bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of dietary electrolyte balance on nursery pig performance1
Authors: Jones Aaron M , Wu Fangzhou , Woodworth Jason C , Dritz Steve S , Tokach Mike D , DeRouchey Joel M , Goodband Robert D 
Published: July 2018

Abstract
Increasing dietary electrolyte balance (dEB) has been reported to linearly improve pig growth performance up to approximately 200 to 250 mEq/kg. However, recent data indicate that increasing dietary dEB reduced growth performance of nursery pigs. To attempt to solve this discrepancy, a total of 2,880 weanling pigs (327 × 1,050; PIC, Hendersonville, TN; 5.2 kg initial BW) were used to determine the effects of increasing dEB on nursery pig performance. Pens of pigs were blocked by BW and gender on arrival. Within block, pens were randomly assigned to one of four dietary treatments. There were 30 pigs per pen (60 pigs per double-sided feeder) and 12 replications (feeder) per treatment. Dietary treatments were fed in two phases. The phase 1 diet was based on corn–soybean meal, contained dried distillers grains with soblubles (DDGS), spray-dried whey, and specialty protein sources, and was fed from days 0 to 8. The phase 2 (days 8 to 21) diets contained corn, soybean meal, and DDGS with reduced amounts of specialty protein sources. Dietary electrolyte balance was determined using the following equation: dEB = [(Na × 434.98) + (K × 255.74) − (Cl × 282.06)] mEq/kg. The dEB of the four phase 1 diets were 84, 137, 190, and 243 mEq/kg, and dEB of the four phase 2 diets were 29, 86, 143, and 199 mEq/kg. After feeding experimental diets for 21 day, a common, commercial corn–soybean meal diet was fed to all pigs from days 21 to 35 and contained a dEB of 257 mEq/kg. During days 0 to 8, increasing dEB increased (quadratic, P &lt; 0.05) ADG, ADFI, and G:F. From days 8 to 21, increasing dEB improved ADG (quadratic, P = 0.022) and ADFI (linear, P = 0.001), resulting in an improvement (quadratic, P = 0.001) in G:F. Overall (days 0 to 21), increasing dEB increased (linear, P &lt; 0.05) ADG, ADFI, and improved (quadratic, P &lt; 0.001) G:F. When a common diet was fed to all pigs from days 21 to 35, there was a linear reduction in ADG and G:F with increasing dietary dEB, but no effect of ADFI. For the overall nursery period (days 0 to 35), increasing dEB from days 0 to 21 increased (linear, P &lt; 0.001) ADG and final BW, which was the result of increased (quadratic, P &lt; 0.05) G:F and marginally greater (linear, P = 0.077) ADFI. In conclusion, increasing dietary dEB up to 243 and 199 mEq/kg (in phases 1 and 2, respectively) in nursery diets improved growth performance of weanling pigs.
Gender, Informal Employment and Trade Liberalization in Mexico
Authors: Ben Yahmed Sarra , Bombarda Pamela 
Published: July 2018

Abstract
This paper studies how import liberalization affects formal employment across gender. The theory offers a mechanism to explain how male and female formal employment shares can respond differently to trade liberalization through labor reallocation across tradable and nontradable sectors. Using Mexican data over the period 1993–2001, we find that Mexican tariff cuts increase the probability of working formally for both men and women within four-digit manufacturing industries. The formalization of jobs within tradable sectors is driven by large firms. Constructing a regional tariff measure, we find that regional exposure to import liberalization increases the probability of working formally in the manufacturing sector for both men and women, and especially for men. However in the service sectors, the probability of working formally decreases for low-skilled women.
Exploring Patient and Caregiver Perceptions of Primary Healthcare Sector Home Care for Simple Acute Wounds
Authors: Goh Ling Jia , Zhu Xiaoli 
Published: July 2018

ABSTRACT

GENERAL PURPOSE:
To provide information about a study exploring patient and caregiver perceptions of home wound care for patients with simple acute wounds in Singapore.

TARGET AUDIENCE:
This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.

LEARNING OBJECTIVES/OUTCOMES:
After completing this continuing education activity, you should be able to:
1. Assess benefits and barriers to home wound care management.
2. Analyze the methodology, results, and implications of the study.

