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Improvement of meat protein digestibility in infants and the elderly.

Food Chem 2021 Mar 26;356:129707. Epub 2021 Mar 26.

Division of Animal and Dairy Science, Chungnam National University, Daejeon 34134, South Korea. Electronic address:

Meat is a valuable protein source with a balanced composition of essential amino acids and various nutrients. This review aims to identify methods to improve digestion of meat proteins, as well as evaluate the digestive characteristics of infants and the elderly. Immature digestive conditions in infants, including a high gastric pH and low protease concentration, can hinder protein digestion, thus resulting in inhibited growth and development. Read More

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Using SHRP2 NDS data to examine infrastructure and other factors contributing to older driver crashes during left turns at signalized intersections.

Accid Anal Prev 2021 Apr 16;156:106141. Epub 2021 Apr 16.

Department of Civil & Environmental Engineering, University of Massachusetts Amherst, 214 Marston Hall, 130 Natural Resources Road, Amherst, MA, 01003, USA.

Drivers age 65 and over have higher rates of crashes and crash-related fatalities than other adult drivers and are especially over-represented in crashes during left turns at intersections. This research investigated the use of SHRP2 Naturalistic Driving Study (NDS) data to assess infrastructure and other factors contributing to left turn crashes at signalized intersections, and how to improve older driver safety during such turns. NDS data for trips involving signalized intersections and crash or near-crash events were obtained for two driver age groups: drivers age 65 and over (older drivers) and a sample of drivers age 30-49, along with NDS pre-screening and questionnaire data. Read More

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Placing covered self-expanding metal stents by suspension laryngoscope in benign tracheal stenosis.

Am J Otolaryngol 2021 Apr 13;42(5):103040. Epub 2021 Apr 13.

Department of Thoracic Surgery, Beijing Tongren Hospital, Capital Medical University, Beijing, China. Electronic address:

Background: Tracheobronchial stent placement for malignant airway strictures has been proved to improve respiratory function, but experience for benign tracheobronchial stenoses is limited. The purpose of our study is to investigate the efficacy of covered expandable metallic stents, inserted through a suspension laryngoscope, treating tracheal stenosis following intubation or tracheostomy.

Methods: From 2010 to 2018, 67 adult patients with the benign tracheal stenosis, underwent stent placement, using a suspension laryngoscope. Read More

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Detection and removal of pacing artifacts prior to automated analysis of 12-lead ECG.

Comput Biol Med 2021 Apr 16;133:104396. Epub 2021 Apr 16.

Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA. Electronic address:

Background: Pacing artifacts must be excluded from the analysis of paced ECG waveform. This study aimed to develop and validate an algorithm to identify and remove the pacing artifacts on ECG and vectorcardiogram (VCG).

Methods: We developed a semi-automatic algorithm that identifies the onset and offset of a pacing artifact based on the VCG signal slope steepness and designed a graphical user interface that permits quality control and fine-tuning the constraining threshold values. Read More

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Lianhuaqingwen capsule inhibits influenza-induced bacterial adhesion to respiratory epithelial cells through down-regulation of cell adhesion molecules.

J Ethnopharmacol 2021 Apr 16:114128. Epub 2021 Apr 16.

State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, 510120, PR China; Faculty of Chinese Medicine, Macau University of Science and Technology, Taipa, Macau SAR, PR China. Electronic address:

Ethnopharmacological Relevance: Influenza virus infection is widely believed to cause mild symptoms, but can lead to high mortality and severe disease complicated by secondary bacterial pneumonia. Traditional Chinese medicine (TCM) has been proposed as a promising agent to treat respiratory viral infections. An herbal formula Lianhuaqingwen capsule (LHQW) comprising two prescriptions: Maxing Shigan decoction and Yinqiao San, has been used clinically to treat respiratory infection with immune regulatory effects. Read More

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Towards personalised medicine in autoimmune hepatitis: Measurement of thiopurine metabolites results in higher biochemical response rates compared to standard weight-based dosing of thiopurine therapy.

J Hepatol 2021 Apr 16. Epub 2021 Apr 16.

Institute of Liver Studies, King's College Hospital, London, SE5 9RS, UK; School of Transplantation, Immunology and Mucosal Biology, Faculty of Life Sciences and Medicine, King's College London, London, UK; European Reference Network - Hepatological Diseases (ERN RARE-LIVER).

