bluuebunny/crossref_metadata_2025_split huggingface dataset:
Blending gestation and lactation diets during the transition period reduces energy mobilization by sows in late gestation, with no impact on subsequent lactation performance
Authors: Gregory N , Huber L 
Published: June 2024

Abstract
Fifty-three gilts and fifty-three multiparous (MP) sows were used to evaluate a blended feeding program using gestation and lactation diets during the transition period on changes in sow back fat (BF) depth and BW, blood metabolites, and litter growth performance in the subsequent lactation period. A 2 × 2 factorial experimental design was generated including the factors of parity and feeding program. The MP sows and gilts were assigned to one of two feeding programs on day 104 ± 1 of gestation: 1) 2 kg/d of a standard lactation diet until farrowing when sows received step-up access to the lactation diet until ad libitum access was given on day 4 of lactation (CON) and 2) a dynamic blend of standard gestation and lactation diets that met estimated daily requirements for standardized ileal digestible Lys and net energy according to the NRC (2012) until day 4 of lactation where sows were provided ad libitum access to the lactation diet (TRAN). Litters were standardized to 13 ± 1 piglets within 24-h of birth. In gestation, ADFI was greatest for TRAN-MP sows (interaction; P &lt; 0.05), with greater ADFI for TRAN versus CON sows (main effect; 2.95 vs. 2.13 ± 0.08 kg; P &lt; 0.05). Feeding program did not influence ADFI in lactation, but MP sows had greater ADFI versus gilts (main effect; 5.96 vs. 4.47 ± 0.28 kg; P &lt; 0.001). Immediately after farrowing, TRAN sows had greater BW and BF vs. CON sows, regardless of parity (main effect; 224.1 vs. 215.4 ± 4.1 kg and 17.3 vs. 16.2 ± 0.4 mm, respectively; P &lt; 0.05). At weaning, no feeding program-related differences were observed for BW or BF, but MP sows had thicker BF compared to gilts (main effect; 14.4 vs. 13.4 ± 0.5 mm; P &lt; 0.05). The TRAN-MP sows had heavier piglets at birth compared to all other groups (interaction; P &lt; 0.05) and MP sows had greater litter birth weight and average piglet BW at birth versus gilts (main effect; P &lt; 0.05). No effect of feeding program was observed for piglet BW at weaning. On lactation day 1, serum beta-hydroxybutyric acid and non-esterified fatty acid concentrations were lower for TRAN compared to CON sows (main effect; 12.0 vs. 19.4 ± 7.8 mmol/L and 0.35 vs. 0.57 ± 0.10 mmol/L, respectively; P &lt; 0.05) and serum glucose concentration was greater for TRAN compared to CON sows (main effect; 4.41 vs. 3.88 ± 0.22 mmol/L; P &lt; 0.05), but these differences were no longer detectable at weaning. Therefore, a simple transition feeding program using a blend of a standard gestation and lactation diets reduced energy mobilization by sows in late gestation, with no impact on subsequent lactation performance.
Listening Effort Measured With Pupillometry in Cochlear Implant Users Depends on Sound Level, But Not on the Signal to Noise Ratio When Using the Matrix Test
Authors: Stronks Hendrik Christiaan , Tops Annemijn Laura , Quach Kwong Wing , Briaire Jeroen Johannes , Frijns Johan Hubertus Maria 
Published: June 2024

Objectives:
We investigated whether listening effort is dependent on task difficulty for cochlear implant (CI) users when using the Matrix speech-in-noise test. To this end, we measured peak pupil dilation (PPD) at a wide range of signal to noise ratios (SNR) by systematically changing the noise level at a constant speech level, and vice versa.

Design:
A group of mostly elderly CI users performed the Dutch/Flemish Matrix test in quiet and in multitalker babble at different SNRs. SNRs were set relative to the speech-recognition threshold (SRT), namely at SRT, and 5 and 10 dB above SRT (0 dB, +5 dB, and +10 dB re SRT). The latter 2 conditions were obtained by either varying speech level (at a fixed noise level of 60 dBA) or by varying noise level (with a fixed speech level). We compared these PPDs with those of a group of typical hearing (TH) listeners. In addition, listening effort was assessed with subjective ratings on a Likert scale.

