bluuebunny/crossref_metadata_2025_split huggingface dataset:
Feeding behavior of growing and finishing pigs fed different dietary threonine levels in a group-phase feeding and individual precision feeding system
Authors: Remus Aline , Hauschild Luciano , Létourneau-Montminy Marie-Pierre , Andretta Ines , Pomar Candido 
Published: September 2020

AbstractFeeding behavior is an important aspect of pig husbandry as it can affect protein deposition (PD) in pigs. A decrease in plasma threonine (Thr) levels may influence feed intake (FI) due to amino acid imbalance. We set out to study whether different Thr inclusion rates of 70%, 85%, 100%, 115%, and 130% of the ideal Thr:lysine (Lys) ratio of 0.65 in two different feeding programs (individual precision feeding and group-phase feeding could affect pig feeding behavior and consequently PD. Two 21-d trials were performed in a 2 × 5 factorial setup (feeding systems × Thr levels) with 110 pigs in the growing phase [25.0 ± 0.8 kg of body weight (BW)] and 110 pigs in the finishing phase (110.0 ± 7.0 kg BW), which correspond to 11 pigs per treatment in each trial. Pigs were housed in the same room and fed using computerized feeding stations. The total lean content was estimated by dual x-ray absorptiometry at the beginning (day 1) and the end (day 21) of the trial. Multivariate exploratory factor analysis was performed to identify related variables. Confirmatory analysis was performed by orthogonal contrasts and Pearson correlation analysis. Graphical analysis showed no difference in feeding patterns between feeding systems during the growing or finishing phase. Pigs exhibited a predominant diurnal feeding, with most meals (73% on average) consumed between 0600 and 1800 h. Exploratory factor analysis indicated that feeding behavior was not related to growth performance or PD in growing or finishing pigs. Changes in feeding behavior were observed during the growing phase, where increasing dietary Thr resulted in a linear increase in the FI rate (P &lt; 0.05). During the finishing phase, the duration of the meal and FI rate increased linearly as dietary Thr increased in the diet (P &lt; 0.05). These changes in feeding behavior are, however, correlated to BW. In conclusion, the exploratory factor analysis indicated that feeding behavior had no correlation with growth performance or protein and lipid deposition in growing or finishing pigs. Dietary Thr levels and feeding systems had no direct effect on FI.
Self-Regulations for Educators Questionnaire (SREQ) for implementation programming
Authors: Vazou Spyridoula , Bai Yang , McLoughlin Gabriella M , Welk Gregory J 
Published: September 2020

AbstractThe adoption and dissemination of evidence-based programs is predicated on multiple factors, including the degree to which key stakeholders are motivated to implement program best practices. The present study focuses on the development of indicators that capture motivations of teachers to adopt school wellness programming since personal motivations are central to achieving sustainable impacts in these settings. The study specifically describes the measurement development and validation of the Self-Regulations for Educators Questionnaire (SREQ), designed to measure educators’ autonomous and controlled motivation for adopting evidence-based programming in their schools. A naturalistic design to study motivation to adopt aspects of NFL PLAY60 programming through the NFL PLAY60 FitnessGram Partnership Project was used. A total of 1,106 teachers completed the SREQ online. Internal validity was assessed through exploratory and confirmatory factor analysis, and predictive validity using structural equation modeling (SEM). The results supported the two-factor solution with separate items capturing aspects of autonomous and controlled motivation. Both factors had good internal reliability and the item-total correlation coefficients were above 0.40 for both factors. The results also supported the predictive validity as autonomous motivation positively predicted the level of overall engagement, teaching effectiveness, fitness testing reports sent home, and completion of fitness testing with students (p &lt; .05). Controlled motivation positively predicted whether the teachers conducted fitness testing and the engagement of Play 60 Challenge (p &lt; .05). Findings suggest that the SREQ displays a number of psychometric characteristics that make the instrument useful for examining motivation of providers to implement evidence-based best practices.
Le silence et le contrat : la consécration d’un antagonisme par le droit OHADA
Authors: Paul Francis Ohandja 
Published: September 2020

