bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of concurrent increases in supplementation of calcium and phytase on growth performance, balance of Ca and P, and bone mineralization in nursery pigs
Authors: Zhai Hengxiao , Bergstrom Jon , Zhang Jingcheng , Dong Wei , Wang Zhenzhen , Stamatopoulos Kostas , Cowieson Aaron J 
Published: November 2023

Abstract
The objective of this study was to investigate the effects of concomitantly increasing supplementation of Ca and phytase on growth performance, balance of Ca and P, and bone mineralization in nursery pigs. There were eight experimental diets. The positive control (PC) one and two were formulated to contain 0.64% and 0.85% total Ca, respectively, whereas the dietary concentrations of other nutrients were identical and adequate. The negative control (NC) was deficient in total Ca (0.48%) and total P (0.41%). Five combinations of incremental levels of Ca and phytase (0.48% and 1,750 phytase units [FYT]/kg, 0.52% and 2,000 FYT/kg, 0.55% and 2,250 FYT/kg, 0.59% and 2,600 FYT/kg, and 0.63% and 3,000 FYT/kg) were added to the NC to establish the remaining five experimental diets. Each diet was fed to six pens of six pigs (three barrows and three gilts per pen). All diets contained 3 g/kg TiO2, and fecal samples were collected from each pen during the trial. In the end, one pig per pen was euthanized to collect the right tibia and urine in bladder. The results showed that the pigs of NC gained less weight, consumed less feed, and utilized feed less efficiently than their counterparts fed the PC and the treatments with phytase (P &lt; 0.01). With increasing supplementation of Ca and phytase, there was a tendency for gain:feed to decrease (P &lt; 0.10). There was a significant reduction in bone dry weight; and in percentages, as well as weights of bone ash, Ca, and P; in pigs of NC compared with pigs of PC1, PC2, or phytase treatments. In comparison to PC2, PC1 and phytase treatments resulted in a higher percentage of bone P and greater weights of bone ash, Ca, and P (P &lt; 0.05). There was no significant effect of concurrent supplementation of Ca and phytase on bone mineralization. The NC had significantly lower apparent total tract digestibility (ATTD) of Ca and P, lower concentrations of digestible Ca and P, but a higher ATTD Ca/ATTD P ratio than PC1, PC2, or the phytase treatments. The averages of ATTD of Ca and P in treatments with phytase were significantly higher than PC1 or PC2 (P &lt; 0.01). With increasing addition of Ca and phytase, the ATTD of P, digestible Ca and P, and the ATTD Ca/ATTD P ratio increased linearly (P &lt; 0.05), which contrasted with a linear reduction in ATTD of Ca (P &lt; 0.05). Meanwhile, there was a linear (P &lt; 0.01) increase in the concentration of urinary Ca. In conclusion, increasing the dietary supplementation of phytase in conjunction with the increasing dietary Ca level increased the dietary ATTD Ca/ATTD P ratio without damaging the absorption of P in the current study. The higher ATTD Ca/ATTD P ratio did not improve the bone mineralization markedly and thus the extra Ca was voided through urine.
The Short- and Longer-Term Effects of a Child Labor Ban
Authors: Piza Caio , Souza André Portela , Emerson Patrick M , Amorim Vivian 
Published: November 2023

Abstract
This paper investigates whether the 1998 Brazilian law that increased the minimum employment age from 14 to 16 lowered child labor and increased school attendance and whether those effects persisted beyond age 16. Using a regression discontinuity design, the results indicate that the ban had a significant impact on urban boys, a cohort that represents half of all paid child labor in Brazil. This cohort had a 35 percent decrease in paid labor, driven mainly by a decrease in informal work, and an 11 percent increase in the share of those only attending school. In addition, there is evidence that these effects persist past the age of enforcement where the affected cohort was less likely to work and more likely to be only attending school beyond age 16. Overall, the results suggest that enforced bans on child labor can have significant immediate and persistent impacts on affected populations.
Prelicensure Undergraduate Nursing Student Perceptions of Professional Identity in Nursing
Authors: Owens Rhoda A. , Denny Dawn L. 
Published: November 2023