BACKGROUND:
To control healthcare expenditure, patients with simple, acute, low-risk wounds are encouraged to perform self–wound care at home. However, patient perception of this care is not known.

OBJECTIVE:
To explore patient and caregiver perceptions of home wound care for patients with simple acute wounds in the primary healthcare sector in Singapore.

METHODS:
This study used the constructivist grounded theory approach. Nine participants from 2 polyclinics were interviewed. In vivo codes were extracted, and the constant comparative technique was applied throughout the analytical process.

RESULTS:
Fear, lack of knowledge, and the difficulty in performing care resulted in many patients avoiding self–wound care. Age, educational level, and cost did not have much impact. Participants with some first aid knowledge and those who appreciated the flexibility of self–wound care were more likely to embrace this concept. Participants also suggested that telecommunications and mobile nurses could assist in this concept.

CONCLUSIONS:
Generally, patients are willing to accept this self–wound care concept. To ensure successful implementation, nurses should encourage eligible patients to attend educational programs to prepare them to perform wound care at home.
Comparison of Preoperative Administration of Pregabalin and Duloxetine on Cognitive Functions and Pain Management After Spinal Surgery
Authors: Altiparmak Başak , Güzel Çiğdem , Gümüş Demirbilek Semra 
Published: July 2018

Study Objective:
Surgical trauma is known to induce hyperalgesia, and if pain management is insufficient, it contributes to persistent pain in the postoperative period.
In this study, our primary aims were to compare the effect of pregabalin and duloxetine on postoperative pain scores and cognitive functions. Our secondary aim was to determine drug-related side effects.

Design:
This was a prospective, randomized, double-blind, placebo-controlled study.

Settings:
The study was carried out in the setting of the operating room and the surgical ward.

Patients:
Ninety-four patients, 18 to 65 years of age, ASA status I-II, scheduled for elective repair of lumbar disc herniation were enrolled in the study.

Interventions:
The patients were randomly divided into 3 groups: the first group received pregabalin 75 mg orally 1 hour before the surgery and at the postoperative 12th and 24th hours. The second group received duloxetine 60 mg orally 1 hour before the surgery. At the postoperative 12th hour, they received a placebo capsule, and, at the 24th hour, they received duloxetine 60 mg again. The third group received placebo capsules orally at all timepoints.

Measurements:
Postoperative pain evaluation was conducted using a Visual Analogue Scale at the postoperative first minute, 30th minute, first hour, and the 12th, 24th, and 48th hours. The preoperative and postoperative sixth hour cognitive functions were evaluated with Montreal Cognitive Assessment (MoCA) test.

Main Results:
There was a significant reduction in mean MoCA scores postoperatively in all groups (P<0.01). The highest MoCA score reduction was in the pregabalin group (1.83±1.31 point), then in the duloxetine group (1.16±0.82), and the least decrease was in the control group (0.49±0.61). At all timepoints, the mean Visual Analogue Scale scores of the pregabalin and duloxetine groups were similar to each other, and they were lower than that of the control group (P<0.05).

Conclusions:
Preoperative use of duloxetine 60 mg can be an useful alternative to pregabalin 75 mg, as it has a similar analgesic effect on postoperative pain, with fewer incidences of drug-related negative effects on cognitive function.
Breakdown of Neural Function under Isoflurane Anesthesia
Authors: Awal Mehraj R. , Austin Doug , Florman Jeremy , Alkema Mark , Gabel Christopher V. , Connor Christopher W. 
Published: July 2018

Abstract

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New

Background
Previous work on the action of volatile anesthetics has focused at either the molecular level or bulk neuronal measurement such as electroencephalography or functional magnetic resonance imaging. There is a distinct gulf in resolution at the level of cellular signaling within neuronal systems. The authors hypothesize that anesthesia is caused by induced dyssynchrony in cellular signaling rather than suppression of individual neuron activity.

Methods
Employing confocal microscopy and Caenorhabditis elegans expressing the calcium-sensitive fluorophore GCaMP6s in specific command neurons, the authors measure neuronal activity noninvasively and in parallel within the behavioral circuit controlling forward and reverse crawling. The authors compare neuronal dynamics and coordination in a total of 31 animals under atmospheres of 0, 4, and 8% isoflurane.