Background: Patients with autoimmune hepatitis (AIH) usually receive maintenance therapy with thiopurines, such as azathioprine (AZA) or mercaptopurine (MP). Genetic polymorphisms in AZA metabolism can lead to variations in thioguanine nucleotide (TGN) and 6-methylmercaptopurine (MMP), both of which can cause adverse drug reactions (ADR). In inflammatory bowel disease (IBD), a therapeutic TGN range (225-450 pmol/8x10 erythrocytes) has been identified to optimise effectiveness. Read More

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Independent external validation using the EORTC HNCG-ROG 1219 DAHANCA trial data of NTCP models for acute oral mucositis.

Radiother Oncol 2021 Apr 16. Epub 2021 Apr 16.

Department of Radiation Oncology, Catharina Hospital, Eindhoven, The Netherlands.

Purpose: To externally validate previously published Normal Tissue Complication Probability (NTCP) models developed by separate teams for grade 3 oral mucositis (g3OM).

Materials And Methods: Two models were validated: a logistic model, based on 144 head and neck cancer (HNC) patients receiving induction chemotherapy followed by chemo-IMRT; a multivariable logistic model for prediction of g3OM for 253 patients receiving radical treatment for the head and neck squamous cell carcinoma (HNSCC). The EORTC HNCG-ROG 1219 DAHANCA trial dataset, consisting of 169 patients was used as the validation cohort. Read More

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Development and validation of real-time PCR assays for the detection of Ehrlichia species and E. chaffeensis in clinical specimens.

J Microbiol Methods 2021 Apr 16:106225. Epub 2021 Apr 16.

Rickettsial Zoonoses Branch, Division of Vector-Borne Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA, United States of America. Electronic address:

Ehrlichiosis, caused by Gram-negative bacteria of the genus Ehrlichia, is considered an emerging infectious disease due to the increasing number of reported cases. Symptoms are non-specific and occur within 1 to 2 weeks following the bite of an infected tick. Confirmatory laboratory diagnostic methods vary in sensitivity and specimen requirements, which can lead to delayed diagnosis. Read More

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Enablers and barriers in hospital-to-home transitional care for stroke survivors and caregivers: A systematic review.

J Clin Nurs 2021 Apr 19. Epub 2021 Apr 19.

College of Nursing and Health Sciences, Flinders University, Adelaide, SA, Australia.

Aims And Objectives: To synthesise qualitative research evidence on the experience of stroke survivors and informal caregivers in hospital-to-home transitional care.

Background: Due to a shortened hospital stay, stroke survivors/caregivers must take over complex care on discharge from hospital to home. Gaps in the literature warrant a meta-synthesis of qualitative studies on perceived enablers and barriers during this crucial period. Read More

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Sequence deeper without sequencing more: Bayesian resolution of ambiguously mapped reads.

PLoS Comput Biol 2021 Apr 19;17(4):e1008926. Epub 2021 Apr 19.

Department of Molecular Biology and Cell Genetics, Division of the Biological Sciences, The University of Chicago, Chicago, Illinois, United States of America.

Next-generation sequencing (NGS) has transformed molecular biology and contributed to many seminal insights into genomic regulation and function. Apart from whole-genome sequencing, an NGS workflow involves alignment of the sequencing reads to the genome of study, after which the resulting alignments can be used for downstream analyses. However, alignment is complicated by the repetitive sequences; many reads align to more than one genomic locus, with 15-30% of the genome not being uniquely mappable by short-read NGS. Read More

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Assessment of Upper-extremity Joint Angles using Harmony Exoskeleton.

IEEE Trans Neural Syst Rehabil Eng 2021 Apr 19;PP. Epub 2021 Apr 19.

The biomechanical complexity of the human shoulder, while critical for functionality, poses a challenge for objective assessment during sensorimotor rehabilitation. With built-in sensing capabilities, robotic exoskeletons have the potential to serve as tools for both intervention and assessment. The bilateral upper-extremity Harmony exoskeleton is capable of full shoulder articulation, forearm flexion-extension, and wrist pronation-supination motions. Read More

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Twelve tips for creating an escape room activity for medical education.

Med Teach 2021 Apr 19:1-6. Epub 2021 Apr 19.

Department of Pediatrics, Division of Pediatric Emergency Medicine, Baylor College of Medicine, Houston, TX, USA.