Abstract
This qualitative descriptive study explored the perceptions of 63 prelicensure undergraduate nursing students about their learning experiences and the formation and development of professional identity in nursing (PIN). Students enrolled in a required course that included PIN concepts completed a guided reflective writing assignment. Four themes emerged with data analysis: 1) learning and applying ethics and values, 2) nursing knowledge is specific to nursing practice, 3) all nurses should be leaders, and 4) demonstrating professional comportment. Implications include effective use of reflective writing assignments to facilitate student PIN formation. Future research is warranted.
Trichomonas vaginalis in bronchoalveolar lavage fluid of a patient with severe pneumonia detected by metagenomic next-generation sequencing: A case report
Authors: Li Zhenzhen , Wang Jiang , Gou Xuejing , Guo Zhendong , Xu Feng 
Published: November 2023

Rationale:

Trichomonas vaginalis (T. vaginalis) is a common anaerobic parasitic protozoan. However, to the best of our knowledge, there are few reports documenting T. vaginalis infection outside the genitourinary tract. Severe pneumonia caused by T. vaginalis infection has been rarely reported.

Patient concerns:
The 80-year-old female patient had a 20-year history of type II diabetes; however, she was not on regular medication. She was hospitalized due to a coma which continued 2 hours caused by trauma after a car accident. After her admission, she was provided with continuous mechanical ventilation; during the ventilation, she was still in a coma, accompanied by repeated fever and presence of much yellow sticky phlegm. The head CT scan indicated temporal lobe hematoma and subarachnoid hemorrhage. The lung CT scan showed bilateral pulmonary inflammatory consolidation and mass lesions.

Diagnoses:
She was initially diagnosed with severe pneumonia and acute respiratory distress syndrome. Subsequently, fiberoptic bronchoscopy was conducted, and bronchoalveolar lavage fluid (BALF) was collected and sent for metagenomic next-generation sequencing (mNGS). The result indicated the presence of abundant sequences from the T. vaginalis genome. Thus, she was diagnosed with pulmonary T. vaginalis infection.

Intervention:
Anti-infective ornidazole treatment has significantly improved her symptoms.

Outcomes:
After treatment, the patient regained consciousness and was able to communicate, and there was no obvious expectoration, fever, or positive bronchus sign in the lungs. Thereby, she was discharged from the hospital.

Lessons:
Special attention should be paid to infections other than common bacterial infections, such as T. vaginalis. Moreover, infection of rare pathogenic microorganisms might show symptoms similar to common bacterial infection, leading to misdiagnosis, further highlighting the usefulness of mNGS in detecting pathogens in a timely, sensitive, and accurate manner.
Dural arteriovenous fistula with progressive dementia and parkinsonism: Two case reports and a literature review
Authors: Xie Jiangbo , Zhang Tingting , Zhang Ying , Wu Weiwei , Li Peichun , Zhang Xuezheng 
Published: November 2023

Rationale:
Dural arteriovenous fistulas (DAVFs) are rare cerebral abnormal arteriovenous anastomoses. It is uncommon for DAVFs with parkinsonism and dementia, so it is easily misdiagnosed. Neuroimaging examinations show that multifocal DAVFs are related to venous thrombosis and white matter changes, suggesting that cerebral circulatory disorders caused by venous hypertensive encephalopathy lead to dementia in patients. Digital subtraction angiography confirmed the diagnosis and subsequent treatment of DAVFs.

Patient concerns:
We report 2 cases, one caused by bilateral white matter lesions and the other caused by bilateral thalamus lesions. Their symptoms are all manifested as progressive dementia and parkinsonism.

Diagnosis:
They were diagnosed with dural arteriovenous fistulas by digital subtraction angiography.

Outcomes:
The first patient developed progressive cognitive impairment, 6 months later, the patient developed bedridden, incontinence, and severe cognitive function.The second patient became increasingly bedridden 3 months after discharge and died of aspiration pneumonia.

Lessons:
There are few reports of progressive dementia and parkinsonism in DAVF patients, and neurologists should be vigilant to avoid misdiagnosing DAVF.
Efficacy and safety of agomelatine in the treatment of patients with depressive disorder: A meta-analysis
Authors: Guo Yue-Han , Zhou Le , Cui Zi-Ang , Wang Jian , Zhang Lei , Xu Ting , Xie Yi-Dan , Chen Hui 
Published: November 2023

Objective:
To systematically assess the efficacy and safety of agomelatine in the treatment of patients with depressive disorder.