Results
When not anesthetized, the interneurons controlling forward or reverse crawling occupy two possible states, with the activity of the “reversal” neurons AVA, AVD, AVE, and RIM strongly intercorrelated, and the “forward” neuron AVB anticorrelated. With exposure to 4% isoflurane and onset of physical quiescence, neuron activity wanders rapidly and erratically through indeterminate states. Neuron dynamics shift toward higher frequencies, and neuron pair correlations within the system are reduced. At 8% isoflurane, physical quiescence continues as neuronal signals show diminished amplitude with little correlation between neurons. Neuronal activity was further studied using statistical tools from information theory to quantify the type of disruption caused by isoflurane. Neuronal signals become noisier and more disordered, as measured by an increase in the randomness of their activity (Shannon entropy). The coordination of the system, measured by whether information exhibited in one neuron is also exhibited in other neurons (multiinformation), decreases significantly at 4% isoflurane (P = 0.00015) and 8% isoflurane (P = 0.0028).

Conclusions
The onset of anesthesia corresponds with high-frequency randomization of individual neuron activity coupled with induced dyssynchrony and loss of coordination between neurons that disrupts functional signaling.
Role of Muscle Strength in Balance Assessment and Treatment in Chronic Obstructive Pulmonary Disease
Authors: McLay Rachel , O'Hoski Sachi , Beauchamp Marla K. 
Published: July 2018

Purpose:
The purpose of this review is to examine the role of muscle strength in the assessment and management of balance problems among individuals with chronic obstructive pulmonary disease (COPD). Our specific aims are to (1) synthesize the literature on the role of muscle strength in balance control among older adults; (2) provide an overview of what is known about these relationships in people with COPD; and (3) describe clinical applications of assessing and training muscle strength in the context of improving balance among individuals with COPD.

Summary of Key Points:
Muscle strength is a key contributor to balance in both healthy populations and in people with COPD. Although impairments in skeletal muscle have been well studied in people with COPD, the contributions of this dysfunction to the observed balance deficits in COPD has not been as well studied to date. Furthermore, current research only supports associations between muscle strength and balance performance, and we are unable to determine cause and effect. Future research should address the impact of potential deficits in muscle power and endurance on postural control and fall risk in people with COPD.

Recommendations:
Comprehensive assessment of balance in people with COPD should include an assessment of muscle strength but also cannot ignore the many other subsystems underlying balance. When targeting muscle strength as part of a balance training program, specific considerations should be given to functional lower-body and core exercises that challenge different balance systems.
Do Lower Extremity Strength and Lower Extremity Blood Flow Predict the Score on the Functional Gait Assessment in Patients Enrolled in Phase II Cardiac Rehabilitation?
Authors: Himes Marcia K. , Moore Elizabeth S. , Robinson Barbara S. , Daniel Todd E. 
Published: July 2018

Purpose:
Fall prevention, and the reduction of fall-related injuries, is critically important for preserving independence among older adults. Phase II cardiac rehabilitation (CR) is a medically supervised program allowing individuals with certain cardiac diagnoses or cardiac procedures to exercise safely. The relationship among lower extremity blood flow, lower extremity strength, and fall risk in adults who are community-dwelling has been established; however, that relationship in patients enrolled in phase II CR remains unknown.

Methods:
This cross-sectional study used exploratory analysis to determine whether the ankle brachial index (ABI) and the 30-second chair stand test (30CST) could predict the score on the functional gait assessment (FGA). A convenience sample (N = 57) of individuals aged 50 years and older, enrolled in a phase II CR program, was selected.

Results:
No correlation was found between the ABI and FGA score (r = 0.02, P = .438). A significant positive correlation was found between the 30CST and FGA score (r = 0.71, P < .001). In addition, the 30CST predicted FGA scores, accounting for 46% of the variance, F(2,54) = 23.97, P < .001, R
2 = 0.46.

Conclusions:
The 30CST could be considered for use as a quick fall-risk screening measure in the phase II CR population.
Relationship Between Advanced Maternal Age and Timing of First Developmental Evaluation in Children with Autism
Authors: Rubenstein Eric , Durkin Maureen S. , Harrington Rebecca A. , Kirby Russell S. , Schieve Laura A. , Daniels Julie 
Published: July 2018

ABSTRACT:

Objective:
Mothers of advanced maternal age (AMA) at childbirth (age ≥35 years) may have different perceptions of autism spectrum disorder (ASD) risk, independent of sociodemographic factors, that may affect ASD identification. We aimed to estimate associations between AMA and both age of a child's first evaluation noting developmental concerns and time from first evaluation to first ASD diagnosis.

