bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of age, sex, and hot carcass weight on cooked lamb flavor and off-flavor in four muscle cuts
Authors: Garza Horacio , Jaborek Jerad R , Zerby Henry N , Moeller Steven J , Wick Macdonald P , Fluharty Francis L , England Eric M , Garcia Lyda G 
Published: May 2021

Abstract
The present study used 48 lambs originating from three different locations in the Western United States (16 lambs per location; 8 ewes and 8 wethers per location). Each consisting of similar breed composition (Suffolk cross) that were selected to represent weight by age at harvest treatments: light weight carcasses at 5 mo (LW5, 31.81 ± 1.88 kg), light weight carcasses at 12 mo (LW12, 35.09 ± 4.45 kg), heavy weight carcasses at 12 mo (HW12, 57.89 ± 4.70 kg) with different carcass weight compositions. Older heavy weight lambs (HW12) had greater (P ≤ 0.01) hot carcass weight, ribeye area, backfat and body wall thickness, and yield grade compared with light weight lamb carcasses (LW5 and LW12). The longissimus thoracis longissimus thoracis (LT) from older lamb carcasses (LW12 and HW12) had a greater (P ≤ 0.01) total lipid percentage compared with younger lamb carcasses (LW5). Across harvest weight and age treatments, wether carcasses had greater (P ≤ 0.05) total lipid percentage compared with ewe carcasses. Slice shear force values were greater (P ≤ 0.01) for both the LT and semimembranosus from older lambs (LW12 and HW12) compared with LW5 lambs, with no differences between ewes and wethers. Lamb flavor intensity was greater (P ≤ 0.05) for the LT of LW12 lambs and tended (P = 0.08) to be greater for HW12 lambs, compared with the LT from LW5 lambs. The off-flavor intensity of the LT was greater (P ≤ 0.01) for older lambs (LW12 and HW12) compared with LW5 lambs. Interestingly, the lamb flavor and off-flavor intensity scores of the ground shoulder exhibited a treatment × sex interaction. Lamb flavor intensity of LW12 lamb was greater (P ≤ 0.05) from ewes compared with wethers, whereas wethers had a greater (P ≤ 0.05) lamb flavor intensity compared with ewes for HW12 lambs, and LW12 ewe lambs had a greater (P ≤ 0.05) off-flavor intensity compared with all other treatment × sex treatment combinations. Overall, lambs in the present study possessed a mild lamb flavor, typically with greater lamb flavor and off-flavor intensities for older animals; while slice shear force and LT lipid percentage increased as animal age increased at the time of harvest.
Socialism, Nationalism and Tom Nairn’s Dream of Escape
Authors: Campsie Alexandre 
Published: May 2021

Abstract
The relationship between socialism and nationalism in the thought of Scottish intellectual Tom Nairn has been of considerable historical interest. Focusing on the 1960s and 1970s, this article identifies a set of key themes that emerged during Nairn’s time within the London New Left, and which shed light on his move towards Scottish nationalism. It demonstrates that he gravitated towards Continental theory in the 1960s as it offered the prospect of political and personal emancipation from the conservatism of the British state. He in turn viewed the student movement of 1968 as an anti-authoritarian social formation ready to topple the establishment—though in a peculiarly intellectualized way that inoculated him from its wilder experimentalism. Nairn’s move towards nationalism in the 1970s was his way of furthering this project, though not straightforwardly. Echoing New Right critiques, Nairn argued that demands for Scottish independence stood alongside globalization and European integration as material forces sweeping aside the decrepit British state. He also used support for nationalism to admonish the ‘metropolitan-minded’ socialists of a New Left he was growing estranged from. Whether due to academic obscurantism or what he saw as a superficial concern with social movement politics, Nairn felt the English New Left was becoming divorced from its original aims of personal and cultural self-determination. Now back in living in Scotland, he saw nationalism as the best vehicle for escape. Nairn however simultaneously celebrated the utopianism and rooted pragmatism of Scottish nationalism, a distinctive position which characterises his career more broadly.
Matched Comparison of Bone Transport Using External Fixator Over a Nail Versus External Fixator Over a Plate for Segmental Tibial Bone Defects
Authors: Park Kyeong-Hyeon , Oh Chang-Wug , Kim Joon-Woo , Oh Jong-Keon , Yoon Yong-Cheol , Seo Il , Ha Sung-Soo , Chung Seung-Ho 
Published: May 2021

Objective:
To compare the outcomes and complications of bone transport over a nail (BTON) with those of bone transport over a plate (BTOP) for segmental tibial bone defects.

