Six angus steers were also fed a forage-based diet (n = 3) or a concentrate-based diets (n = 3) in switchback design with two periods. All animals were adapted to diets for a minimum of 3 wk, then feed intake, refusals, and feces were collected. Feed and fecal dry matter (DM), organic matter (OM), neutral detergent fiber (NDF), acid detergent fiber (ADF), and starch were analyzed. Refusals were analyzed for DM. Data were analyzed using Proc Mixed in SAS with diet and species as fixed and period as a random effect. Dry matter intake as percentage of body weight for each animal within each period was used as a covariable. There was an interaction (P &lt; 0.01) between species and diet for DM and OM digestibility. When fed the concentrate-based diet, DM and OM digestibility were similar between wethers and steers (P &gt; 0.18); however, when fed the forage-based diet, DM and OM digestibility was less (P &lt; 0.01) for wethers than steers. Like DM and OM, an interaction (P &lt; 0.05) between species and diet was present for starch digestibility. When fed the forage-based diet, starch digestibility did not differ (P = 0.66) between wethers and steers; however, when fed concentrate-based diet, wethers had a greater starch digestibility (P &lt; 0.05) than steers. There was no interaction (P &gt; 0.45) between species and diet for NDF and ADF digestibility. Regardless of the diet fed, NDF and ADF digestibilities were greater (P &lt; 0.05) in steers than wethers. Present day sheep were not a good model for cattle when fed forage-based diets, but sheep were an acceptable model for cattle when fed concentrate-based diets.
Assessment of Epicardial Adipose Tissue Thickness in Children with Familial Mediterranean Fever
Authors: Ghobrial Emad E , Farag Yomna M , Abdul-Aziz Doaa M , Omar Mai A 
Published: June 2019

Abstract

Background
Familial Mediterranean fever (FMF) is suggested to be associated with increased risk of atherosclerosis. Epicardial adipose tissue (EAT) thickness is used in prediction of atherosclerotic risk. The aim of our study was to evaluate EAT thickness in FMF patients for early detection of risk of atherosclerosis and to be compared with its level in healthy controls.

Methods
Thirty 6- to 18-year-old children with FMF and 30 age- and sex-matched children (control group) were included in the study. Disease characteristics, disease severity and Mediterranean fever gene mutations were recorded. EAT thicknesses was measured by echocardiography.

Results
EAT in patients’ group was significantly greater than that of controls (5.21 ± 2.3 vs. 2.81 ± 2.96 mm, p = 0.001) and was correlated with cholesterol level and platelets count (p = 0.047 and 0.018, respectively).

Conclusion
This study concluded that EAT thickness was statistically increased in FMF patients than controls with a positive correlation with cholesterol level and platelet count. This finding suggests a higher risk for atherosclerosis in these patients. Follow-up study is needed to verify the effect of treatment of FMF on the EAT thickness. Further studies with larger number of patients following-up EAT are needed to verify this finding.
Use of Thermal Imaging to Identify Deep-Tissue Pressure Injury on Admission Reduces Clinical and Financial Burdens of Hospital-Acquired Pressure Injuries
Authors: Koerner Suzanne , Adams Diane , Harper Scot L. , Black Joyce M. , Langemo Diane K. 
Published: June 2019

ABSTRACT
A deep-tissue pressure injury (DTPI) is a serious type of pressure injury that begins in tissue over bony prominences and can lead to the development of hospital-acquired pressure injuries (HAPIs). Using a commercially available thermal imaging system, study authors documented a total of 12 thermal anomalies in 9 of 114 patients at the time of admission to one of the study institution’s ICUs over a 2-month period. An intensive, proven wound prevention protocol was immediately implemented for each of these patients. Of these 12 anomalies, 2 ultimately manifested as visually identifiable DTPIs. This represented a 60% reduction in the authors' institution’s historical DTPIs/HAPI rate. Because these DTPIs were documented as present on admission using the thermal imaging tool, researchers avoided a revenue loss associated with nonreimbursed costs of care and also estimated financial benefits associated with litigation expenses known to be generated with HAPIs.
Using thermal imaging to document DTPIs when patients present has the potential to significantly reduce expenses associated with pressure injury litigation. The clinical and financial benefits of early documentation of skin surface thermal anomalies in anatomical areas of interest are significant.
Is It Safe to Ask the Questions That Matter Most to Me? Observations From a Female Residency Applicant
Authors: Weaver Alice N. , Willett Lisa L. 
Published: June 2019

