bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of the LIPEX finishing diet regimen on pork quality, fatty acid profile, palatability, and color stability12
Authors: Gonzalez John M , Houser Terry A , O’Quinn Travis G , Nuttelman Dennis E , Odgaard Richard L , Coulter John M , Faltys Gary , Stelzleni Alexander M , Azain Michael J 
Published: December 2019

Abstract
The objective of this study was to determine the effects of the LIPEX finishing diet regimen on pork chop n-3 polyunsaturated fatty acid (PUFA) content and fresh meat quality. Twenty-eight finishing pigs (PIC 359 × F1 Hermitage/NGT; initial BW 81.5 ± 2.55 kg) were subjected to a 49-d feeding trial. Treatments consisted of a 2 × 2 factorial design with Sex (n = 14 barrows and gilts each) and Diet as main effects. Dietary treatments consisted of a 2-phase standard finishing diet regimen or a 2-phase LIPEX finishing diet regimen (EXL Milling, Lloydminster, SK, Canada). The LIPEX diet regimen added the EXL LIPEX.FA369 additive during phase 1 and the EXL LIPEX.FA369 and XFE Omega-3 Finishing Touch during phase 2. Five-days postmortem, whole boneless pork loins were transported to the Kansas State University Meats Laboratory, aged 14 d, and halved immediately behind the spinalis dorsi. After blooming for 30 min, chops were evaluated for Japanese color score and National Pork Producers Council (NPPC) color and marbling scores. A 2.54-cm chop was taken immediately anterior to the loin cut and was used for fatty acid and proximate composition analyses. Four 2.54-cm chops were cut from the posterior portion of the loin and were utilized for a 7-d simulated retail display analyses, Warner-Bratzler shear force (WBSF), and trained sensory panel. There were no Sex × Diet interactions for all variables measured in the study (P &gt; 0.10). The LIPEX finishing regimen increased chop C18:3n-3, C20:5, and C22:5, which decreased the n-6:n-3 ratio (P &lt; 0.01). There were no Diet effects on pH, Japanese and NPPC color and marbling scores, and proximate composition (P &gt; 0.23). Diet did not affect cook loss, WBSF, and trained sensory panel scores (P &gt; 0.012). There were no 2- or 3-way interactions between Diet, Sex, and Day, or Diet and Sex main effects for L*a* values, surface oxy- and metmyoglobin percentages, or visual panel chop redness and surface discoloration scores (P &gt; 0.14). Feeding the LIPEX finishing diet regimen increased chop n-3 PUFA content without negatively impacting fresh chop palatability or color stability.
Scaling of petiole anatomies, mechanics and vasculatures with leaf size in the widespread Neotropical pioneer tree species Cecropia obtusa Trécul (Urticaceae)
Authors: Levionnois Sébastien , Coste Sabrina , Nicolini Eric , Stahl Clément , Morel Hélène , Heuret Patrick 
Published: December 2019

AbstractAlthough the leaf economic spectrum has deepened our understanding of leaf trait variability, little is known about how leaf traits scale with leaf area. This uncertainty has resulted in the assumption that leaf traits should vary by keeping the same pace of variation with increases in leaf area across the leaf size range. We evaluated the scaling of morphological, tissue-surface and vascular traits with overall leaf area, and the functional significance of such scaling. We examined 1,271 leaves for morphological traits, and 124 leaves for anatomical and hydraulic traits, from 38 trees of Cecropia obtusa Trécul (Urticaceae) in French Guiana. Cecropia is a Neotropical genus of pioneer trees that can exhibit large laminas (0.4 m2 for C. obtusa), with leaf size ranging by two orders of magnitude. We measured (i) tissue fractions within petioles and their second moment of area, (ii) theoretical xylem hydraulic efficiency of petioles and (iii) the extent of leaf vessel widening within the hydraulic path. We found that different scaling of morphological trait variability allows for optimisation of lamina display among larger leaves, especially the positive allometric relationship between lamina area and petiole cross-sectional area. Increasing the fraction of pith is a key factor that increases the geometrical effect of supportive tissues on mechanical rigidity and thereby increases carbon-use efficiency. We found that increasing xylem hydraulic efficiency with vessel size results in lower leaf lamina area: xylem ratios, which also results in potential carbon savings for large leaves. We found that the vessel widening is consistent with hydraulic optimisation models. Leaf size variability modifies scaling of leaf traits in this large-leaved species.
Towards total protection from impact: a viability study using EPE foam to protect falling eggs
Authors: Liu Gui-Rong , Chen Guang , Duan Shu-Yong 
Published: December 2019