Design:
Retrospective matched study design.

Setting:
A major metropolitan tertiary referral trauma center.

Patients:
Thirty-six patients with segmental tibial bone defects of >4 cm were included in this study.

Intervention:
Either BTON or BTOP was performed on 18 patients.

Main Outcome Measurements:
We compared the healing of the distraction process and of the docking site between the techniques. Distraction parameters including external fixator (EF) time, external fixation index, and healing index were compared. Bone and functional results were compared according to the Paley–Maar classification. Complications associated with each procedure were compared.

Results:
Both BTON and BTOP achieved similar rates of primary union (83% vs. 89%) at the distraction or docking site. Significantly less time wearing an EF was needed for BTOP than for BTON (2.8 vs. 5.4 months; P < 0.01). The external fixation index was significantly lower for BTOP than for BTON (0.45 vs. 0.94 mo/cm; P < 0.01), whereas the healing indexes were similar. The final outcomes and complication incidences were not significantly different.

Conclusions:
The EF time was significantly shorter for BTOP than for BTON; however, the final outcomes were similar. Therefore, BTOP could be considered an attractive option for bone transport in patients with segmental tibial defects.

Level of Evidence:
Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
Mobilization During Critical Illness: A Higher Level of Mobilization Improves Health Status at 6 Months, a Secondary Analysis of a Prospective Cohort Study
Authors: Paton Michelle , Lane Rebecca , Paul Eldho , Cuthburtson Georgina A. , Hodgson Carol L. 
Published: May 2021

OBJECTIVES:
To determine the influence of active mobilization during critical illness on health status in survivors 6 months post ICU admission.

DESIGN:
Post hoc secondary analysis of a prospective cohort study conducted between November 2013 and March 2015.

SETTING:
Two tertiary hospital ICU’s in Victoria, Australia.

PATIENTS:
Of 194 eligible patients admitted, mobility data for 186 patients were obtained. Inclusion and exclusion criteria were as per the original trial.

INTERVENTIONS:
The dosage of mobilization in ICU was measured by: 1) the Intensive Care Mobility Scale where a higher Intensive Care Mobility Scale level was considered a higher intensity of mobilization or 2) the number of active mobilization sessions performed during the ICU stay. The data were extracted from medical records and analyzed against Euro-quality of life-5D-5 Level version answers obtained from phone interviews with survivors 6 months following ICU admission. The primary outcome was change in health status measured by the Euro-quality of life-5D-5 Level utility score, with change in Euro-quality of life-5D-5 Level mobility domain a secondary outcome.

MEASUREMENTS AND MAIN RESULTS:
Achieving higher levels of mobilization (as per the Intensive Care Mobility Scale) was independently associated with improved outcomes at 6 months (Euro-quality of life-5D-5 Level utility score unstandardized regression coefficient [β] 0.022 [95% CI, 0.002–0.042]; p = 0.033; Euro-quality of life-5D-5 Level mobility domain β = 0.127 [CI, 0.049–0.205]; p = 0.001). Increasing the number of active mobilization sessions was not found to independently influence health status. Illness severity, total comorbidities, and admission diagnosis also independently influenced health status.

CONCLUSIONS:
In critically ill survivors, achieving higher levels of mobilization, but not increasing the number of active mobilization sessions, improved health status 6 months after ICU admission.
Buspirone for the Treatment of Generalized Anxiety Disorder in Down Syndrome: 3 Cases
Authors: Howe Yamini J. , Thom Robyn P. , Notson Erin E. , McDougle Christopher J. , Palumbo Michelle L. 
Published: May 2021

ABSTRACT:

Objective:
Reports on the pharmacologic treatment of anxiety, including generalized anxiety disorder (GAD), in individuals with Down syndrome (DS) are lacking.

Methods:
We present the case histories of 1 adolescent and 2 young adults with DS and the treatment course of comorbid GAD with buspirone.

Results:
Treatment with buspirone was safe and well-tolerated and resulted in sustained improvement in symptoms of anxiety for a minimum of 2 years in all 3 cases.