Methods:
Randomized controlled trials (RCTs) related to agomelatine in the treatment of patients with depressive disorder published in PubMed, Web of Science, CNKI, VIP, and Wangfang were retrieved. Extracted data on the efficacy and safety of agomelatine and placebo in the treatment of depressive disorder, and the collected data were processed by RevMan5.4 software.

Results:
A total of 10 RCTs were included. Meta-analysis showed that the HAMD-17 total scores of agomelatine group were statistically different from those of placebo group (odds ratio [OR]: 2.04, 95% confidence intervals [CIs]: 1.71–2.43, P < .001). High heterogeneity was found between agomelatine groups and placebo groups (P < .0001, and I2 = 78%), so a subgroup analysis was further performed, and the heterogeneity became insignificant (P = .33, and I2 = 14%) after excluding the studies, of which course of treatment was 24 weeks or the sample size was relatively small. The adverse events between agomelatine and placebo groups were not statistically significant (OR: 1.15, 95% CIs: 0.69–1.92; P = .05).

Conclusion:
Agomelatine was superior comparable to placebo in the treatment of patients with depressive disorder, and has fewer adverse events.
Acupuncture combined with Chinese herbal medicine in the treatment of perimenopausal insomnia: A systematic review and meta-analysis
Authors: Li Zhao , Yin Shao , Feng Jie , Gao Xu , Yang Qicheng , Zhu Fengya 
Published: November 2023

Background:
Perimenopausal insomnia (PMI) is a relatively common menopausal symptom that can cause serious problems for the women themselves and their families. Today, the world is facing the trend and challenges of an aging population. It is reported that about 1.5 million women worldwide enter menopause every year, with sleep disorder identified as a core symptom. The efficacy of acupuncture combined with traditional Chinese medicine for treating PMI has been recognized by patients and doctors.

Methods:
We searched 8 databases to identify 15 randomized controlled trials evaluating the effects of acupuncture combined with traditional Chinese medicine on sleep in patients with PMI compared with Western medicine alone. Subsequently, data extraction and analysis were performed to assess the quality and risk of bias of the study method design, and a meta-analysis of the data was performed.

Results:
This study included 15 randomized controlled trials involving 1188 patients with PMI. The results show that acupuncture combined with traditional Chinese medicine seems to be more effective than Western medicine in the treatment of PMI: efficiency (RR: 1.18; 95% CI: 1.08, 1.29; P = .001); the Pittsburgh Sleep Quality Index (PSQI) (WMD: −2.77; 95% CI: 4.15–1.39; P < .0001); follicle-stimulating hormone (FSH) (WMD: −31.45; 95% CI: 42.7–20.2; P < .001) and the Hamilton Anxiety Score (HAMA) (WMD: −2.62, 95% CI: −3.93, −1.32; P < .0001). Compared with western medicine, E2 (WMD: 5.07; 95% CI: 5.78–15.92; P = .36) and LH (WMD: −4.86; 95% CI: 11.5–1.78; P = .151) had no difference.

Conclusion:
The current analysis results show that acupuncture combined with Chinese medicine seems to have a more positive effect than western medicine alone in improving sleep and FSHF in PMI patients, but no difference has been found in improving E2 and LH. This study provides a basis for acupuncture combined with Chinese medicine to treat PMI. However, due to the higher risk of evaluation in included studies, more rigorous randomized controlled trials and higher quality studies are needed to validate included studies.
Transient spinal cord dysfunction after surgery for intraspinal tumors: A case report
Authors: Tian Zhikang , Li Qingwei , Gao Sheng , Meng Chunyang 
Published: November 2023

Rationale:
Limb dysfunction is not uncommon clinically after intramural tumor surgery. However, there are no relevant literature reports on the recovery of unilateral motor function caused by spinal cord dysfunction after short-term observation and treatment. The report of such cases is of great value for improving the cognition of postoperative complications of meningioma reducing misdiagnosis and providing reference for clinical treatment.

Patient concerns:
A 73-year-old female patient with numbness and weakness in both lower limbs accompanied by unstable walking for 2 months. Combined with imaging data and postoperative pathological diagnosis, it was diagnosed as thoracic spinal meningioma. The patient experienced transient unilateral limb dysfunction after surgery.