Tens of thousands of senior medical students interview for medical residency positions each year. As the applicant pool shifts to include more women, married individuals, and young parents, the criteria by which interviewees evaluate programs are also changing. Concerns including parental leave policies, lactation facilities, access to childcare, partner recruitment resources, and inclusivity in the work environment are important in selecting an ideal program. However, the National Resident Matching Program Match Communication Code of Conduct prohibits interviewers from addressing gender, marital status, and intent to bear children, so the burden of introducing such topics falls on the interviewees. These topics can be difficult to discuss with potential employers, especially when weighed against the pressure to obtain a competitive position through the Match.
In this Invited Commentary, the authors draw on personal experience to examine the questions that residency programs need to answer, encouraging both applicants and programs to improve communication during the residency interview process.
Microbiome and autoimmune diseases: cause and effect relationship
Authors: Nogueira Ana Rita , Shoenfeld Yehuda 
Published: June 2019

Purpose of review
The human body is the host of trillions of different prokaryotic microorganisms that colonize the skin and the mucosae. The interaction between human cells and these organisms is mediated by the immune system, sustaining a very complex and fragile balance. The immune cells need to prevent uncontrolled growth of pathogenic microbes and promote tolerance toward the existence of the beneficial ones. Growing evidence associates the disruption of this symbiotic relationship with the development of autoimmune diseases.

Recent findings
Human studies led to the identification of gut dysbiosis patterns in patients with rheumatoid arthritis, lupus and multiple sclerosis. Interestingly, the inoculation of pathogenic bacteria in animal models was associated with the development of these autoimmune diseases.

Summary
A better understanding of the microbiota–human interaction will enable the development of novel treatment choices. Currently, new molecules using helminth compounds are under investigation and have already revealed promising results.
Intraoperative Use of O-arm in Pediatric Cervical Spine Surgery
Authors: Verhofste Bram P. , Glotzbecker Michael P. , Hresko Michael T. , MacDougall Robert D. , Birch Craig M. , O’Neill Nora P. , Karlin Lawrence I. , Emans John B. , Proctor Mark R. , Hedequist Daniel J. 
Published: June 2019

Introduction:
Traditionally, fluoroscopy and postoperative computed tomographic (CT) scans are used to evaluate screw position after pediatric cervical spine fusion. However, noncontained screws detected postoperatively can require revision surgery. Intraoperative O-arm is a 3-dimensional CT imaging technique, which allows intraoperative evaluation of screw position and potentially avoids reoperations because of implant malposition. This study’s objective was to evaluate the use of intraoperative O-arm in determining the accuracy of cervical implants placed by a free-hand technique using anatomic landmarks or fluoroscopic guidance in pediatric cervical spine instrumentation.

Methods:
A single-center retrospective study of consecutive examinations of children treated with cervical spine instrumentation and intraoperative O-arm from 2014 to 2018 was performed. In total, 44 cases (41 children, 44% men) with a mean age of 11.9 years (range, 2.1 to 23.5 y) were identified. Instability (n=16, 36%) and deformity (n=10, 23%) were the most frequent indications. Primary outcomes were screw revision rate, neurovascular complications caused by noncontained screws, and radiation exposure.

Results:
A total of 272 screws were inserted (60 occipital and 212 cervical screws). All screws were evaluated on fluoroscopy as appropriately placed. Four screws (1.5%) in 4 cases (9%) were noncontained on O-arm imaging and required intraoperative revision. A mean of 7.7 levels (range, 5 to 13) were scanned. The mean CT dose index and dose-length product were 15.2±6.87 mGy and 212.3±120.48 mGy×cm. Mean effective dose was 1.57±0.818 mSv. There was no association between screw location and noncontainment (P=0.129). No vertebral artery injuries, dural injuries, or neurologic deficits were related to the 4 revised screws.