Results:
PPD for the CI group did not significantly depend on SNR, whereas SNR significantly affected PPDs for TH listeners. Subjective effort ratings depended significantly on SNR for both groups. For CI users, PPDs were significantly larger, and effort was rated higher when speech was varied, and noise was fixed for CI users. By contrast, for TH listeners effort ratings were significantly higher and performance scores lower when noise was varied, and speech was fixed.

Conclusions:
The lack of a significant effect of varying SNR on PPD suggests that the Matrix test may not be a feasible speech test for measuring listening effort with pupillometric measures for CI users. A rating test appeared more promising in this population, corroborating earlier reports that subjective measures may reflect different dimensions of listening effort than pupil dilation. Establishing the SNR by varying speech or noise level can have subtle, but significant effects on measures of listening effort, and these effects can differ between TH listeners and CI users.
Practices in Pediatric Cosmetic Dermatologic Procedures: A National Survey
Authors: Hoffman Lauren , Ahmed Sarah , Krakowski Andrew C. , Chapas Anne 
Published: June 2024

BACKGROUND
Adult populations have traditionally been the primary recipients of cosmetic treatments, but a growing trend shows an increase in such procedures among pediatric patients.

OBJECTIVE
The objective of the authors' study was to investigate types of procedures currently being performed by pediatric and cosmetic dermatologists and factors that may influence their choice of treatments in a pediatric population.

METHODS
The authors conducted an anonymous online survey targeting healthcare practitioners who frequently use lasers for pediatric cutaneous conditions. The survey collected information on participants' primary scope of practice, pediatric cosmetic procedures they performed, counseling topics, and procedural details.

RESULTS
Of 85 survey respondents, 73 (86.00%) completed all questions. Most respondents identified as pediatric dermatologists (77.65%), followed by general dermatologists (18.82%), cosmetic dermatologists (8.24%), and dermatologic/Mohs surgeons (1.18%). Top pediatric cosmetic conditions treated included hypertrophic/traumatic scars (95.29%), acne (89.41%), axillary and facial hyperhidrosis (77.65%), hypertrichosis/hirsutism (67.06%), and pigmented lesion removal (64.71%). Commonly performed procedures were vascular lasers (77.65%), laser hair removal (50.59%), and pigmented lasers (28.24%), among others. Respondents prioritized understanding risks/benefits, clinically indicated treatment, and the natural course of the condition.

CONCLUSION
As the first multisociety, national survey, these results offer valuable insight into the current landscape of pediatric cosmetic treatments from the perspective of dermatologists.
Bruxism, temporomandibular disorders, and headache: a narrative review of correlations and causalities
Authors: Voß Leonie Caroline , Basedau Hauke , Svensson Peter , May Arne 
Published: June 2024

Abstract
The co-occurrence of bruxism, temporomandibular disorders (TMDs), and headache is common in patients. However, there is conflicting evidence regarding whether this association is simply a result of their high prevalence or whether there are indeed causal relationships. This review provides an overview of the current state of research while taking into account the controversies surrounding research methods, particularly in definitions and diagnostic standards. Bruxism—defined as repetitive jaw muscle activity during sleep or wakefulness—is not a painful disorder but may—particularly in co-occurrence with TMD—worsen pre-existing headache. It seems important to differentiate between sleep and awake bruxism because of different impact on pathophysiological processes in different primary headache disorders such as migraine and tension-type headache. Temporomandibular disorder is a heterogenous entity with both myofascial and arthrogenous types of pain in addition to nonpainful disorders. Research suggests a correlation between TMD pain and migraine, as well as between awake bruxism and tension-type headache. However, psychosocial factors may act as confounders in these relationships. Determining causality is challenging because of the limited number of experimental and clinical studies conducted on this topic. The main finding is an apparent lack of consensus on the definition and assessment criteria for bruxism. Treatment wise, it is important to differentiate all 3 conditions because treatment of one condition may have an effect on the other 2 without proving causality. For future research, it is crucial to establish greater consistency and applicability in diagnostic procedures and definitions. In addition, more experimental and clinical studies investigating the question of causality are needed.
Educational needs and preferences of adult patients with acute pain: a mixed-methods systematic review
Authors: Bérubé Mélanie , Verret Michael , Bourque Laurence , Côté Caroline , Guénette Line , Richard-Denis Andréane , Ouellet Simon , Singer Lesley Norris , Gauthier Lynn , Gagnon Marie-Pierre , Gagnon Marc-Aurèle , Martorella Géraldine 
Published: June 2024