Diagnoses:
Magnetic resonance imaging and its enhanced magnetic resonance imaging suggest a space occupying lesion on the left side of the spinal canal at the level of the thoracic 3 to 4 vertebral body, possibly a meningioma. The postoperative pathology was grade I meningioma.

Intervention:
Administer 10 mL of dexamethasone, 1 g of methylprednisolone, and 250 mL of mannitol for treatment.

Outcomes:
After 3 hours, the patient’s muscle strength gradually recovered, and after 12 hours, it was better than the preoperative level.

Conclusion:
Spinal cord dysfunction may occur after surgery for intraspinal meningioma in the upper thoracic spine. Unlike spinal cord dysfunction caused by spinal cord injury, this dysfunction is short-term and transient. The use of hormones and diuretics is a feasible solution that can quickly restore patient limb function.
Intralymphatic histiocytosis of the upper eyelid in a patient of Korean descent: A case report
Authors: Ha Dong Hee , Kim Hee Sung , Lee Jeong Kyu 
Published: November 2023

Rationale:
Diagnosing intralymphatic histiocytosis can be challenging due to its rarity. We present a case of intralymphatic histiocytosis in the upper eyelid of a Korean patient. We treated the condition by surgical debulking and intralesional triamcinolone injection.

Patient concerns:
A 59-year-old man was referred to our clinic with a 7-year history of unilateral swelling in the right upper eyelid. He had previously been treated with long-term oral steroids and immunosuppressants, but his eyelid swelling persisted. Unilaterally non-pitting erythematous edema was localized on the right upper eyelid without any itching or pain. His best corrected visual acuity at presentation was 20/20 for both eyes. Enhanced orbital computerized tomography revealed edematous soft tissue thickening in the right upper eyelid. In the laboratory testing, the erythrocyte sedimentation rate showed an increase of 19, and the antinuclear antibody titer was positive with a homogeneous pattern.

Diagnoses:
We diagnosed the patient with intralymphatic histiocytosis based on the histopathological findings.

Intervention:
We attempted surgical debulking and biopsy on the right upper eyelid due to the persistent symptoms and the absence of a definitive diagnosis.

Outcomes:
The patient has demonstrated significant improvement after receiving an intralesional triamcinolone injection in the right upper eyelid following the surgery and is currently under follow-up with no signs of recurrence.

Lesson:
Ophthalmologists should consider intralymphatic histiocytosis in cases of persistent eyelid swelling that do not respond to treatment, even in Asian patients. Surgical debulking and intralesional triamcinolone injections may be beneficial for improvement.
Diagnostic value of anti-mitochondrial antibody in patients with primary biliary cholangitis: A systemic review and meta-analysis
Authors: Xu Qingling , Zhu Weijia , Yin Yufeng 
Published: November 2023

Background:
Anti-mitochondrial antibodies (AMA) and the M2 subtype are considered serological hallmarks in the diagnosis of primary biliary cholangitis (PBC). However, these autoantibodies may be undetectable in some patients. This meta-analysis aimed to evaluate the diagnostic accuracy of serum AMA and M2 for PBC.

Methods:
We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library for relevant studies. Pooled sensitivity, specificity, positive likelihood ratio (LR+), negative likelihood ratio (LR−), and diagnostic odds ratio (DOR) were calculated using a random-effects model. We also constructed hierarchical summary receiver operating characteristic curves and calculated the area under the curve values.

Results:
Our meta-analysis included 28 studies, of which 24 examined the diagnostic accuracy of AMA for PBC. Pooled sensitivity and specificity of AMA were 84% (95% confidence intervals [CI] 77–90%) and 98% (96–99%), respectively. Pooled LR+, LR−, and DOR were 42.2 (22.1–80.5), 0.16 (0.11–0.24), and 262 (114–601), respectively. Sixteen studies explored the diagnostic value of the M2 subtype, demonstrating pooled sensitivity and specificity of 89% (81–94%) and 96% (93–98%), respectively. Pooled LR+, LR−, and DOR were 20.3 (8.0–51.1), 0.12 (0.05–0.26), and 169 (41–706), respectively. The hierarchical summary receiver operating characteristic curves for both of serum AMA and M2 subtype lie closer to the upper left corner of the plot with area under the curve values of 0.98 (95% CI = 0.96–0.99) and 0.98 (95% CI = 0.96–0.99) respectively.