Conclusion:
Buspirone's generally benign adverse effect profile makes it well suited for treating anxiety in individuals with DS in light of their common medical comorbidities.
Recent insights into pathophysiology and management of mechanical complications of myocardial infarction
Authors: Fatehi Hassanabad Ali , Elbatarny Malak , Wong Jonathan V.S. , Kim Angela , Ali Imtiaz S. 
Published: May 2021

Purpose of review
Mechanical complications of myocardial infarction are a group of postischemic events and include papillary muscle rupture resulting in ischemic mitral regurgitation, ventricular septal defect, left ventricle free wall rupture, pseudoaneurysm, and true aneurysm. Advances made in management strategies, such as the institution of ‘Code STEMI’ and percutaneous interventions, have lowered the incidence of these complications. However, their presentation is still associated with increased morbidity and mortality. Early diagnosis and appropriate management is crucial for facilitating better clinical outcomes.

Recent findings
Although the exact timing of a curative intervention is not known, emerging percutaneous and transcatheter approaches and improving mechanical circulatory support (MCS) devices have greatly enhanced our ability to manage and treat some of the complications postinfarct.

Summary
Although the incidence of mechanical complications of myocardial infarction has decreased over the past few decades, these complications are still associated with high rates of morbidity and mortality. The combination of early and accurate diagnosis and subsequent appropriate management are imperative for optimizing clinical outcomes. Although more randomized clinical trials are needed, mechanical circulatory support devices and emerging therapeutic strategies can be offered to carefully selected patients.
Physician Assistant Teaching Effectiveness Through Incorporation of Active Learning and Interdisciplinary Pharmacy Students
Authors: Christopher Amy , Jenjebir Anastassia 
Published: May 2021

Purpose
This study evaluated exam performance and course evaluation in a physician assistant (PA) interdisciplinary active learning (IAL)-incorporated program facilitated by a pharmacist and pharmacy student.

Methods
Two PA cohorts (n = 38 each) were compared using IAL versus minimal active learning (MAL). Course evaluation surveys of instruction were assessed for 2 pharmacology courses. Both cohorts were assessed for differences in exam scores and performance on higher analytical exam questions.

Results
The IAL cohort achieved higher course evaluation scores compared to the MAL cohort (p < .05). The students' positive comments demonstrated their desire for more IAL. No significant difference was seen in overall exam scores in either cohort or course (p < .45). IAL in neurology demonstrated significant improvement in exam performance on moderate Bloom's taxonomy-level questions (p = .008).

Conclusions
IAL may enable health professionals to provide more collaborative care. The students preferred IAL and demonstrated improved performance on comprehension and application exam questions.
Association Between COL5a1, COL11a1, and COL11a2 Gene Variations and Rotator Cuff Tendinopathy in Young Athletes
Authors: Alakhdar Yasser , Cook Jill , Gallego Diana , Querol Felipe , Chulvi-Medrano Iván , Alberola Antonio , Hernández-Sánchez Sergio 
Published: May 2021

Objective:
Tendinopathy is a prevalent condition in young athletes and in older nonathletic people. Recent tendinopathy research has shown a growing interest in the role played by genetic factors, basically genes involved in collagen synthesis and regulation, in view of collagen disorganization typically present in tendon pathologies.

Design:
A case–control, genotype–phenotype association study.

Setting:
La Ribera Hospital, Valencia, Spain.

Participants:
A group of 137 young athletes (49 with rotator cuff tendon pathology and 88 healthy counterparts) who played upper-limb–loading sports were clinically and ultrasound (US) assessed for rotator cuff tendinopathy were included.

Intervention:
Genetic analysis was performed to determine whether there was a relationship between rotator cuff pathology and the genotype.

Main Outcome Measures:
We hypothesized that the following single nucleotide polymorphisms: COL5a1 rs12722, COL11a1 rs3753841, COL11a1 rs1676486, and COL11a2 rs1799907 would be associated with rotator cuff tendinopathy.

Results:
A direct relationship between CC genotype and bilateral US pathological images was statistically significant (χ2 = 0.0051) and confirmed by the Fisher test, with a correlation coefficient of 0.345 and a Cramer's v of 0.26.