Résumé :
En théorie générale, la relation entre le silence et le contrat est querellée. Une partie de la doctrine y voit une ambivalence tandis qu’une autre préfère parler de contradiction. À la lecture des contrats OHADA, nous retenons plutôt dans cette relation la consécration d’un antagonisme. Le silence entendu comme le fait de ne rien dire, de ne pas agir, l’absence ou l’omission de mentions ou de formalités dans un acte est inopérant lors de la formation du contrat envisagé comme le lieu et le moyen d’expression substantielle et formelle des volontés. Cette position est consacrée de façon explicite par le législateur OHADA. Seulement, après formation du contrat, le silence devient opérant sur les plans objectif et subjectif. Le législateur OHADA consacre cette seconde position de façon implicite. Au fond, il ne s’agit donc que d’un antagonisme apparent qui permet en réalité de mieux comprendre le régime des contrats OHADA.
Improving Quiet at Night on a Telemetry Unit: Introducing a Holistic Sleep Menu Intervention
Authors: Antonio Christian Karl 
Published: September 2020

ABSTRACT
In a patient's recovery process, restful sleep is crucial. Although the essential role of sleep in healing has long been recognized, excessive noise in hospital environments remains a persistent and pervasive problem. For hospitalized patients, environmental noise can result in sleep deprivation and adverse health outcomes; not surprisingly, hospital noise ranks as a major patient complaint. At a small suburban community hospital, patients responding to a quiet-at-night question in the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey gave the hospital's telemetry unit the lowest possible score: 1 out of 5 points. In response, the unit's quality improvement team, coordinated by a clinical nurse leader, introduced a holistic “sleep menu” intervention. The multicomponent intervention subsequently improved patients' care experience and staff engagement. The percentage of patients who self-reported five or more hours of uninterrupted sleep rose from 31% at baseline to 80% during the intervention. This improvement was sustained over the three-month intervention period and led to a quiet-at-night HCAHPS score of 4. The sleep menu initiative resulted in substantial benefits that optimized both patient and organizational outcomes.
Vaccine Hesitancy is Prevalent Among U.S. Parents
Authors: Rosenberg Karen 
Published: September 2020

According to this study:

Parental hesitancy about vaccines, especially influenza vaccine, is prevalent in the United States.In a survey of families of children between six months and less than 18 years of age, the prevalence of hesitancy regarding routine childhood vaccines was 6.1%. For the influenza vaccine, it was 25.8%.
Kirner's deformity of the fifth finger
Authors: Tianxiao Ma , Wang Dongyue , Song Lihua 
Published: September 2020

Abstract

Rationale:
Kirner's deformity is an uncommon deformity of finger, characterized by palmo-radial curvature of distal phalanx of the fifth finger. The specific mechanism remains unknown yet. This study aims to present a case report to add the knowledge on this type of deformity.

Patient concerns:
A 9-year-old girl presenting with deformity of her fifth finger since she was born was admitted to our hand surgery clinic. MRI findings showed widened epiphyseal plate, L-shaped physis, but normal flexor digitorum profundus tendon insertion, without any significantly enhanced soft issues.

Diagnosis:
Kirner's deformity of the fifth finger.

Interventions:
We presented 2 surgical choices for the patient: one was wedge osteotomy of the distal phalanx to correct the mechanical line of the distal phalanx and fixation with Kirschner wire and the other one was cut-off of deep flexor tendon insertion with brace immobilization, but her guardians refused either of them.

Outcomes:
Consecutive follow-up was performed for 19 months after the first visit, showing no any change in finger shape and function.

Lessons:
The L-shaped epiphyses may be the cause of Kirner's deformity and further attention should be paid on in the clinic. This case report provided a basis for the etiological diagnosis and future treatment of Kirner's deformity.
Acupotomy for patients with tarsal tunnel syndrome
Authors: Sun Xiaojie , Zhou Qiaoyin , Shi Chong , Lan Yangjing , Jia Yan , Qiu Zuyun , Shen Yifeng , Li Shiliang 
Published: September 2020