Communication, teamwork, and resilience all require active practice by healthcare teams. Games such as escape rooms can add variety, interactivity, and value to teaching sessions. Escape room activities typically include a variety of sequential puzzles that lead participants to break free of a room, or can be adapted into an 'escape box' challenge where participants work to successfully unlock a box. Read More

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Intratendinous Strain Variations of the Supraspinatus Tendon Depending on Repair Technique: A Biomechanical Analysis Regarding the Cause of Medial Cuff Failure.

Am J Sports Med 2021 Apr 19:3635465211006138. Epub 2021 Apr 19.

University of Cologne, Faculty of Medicine, Cologne, Germany.

Background: Double-row (DR) and transosseous-equivalent (TOE) techniques for rotator cuff repair offer more stability and promote better tendon healing compared with single-row (SR) repairs and are preferred by many surgeons. However, they can lead to more disastrous retear patterns with failure at the medial anchor row or the musculotendinous junction. The biomechanics of medial cuff failure have not been thoroughly investigated thus far. Read More

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Applying Unconventional Spectroscopies to the Single-Molecule Magnets, Co(PPh3)2X2 (X = Cl, Br, I): Unveiling Magnetic Transitions and Spin-Phonon Coupling.

Chemistry 2021 Apr 19. Epub 2021 Apr 19.

Texas A&M University College Station, Department of Chemistry, UNITED STATES.

Large separation of magnetic levels and slow relaxation in metal complexes are desirable properties of single-molecule magnets (SMMs). Spin-phonon coupling (interactions of magnetic levels with phonons) is ubiquitous, leading to magnetic relaxation and loss of memory in SMMs and quantum coherence in qubits. Direct observation of magnetic transitions and spin-phonon coupling in molecules is challenging. Read More

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Combining biomarkers by maximizing the true positive rate for a fixed false positive rate.

Biom J 2021 Apr 19. Epub 2021 Apr 19.

Department of Biostatistics, University of Washington, Seattle, WA, USA.

Biomarkers abound in many areas of clinical research, and often investigators are interested in combining them for diagnosis, prognosis, or screening. In many applications, the true positive rate (TPR) for a biomarker combination at a prespecified, clinically acceptable false positive rate (FPR) is the most relevant measure of predictive capacity. We propose a distribution-free method for constructing biomarker combinations by maximizing the TPR while constraining the FPR. Read More

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Psychological changes in young people with anorexia nervosa during an inpatient treatment: exploration of optimal length of stay predictors.

Neuropsychiatr 2021 Apr 19. Epub 2021 Apr 19.

Eating Disorders Service for Children and Adolescents, Elysium Healthcare, Rhodes Wood Hospital, London, UK.

Objective: The current study aimed to monitor psychological changes in young people (YP) with anorexia nervosa (AN) during a specialist inpatient treatment in order to explore possible predictors of an optimal length of stay. Outcome measures were analysed to determine if significant changes occur earlier or later on during the treatment.

Methods: Eating Disorder Examination Questionnaire (EDE-Q), Children's Depression Inventory (CDI), State-Trait Anxiety Inventory (STAI) and Compulsive Exercise Test (CET) measures administered to YP (n = 42) at three time points-admission, 85% ideal body weight (IBW) and discharge-were analysed using linear mixed effects model and regression analysis to determine change between the time points and possible predictors in length of stay. Read More

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A Clinical and Budgetary Impact Analysis of Introducing Sugammadex for Routine Reversal of Neuromuscular Blockade in a Hypothetical Cohort in the US.

Adv Ther 2021 Apr 19. Epub 2021 Apr 19.

Department of Anesthesiology, University of Michigan, Ann Arbor, MI, USA.

Introduction: Sugammadex rapidly reverses the effects of rocuronium- and vecuronium-induced neuromuscular blockade (NMB), offering a more complete and predictable NMB recovery than cholinesterase inhibitors. Despite clinical benefits, cost pressures on hospital budgets influence the choice of the NMB reversal method. This study evaluated clinical and healthcare system payer's budget impacts associated with sugammadex in the US for routine reversal of moderate or deep rocuronium- or vecuronium-induced NMB in adults undergoing surgery. Read More

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Are biosynthesized nanomaterials toxic for the environment? Effects of perlite and CuO/perlite nanoparticles on unicellular algae Haematococcus pluvialis.

Ecotoxicology 2021 Apr 19. Epub 2021 Apr 19.