Conclusion:
A significant association was found between COL5a1 rs12722 genotype and rotator cuff pathology, with the CC genotype conferring increased risk of tendon abnormalities and being associated with rotator cuff pathology.
Medical Encounters in a 90-km Ultramarathon Running Event: A 6-year Study in 103 131 Race Starters—SAFER XVII
Authors: Sewry Nicola , Schwellnus Martin , Boulter Jeremy , Seocharan Ishen , Jordaan Esme 
Published: May 2021

Objective:
To determine the incidence and nature of illness-related medical encounters (MEs) at a 90-km, ultramarathon, mass, community-based, endurance running event.

Design:
Retrospective, descriptive epidemiological study.

Setting:
Comrades Marathon (90 km), South Africa.

Participants:
One lakh three thousand one hundred thirty-one race starters over 6 years (2014-2019).

Independent Variables:
Incidence of moderate and serious/life-threatening MEs.

Main Outcome Measures:
All MEs were recorded by race medical doctors on race day each year. Medical encounters were recorded by severity, organ system, and final specific diagnosis (2019 consensus statement definition on mass community–based events). Incidences (I: per 1000 starters; 95% confidence intervals) were calculated for MEs.

Results:
There were 1971 illness-related MEs, with an overall incidence of 19.1 (range, 18.3-20.0). The incidence for serious/life-threatening MEs was 1.8 (range, 1.6-2.1). Incidences of MEs by organ systems affected were as follows: fluid/electrolyte (8.8; 8.3-9.4), central nervous system (4.0; 3.7-4.5), and gastrointestinal system (2.9; 2.6-3.2). Dehydration (I = 7.5: 7.0-8.1) and exercise-associated muscle cramping (I = 3.2: 2.9-3.6) were the 2 most common specific diagnoses.

Conclusion:
The incidence of MEs in the 90-km Comrades Marathon was one of the highest incidences of MEs reported in an endurance running event (1 in 52 starters and 1 in 556 starters for serious/life-threatening MEs). Preventative measures to reduce MEs are needed, and further investigations into the risk factors associated with MEs could assist in managing the risk and better prepare athletes, race organizers, and medical directors.
Role of ketones, ketogenic diets and intermittent fasting in ICU
Authors: Gunst Jan , Casaer Michael P. , Langouche Lies , Van den Berghe Greet 
Published: May 2021

Purpose of review
To summarize the clinical evidence for beneficial effects of ketones, ketogenic diets and intermittent fasting in critical illness, and to review potential mechanisms behind such effects.

Recent findings
Recent evidence demonstrates that activation of a metabolic fasting response may be beneficial to recover from critical insults. Potential protective mechanisms are, among others, activation of ketogenesis and of damage removal by autophagy. Novel feeding strategies, including ketone supplements, ketogenic diets and intermittent fasting regimens, can activate these pathways – at least partially – in critically ill patients. Randomized controlled trials (RCTs) studying these novel feeding strategies as compared with standard care, are scarce and have not shown consistent benefit. Yet, all RCTs were small and underpowered for clinical endpoints. Moreover, in intermittent fasting studies, the duration of the fasting interval may have been too short to develop a sustained metabolic fasting response.

Summary
These findings open perspectives for the further development of fasting-mimicking diets. Ultimately, clinical benefit should be confirmed by RCTs that are adequately powered for clinically relevant, patient-centered endpoints.
Labelling and denominating lung toxicity effects of pesticides
Authors: de Boer Alie 
Published: May 2021

Purpose of review
With the development and use of pesticide products increasing, information on the safe handling of pesticides becomes increasingly important. In this article, the denomination of lung toxicity on labelling is reviewed.

Recent findings
The results highlight that whereas hazards, warning statements and instructions for safe use are broadly defined, the different categories of products used as pesticides are associated with different types of clinical manifestations of toxicity. These clinical manifestations are however not directly warned for by means of information provided on the label: more overarching terminology is used to describe hazards associated with acute toxicity, respiratory sensitization, specific lung toxicity after single or repeated exposure, as well as hazards from aspiration.