Methods:
We used data for 8-year-olds identified with ASD in the 2008 to 2012 Autism and Developmental Disabilities Monitoring Network. We estimated differences in age at first evaluation noting developmental concerns and time to first ASD diagnosis by AMA using quantile and Cox regression.

Results:
Of 10,358 children with ASD, 19.7% had mothers of AMA. AMA was associated with higher educational attainment and previous live births compared with younger mothers. In unadjusted analyses, AMA was associated with earlier first evaluation noting developmental concerns (median 37 vs 40 mo) and patterns in time to first evaluation (hazard ratio: 1.12, 95% confidence interval: 1.06–1.18). Associations between AMA and evaluation timing diminished and were no longer significant after adjustment for socioeconomic and demographic characteristics. Children's intellectual disability did not modify associations between AMA and timing of evaluations.

Conclusion:
Advanced maternal age is a sociodemographic factor associated with younger age of first evaluation noting developmental concerns in children with ASD, but AMA was not independently associated likely, because it is a consequence or cofactor of maternal education and other sociodemographic characteristics. AMA may be a demographic factor to consider when aiming to screen and evaluate children at risk for ASD.
Ultrasound-guided Sympathetic Block of the Radial Artery with Botulinum Toxin to Treat Vasospasm
Authors: Weum Sven , de Weerd Louis 
Published: July 2018

Summary:
Vasospastic disorders in the hand have been treated with surgical sympathectomy and recently with botulinum toxin A (BTX) injections in the palm. The purpose of this study was to evaluate if it is possible to obtain precise administration of BTX around the radial artery using a single ultrasound-guided injection. We present a novel technique using 1 single ultrasound-guided BTX injection around the radial artery to treat vasospastic symptoms. Ten patients were included in a pilot study. All patients were referred by a rheumatologist after been diagnosed with primary or secondary Raynaud. Under ultrasound guidance, BTX was injected around the radial artery and its comitant veins 3–5 cm proximal to the wrist. Ultrasound-guided injection of BTX allowed for a precise distribution of BTX into the perivascular space of the radial artery and its comitant veins. Intravascular injection could easily be excluded. One patient reported temporary reduced grip strength, most likely due to leakage of BTX to the flexor pollicis longus muscle. No other complications were registered. All patients reported reduced number of vasospastic episodes, warmer hands, and reduced pain. Ultrasound-guided injection enables precise administration of BTX in the space surrounding the radial artery and its comitant veins. This novel approach could be a promising treatment for vasospastic disorders of the hands in patients with primary and secondary Raynaud.
Two-stage Reconstruction of the Large and Ptotic Breasts: Skin Reduction Mastectomy with Prepectoral Device Placement
Authors: Rammos Charalambos K. , Mammolito Denise , King Victor A. , Yoo Aran 
Published: July 2018

Summary:
Wise pattern skin reduction mastectomy with prepectoral placement of the device is a recent technique for reconstruction in patients with large and ptotic breasts. Expanders in the first stage, followed by implant exchange in the second stage are placed above the pectoralis major muscle, totally covered by acellular dermal matrix and an inferior dermal flap. This technique was performed on 6 breasts in 4 obese patients with macromastia and grade 2 and 3 ptosis. Two patients experienced complications at the T-junction. One patient experienced superficial skin sloughing managed conservatively. The second patient developed full-thickness necrosis treated with excision and primary closure. No implant loss occurred. All patients were exchanged in a second stage to an implant, and 2 of them had symmetry procedures, with good cosmetic results. Larger, long-term studies are required to further characterize results and define the limitations of this newer surgical technique.
A NOVEL CASE SERIES OF NMNAT1-ASSOCIATED EARLY-ONSET RETINAL DYSTROPHY: EXTENDING THE PHENOTYPIC SPECTRUM
Authors: Kumaran Neruban , Robson Anthony G. , Michaelides Michel 
Published: July 2018

Purpose:
To report two siblings with NMNAT1-associated retinopathy presenting with a later onset and milder phenotype than previously described.