Conclusions:
Intraoperative non-navigated O-arm is a safe and efficient method to evaluate screw position in pediatric patients undergoing cervical spine instrumentation. Noncontained screws were detected in 9% of cases (n=4). O-arm delivers low radiation doses, allows for intraoperative screw revision, and negates the need for postoperative CT scans after confirmation of optimal implant position.

Level of Evidence:
Level IV.
Neonatal Group B Streptococcal Infection in a Tertiary Care Hospital in Saudi Arabia
Authors: Al Luhidan Lama , Madani Areej , Albanyan Esam A. , Al Saif Saif , Nasef Minosh , AlJohani Sameera , Madkhali Azzah , Al Shaalan Mohammed , Alalola Sulaiman 
Published: June 2019

Background:
Group B streptococcus (GBS) is a leading cause of neonatal bacterial sepsis and meningitis globally. Studies concerning the incidence and burden of neonatal GBS disease in Saudi Arabia are lacking. This study determined the incidence and burden of GBS infection among neonates in association with maternal GBS screening.

Methods:
A retrospective cohort chart review study included all neonatal GBS disease cases identified through microbiology lab records within the first 90 days of life in the hospital from January 2004 to December 2016. Charts were reviewed to collect maternal and neonatal characteristics using a standardized form.

Results:
Over 13 years, of 108,609 live births, 55 GBS disease cases were identified (overall incidence, 0.51/1000 live births), 69.1% (n = 38) of those had early onset disease (EOD). The annual incidence in 2015 and 2016 was significantly higher than in any previous year (P < 0.0001), coinciding with the discontinuation of routine universal maternal GBS screening. Median age at presentation was 1 day (range, 0–54 days). We found that 67.3% (n = 37) of mothers were not screened antenatally, 72.9% (n = 27) of whom had neonates present with EOD. Neonates of unscreened mothers were more likely to have GBS disease (P = 0.01) and to present with EOD (P = 0.005). Urinary tract infection was the most common manifestation (47.3%, n = 26), followed by sepsis (43.6%, n = 24). Mortality rate was 3.6% (n = 2).

Conclusions:
The incidence of neonatal GBS infection in Saudi Arabia is similar to the worldwide incidence. Universal antenatal screening discontinuation was significantly associated with an increase in EOD incidence.
Safety and Efficacy of Tigecycline to Treat Multidrug-resistant Infections in Pediatrics: An Evidence Synthesis
Authors: Sharland Mike , Rodvold Keith A. , Tucker Hal R. , Baillon-Plot Nathalie , Tawadrous Margaret , Hickman M. Anne , Raber Susan , Korth-Bradley Joan M. , Díaz-Ponce Humberto , Wible Michele 
Published: June 2019

Background:
The need for antimicrobial therapies effective against multidrug resistant organisms for children remains unmet. Tigecycline shows antibacterial activity across a broad spectrum of bacteria and is approved for treating complicated skin and skin-structure infections, complicated intra-abdominal infections and, in the United States, community-acquired bacterial pneumonia for adult patients. No blinded, randomized phase 3 tigecycline clinical trials on neonates or children have been completed or planned. This review aimed to provide a comprehensive synthesis of all the existing data sources, both on-label and off-label, for tigecycline use in children.

Methods:
Data on tigecycline use in children were identified from published and unpublished sources including clinical trials, expanded access and compassionate use programs, databases of healthcare records and patient safety monitoring.

Results:
Pharmacokinetic simulations predicted that tigecycline 1.2 mg/kg (maximum dose 50 mg) every 12 hours (q12h) in children 8–11 years and 50 mg q12h in children 12 to <18 years would achieve exposure similar to adults receiving 50 mg q12h. Available phase 2 pediatric clinical trial data and data from other sources demonstrated similar clinical efficacy between adult and pediatric patients treated with tigecycline. These data showed no new or unexpected safety concerns with tigecycline in children.