Summary
This misalignment between hazard labelling and experienced issues increases the difficulty for users of products and clinicians in dealing with adverse events. Together with ensuring that in risk assessment, an integrated approach is taken to study pesticide products, improving the labels will support the safe handling of pesticides.
Artificial intelligence in prostate histopathology: where are we in 2021?
Authors: Oszwald André , Wasinger Gabriel , Pradere Benjamin , Shariat Shahrokh F. , Compérat Eva M. 
Published: May 2021

Purpose of review
Artificial intelligence has made an entrance into mainstream applications of daily life but the clinical deployment of artificial intelligence-supported histological analysis is still at infancy. Recent years have seen a surge in technological advance regarding the use of artificial intelligence in pathology, in particular in the diagnosis of prostate cancer.

Recent findings
We review first impressions of how artificial intelligence impacts the clinical performance of pathologists in the analysis of prostate tissue. Several challenges in the deployment of artificial intelligence remain to be overcome. Finally, we discuss how artificial intelligence can help in generating new knowledge that is interpretable by humans.

Summary
It is evident that artificial intelligence has the potential to outperform most pathologists in detecting prostate cancer, and does not suffer from inherent interobserver variability. Nonetheless, large clinical validation studies that unequivocally prove the benefit of artificial intelligence support in pathology are necessary. Regardless, artificial intelligence may soon automate and standardize many facets of routine work, including qualitative (i.e. Gleason Grading) and quantitative measures (i.e. portion of Gleason Grades and tumor volume). For the near future, a model where pathologists are enhanced by second-review or real-time artificial intelligence systems appears to be the most promising approach.
How the use of the artificial intelligence could improve surgical skills in urology: state of the art and future perspectives
Authors: Cacciamani Giovanni E. , Anvar Arya , Chen Andrew , Gill Inderbir , Hung Andrew J. 
Published: May 2021

Purpose of review
As technology advances, surgical training has evolved in parallel over the previous decade. Training is commonly seen as a way to prepare surgeons for their day-to-day work; however, more importantly, it allows for certification of skills to ensure maximum patient safety. This article reviews advances in the use of machine learning and artificial intelligence for improvements of surgical skills in urology.

Recent findings
Six studies have been published, which met the inclusion criteria. All articles assessed the application of artificial intelligence in improving surgical training. Different approaches were taken, such as using machine learning to identify and classify suturing gestures, creating automated objective evaluation reports, and determining surgical technical skill levels to predict clinical outcomes. The articles illustrated the continuously growing role of artificial intelligence to address the difficulties currently present in evaluating urological surgical skills.

Summary
Artificial intelligence allows us to efficiently analyze the surmounting data related to surgical training and use it to come to conclusions that normally would require human intelligence. Although these metrics have been shown to predict surgeon expertise and surgical outcomes, evidence is still scarce regarding their ability to directly improve patient outcomes. Considering this, current active research is growing on the topic of deep learning-based computer vision to provide automated metrics needed for real-time surgeon feedback.
Alternatives to the Cerebrospinal Fluid Venereal Disease Research Laboratory Test for Neurosyphilis Diagnosis
Authors: Marra Christina M. 
Published: May 2021

Background
The diagnosis of neurosyphilis relies in large part on the cerebrospinal fluid (CSF) Venereal Disease Research Laboratory (VDRL) test, which is diagnostically specific but not sensitive.

Methods
We determined the sensitivity and specificity of 3 CSF tests in addition to the CSF-VDRL in participants with syphilis enrolled in a research study: detection of Treponema pallidum ribosomal RNA, T. pallidum particle agglutination titer, and chemokine (C-X-C motif) ligand 13 (CXCL13) concentration. Neurosyphilis was defined as asymptomatic or symptomatic meningitis: CSF white blood cells >10/μL without or with neurological symptoms, including new vision or hearing loss.

Results
Cerebrospinal fluid–VDRL, CSF T. pallidum ribosomal RNA detection, and CSF T. pallidum particle agglutination titer ≥1:640 were specific (89%–96%) but not sensitive (12%–48%). In contrast, diagnostic sensitivity of CSF-CXCL13 thresholds established from receiver operating characteristic curves using the Youden index was 78% to 83% and specificity was 76% to 81%. In individuals with nonreactive CSF-VDRL, neurosyphilis diagnosis could be confirmed by CSF-CXCL13 concentration in 69% to 75%.

Conclusions
Further studies of CSF-CXCL13 should include CSF samples from multiple cohorts and countries and should use standard neurosyphilis definitions to establish uniform thresholds for diagnosis.