Abstract
Many patients experience acute pain, which has been associated with numerous negative consequences. Pain education has been proposed as a strategy to improve acute pain management. However, studies report limited effects with educational interventions for acute pain in adults, which can be explained by the underuse of the person-centered approach. Thus, we aimed to systematically review and synthetize current evidence from quantitative, qualitative and mixed-methods studies describing patients' needs and preferences for acute pain education in adults. We searched original studies and gray literature in 7 databases, from January 1990 to October 2023. Methodological quality was assessed with the Mixed Methods Appraisal Tool. A total of 32 studies were included (n = 1847 patients), two-thirds of which were qualitative studies of high methodological quality. Most of the studies were conducted over the last 15 years in patients with postsurgical and posttraumatic pain, identified as White, with a low level of education. Patients expressed the greatest need for education when it came to what to expect in pain intensity and duration, as well how to take the medication and its associated adverse effects. The most frequently reported educational preferences were for in-person education while involving caregivers and to obtain information first from physicians, then by other professionals. This review has highlighted the needs and preferences to be considered in pain education interventions, which should be embedded in an approach cultivating communication and partnership with patients and their caregivers. The results still need to be confirmed with different patient populations.
Biomechanical evaluation of 3D-printed joint-type orthosis for hallux valgus
Authors: Chen Chen-Sheng , Chang Yu-Sheng , Lin Kuang-Wei , Chien Mu-Jung , Wang Chien-Shun 
Published: June 2024

Background:
Orthoses play an important role in the conservative treatment of hallux valgus (HV) with different therapeutic effects. In this study, a new HV orthosis was developed using three-dimensional (3D) printing technology. In addition, its kinematic effect was evaluated using motion analysis.

Methods:
Seventeen participants with an HV angle of >20° were included in the study. The first metatarsophalangeal abduction angle before and after the orthosis was measured statically. Subsequently, dynamic first metatarsophalangeal abduction, dorsiflexion angle and ground reaction force with and without the orthosis were recorded and calculated during walking using a Vicon motion analysis system and force plates. The patients’ comfort scales were determined after the motion analysis.

Results:
The angular corrections of the orthosis in the first metatarsophalangeal abduction were 14.6° and 6.3° under static and dynamic conditions, respectively. Reduced hallux dorsiflexion was observed with the orthosis in the early stance phase. However, no significant changes in ground reaction forces were observed.

Conclusion:
The results of our study confirm the potential of the 3D-printed HV orthosis in the static and dynamic correction of deformities while ensuring patient comfort with minimal impact on hallux kinematics, suggesting the potential of our design for long-term use.
Provision of Behavioral Health Services at Community Health Centers and Hospital Emergency Department Visits
Authors: Carey Kathleen , Cole Megan B. 
Published: June 2024

Background:
Numerous US patients seek the hospital emergency department (ED) for behavioral health care. Community Health Centers (CHCs) offer a potential channel for redirecting many to a more patient-centered, lower cost setting.

Objective:
The aim of this study was to identify unique market areas serviced by CHCs and to examine whether CHCs are effective in offsetting behavioral health ED visits.

Research Design:
We identified CHC-year specific service areas using patient origin zip codes. We then estimated random effects models applied to 42 federally qualified CHCs operating in New York State during 2013–2020. The dependent variables were numbers of ED mental health (substance use disorder) visits per capita in a CHC’s service area, drawn from HCUP State Emergency Department Databases. Key explanatory variables measured CHC number of mental health (substance use disorder) visits, number of unique mental health (substance use disorder) patients, and mental health (substance use disorder) intensity, obtained from the HRSA Uniform Data System.

Results:
Controlling for population, we observed small negative effects of CHC behavioral health integration in explaining ED behavioral health utilization. Measures of mental health utilization in CHCs were associated with 1.3%–9.3% fewer mental health emergency department visits per capita in Community Health Centers’ service areas. Measures of substance use disorder utilization in Community Health Centers were associated with 1.3%–3.0% fewer emergency department visits per capita.

Conclusion:
Results suggest that behavioral health integration in CHCs may reduce reliance on hospital EDs, but that policymakers explore more avenues for regional coordination strategies that align services between CHCs and local hospitals.
Highly Stable Beneficiary Attribution in Medicare’s Comprehensive Primary Care Plus Model
Authors: He Fang , Hirsch Ariella , Beadles Chris , Tang Yan , Hagerty Bridget , Irie Sarah 
Published: June 2024

Background:
Advanced primary care models are key in moving primary care practices toward greater accountability for the quality and cost of a beneficiary’s care. One critical but often overlooked detail in model design is the beneficiary attribution methodology. Attribution results are key inputs in calculating practice payments. Stable attribution yields predictable practice payments, fostering longer-term investments in advanced primary care.