Department of Plant Sciences, Faculty of Natural Sciences, University of Tabriz, Tabriz, Iran.

The properties of nanomaterials such as perlite nanoparticles and their increased application have raised concerns about their probable toxic impacts on the aquatic ecosystems and algae. Here, a novel biochemical synthesis and immobilization of CuO is reported on perlite nanoparticles (CuO/Per-NPs) and its toxic effect on alga has been compared with nanoperlites. This biosynthesis of CuO/Per-NPs performed using phytochemicals of Haematococcus pluvialis, Sargassum angustifolium, and walnut leaves in the aqueous extract. Read More

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Communicating uncertainty: contrasting the communication experiences of patients with advanced COPD and incurable lung cancer.

Fam Pract 2021 Apr 19. Epub 2021 Apr 19.

Primary Care Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK.

Background: Due to the uncertain disease trajectory and variable rate of progression in chronic obstructive pulmonary disease (COPD), health care professionals (HCPs) are challenged in explaining what the future may hold for patients compared to those with lung cancer (LC). Support and communication of timely information can significantly improve health outcomes.

Objective: This study sought to identify factors that impact communication and support and recommend ways to improve patients' understanding of living with life-threatening illness. Read More

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Differentiation of clinical patterns and survival outcomes of hepatocellular carcinoma on hepatitis B and nonalcoholic fatty liver disease.

J Chin Med Assoc 2021 Apr 12. Epub 2021 Apr 12.

Department of Gastroenterology, Ren-Ai Branch, Taipei City Hospital, Taipei, Taiwan, ROC Department of Pathology, Ren-Ai Branch, Taipei City Hospital, Taipei, Taiwan, ROC Department of Obstetrics and Gynecology, Taipei Medical University Hospital, Taipei, Taiwan, ROC University of Taipei, Taipei, Taiwan, ROC.

Background: The main etiologies of hepatocellular carcinoma (HCC) were often hepatitis B virus (HBV) or C and alcohol, rarely autoimmune and biliary diseases. Nonalcoholic fatty liver disease (NAFLD) has been an emerging role that could lead to chronic liver disease, nonalcoholic steatohepatitis, cirrhosis, and eventually HCC in recent years. The aim of our study is to investigate and compare the clinical features of HCC in NAFLD and HBV patients, including age, gender, cirrhosis, liver function tests, largest tumor size and cancer stage at the time of diagnosis. Read More

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Chronic hepatitis B virus infection and fibrosis: novel non-invasive approaches for diagnosis and risk stratification.

Minerva Gastroenterol (Torino) 2021 Apr 19. Epub 2021 Apr 19.

Department of Medical Sciences, University of Turin, Turin, Italy -

Despite the availability of an effective vaccination, chronic hepatitis B virus (HBV) infection is still a major health concern worldwide. Chronic HBV infection can lead to fibrosis accumulation and overtime to cirrhosis, the principal risk factor for liver failure and hepatocellular carcinoma development. Liver biopsy is still considered the gold standard for fibrosis assessment, even though it is invasive and not exempt of complications. Read More

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Daptomycin-induced eosinophilic pneumonia: Are there any risk factors?

Infect Dis Now 2021 Jan 9. Epub 2021 Jan 9.

Service de Pneumologie et Soins Intensifs Respiratoires, Centre de Référence Constitutif des maladies Pulmonaires rares de l'Adultes de Dijon, réseau OrphaLung, Filère RespiFil, Centre Hospitalier Universitaire de Bourgogne, 14, rue Paul-Gaffarel, 21000 Dijon, France; Université de Bourgogne Franche-Comté, Faculté de médecine, Dijon, France; NSERM U123-1, Dijon, France.

Objectives: Daptomycin is a widely used antibiotic. Rhabdomyolysis related to daptomycin is one of the adverse effects of treatment, justifying the need for regular monitoring of muscle enzymes throughout treatment. Daptomycin may also lead to eosinophilic pneumonia. Read More

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January 2021

Did COVID-19 related delays in surgical management lead to patient morbidity in the orthopaedic oncological population?

Bone Jt Open 2021 Apr;2(4):236-242

Department of Orthopaedics, North Shore-Long Island Jewish Hospital, Northwell Health Medical Center, New Hyde Park, New York, USA.