Abstract
Total protection of fragile goods and equipment during transport has become critically important as fast delivery systems are growing rapidly due to the rise of mass online commerce worldwide. This paper therefore studies the protection of falling eggs —one of the most fragile goods—through packaging. Intensive experiments are first conducted to obtain the critical stress at which the eggshell is damaged by falling impact. Tests are first conducted of unpackaged eggs dropping onto a granite platform from various heights. Finite element method (FEM) models of unpackaged eggs are then built to simulate the behaviour of eggs and compute their stress levels. The experimental data is compared with the results of FEM simulations to determine the critical stress at which the eggshell is damaged. A series of tests and numerical simulations are then carried out for eggs wrapped in expanded polyethylene (EPE) foam. The stress distribution of both a single egg and multiple eggs in packaging are studied. An empirical formula between the drop speed (or height) and the bottom thickness of the EPE foam packaging is obtained, which can be useful in the design of packaging for the total protection of eggs that may fall during usual transport and delivery operations. The experimental and numerical results from this study show that it is viable to protect fragile goods, as long as the EPE form packaging has sufficient thickness. The proposed study and design procedure are helpful for the selection of key parameters of foam packaging to protect fragile industry products from impact.
Current Wound Care Education in Entry-Level Doctor of Physical Therapy Curricula
Authors: Moore Kelly D. , Hardin Autumn , VanHoose Lisa , Huang Han-Hung 
Published: December 2019

ABSTRACT

OBJECTIVE
To investigate how wound care instruction is currently delivered within entry-level doctor of physical therapy (DPT) educational curricula.

METHODS
An electronic survey was distributed to 226 DPT programs in the US. The questionnaire contained 27 questions about the characteristics of the wound care instruction as well as the credentials, clinical experience, and teaching experience of the instructors. Descriptive statistics were analyzed for each questionnaire item response.

MAIN RESULTS
The response rate was 22.1% (n = 50). The majority of respondents reported 10 to 29 contact hours of wound care instruction throughout the curriculum. More than half of the programs reported that their students completed a wound care observation in clinical settings. Forty-four percent of programs stated that their students had the opportunity to participate in a clinical rotation focused solely on wound care. All respondents reported that their wound care instructors were physical therapists. Of those instructors, most were seasoned clinicians, and 46% held a wound care-related certification.

CONCLUSIONS
Current entry-level DPT curricula provide physical therapy students with adequate contact hours in wound care and the opportunity for clinical experiences. The instructors are seasoned physical therapists, and nearly half of them hold advanced certification in the content area. Further studies are warranted to investigate how physical therapists practice in wound management in various clinical settings.
Nicotine toxicity
Authors: Quail M. Thomas 
Published: December 2019

Abstract:
Compared with children exposed to traditional cigarettes, those exposed to nicotine in e-cigarettes are 5.2 times more likely to be admitted to a healthcare facility and have 2.6 times the risk of a severe outcome. This article discusses nicotine toxicity in children accidentally exposed to e-cigarettes containing nicotine and reviews appropriate nursing interventions.
Prioritizing Needs and Outcomes for Adolescent Substance Use Treatment Planning: An Online Modified-Delphi Process
Authors: Grant Sean , Pedersen Eric R. , Hunter Sarah B. , Khodyakov Dmitry , Griffin Beth Ann 
Published: December 2019

Objectives:
Key stakeholders can have differing views about which information is essential to inform placement decisions for all patients. This study examined consensus across stakeholder groups on the most important individual needs and treatment outcomes for informing decisions specifically about the level of care for an adolescent in substance use treatment.

