bluuebunny/crossref_metadata_2025_split huggingface dataset:
Balancing quality improvement and unintended effects: The impact of implementing admission order sets for chronic obstructive pulmonary disease and heart failure at two teaching hospitals
Authors: Lander Bryn , Balka Ellen 
Published: December 2018

AbstractRationale, aims, and objectivesLocal health administrators implemented chronic obstructive pulmonary disease and heart failure admission order sets to increase guideline adherence. We explored the impact of these order sets on workflows and guideline adherence in the internal medicine specialty in two Canadian teaching hospitals.MethodsA mixed methods study combined shadowing care providers (250 h), meeting observation and interviews (11 h), and patient medical chart audits for heart failure (n = 120) and chronic obstructive pulmonary disease (n = 120) patients. The chart audits analysed details of the admission process and 14 guideline elements associated with heart failure (nine) and chronic obstructive pulmonary disease (five).ResultsA subset (10/14) of the evaluated guideline elements were included in the heart failure or chronic obstructive pulmonary disease order sets. Order set use significantly increased adherence to some (4/10) of these elements. However, our qualitative work uncovered a perception that use of these two order sets increased order duplication. Our chart audits supported this perception. Order set use increased order duplication for heart failure (92% vs 43%) and chronic obstructive pulmonary disease (75% vs 43%).ConclusionIt is unclear whether, for these two hospitals, the gains brought by implementation of chronic obstructive pulmonary disease and heart failure admission order sets were worth their associated organisational shortcomings. Problems with order set implementation appeared to stem from poor integration with pre‐existing complex organisational systems. Health administrators and clinicians interested in implementing order sets within their own hospitals need to remain cognizant of how these tools will fit into existing systems and practices.
Effect of microwave and infrared drying over polyphenol content in Vaccinium meridionale (Swartz) dry leaves
Authors: Borda‐Yepes Victor H. , Chejne Farid , Daza‐Olivella Laura V. , Alzate‐Arbelaez Andres F. , Rojano Benjamin A. , Raghavan Vijaya G. S. 
Published: December 2018

AbstractIn the present work the drying of blueberry (mortiño) leaves (Vaccinium meridionale‐Swartz) was done using a hybrid equipment with infrared drying and normal microwave drying. During the drying tests there was a record of moisture content versus time; samples of leaves were taken during the drying time to analyze total phenol (PT) content, FRAP assay and catechin measures by HPLC‐DAD. The PT analysis shows that its content in dry blueberries, increased 12 times more with the microwave drying than infrarred drying. While FRAP assay shows that dry blueberries antioxidant capacity increased nine times more with microwave process in comparison to infrared process. In the catechins content by HPLC‐DAD in dry blueberries, a better result for concentration was found in microwave process than in infrared process. Similar result occurred for (−) epicatechin. Finally, (+) catechin concentrations in blueberry leaves were compared with commercial materials such as tea leaves and mate leaves.Practical applicationsThe consumption of nutraceutical products rich in polyphenols has become important in the last decades. In this research, the effect of microwave and infrared drying on the content of polyphenols on blueberry leaves (Vaccinium meridionale, Swartz) was studied because it was found in previous studies that the leaves contain a potential of polyphenols that can be used to develop nutraceutical beverages similar to tea drinks.
Effect of different solvents on subcritical solvent extraction of oil from Assam tea seeds (Camellia sinensis var. assamica): Optimization of oil extraction and physicochemical analysis
Authors: Uoonlue Nontakarn , Muangrat Rattana 
Published: December 2018

AbstractThe optimal conditions for extracting oil from Assam tea seeds under subcritical hexane, petroleum ether, and isopropanol conditions to achieve maximum oil yield were investigated for each solvent. The oil yield, physicochemical properties, and stability obtained were compared with those obtained by Soxhlet extraction. Results showed that the optimal conditions for subcritical hexane, petroleum ether, and isopropanol extraction were at temperatures of 75, 75, and 105 °C under pressure of 1,500 psi for 15 min, which gave the highest percentage oil yield of 16.92, 16.27, and 15.05%, respectively. For each solvent, the oil yield obtained by subcritical solvent extraction and Soxhlet extraction methods was not significantly different (p > .05). The extracted oil samples were rich in oleic and linoleic acids. Using subcritical solvent extraction, the oil samples had higher phenolic and beta‐carotene content and antioxidant activity and were more stable than those extracted using Soxhlet extraction, and they enhanced the oxidative stability of soybean oil.Practical applicationsThe subcritical solvent extraction method is a potential technique for extracting oil from Assam tea seeds, providing faster extraction than the Soxhlet method. Assam tea seed oil obtained by the subcritical extraction method has higher antioxidant activity and better stability than that obtained by the Soxhlet extraction method. Additionally, the tea seed oil extracted by both methods had a similar fatty acid composition without significant differences. The main fatty acids of tea seed oil were oleic and linoleic acids. Therefore, the high level of unsaturated fatty acids and good antioxidant activity of tea seed oil make it suitable for use in the food and cosmetic industries.
Evaluation of the effects of temperature on processed coffee beans in the presence of fungi and ochratoxin A
Authors: Sousa T. M. A. , Batista L. R. , Passamani F. R. F. , Lira N. A. , Cardoso M. G. , Santiago W. D. , Chalfoun S. M. 
Published: December 2018