Conclusion:
This meta-analysis provides evidence affirming the utility of AMA and M2 as sensitive and specific serological hallmarks that can facilitate early screening and diagnosis of PBC.
Tibial nerve compression due to osteochondroma of the fibular head: A case report
Authors: Lee Young-Keun , Ho Ji Woong 
Published: November 2023

Rationale:
Osteochondroma is one of the most common primary benign bone tumors. In most cases, this disease is asymptomatic. However, it may become symptomatic owing to nerve and vascular compression when it affects the knee joint. Isolated tibial nerve palsy caused by proximal fibular osteochondroma is rare.

Patients concerns:
A 60-year-old male, was treated for degenerative arthritis of the right knee, referred to the right great toe flexion limitation that occurred 3 weeks prior.

Diagnoses:
Magnetic resonance imaging revealed compression of the tibial nerve and surrounding muscles due to an osseous lesion in the fibular head. A nerve conduction test confirmed tibial neuropathy in the right lower leg.

Interventions:
Exploratory surgery was performed to decompress the tibial nerve and remove the bony lesion histopathologically diagnosed as an osteochondroma.

Outcomes:
Fifty-five months postoperatively, toe flexion recovered to normal. No recurrence of osteochondroma was observed.

Lessons:
As in our case, if a bony lesion is diagnosed on radiographs with neurological symptoms, early decompression surgery is necessary. Moreover, since it can be misdiagnosed as a simple bony spur, magnetic resonance imaging and tissue biopsy are also indicated.
Older Taiwanese Volunteers as Standardized Patients
Authors: Ho Yun-Chi , Kao Sheng-Po , Chen Che-Han , Chu Shao-Yin 
Published: November 2023

Introduction
Most standardized patients (SPs) in Taiwan are middle-aged or older volunteers with a high retention rate and selflessly devote themselves to the service. This study explored the psychological process behind the continued altruistic behaviors of SPs to understand the formation of service motivation, professional identity, and internal transformation.

Methods
Sixteen volunteers, aged 50 to 70 years, who served as SPs for 3 to 11 years in a religious hospital were enrolled in this study. Individual semistructured interviews were conducted. Each person was interviewed for approximately 120 minutes. We used a thematic analysis to analyze the interview transcripts.

Results
We identified 3 major themes and 8 subthemes. The first theme, SPs' service motivation, included the following 3 subthemes: past medical experiences, acquisition of medical knowledge, and emotional connections. The second theme, SPs' identity formation, included the following 3 subthemes: role recognition, work ethic, and a sense of religious mission. The third theme, SPs' physical and psychological support, included 2 subthemes: internal transformation and personal well-being.

Conclusions
The interview results showed doctor-patient or life experiences served as the impetus prompting SPs to engage in such altruistic behavior. In addition, identity formation endowed older SPs with a life purpose and a sense of fulfillment and self-actualization through fostering and training medical students. In addition, a clear recognition of the role of an SP and self-worth helped volunteers mitigate any physical and mental problems caused by negative life experiences. Standardized patients continued to complete their tasks with a positive attitude.
Optogenetic Silencing of Medial Septal GABAergic Neurons Disrupts Grid Cell Spatial and Temporal Coding in the Medial Entorhinal Cortex
Authors: Robinson Jennifer C. , Ying Johnson , Hasselmo Michael E. , Brandon Mark P. 
Published: November 2023

SummaryThe hippocampus and medial entorhinal cortex (MEC) form a cognitive map that facilitates spatial navigation. As part of this map, MEC grid cells fire in a repeating hexagonal pattern across an environment. This grid pattern relies on inputs from the medial septum (MS). The MS, and specifically its GABAergic neurons, are essential for theta rhythm oscillations in the entorhinal-hippocampal network, however, it is unknown if this subpopulation is also essential for grid cell function. To investigate this, we used optogenetics to inhibit MS-GABAergic neurons during grid cell recordings. We found that MS-GABAergic inhibition disrupted grid cell spatial periodicity both during optogenetic inhibition and during short 30-second recovery periods. Longer recovery periods of 60 seconds between the optogenetic inhibition periods allowed for the recovery of grid cell spatial firing. Grid cell temporal coding was also disrupted, as observed by a significant attenuation of theta phase precession. Together, these results demonstrate that MS-GABAergic neurons are critical for grid cell spatial and temporal coding in the MEC.