bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effectiveness of interventions to reduce the transmission of acute respiratory infections in care homes: a systematic review
Authors: Willcox Merlin L , Lavu Deepthi , Yousaf Usaid , Dalton Sam , Roberts Nia , Plüddemann Annette 
Published: August 2024

Abstract

Background
Care home residents are at high risk from outbreaks of respiratory infections, such as influenza and COVID-19. We conducted a systematic review of randomized controlled trials, to determine which interventions (apart from vaccines) are effective at reducing transmission of acute respiratory illnesses (ARIs) in care homes.

Methods
We searched CINAHL, Medline, Embase and Cochrane for randomized controlled trials (RCTs) of interventions to prevent transmission of ARIs in care homes (excluding vaccines), to April 2023.

Results
A total of 21 articles met inclusion criteria. Two infection control interventions significantly reduced respiratory infections. Oseltamivir significantly reduced risk of symptomatic laboratory-confirmed influenza (OR 0.39, 95%CI 0.16–0.94, three trials), and influenza-like illness (OR 0.50, 95%CI 0.36–0.69), even in a vaccinated population. High dose vitamin D supplementation reduced incidence of ARIs (incidence rate ratio 0.60; 95%CI 0.38–0.94, one trial). Nine other RCTs of vitamin, mineral, probiotic and herbal supplements showed no significant effect.

Conclusion
Transmission of respiratory infections in care homes can be reduced by educational interventions to improve infection control procedures and compliance by staff, by antiviral prophylaxis soon after a case of influenza has been detected, and by supplementation with high-dose Vitamin D3. Further research is needed to confirm the effect of high-dose Vitamin D3.
Longitudinal analysis of serum urate in prediabetic phase
Authors: Marrugo Javier , Santacroce Leah M , Paudel Misti L , Fukui Sho , Tedeschi Sara K , Solomon Daniel H 
Published: August 2024

Abstract

Objectives
Despite the well-established association between prediabetes and hyperuricaemia, knowledge about serum urate (SU) trends during the prediabetic phase is limited. Therefore, we aimed to assess the longitudinal changes of SU in individuals with prediabetes.

Methods
Individuals with prediabetes, defined by initial haemoglobin A1c (HbA1c) levels between 5.7% and 6.4%, were identified using electronic health records from an academic health system (2007–2022). We required at least one SU test before and after the prediabetes diagnosis. The primary outcome was the longitudinal SU trends during the follow-up period, estimated with a multivariable mixed-effects model. Patients were censored at diabetes onset. Marginal effects of covariates on SU changes were estimated. Subsequent analyses examined SU variations in subgroups stratified by age, sex, BMI, HbA1c, estimated glomerular filtration rate and metformin use.

Results
Out of 25 526 individuals with prediabetes, 1521 met the SU cohort requirements, contributing to 6832 SU observations. At baseline, median age was 63 years and 40% were female. Median values were SU 6.3 mg/dl, HbA1c 5.9% and BMI 30 kg/m2. Median follow-up was 7.4 years. Older age, male sex, greater BMI and higher HbA1c were significant predictors of increased longitudinal SU levels. Individuals with a BMI ≥30 kg/m2 exhibited higher SU levels compared with those with lower BMI values.

Conclusion
Among individuals with prediabetes, several baseline variables were significant predictors of increased SU levels over time. These longitudinal trends in SU, support the potential for early intervention during the prediabetic phase, possibly reducing the risk of gout.
Mealworm larvae and black soldier fly larvae as novel protein supplements for cattle consuming low-quality forage
Authors: Carrasco Mikael N , Drewery Merritt L 
Published: August 2024