Conclusions:
Information presented here may help guide the appropriate use of tigecycline in children with multidrug resistant infections. Continued pharmacovigilance from real-world observational studies may also further refine appropriate use of tigecycline.
Impact of Shifts to Birth Testing on Early Infant Diagnosis Program Outcomes in KwaZulu-Natal, South Africa
Authors: Smith Shayla , Govender Kerusha , Moodley Pravi , La Russa Philip , Kuhn Louise , Archary Moherndran 
Published: June 2019

Background:
South African early infant diagnosis guidelines shifted to recommending an initial HIV nucleic acid-based test (NAT) test at birth in 2015. Prior to this, initial NAT was recommended at 6 weeks of age. Here we examine parameters of early infant diagnosis performance in KwaZulu-Natal before and after this change.

Methods:
Data on all HIV diagnostic NAT conducted for the province between January 2013 and April 2016 were assembled and analyzed. Laboratory barcodes allowed identification of repeat tests on the same child. We evaluated coverage, positivity rates, age at testing and frequency of repeat tests across birth cohorts.

Results:
In birth cohorts 2013 and 2014, 62.1% and 61.8%, respectively, of tests <16 weeks were done in children who were 6–8 weeks of age. In birth cohort 2015, 41.3% of tests <16 weeks were done earlier at <2 weeks of age. The percentage of children with a positive result who had at least 1 follow-up test increased from 11.5% and 13.1% in birth cohorts 2013 and 2014, respectively, to 24.8% in 2015. The percentage of infants with an initial nonpositive result who received at least 1 follow-up test did not appreciably change from 15.0% and 14.4% in 2013 and 2014, respectively, to 14.7% in 2015.

Conclusions:
Birth testing allows for earlier identification of HIV-infected infants who need urgent antiretroviral treatment initiation. Although follow-up testing rates may be underestimated in this data source, repeat testing rates remained low. More effort is needed to ensure infants tested at birth continue to be engaged in care and undergo follow-up testing.
Intracochlear Pressure Transients During Cochlear Implant Electrode Insertion: Effect of Micro-mechanical Control on Limiting Pressure Trauma
Authors: Banakis Hartl Renee M. , Kaufmann Christopher , Hansen Marlan R. , Tollin Daniel J. 
Published: June 2019

Hypothesis:
Use of micro-mechanical control during cochlear implant (CI) electrode insertion will result in reduced number and magnitude of pressure transients when compared with standard insertion by hand.

Introduction:
With increasing focus on hearing preservation during CI surgery, atraumatic electrode insertion is of the utmost importance. It has been established that large intracochlear pressure spikes can be generated during the insertion of implant electrodes. Here, we examine the effect of using a micro-mechanical insertion control tool on pressure trauma exposures during implantation.

Methods:
Human cadaveric heads were surgically prepared with an extended facial recess. Electrodes from three manufacturers were placed both by using a micro-mechanical control tool and by hand. Insertions were performed at three different rates: 0.2 mm/s, 1.2 mm/s, and 2 mm/s (n = 20 each). Fiber-optic sensors measured pressures in scala vestibuli and tympani.

Results:
Electrode insertion produced pressure transients up to 174 dB SPL. ANOVA revealed that pressures were significantly lower when using the micro-mechanical control device compared with insertion by hand (p << 0.001). No difference was noted across electrode type or speed. Chi-square analysis showed a significantly lower proportion of insertions contained pressure spikes when the control system was used (p << 0.001).