Aims: The aim of this study was to assess orthopaedic oncologic patient morbidity resulting from COVID-19 related institutional delays and surgical shutdowns during the first wave of the pandemic in New York, USA.

Methods: A single-centre retrospective observational study was conducted of all orthopaedic oncologic patients undergoing surgical evaluation from March to June 2020. Patients were prioritized as level 0-IV, 0 being elective and IV being emergent. Read More

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Promoting resilience for children of parents with opioid use disorder: A pilot study of a directed intervention.

J Child Adolesc Psychiatr Nurs 2021 Apr 19. Epub 2021 Apr 19.

School of Nursing, College of Health and Human Services, University of North Carolina Wilmington, Wilmington, North Carolina, USA.

Problem: Having a parent with Opioid Use Disorder (OUD) is a childhood adverse experience (ACE), magnified by other accompanying ACEs. Outcomes for these children tend to include developing mental illness and/or Substance Use Disorders themselves. Few studies address these children's experiences and needs. Read More

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Challenges facing nurse managers during and beyond COVID-19 pandemic in relation to perceived organizational support.

Nurs Forum 2021 Apr 19. Epub 2021 Apr 19.

Nursing Administration, Faculty of Nursing, Menoufia University, Shibin Al Kawm, Egypt.

Aim: To explore challenges facing nurse managers during and beyond coronavirus disease, 2019 (COVID-19) pandemic and its relation to perceived organizational support.

Background: When faced with high-pressure situations like the COVID-19 pandemic, it is critical that nurse managers be equipped with the support they need to successfully surpass these hard times.

Methods: Descriptive correlational design was utilized. Read More

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Response durability after cessation of immune checkpoint inhibitors in patients with metastatic Merkel cell carcinoma: a retrospective multicenter DeCOG study.

Cancer Immunol Immunother 2021 Apr 18. Epub 2021 Apr 18.

Department of Dermatology, University Medical Center of the Johannes Gutenberg University, Mainz, Germany.

Background: Immune checkpoint inhibitors (ICI) have led to a prolongation of progression-free and overall survival in patients with metastatic Merkel cell carcinoma (MCC). However, immune-mediated adverse events due to ICI therapy are common and often lead to treatment discontinuation. The response duration after cessation of ICI treatment is unknown. Read More

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Clinical course, treatment and visual outcome of an outbreak of Burkholderia contaminans endophthalmitis following cataract surgery.

J Ophthalmic Inflamm Infect 2021 Apr 19;11(1):12. Epub 2021 Apr 19.

Department of Ophthalmology, University Hospital of North Norway, Tromsø, Norway.

Background: Postoperative endophthalmitis is a rare but dreaded complication of intraocular surgery and often results in severe visual impairment or blindness. The present study describes the clinical course, treatment and visual outcome of an outbreak of Burkholderia contaminans endophthalmitis following cataract surgery.

Methods: Among 290 patients who underwent uneventful phacoemulsification cataract surgery at one outpatient clinic between January 4th and 28th 2019, 6 cases developed Burkholderia contaminans endophthalmitis. Read More

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and Trainees Choose a Career in Pediatric Pulmonology. A Qualitative Study.

ATS Sch 2020 Aug 5;1(4):372-383. Epub 2020 Aug 5.

Department of Pulmonary and Critical Care Medicine, School of Medicine, Indiana University, Indianapolis, Indiana.

There is concern that inadequate recruitment of new subspecialty trainees to replace the aging physician population will lead to significant workforce issues in pediatric pulmonology. The factors leading trainees to pursue a fellowship in pediatric pulmonology are unclear. To gain a better understanding of the decision-making process surrounding the choice to pursue a pediatric pulmonary fellowship and to provide informed recommendations to increase recruitment of new trainees. Read More

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Crisis Leadership Education for Critical Care Fellows. A Longitudinal Curriculum Using Simulation.

ATS Sch 2020 Feb 21;1(1):11-19. Epub 2020 Feb 21.

Division of Pulmonary, Critical Care and Sleep Medicine, Department of Medicine and.

: Leadership and teamwork are critical to the performance of a multidisciplinary team responding to emergencies in the intensive care unit; yet, these skills are variably taught to pulmonary and critical care trainees. Currently, there is no standardized leadership curriculum in critical care training. : We developed a longitudinal crisis leadership curriculum for first-year pulmonary and critical care fellows using high-fidelity simulation as a medium to practice and solidify skills. Read More

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February 2020