Methods:
We conducted an online modified-Delphi process with treatment providers, policymakers, researchers, and parents of adolescents who have received substance use treatment. Participants rated 48 individual needs from the Global Appraisal of Individual Needs–Initial that were mapped onto the 6 dimensions of the American Society of Addiction Medicine Criteria. In addition, participants rated 10 treatment outcomes from the Substance Abuse and Mental Health Services Administration's National Outcome Measures. We assessed consensus within stakeholder groups using the RAND/UCLA Appropriateness Method. We considered the items reaching consensus with the highest ratings across stakeholder groups as the most important individual needs and treatment outcomes.

Results:
We recruited 194 participants (81 providers, 54 policymakers, 32 researchers, 27 parents). Participants identified suicidality and severity of substance use disorder symptoms as the most important individual needs, and reduction in substance use as the most important treatment outcome.

Conclusions:
Standardized procedures for matching adolescents to levels of care for substance use treatment should at a minimum be based on assessments of suicidality and severity of substance use disorder symptoms, and consider reduction in substance use as a primary treatment outcome. These findings can progress the development of “level-of-care” decision rules specifically for adolescents.
Best Practices for Conducting Interprofessional Team Rounds to Facilitate Performance of the ICU Liberation (ABCDEF) Bundle
Authors: Stollings Joanna L. , Devlin John W. , Lin John C. , Pun Brenda T. , Byrum Diane , Barr Juliana 
Published: December 2019

Objectives:
Daily ICU interprofessional team rounds, which incorporate the ICU Liberation (“A” for Assessment, Prevention, and Manage Pain; “B” for Both Spontaneous Awakening Trials and Spontaneous Breathing Trials; “C” for Choice of Analgesia and Sedation; “D” for Delirium Assess, Prevent, and Manage; “E” for Early Mobility and Exercise; “F” for Family Engagement and Empowerment [ABCDEF]) Bundle, support both the care coordination and regular provider communication necessary for Bundle execution. This article describes evidence-based practices for conducting effective interprofessional team rounds in the ICU to improve Bundle performance.

Design:
Best practice synthesis.

Methods:
The authors, each extensively involved in the Society of Critical Care Medicine’s ICU Liberation Campaign, reviewed the pertinent literature to identify how ICU interprofessional team rounds can be optimized to increase ICU Liberation adherence.

Results:
Daily ICU interprofessional team rounds that foster ICU Liberation Bundle use support both care coordination and regular provider communication within and between teams. Evidence-based best practices for conducting effective interprofessional team rounds in the ICU include the optimal structure for ICU interprofessional team rounds; the importance of conducting rounds at patients’ bedside; essential participants in rounds; the inclusion of ICU patients and their families in rounds-based discussions; and incorporation of the Bundle into the Electronic Health Record. Interprofessional team rounds in the ICU ideally employ communication strategies to foster inclusive and supportive behaviors consistent with interprofessional collaboration in the ICU. Patient care discussions during interprofessional team rounds benefit from being patient-centered and goal-oriented. Documentation of ICU Liberation Bundle elements in the Electronic Health Record may help facilitate team communication and decision-making.

Conclusions:
Conducting high-quality interprofessional team rounds in the ICU is a key strategy to support ICU Liberation Bundle use.
Impact of Anticoagulation on Mortality and Resource Utilization Among Critically Ill Patients With Major Bleeding
Authors: Fernando Shannon M. , Mok Garrick , Castellucci Lana A. , Dowlatshahi Dar , Rochwerg Bram , McIsaac Daniel I. , Carrier Marc , Wells Philip S. , Bagshaw Sean M. , Fergusson Dean A. , Tanuseputro Peter , Kyeremanteng Kwadwo 
Published: December 2019

Objectives:
Patients with major bleeding are commonly admitted to the ICU. A growing number are on either oral or parenteral anticoagulation, but the impact of anticoagulation on patient outcomes is unknown. We sought to examine this association between anticoagulation therapy and mortality, as well as the independent effects of warfarin compared to direct oral anticoagulants.

Design:
Analysis of a prospectively collected registry (2011–2017) of consecutive ICU patients admitted with major bleeding (as defined by International Society on Thrombosis and Haemostasis clinical criteria).

Setting:
Two hospitals within a single tertiary care level hospital system.