Abstract
The global population is projected to increase, indicating that there will be greater demand for animal protein to meet the associated food needs. This demand will place additional pressure on livestock systems to increase output while also minimizing natural resource inputs. Insect protein has emerged as a potential alternative to conventional protein feeds, such as soybean meal. Mealworm larvae (MWL; Tenebrio molitor) have been studied in poultry and swine as an alternative protein source; however, there is no research currently evaluating MWL for cattle. Black soldier fly larvae (BSFL; Hermetia illucens) have also received attention for their potential use in livestock feed due to their scalability and nutritional value, but research in cattle is limited. The objective of this study was to evaluate the effects of whole-dried MWL and defatted BSFL as protein supplements for cattle consuming forage. Five ruminally cannulated steers were utilized in a 5 × 5 Latin square experiment to determine how MWL and BSFL supplementations affect forage utilization. Steers consuming ad libitum low-quality forage (76.5% neutral detergent fiber [NDF], 4.2% crude protein) were provided one of the five treatments each period: 1) control with no supplement (CON), 2) soybean meal (CONV), 3) BSFL, 4) MWL, or 5) 50/50 by-weight blend of BSFL and MWL (MIX). All treatments were provided at 100 mg N/kg BW and periods included 8 d for treatment adaptation, 5 d for intake and digestion, and 1 d for ruminal fermentation measures. Protein supplementation stimulated forage organic matter intake (FOMI; P ≤ 0.01) relative to CON (3.28 kg/d). There was a significant difference in FOMI (P ≤ 0.01) between BSFL (4.30 kg/d) and CONV (4.71 kg/d), but not between CONV and MWL (P = 0.06, 4.43 kg/d). Total digestible OM intake (TDOMI) was also stimulated by the provision of protein (P ≤ 0.01), from 1.94 kg/d for CON to an average of 3.24 kg/d across protein supplements. Organic matter digestibility (OMD) and NDF digestibility (NDFD) were not affected by treatment (P ≥ 0.37), for an average OMD of 66.5% and NDFD of 62.7%. There was also no treatment effect on ruminal volatile fatty acid (P = 0.96) or ammonia-N (P = 0.22) concentrations. These data indicate that MWL may stimulate forage utilization by beef cattle to a greater extent than BSFL, but both are viable protein supplements.
Adolescent exposure to a mixture of per- and polyfluoroalkyl substances (PFAS) depletes the ovarian reserve, increases ovarian fibrosis, and alters the Hippo pathway in adult female mice
Authors: Clark Kendra L , George Jitu W , Davis John S 
Published: August 2024

Abstract
Per- and polyfluoroalkyl substances (PFAS) are synthetic chemicals known for their environmental persistence and resistance to biodegradation. This study investigated the impact of adolescent exposure to a PFAS mixture on adult ovarian function. Female CD-1 mice were orally exposed to vehicle control or a PFAS mixture (comprised of perfluorooctanoic acid, perfluorooctanesulfonic acid, undecafluoro-2-methyl-3-oxahexanoic acid, and perfluorobutanesulfonic acid) for 15 d. After a 42-d recovery period, reproductive hormones, ovarian fibrosis, and ovarian gene and protein expression were analyzed using ELISA, Picrosirius red staining, qPCR, and immunoblotting, respectively. Results revealed that PFAS exposure did not affect adult body or organ weight, although ovarian weight slightly decreased. PFAS-exposed mice exhibited a disturbed estrous cycle, with less time spent in proestrus than control mice. Follicle counting indicated a reduction in primordial and primary follicles. Serum analysis revealed no changes in steroid hormones, follicle-stimulating hormone, or anti-Müllerian hormone, but a significant increase in luteinizing hormone was observed in PFAS-treated mice. Ovaries collected from PFAS-treated mice had increased mRNA transcripts for steroidogenic enzymes and fatty acid synthesis-related genes. PFAS exposure also increased collagen content in the ovary. Additionally, serum tumor necrosis factor-α levels were higher in PFAS-treated mice. Finally, transcripts and protein abundance for Hippo pathway components were upregulated in the ovaries of the PFAS-treated mice. Overall, these findings suggest that adolescent exposure to PFAS can disrupt ovarian function in adulthood.
Comparative analysis of water-use strategies in three subtropical mangrove species: a study of sap flow and gas exchange monitoring
Authors: Wu Sipan , Gu Xiaoxuan , Peng Xiufan , Chen Luzhen 
Published: August 2024