Conclusion:
Results confirm previous data that suggest CI electrode insertion can cause pressure transients with intensities similar to those elicited by high-level sounds. Results suggest that the use of a micro-mechanical insertion control system may mitigate trauma from pressure events, both by reducing the amplitude and the number of pressure spikes resulting from CI electrode insertion.
The effect of acupuncture on the expression of inflammatory factors TNF-α, IL-6,IL-1 and CRP in cerebral infarction
Authors: Chen Yuru , Huang Wei , Li Zunjiang , Duan Yunbiao , Liang Zhaoxiong , Zhou Hong , Tang Chuyue 
Published: June 2019

Abstract

Background:
The mechanisms of acupuncture on the treatment of cerebral infarction remain unclear, the aim of the present study was to provides a protocol of systematic review and meta-analysis, with which we will collect clinical evidence to verify whether acupuncture will have an effect on reducing the levels of tumor necrosis factor α (TNF-α), C-reactive protein (CRP), interleukin-1 (IL-1), and interleukin (IL-6) after cerebral infarction based on evidence-based studies.

Methods:
Included studies will be retrieved according to inclusion and exclusion criteria from 5 English databases (the MEDLINE via PubMed, the Cochrane Library, Embase, the Web of Science, and Ovid database), and 4 Chinese databases (China Science and Technology Journal Database (VIP), Chinese Biomedical Literature Database (CBM), Wan-fang Database, China National Knowledge Infrastructure (CNKI)) from October 1990 to October 2017. The inflammatory factor levels of TNF-α and IL-1,IL-6,CRP will be marked as major outcomes. We will use RevMan V.5.3 software to calculate the data synthesis and will conduct meta-analysis based on the collected data.

Results:
The inflammatory factor levels of TNF-α and IL-1,IL-6,CRP, mortality and adverse effects will be measured and comprehensively assessed to evaluate the adjunctive effect of XBP on CHF from this systematic review and meta-analysis with current clinical evidence.

Conclusion:
The systematic review and meta-analysis will assess the effect of acupuncture on the expression of inflammatory factors TNF-α, IL-6, IL-1 and CRP in cerebral infarction with up-to-date clinical evidence.

PROSPERO registration number:
PROSPERO CRD42017078583.
Effects of surgery start time on postoperative cortisol, inflammatory cytokines, and postoperative hospital day in hip surgery
Authors: Kwon Young Suk , Jang Ji Su , Hwang Sung Mi , Tark Hyunjin , Kim Jong Ho , Lee Jae Jun 
Published: June 2019

Abstract

Background:
The aim of this study was to compare morning surgery (Group A), characterized by high cortisol levels, with afternoon surgery (Group B), characterized by low cortisol levels, with respect to cortisol, inflammatory cytokines (interleukin [IL]-6, IL-8), and postoperative hospital days (POHD) after hip surgery.

Methods:
The study was conducted in a single center, prospective, randomized (1:1) parallel group trial. Patients undergoing total hip replacement or hemiarthroplasty were randomly divided into two groups according to the surgery start time: 8 am (Group A) or 1–2 pm (Group B). Cortisol and cytokine levels were measured at 7:30 am on the day of surgery, before induction of anesthesia, and at 6, 12, 24, and 48 hours (h) after surgery. Visual analogue scale (VAS) and POHD were used to evaluate the clinical effect of surgery start time. VAS was measured at 6, 12, 24, and 48 h postoperatively, and POHD was measured at discharge.

Results:
In total, 44 patients completed the trial. The postoperative cortisol level was significantly different between the two groups. (24 h, P < .001; 48 h, P < .001). The percentage of patients whose level returned to the initial level was higher in Group B than in Group A (P < .001). Significant differences in IL-6 levels were observed between the two groups at 12, 24, and 48 h after surgery (P = .015; P = .005; P = .002), and in IL-8 levels at 12 and 24 h after surgery (P = .002, P < .001). There was no significant difference between the two groups in VAS and POHD. However, only three patients in Group A were inpatients for more than 3 weeks (P = .233).

Conclusions:
Afternoon surgery allowed for more rapid recovery of cortisol to the baseline level than morning surgery, and IL-6 and IL-8 were lower at 1–2 days postoperatively. The results of this study suggest that afternoon surgery may be considered in patients with postoperative delayed wound healing or inflammation because of the difference in cortisol, IL-6 and 8 in according to surgery start time.
Clinical trial registration number: NCT03076827 (ClinicalTRrial.gov).