Patients:
We analyzed 1,598 patients identified with major bleeding, of which 245 (15.3%) had been using anticoagulation at the time of ICU admission. Of patients on anticoagulation, 149 were using warfarin, and 60 were using a direct oral anticoagulant.

Interventions:
None.

Measurements and Main Results:
The primary outcome, in-hospital mortality, was analyzed using a multivariable logistic regression model. Patients with anticoagulation-associated major bleeding had higher in-hospital mortality (adjusted odds ratio, 1.49; 95% CI, 1.16–1.92). Among survivors, anticoagulation use was associated with longer median hospital length of stay, and higher mean costs. No differences in hospital mortality were seen between warfarin- and direct oral anticoagulant-associated major bleeding. Patients with warfarin-associated major bleeding had longer median length of stay (11 vs 6 d; p = 0.02), and higher total costs than patients with direct oral anticoagulant-associated major bleeding.

Conclusions:
Among ICU patients admitted with major bleeding, pre-admission anticoagulation use was associated with increased hospital mortality, prolonged length of stay, and higher costs among survivors. As compared to direct oral anticoagulants, patients with warfarin-associated major bleeding had increased length of stay and costs. These findings have important implications in the care of ICU patients with major bleeding.
Hip survival rate in the patients with avascular necrosis of femoral head after transtrochanteric rotational osteotomy: a systematic review and meta-analysis
Authors: Xu Ying-Xing , Ren Yuan-Zhong , Zhao Zhi-Ping , Wang Ying-Zhen , Wang Teng , Li Tao 
Published: December 2019

Abstract

Background:
The clinical outcome of transtrochanteric rotational osteotomy (TRO) for osteonecrosis of the femoral head (ONFH) remains controversial, and the promising clinical results of several Japanese studies could not be reproduced in American and European studies. Trying to solve controversies on TRO for ONFH rising from apparently conflicting studies, a meta-analysis was conducted to assess the 5- and 10-year hip survival rates (with conversion to artificial joint replacement and radiographic failure as endpoints) after TRO.

Methods:
All eligible studies were searched in seven comprehensive databases including PubMed, Web of Science, Embase, Cochrane Library, VIP Database, China Knowledge Resource Integrated Database, and Wan Fang Database prior to June 2019. The outcomes evaluated were 5- and 10-year hip survival rates after TRO. The odds ratio and risk difference for the non-comparative binary data with the 95% confidence intervals (CIs) were calculated for each outcome. The included studies were assessed for methodologic bias and potential reasons for heterogeneity were explored.

Results:
Nineteen studies of TRO for ONFH were eligible for this meta-analysis according to inclusion criteria. Based on the previous report, two calculation methods (Methods 1 and 2) were adopted in this meta-analysis. Furthermore, we performed a sub-group analysis of the 5- and 10-year hip survival rates (Method 1) after TRO for ONFH: Asian sub-population and non-Asian sub-population. Taking conversion to artificial joint replacement as the endpoint, 5- and 10-year hip survival rates (Method 1) after TRO for ONFH in the Asian population were 0.86 (95% CI = 0.82–0.89) and 0.72 (95% CI = 0.65–0.78), respectively, and 5- and 10-year hip survival rates after TRO for ONFH in the non-Asian population were 0.55 (95% CI = 0.43–0.67) and 0.42 (95% CI = 0.28–0.55), respectively. The 5- and 10-year hip survival rates (Method 2) after TRO for ONFH were 0.90 (95% CI = 0.79–0.95) and 0.89 (95% CI = 0.81–0.94), respectively. Taking radiographic failure as the endpoint, 5- and 10-year hip survival rates after TRO for ONFH were 0.70 (95% CI = 0.64–0.76) and 0.53 (95% CI = 0.46–0.61), respectively.