Abstract
Water-use strategies play a crucial role in the adaptive capabilities of mangroves to the saline intertidal conditions, yet the intricacies of daily water-use patterns in mangrove species, which are pivotal for maintaining water balance, remain poorly understood. In this comprehensive study, we aimed to clarify the water use strategies of three co-occurring mangrove species, Avicennia marina, Aegiceras corniculatum and Kandelia obovata, through stem sap flow monitoring, leaf gas exchange and stem diameter change measurements. Our findings revealed that the daily sap flow density of Avicennia and Aegiceras reached the peak about 1 h earlier than that of Kandelia. When transpiration was strong, Kandelia and Aegiceras used stem storage to meet water demand, while Avicennia synchronized stem water storage. These three mangrove species adopted cross-peak water used and unique stem water storage to regulate their water balance. In Kandelia, the daily sap flow in per sapwood area was significantly lower, while water-use efficiency was significantly higher than those of Avicennia and Aegiceras, indicating that Kandelia adopted a more conservative and efficient water-use strategy. Sap flow in Avicennia was the most sensitive to environmental changes, while Kandelia limited water dissipation by tightly controlling stomata. Meteorological factors (photosynthetically active radiation, vapor pressure deficit and air temperature) were the main driving factors of sap flow. The increase of soil temperature can promote the water use of mangrove species, while the increase of salinity resulted in more conservative water use. Our results highlight the diversity of daily water-use strategies among the three co-occurring mangrove species, pinpointing Kandelia as the most adaptive at navigating the changing conditions of intertidal habitats in the future climate. In conclusion, our findings provide a mesoscale perspective on water-use characteristics of mangroves and also provides theoretical basis for mangroves afforestation and ecological restoration.
“Praise in Public; Criticize in Private”: Unwritable Assessment Comments and the Performance Information That Resists Being Written
Authors: Gingerich Andrea , Lingard Lorelei , Sebok-Syer Stefanie S. , Watling Christopher J. , Ginsburg Shiphra 
Published: August 2024

Abstract

Purpose
Written assessment comments are needed to archive feedback and inform decisions. Regrettably, comments are often impoverished, leaving performance-relevant information undocumented. Research has focused on content and supervisor’s ability and motivation to write it but has not sufficiently examined how well the undocumented information lends itself to being written as comments. Because missing information threatens the validity of assessment processes, this study examined the performance information that resists being written.

Method
Two sequential data collection methods and multiple elicitation techniques were used to triangulate unwritten assessment comments. Between November 2022 and January 2023, physicians in Canada were recruited by email and social media to describe experiences with wanting to convey assessment information but feeling unable to express it in writing. Fifty supervisors shared examples via survey. From January to May 2023, a subset of 13 participants were then interviewed to further explain what information resisted being written and why it seemed impossible to express in writing and to write comments in response to a video prompt or for their own “unwritable” example. Constructivist grounded theory guided data collection and analysis.

Results
Not all performance-relevant information was equally writable. Information resisted being written as assessment comments when it would require an essay to be expressed in writing, belonged in a conversation and not in writing, or was potentially irrelevant and unverifiable. In particular, disclosing sensitive information discussed in a feedback conversation required extensive recoding to protect the learner and supervisor-learner relationship.

Conclusions
When documenting performance information as written comments is viewed as an act of disclosure, it becomes clear why supervisors may feel compelled to leave some comments unwritten. Although supervisors can be supported in writing better assessment comments, their failure to write invites a reexamination of expectations for documenting feedback and performance information as written comments on assessment forms.
Impact of Predictive Hemodynamic Monitoring on Intraoperative Hypotension and Postoperative Complications in Multi-level Spinal Fusion Surgery
Authors: Carreon Leah Y. , Glassman Steven D. , Chappell Desiree , Garvin Steven , Lavelle Anna M. , Gum Jeffrey L. , Djurasovic Mladen , Saasouh Wael 
Published: August 2024

Study Design.
Prospective longitudinal comparative cohort.

Objectives.
To determine if the use of predictive hemodynamic monitoring (PHM) during elective multi-level posterior instrumented spine fusions decreases episodes of intraoperative hypotension (IOH) and complications.

Background.
A recent study showed an association between complications and duration of IOH in patients undergoing multi-level spine fusions. Whether the use of PHM to maintain hemodynamic stability intraoperatively decreases postoperative complications has not been evaluated.

Methods.
Adults undergoing elective multi-level posterior thoracolumbar fusion with arterial line blood pressure monitoring were identified and stratified into those in which predictive hemodynamic monitoring (PHM) was used and those in which it was not. Number of minutes of hypotension (MAP <65 mm Hg) and hypertension (MAP ≥100 mm Hg), volume of fluids, blood products and vasopressors administered intraoperatively and within the first 4 hours postoperatively as well as the number and type of postoperative complications were collected.