Methods:
Retrospective case series of two siblings. The authors describe two cases of early-onset retinal dystrophy caused by disease-causing NMNAT1 variants. Visual acuity, clinical examination, and retinal imaging including color fundus photography, spectral domain optical coherence tomography, and fundus autofluorescence were performed. Both cases underwent full-field and pattern electroretinography incorporating the International standards.

Results:
Two siblings were found to harbor the variants c.53A>G, p.(Asn18Ser) and c.769G>A, p.(Glu257Lys) in NMNAT1 after retinal dystrophy panel gene testing. Both had good visual acuity until the ages of 6 and 11 years, respectively, with subsequent gradual worsening into their twenties. At the ages of 10 and 16 years, respectively, electroretinograms indicated generalized rod and cone system dysfunction of moderate severity, with pattern electroretinography evidence of severe macular involvement. Repeat testing at the ages of 26 and 33 years revealed only mild worsening of rod photoreceptor function in both.

Conclusion:

NMNAT1-associated retinopathy has previously only been described as a typical form of Leber congenital amaurosis, with poor visual acuity from birth associated with nystagmus, characteristic macular atrophy, and intraretinal pigmentation from birth. Here, we present two siblings with a novel, later onset, and far milder phenotype. We suggest that this may be due to the two missense NMNAT1 variants resulting in milder reduction of NMNAT1 enzymatic activity. These cases extend the phenotypic spectrum associated with NMNAT1 and further highlight the clinical heterogeneity associated with inherited retinal diseases.
BILATERAL INTRAVITREAL 0.19-MG FLUOCINOLONE ACETONIDE IMPLANT FOR PERSISTENT NONDIABETIC CYSTOID MACULAR EDEMA AFTER VITRECTOMY
Authors: Ong Sally S. , Walter Scott D. , Chen Xi , Thomas Akshay S. , Finn Avni P. , Fekrat Sharon 
Published: July 2018

Background/Purpose:
Iluvien (Alimera Science, Alpharetta, GA) is an injectable, nonbiodegradable, sustained-release 0.19-mg fluocinolone acetonide intravitreal implant. Although currently approved by the Food and Drug Administration only for diabetic macular edema previously treated with a course of corticosteroids without a clinically significant intraocular pressure response, the 0.19-mg fluocinolone acetonide implant could theoretically be used to treat other noninfectious inflammatory conditions including persistent cystoid macular edema because of nondiabetic etiologies.

Methods:
Interventional case report. A 79-year-old man had persistent cystoid macular edema after pars plana vitrectomy in both eyes that was refractory to topical treatments and intravitreal anti–vascular endothelial growth factor. His cystoid macular edema was responsive to preservative-free intravitreal triamcinolone acetonide after which he developed noninfectious endophthalmitis or pseudoendophthalmitis in both eyes precluding further intravitreal triamcinolone acetonide injections. He was subsequently treated with bilateral intravitreal 0.19-mg fluocinolone acetonide implants.

Results:
At the most recent post-treatment follow-up (11 months for the right eye and 13 months for the left eye), the patient demonstrated an improvement in visual acuity, 20/126 to 20/50 in the right eye and 20/80 to 20/40 in the left eye, and in central subfield thickness, 592 μm to 288 μm in the right eye and 565 μm to 287 μm in the left eye, without intraocular pressure elevation.

Conclusion:
The intravitreal 0.19-mg fluocinolone acetonide implant is an effective and potentially safe off-label therapeutic option for persistent nondiabetic cystoid macular edema after vitrectomy.
Fuchs Endothelial Corneal Dystrophy: Update on Pathogenesis and Future Directions
Authors: Sarnicola Caterina , Farooq Asim V. , Colby Kathryn 
Published: July 2018

Abstract:
Fuchs endothelial corneal dystrophy (FECD) is the most common indication for corneal transplantation in the United States, accounting 36% of the almost 47,000 transplants performed in 2016. Although the surgical management of FECD has undergone a revolution over the past 20 years, its pathogenesis remains elusive, with multiple putative disease pathways and an ever increasing number of candidate genes thought to play a role. This review will summarize the recent advancements in our understanding of the biology of FECD, including potential parallels with neurodegenerative disease like amyotrophic lateral sclerosis and will highlight prospects for future treatment advances.