Objective:
We examine attribution stability for Medicare fee-for-service beneficiaries in Medicare’s Comprehensive Primary Care Plus (CPC+) Model.

Design:
To measure attribution stability, we calculate churn rates, which we define as the percentage of beneficiaries eligible for CPC+ who were not attributed to the same practice in a later period. Using 2017–2021 CPC+ program data and Medicare administrative data, we calculate churn rates for CPC+ overall and for beneficiary subgroups. To assess whether CPC+ attribution was responsive enough to changes in a beneficiary’s practice, we calculate how long before attribution changes following a beneficiary’s long-distance move.

Results:
We find that for every 100 beneficiaries attributed to a CPC+ practice, 88 were still attributed to the same practice a year later (ie, churn rate of 12%), 79 were attributed 2 years later, 74 three years later, and 70 four years later. However, some vulnerable subgroups, such as disabled beneficiaries, had higher churn rates. Our analysis of long-distance movers reveals that only after 5 quarters did attribution change for more than half of these movers.

Conclusions:
Overall, high attribution stability may have encouraged CPC+ practices to make longer-term investments in advanced primary care.
The Medical Costs of Determining Eligibility and Waiting for a Kidney Transplantation
Authors: Xu Kunyao , Dor Avi , Mohanty Suman , Han Jialin , Parvathinathan Gomathy , Braggs-Gresham Jennifer L. , Held Philip J. , Roberts John P. , Vaughan William , Tan Jane C. , Scandling John D. , Chertow Glenn M. , Busque Stephan , Cheng Xingxing S. 
Published: June 2024

Background:
Recent efforts to increase access to kidney transplant (KTx) in the United States include increasing referrals to transplant programs, leading to more pretransplant services. Transplant programs reconcile the costs of these services through the Organ Acquisition Cost Center (OACC).

Objective:
The aim of this study was to determine the costs associated with pretransplant services by applying microeconomic methods to OACC costs reported by transplant hospitals.

Research Design, Subjects, and Measures:
For all US adult kidney transplant hospitals from 2013 through 2018 (n=193), we crosslinked the total OACC costs (at the hospital-fiscal year level) to proxy measures of volumes of pretransplant services. We used a multiple-output cost function, regressing total OACC costs against proxy measures for volumes of pretransplant services and adjusting for patient characteristics, to calculate the marginal cost of each pretransplant service.

Results:
Over 1015 adult hospital-years, median OACC costs attributable to the pretransplant services were $5 million. Marginal costs for the pretransplant services were: initial transplant evaluation, $9k per waitlist addition; waitlist management, $2k per patient-year on the waitlist; deceased donor offer management, $1k per offer; living donor evaluation, procurement and follow-up: $26k per living donor. Longer time on dialysis among patients added to the waitlist was associated with higher OACC costs at the transplant hospital.

Conclusions:
To achieve the policy goals of more access to KTx, sufficient funding is needed to support the increase in volume of pretransplant services. Future studies should assess the relative value of each service and explore ways to enhance efficiency.
ANGIOTENSIN II IN THE TREATMENT OF DISTRIBUTIVE SHOCK: A SYSTEMATIC-REVIEW AND META-ANALYSIS
Authors: Xourgia Eleni , Exadaktylos Aristomenis K. , Chalkias Athanasios , Ziaka Mairi 
Published: June 2024