Results.
The 47 cases in the PHM group and 70 in the non-PHM group had similar demographic and operative characteristics. A shorter duration of IOH was seen in the PHM group (8.13 min) compared with the non-PHM group (13.28 min, P=0.029); and a shorter duration of intraoperative hypertension seen in the PHM group (0.46 min) compared with the non-PHM group (1.38 min, P=0.032). There was a smaller number of patients in the PHM group who had a surgical site infection (2.% vs. 13%, P=0.027), postoperative nausea and vomiting (0 vs. 14%, P=0.004) and postoperative cognitive dysfunction (6% vs. 19%, P=0.049) compared with the non-PHM group. There was also a statistically significant shorter length of hospitalization in the PHM (4.62 d) compared with the non-PHM group (5.99 d, P=0.017)

Conclusion.
Predictive hemodynamic monitoring to manage intraoperative hemodynamic instability is associated with a shorter duration of intraoperative hypotension, a lower prevalence of complications, and a decreased hospital stay in multi-level spinal fusion surgery.
Healthcare Use and Expenditures in Rural Survivors of Hospitalization for Sepsis*
Authors: Stinehart Kyle R. , Hyer J. Madison , Joshi Shivam , Brummel Nathan E. 
Published: August 2024

OBJECTIVES:
Sepsis survivors have greater healthcare use than those surviving hospitalizations for other reasons, yet factors associated with greater healthcare use in this population remain ill-defined. Rural Americans are older, have more chronic illnesses, and face unique barriers to healthcare access, which could affect postsepsis healthcare use. Therefore, we compared healthcare use and expenditures among rural and urban sepsis survivors. We hypothesized that rural survivors would have greater healthcare use and expenditures.

DESIGN, SETTING, AND PATIENTS:
To test this hypothesis, we used data from 106,189 adult survivors of a sepsis hospitalization included in the IBM MarketScan Commercial Claims and Encounters database and Medicare Supplemental database between 2013 and 2018.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We identified hospitalizations for severe sepsis and septic shock using the International Classification of Diseases, 9th Edition (ICD-9) or 1CD-10 codes. We used Metropolitan Statistical Area classifications to categorize rurality. We measured emergency department (ED) visits, inpatient hospitalizations, skilled nursing facility admissions, primary care visits, physical therapy visits, occupational therapy visits, and home healthcare visits for the year following sepsis hospitalizations. We calculated the total expenditures for each of these categories. We compared outcomes between rural and urban patients using multivariable regression and adjusted for covariates. After adjusting for age, sex, comorbidities, admission type, insurance type, U.S. Census Bureau region, employment status, and sepsis severity, those living in rural areas had 17% greater odds of having an ED visit (odds ratio [OR] 1.17; 95% CI, 1.13–1.22; p < 0.001), 9% lower odds of having a primary care visit (OR 0.91; 95% CI, 0.87–0.94; p < 0.001), and 12% lower odds of receiving home healthcare (OR 0.88; 95% CI, 0.84–0.93; p < 0.001). Despite higher levels of ED use and equivalent levels of hospital readmissions, expenditures in these areas were 14% (OR 0.86; 95% CI, 0.80–0.91; p < 0.001) and 9% (OR 0.91; 95% CI, 0.87–0.96; p < 0.001) lower among rural survivors, respectively, suggesting these services may be used for lower-acuity conditions.

CONCLUSIONS:
In this large cohort study, we report important differences in healthcare use and expenditures between rural and urban sepsis survivors. Future research and policy work is needed to understand how best to optimize sepsis survivorship across the urban-rural continuum.
Double-Cannula Maneuver for the Double-Roll Configuration of Donor Descemet Membrane Outside Recipient Anterior Chamber During Descemet Membrane Endothelial Keratoplasty
Authors: Kim Eun Chul , HA Minji , Kim Da Ran , Yoon Young Chae , Whang Woong-Joo , Na Kyung-Sun , Kim Hyun-Seung , Kim Man Soo , Hwang Ho Sik 
Published: August 2024

Purpose:
The purpose of this study was to present a new surgical technique to convert a single roll of Descemet membrane (DM) into a double roll using 2 cannulas in a balanced salt solution–filled Petri dish during DM endothelial keratoplasty.

Methods:
A single DM roll stained with trypan blue was placed in a balanced salt solution–filled Petri dish. Two cannulas (28G) were introduced from opposite ends of the single roll, inserted into the roll, and slowly spread apart to change the single roll into a double roll. The DM was aspirated into the modified Jones tube and loaded, maintaining a double-roll configuration with endothelium-down orientation in a bevel-up position. The modified Jones tube with the bevel down was inserted into the recipient anterior chamber through the main wound. The modified Jones tube was rotated to the bevel-up orientation. After checking the graft orientation, the DM was inserted into the recipient anterior chamber. The double-roll DM was easily unfolded by tapping the center of the cornea using a cannula. A 28G cannula was inserted under the DM, and the anterior chamber was filled with air.