Conclusions:
The 5- and 10-year hip survival rates after TRO for ONFH were satisfactory in the Asian population, and were acceptable in the non-Asian population despite high early failure rates.
Anti-cyclic citrullinated peptide antibody predicts the development of rheumatoid arthritis in patients with undifferentiated arthritis
Authors: Li Chun , Zhang Yan , Song Hui , Gao Jie , Zhao Dong-Bao , Zhu Qi , He Dong-Yi , Wang Li , Li Xiang-Pei , Liu Xu-Dong , Xiao Wei-Guo , Wu Xin-Yu , Wu Hua-Xiang , Tu Wei , Hu Shao-Xian , Wang Xin , Li Zhi-Jun , Lu Zhi-Min , Da Zhan-Yun , Liang Bo , Liu Xiao-Min , Zhao Jin-Wei , Li Ling , Han Feng , Qi Wu-Fang , Wei Wei , Ma Xu , Li Zhen-Bin , Zheng Gui-Min , Zhang Feng-Xiao , Li Yi , Wang You-Lian , Ling Guang-Hui , Chen Jin-Wei , Hou Xiao-Qiang , Zhang Jing , Chen Qing-Ping , Liu Chang-Lian , Zhang Yan , Zeng Jia-Shun , Zou Qing-Hua , Fang Yong-Fei , Su Yin , Li Zhan-Guo 
Published: December 2019

Abstract

Background:
Clinical outcomes of undifferentiated arthritis (UA) are diverse, and only 40% of patients with UA develop rheumatoid arthritis (RA) after 3 years. Discovering predictive markers at disease onset for further intervention is critical. Therefore, our objective was to analyze the clinical outcomes of UA and ascertain the predictors for RA development.

Methods:
We performed a prospective, multi-center study from January 2013 to October 2016 among Chinese patients diagnosed with UA in 22 tertiary-care hospitals. Clinical and serological parameters were obtained at recruitment. Follow-up was undertaken in all patients every 12 weeks for 2 years. Predictive factors of disease progression were identified using multivariate Cox proportional hazards regression.

Results:
A total of 234 patients were recruited in this study, and 17 (7.3%) patients failed to follow up during the study. Among the 217 patients who completed the study, 83 (38.2%) patients went into remission. UA patients who developed RA had a higher rheumatoid factor (RF)-positivity (42.9% vs. 16.8%, χ

2

= 8.228, P = 0.008), anti-cyclic citrullinated peptide (CCP) antibody-positivity (66.7% vs. 10.7%, χ

2

= 43.897, P < 0.001), and double-positivity rate of RF and anti-CCP antibody (38.1% vs. 4.1%, χ

2

= 32.131, P < 0.001) than those who did not. Anti-CCP antibody but not RF was an independent predictor for RA development (hazard ratio 18.017, 95% confidence interval: 5.803–55.938; P < 0.001).

Conclusion:
As an independent predictor of RA, anti-CCP antibody should be tested at disease onset in all patients with UA.
Endoplasmic reticulum stress and destruction of pancreatic β cells in type 1 diabetes
Authors: Cao Zhao-Hui , Wu Zhuan , Hu Cong , Zhang Min , Wang Wu-Zhou , Hu Xiao-Bo 
Published: December 2019

Abstract
Type 1 diabetes (T1D) results from dysfunction of pancreatic islets β cells. Recent studies supported that endoplasmic reticulum (ER) stress takes an important role in pancreatic β cell excessive loss, resulting in T1D. Here, we aimed to review the relationship between ER stress and T1D. Additionally, we also reviewed the potential mechanisms underlying ER stress mediated T1D. Studies have shown that severe ER stress is directly involved in the pancreatic β cells destruction and pathogenesis of T1D. ER stress plays a key part in pancreatic β cells and T1D, which will help in developing new effective therapeutics for T1D.
A Rare Case of Lichen Planus–Like Atopic Dermatitis Involving the Hands
Authors: Saleh Jasmine , Vasicek Brooke , Swan James , Speiser Jodi , Mudaliar Kumaran 
Published: December 2019

Abstract:
Lichen planus–like atopic dermatitis clinically mimics lichen planus and can pose a diagnostic challenge. We report a case of a 55-year-old African American woman who developed intensely pruritic papules and plaques on bilateral hands. Histological examination demonstrated acute spongiotic dermatitis with lymphocyte exocytosis into the epidermis. Taken together, a diagnosis of lichen planus–like atopic dermatitis was made. This case serves to highlight that lichen planus–like atopic dermatitis can develop on hands and that it presents as spongiotic dermatitis with lymphocyte exocytosis into the epidermis. Correlating the clinical presentation with histopathological findings will assist in establishing the diagnosis and guiding appropriate management.