ABSTRACT

Objective: While nonnorepinephrine vasopressors are increasingly used as a rescue therapy in cases of norepinephrine-refractory shock, data on their efficacy are limited. This systematic review and meta-analysis aims to synthesize existing literature on the efficacy of angiotensin II (ATII) in distributive shock. Methods: We preregistered our meta-analysis with PROSPERO (CRD42023456136). We searched PubMed, Scopus, and gray literature for studies presenting outcomes on ATII use in distributive shock. The primary outcome of the meta-analysis was all-cause mortality. We used a random effects model to calculate pooled risk ratio (RR) and 95% confidence intervals (CIs). Results: By incorporating data from 1,555 patients included in 10 studies, we found that however, all-cause mortality was similar among patients receiving ATII and controls (RR = 1.02; 95% CI: 0.89 to 1.16, P = 0.81), the reduction in norepinephrine or norepinephrine-equivalent dose at 3 h after treatment initiation was greater among patients receiving ATII (MD = −0.06; 95% CI: −0.11 to −0.02, P = 0.008), while there were no higher rates of adverse events reported among ATII patients. Conclusions: While ATII did not reduce mortality among distributive shock patients, it allowed for significant adjunctive vasopressor reduction at 3 h without an increase in reported adverse events, deeming it a viable alternative for the increasingly adopted multimodal vasopressor for minimizing catecholamine exposure and its adverse events.
INFLAMMATORY RESPONSES TO POLYMICROBIAL INTRA-ABDOMINAL SEPSIS ARE HIGHLY VARIABLE BUT STRONGLY CORRELATED TO ENTEROBACTERIACEAE OUTGROWTH
Authors: Bongers Kale S. , Chanderraj Rishi , Deng Huiyin , Song Yujing , Newstead Michael W. , Metcalf Joseph D. , Falkowski Nicole R. , Puranik Niyati , Kurabayashi Katsuo , Dickson Robert P. , Singer Benjamin H. 
Published: June 2024

ABSTRACT
Sepsis is a common, heterogeneous, and frequently lethal condition of organ dysfunction and immune dysregulation due to infection. The causes of its heterogeneity, including the contribution of the pathogen, remain unknown. Using cecal slurry, a widely used murine model of intraperitoneal polymicrobial sepsis, as well as 16S ribosomal RNA sequencing and measurement of immune markers, we performed a series of translational analyses to determine whether microbial variation in cecal slurry composition (representing intra-abdominal pathogens) mediated variation in septic response. We found wide variation in cecal slurry community composition that changed markedly over the 24-h course of infection. This variation in cecal slurry bacteria led to large variation in physiologic and inflammatory responses. Severity of inflammatory response was positively correlated with intraperitoneal enrichment with Enterobacteriaceae. Likewise, in a human cohort of patients with intra-abdominal abscesses, Enterobacteriaceae was also associated with increased inflammatory markers. Taken together, these data demonstrate that intra-abdominal Enterobacteriaceae drives inflammation in sepsis both in animal models and human subjects. More broadly, our results demonstrate that pathogen identity is a major driver of the host response in polymicrobial sepsis and should not be overlooked as a major source of phenotypic heterogeneity.
HYDROGEN-RICH SALINE UPREGULATES THE SIRT1/NF-ΚB SIGNALING PATHWAY AND REDUCES VASCULAR ENDOTHELIAL GLYCOCALYX SHEDDING IN SEPSIS-INDUCED ACUTE KIDNEY INJURY
Authors: Lin Liheng , Qiu Deliang , Yang Fei , Xia Yu , Cai Siyuan , Liao Xiaojun , Deng Wanxin , Wu Changxue 
Published: June 2024

ABSTRACT
Sepsis causes dysfunction in different organs, but the pathophysiological mechanisms behind it are similar and mainly involve complex hemodynamic and cellular dysfunction. The importance of microcirculatory dysfunction in sepsis is becoming increasingly evident, in which endothelial dysfunction and glycocalyx degradation play a major role. This study aimed to investigate the effects of hydrogen-rich saline (HRS) on renal microcirculation in septic renal failure, and whether Sirt1 was involved in the renoprotective effects of HRS. Rats model of sepsis was established by cecal ligation and puncture, and septic rats were intraperitoneal injected with HRS (10 mL/kg). We found that in sepsis, the degree of glycocalyx shedding was directly proportional to the severity of sepsis. The seven-day survival rate of rats in the HRS+CLP group (70%) was higher than that of the CLP group (30%). HRS improved acidosis and renal function and reduced the release of inflammatory factors (TNF, IL-1β, and IL-6). The endothelial glycocalyx of capillaries in the HRS+CLP group (115 nm) was observed to be significantly thicker than that in the CLP group (44 nm) and EX527 (67.2 nm) groups by electron microscopy, and fewer glycocalyx metabolites (SDC-1, HS, HA, and MMP9) were found in the blood. Compared with the CLP group, HRS reduced renal apoptosis and upregulated Sirt1 expression, and inhibited the NF-κB/MMP9 signaling pathway. In addition, HRS did not damage immune function in septic rats as well. Generally speaking, our results suggest that HRS can alleviate the inflammatory response, inhibit glycocalyx shedding, improve septic kidney injury, and enhance survival rate.