Results:
Three months after surgery, the patient's corrected visual acuity in the right eye was 6/7.5 and the endothelial cell count was 1095/mm2. The corneal thickness was 533 μm, and the cornea was clear.

Conclusions:
The double-cannula maneuver mechanically changes the single roll of the donor DM to a double roll outside the recipient anterior chamber, making DM unfolding easier and minimizing the risk of upside-down apposition of the donor DM.
Treatment of Corneal Neovascularization Before Deep Anterior Lamellar Keratoplasty
Authors: Mansur Shabnam , Cheung Albert Y. 
Published: August 2024

Purpose:
Corneal neovascularization (CNV) can cause intraoperative concerns with deep anterior lamellar keratoplasty (DALK) given the inherent interface. We reviewed the effectiveness of CNV treatments before DALK in minimizing intraoperative and postoperative complications.

Methods:
A retrospective chart review was conducted on all eyes that 1) underwent DALK and 2) had significant CNV on exam before DALK. Eyes were divided into 2 groups: those that received CNV treatment before DALK (argon laser with subconjunctival bevacizumab/dexamethasone [ABD] and/or mitomycin intravascular chemoembolization [MICE]) and those that did not. Outcome measures included intraoperative complications, postoperative CNV recurrence, and keratoplasty rejection/failure.

Results:
This analysis included 16 eyes from 16 patients. Ten eyes had prior CNV treatment, whereas 6 did not. The CNV treatment group had no bleeding-related intraoperative complications and no interface blood occurred. The intraoperative bleeding grade was significantly less in the CNV treatment group (P = 0.024). In the 8 eyes where a big bubble (BB) was attempted (n = 6 ABD only, n = 2 MICE), there was difficulty obtaining a BB in 17% (1 of 6) that underwent ABD only, and 100% (2 of 2) that underwent MICE. Postoperatively, 4 CNV treatment eyes had CNV recurrence; in 3 of these patients, no large caliber vessels recurred. Two patients required additional ABD after DALK to treat the recurrent CNV.

Conclusions:
Treatments for CNV before DALK were effective in minimizing intraoperative bleeding and recurrence of large caliber vessels. However, recurrence of CNV after DALK is possible and may necessitate ongoing treatment.
CADS as a Decision-making Tool: Developing an Oculoplastic Management Algorithm for Facial Nerve Palsy
Authors: Yao Anthony , Jayawickrema Nirodha , Malhotra Raman 
Published: August 2024

Purpose:
The Cornea, Asymmetry, Dynamic, Synkinesis (CADS) score is a validated grading score for periocular involvement in facial nerve palsy (FNP). We conducted a retrospective review of FNP cases, including initial CADS scores and subsequent ophthalmic interventions. The results were used to inform the development of an oculoplastic management algorithm for FNP.

Methods:
Single-center retrospective cohort study of patients with FNP referred to a tertiary unit between 2016 and 2022. Data collected included demographic data, etiology of FNP, treatment initiated, and CADS grading at each visit. Adult patients with ≥6 months of follow-up were included, and cases were excluded if ocular surface or oculoplastic procedures were performed elsewhere prior to the initial review by the unit.

Results:
Of 408 consecutive new patients with FNP, 80 fulfilled inclusion criteria (mean age 57 years, range 21–83 years). Presentations of FNP were unilateral in 98.8% (79/80), with an underlying preganglionic etiology in 75.0% (60/80). At the initial review, surgery was recommended for 61.3% (49/80) of cases. Subgroup analysis of surgical cases for each CADS domain showed 46.9% (23/49) had C-score ≥2, which was predictive of upper lid surgery requirement (e.g., upper lid platinum segment chain; levator recession). About 63.2% (31/49) had an A-score ≥1 which predicted for lower lid surgery requirement (e.g., retractor recession, lower lid sling, medial canthal tendon plication, and lower lid full thickness skin graft) as well as a brow lift. Almost 79.6% (39/49) had a D-score ≥2, which was associated with both upper lid and lower lid surgery requirements. Also, 59.2% (29/49) had an S-score of ≥1 however, this was not associated with the surgical requirement, highlighting a different approach compared with the other CADS domains.

Conclusion:
This study represents a large cohort of patients followed up with a validated ophthalmic-specific FNP grading scale. This was utilized to develop a CADS-based management algorithm to help guide decision-making for surgical intervention versus medical management in FNP.