AbstractBackground:Tarsal tunnel syndrome (TTS) is a painful condition of the ankle that affects patients’ quality of life and ability to work. Multiple clinical studies of nerve decompression by acupotomy have been published in China, and the results are encouraging. However, the efficacy and security of this treatment have not been evaluated scientifically and systematically. The purpose of this systematic review protocol is to evaluate the efficacy and security of acupotomy treatment in patients with TTS, which will be helpful to clinical acupotomy doctors.Methods:Relevant randomized controlled trials will be identified by searching 9 databases (PubMed, Embase, Cochrane Library, Chinese literature databases, the Chinese Biomedical Literature Database, China National Knowledge Infrastructure, SinoMed, Technology Journal and the Wanfang Database. Randomized controlled trials examining the use of acupotomy for TTS patients will be identified independently by 2 reviewers by searching the databases from inception to March 2020. Clinical effects will be evaluated as the primary outcome. Visual analog scale scores will be assessed as a secondary outcome. Review Manager 5.3 will be used to perform a fixed effects meta-analysis, and the evidence level will be evaluated by using the Grading of Recommendations Assessment, Development, and Evaluation framework. Continuous outcomes will be presented as mean differences or standard mean differences, while dichotomous data will be expressed as relative risks.Results:This study will evaluate the effectiveness and safety of acupotomy in the treatment of TTS in randomized controlled trials with high-quality visual analog scale and Roles and Maudsley score.Conclusion:This systematic review will provide evidence to determine whether acupotomy is an effective intervention for patients with TTS.Registration number:DOI 10.17605/OSF. IO/9PYC2 (https://osf.io/9pyc2/)
Diagnosis of multiple pulmonary cavernous hemangiomas via dual-layer spectral CT
Authors: Bae Kyungsoo , An Hyo Jung , Jung Jae Jun , Kim Ho Cheol , Jeon Kyung Nyeo 
Published: September 2020

Abstract

Rationale:
Cavernous hemangioma is a benign vascular tumor, which very rarely occurs in the lung. When appearing as multiple nodules on chest CT, this tumor can be misdiagnosed as metastatic malignancy.

Patient concerns:
A 72-year-old woman presented with incidentally found multiple lung nodules on chest radiograph.

Diagnoses:
Based on information derived from dual-layer spectral CT images, the possibility of slow flow vascular tumor such as cavernous hemangioma was suggested. A pathologic diagnosis of pulmonary cavernous hemangioma was made via video-assisted thoracoscopic biopsy.

Interventions:
After tissue confirmation, the patient was discharged without further intervention.

Outcomes:
The patient recovered without any event. Follow-up chest CT performed 6 months later showed no significant interval change in nodule size and distribution.

Lessons:
Material decomposition images obtained from dual energy CT can help physicians understand the character of tumor vascularity for an accurate diagnosis of pulmonary cavernous hemangioma.
Objective and Subjective Evaluation of Clinical Performance of Scleral Lens with Varying Limbal Clearance in Keratoconus
Authors: Yeung Debby , Murphy Paul J. , Sorbara Luigina 
Published: September 2020

SIGNIFICANCEThis study evaluates how limbal clearance (LC) may impact the clinical performance of scleral lenses based on subjective response on comfort and ocular responses. Limbal zone designs in scleral lenses might affect the integrity of the limbal epithelial tissue as a result of a combined hypoxic and compression-related etiology.PURPOSEThis study aimed to investigate the clinical performance and ocular and subjective responses to the wear of scleral lenses having varying LC.METHODSLenses with varying LC with a difference of 50 μm were fitted on and compared among keratoconic participants. The lenses were worn during a 2-week period. Visual analog scales concerning subjective comfort were completed. Ocular surface findings including hyperemia, limbal staining, and corneal swelling were compared.RESULTSParticipants reported greater comfort achieved with high LC. No difference in limbal and bulbar hyperemia was found (P> .05). Corneal response to scleral lens wear with both low and high LCs seems to result in similar perilimbal staining and negative corneal staining. An increase in corneal pachymetric values was noted at the central and peripheral cornea, with no difference between low- and high-LC lenses (all,P< .05). Quadrant-specific analysis indicated that all meridians at both 6 and 8 mm were increased for the low-LC lenses (all,P< .05) and only the temporal region for the high-LC lenses (P= .02).CONCLUSIONSLimbal clearance may play an important role in subjective performance in scleral lenses but does not impact the degree of hyperemia in either the limbal or bulbar region. Although low LC might result in more compression-related changes to ocular surface, high LC is associated with greater comfort and greater edematous changes. Limbal zone designs in scleral lenses might affect the integrity of the limbal epithelial tissue as a result of a combined hypoxic and compression-related etiology.
Application of a Hybrid Method for Performance Evaluation of Teaching Hospitals in Tehran
Authors: Firouzi Jahantigh Farzad , Ostovare Maryam 
Published: September 2020

Background and Objectives:
Teaching hospitals often face budget limitations and lack of investment. Therefore, the optimal allocation of budget and resources plays an important role in improving the performance and service quality of these hospitals. This research aims to evaluate the performance and determine the efficiency of medical science university hospitals in Tehran.

Methods:
This study identified and categorized 47 effective factors in the performance assessment of hospital units using the Preference Ranking Organization METHod for Enrichment of Evaluation II (PROMETHEE II) method. Moreover, the performance of 40 medical science university hospitals in Tehran was evaluated using an outcome-based model of data envelopment analysis (DEA) with 4 input and 8 output factors and the assumption of scale-dependent efficiency. The hospitals were also ranked according to the Andersen-Petersen (AP) method.

Results:
PROMETHEE II results identified 12 factors as the most important in hospital performance evaluation. DEA indicated that 16 hospitals had performance scores below 1 and are thus inefficient. The AP method identified Hospital 28, which had an efficiency value of 4.533, as the best hospital.

Conclusion:
Given the results of this approach and the identification of a considerable number of teaching hospitals as inefficient hospitals, top managers of medical centers must adopt the necessary planning to improve system performance and realize the optimal application of resources.
Addressing Behavioral Health Concerns in Trauma: Using Lean Six Sigma to Implement a Depression Screening Protocol in a Level I Trauma Center
Authors: Moran Mary E. , Sedorovich Ashley , Kish Jamie , Gothard Andrew , George Richard L. 
Published: September 2020

Background:
Patients with physical injuries or chronic conditions may be impacted by mental health conditions, which significantly affect their participation and progress in treatment. The Patient Health Questionnaire-2 (PHQ-2) depression screening can identify patients who are at greatest risk for depression to provide better whole-person care.

Objective:
The quality improvement project objective was to identify and design a process that would result in the PHQ-2 depression screening for admitted trauma patients with a minimum 75% completion rate.

Methods:
Lean Six Sigma (LSS) process design methodology, DMADV (define, measure, analyze, design, and verify), drove process improvement. Medical records from before (December 2018 through February 2019) and after (March 2019 through May 2019) the intervention were evaluated using frequencies, percentages, χ2, and multivariable logistic regression to determine the effectiveness of the intervention.

Results:
PHQ-2 document location was imperative to successful compliance, which increased from 60.74% (78 of 128) to 80.56% (87 of 108). Specifically, weekend compliance increased from 42.9% (18 of 42) to 82.8% (24 of 29).

Conclusion:
LSS DMADV methodology helped health care professionals design a process to facilitate compliance with the PHQ-2 depression screening protocol in trauma patients. Adherence with this screening can help increase the number of behavioral health consultations, which in turn improves the treatment of traumatic injury survivors.
Using Failure Mode and Effects Analysis in Blood Administration Process in Surgical Care Units: New Categories of Errors
Authors: Aly Nagah Abd El-fattah Mohamed , El-Shanawany Safaa M. , Maher Ghoneim Tamer A. 
Published: September 2020

Background:Blood administration failures and errors have been a crucial issue in health care settings. Failure mode and effects analysis is an effective tool for the analysis of failures and errors in such lifesaving procedures. These failures or errors would lead to adverse outcomes for patients during blood administration.Objectives:The study aimed to: use health care failure mode and effect analysis (HFMEA) for assessing potential failure modes associated with blood administration processes among nurses; develop a categorization of blood administration errors; and identify underlying reasons, proactive measures for identified failure modes, and corrective actions for identified high-risk failures.Methods:A cross-sectional descriptive study was conducted in surgical care units by using observation, HFMEA, and brainstorming techniques. Prioritization of detected potential failures was performed by Pareto analysis.Results:Eleven practical steps and 38 potential failure modes associated with 11 categories of errors were detected in this process. These categories of errors were newly developed in this study. In total, 17 of 38 potential failures were detected as high-risk failures that occurred during the sample-drawing, checking, preparing, administering, and monitoring steps. For cause analysis of failures and errors, proactive suggested actions were undertaken for 38 potential failure modes, and corrective actions for 17 high-risk failures.Conclusion:HFMEA is an efficient and well-organized tool for identification of and reduction in high-risk failures and errors in the blood administration process among nurses without building punitive culture. This tool also helps pay attention to redesigning and standardizing the blood administration process as well as providing training and educational programs for providing knowledge.
CLINICAL AND DEMOGRAPHIC CHARACTERISTICS OF COVID-19 PATIENTS IN LAGOS, NIGERIA: A DESCRIPTIVE STUDY
Authors: Otuonye Ngozi Mirabel , Olumade Testimony Jesupamilerin , Ojetunde Mercy Mayowa , Holdbrooke Susan Abba , Ayoola Joy Boluwatife , Nyam Itse Yusuf , Iwalokun Bamidele , Onwuamah Chika , Uwandu Mabel , Salako Babatunde Lawal , Abayomi Akinola , Osibogun Akin , Bowale Abimbola , Osikomaiya Bodunrin , Thomas Babafemi , Mutiu Bamidele , Odunukwe Nkiruka Nnonyelum 
Published: September 2020

ABSTRACTIntroductionCOVID-19 is an emerging, rapidly evolving global situation, infecting over 25 million people and causing more than 850,000 deaths. Several signs and symptoms have been described to be characteristic of the disease. However, there is a dearth of report on the description of the clinical characteristics of the disease in patients from Nigeria. This study was designed to provide a description of the clinical and demographic characteristics of COVID-19 patients in Nigeria.MethodsThis study is a case series that includes patients that are evaluated between June and August 30, 2020, and diagnosed with COVID-19. Patient health records were reviewed and evaluated to describe the clinical characteristics on presentation.ResultsA total of 154 COVID-19 patients were included in this study, with a mean age (S.D.) of 46.16 (13.701). Most of the patients survived (mortality rate of 2.6%), and were symptomatic (89.6%). There were more males (74.7%) than females, and the most common symptoms were fever, breathing difficulty, dry cough and malaise. Co-morbidities were also present in almost half of the study participants (49.4%).ConclusionThis study presents the most extensive description, to date, on the clinical and demographic characteristics of COVID-19 patients in Nigeria. Males are more likely than females to be infected with COVID-19 and the most occurring symptoms are fever, breathing difficulty, malaise, dry cough and chest pain. Old age and the presence of co-morbidities may also be associated with developing the severe disease.
Cannabis use and risk of type 2 diabetes: a two-sample Mendelian randomization study
Authors: Baumeister Sebastian-Edgar , Nolde Michael , Alayash Zoheir , Leitzmann Michael , Baurecht Hansjörg , Meisinger Christa 
Published: September 2020

AbstractCannabis has effects on the insulin/glucose metabolism. As the use of cannabis and the prevalence of type 2 diabetes increase worldwide, it is important to examine the effect of cannabis on the risk of diabetes. We conducted a Mendelian randomization study by using 19 single-nucleotide polymorphisms as instrumental variables for lifetime cannabis use and 14 SNPs to instrument cannabis use disorder, and linking these to type 2 diabetes risk using genome-wide association study data (lifetime cannabis use [N = 184,765]; cannabis use disorder [2,387 cases / 48,985 controls], type 2 diabetes [74,124 cases / 824 controls]). The MR analysis suggested no effect of lifetime cannabis use (inverse variance weighted odds ratio [95% confidence interval] = 1.00 [0.93-1.09], P-value = 0.935) and cannabis use disorder (OR = 1.03 [0.99-1.08]) on type 2 diabetes. Sensitivity analysis to assess potential pleiotropy led to no substantive change in the estimates. This study adds to the evidence base that cannabis use does not play a causal role in type 2 diabetes.