The coffee bean is sensitive to contamination with ocratoxigenic fungi; temperature influences the growth, and germination of these fungi, as well as the fungal toxins produced. The objectives of this study were to assess the distribution of toxigenic species, analyze the concentration of ochratoxin A (OTA) in Arabica coffee beans, and aplicate a mathematical model that considers the influence of actual temperature to predict the effects of projected temperature increase on OTA production. This toxin was, however, not detected in any of the coffee bean species analyzed here. The species with the highest incidence were Aspergillus niger and Aspergillus ochraceus. The results of the mathematical model demonstrated the influence of temperature on the production of the toxin. This information indicates the distribution of toxigenic fungal species in the regions of coffee cultivation in Minas Gerais, and thus, will assist the producers in adopting preventive measures.Practical applicationsBrazil is the largest coffee producer and exporter, which makes it a leader in the global coffee market; the state of Minas Gerais is responsible for 50% of this production. Following the global trend, Brazil has regulated the maximum permissible limit for ochratoxin A in coffee beans. This has led to a great interest in monitoring fungi and toxin production, mainly during the postharvest stage in the coffee cultivation regions of Brazil. Preventive measures can aid in the safe production of coffee beans, and the use of mathematical models capable of predicting the growth and production of fungal toxins are fundamental to informing the producers of the most favorable conditions in terms of temperature, as well as increases in ambient temperature, in specific regions of interest.
Effect of Living Wills on End‐of‐Life Care: A Systematic Review
Authors: Higel Thomas , Alaoui Anna , Bouton Céline , Fournier Jean‐Pascal 
Published: December 2018

OBJECTIVESTo comprehensively assess the effect of a living will on end‐of‐life care.DESIGNSystematic review with narrative analysis following Preferred Reporting Items for Systematic Reviews and Meta‐Analyses methodology.PARTICIPANTSAll interventional and observational studies were included, excepting those with fictive cases. Included studies were conducted in adults with and without living wills, excluding individuals with specific psychiatric living wills.MEASUREMENTSTwo authors independently extracted study and participant characteristics and outcomes related to end‐of‐life care (place of death, hospitalization and intensive care unit management, life‐sustaining treatments, restricted care). Risk of bias was assessed using the Risk Of Bias In Non‐randomized Studies of Interventions tool.RESULTSFrom 7,596 records identified, 28 observational studies were included, 19 conducted in the United States, 7 in Europe, and 1 each in Canada and Australia. Place of death was assessed in 14 studies, life‐sustaining treatments in 13, decision for restricted care in 12, and hospitalization in 8. Risk of bias was serious for 26 studies and moderate for 2. Twenty‐one studies reported significantly less medical management for individuals with a living will, 3 reported more medical management, and the difference was not significant in 37.CONCLUSIONMethodological quality of included studies was insufficient to offer reliable results. The effect of living wills appears limited in view of the importance and direction of potential biases. Further studies including larger populations, considering main confounding factors, and documenting the real presence of a living will in medical records are necessary to reach stronger conclusions on the effect of living wills on end‐of‐life care. J Am Geriatr Soc 67:164–171, 2019.
High‐Risk Comorbidity Combinations in Older Patients Undergoing Emergency General Surgery
Authors: Ho Vanessa P. , Schiltz Nicholas K. , Reimer Andrew P. , Madigan Elizabeth A. , Koroukian Siran M. 
Published: December 2018

BACKGROUND/OBJECTIVESOver a million older patients in the United States are admitted yearly for emergency general surgery (EGS) conditions. Seven procedure types dominate: colon, small bowel, gallbladder, ulcer disease, adhesiolysis, appendix, and laparotomy operations. A higher comorbidity burden is known to increase mortality in this population, but the impact of specific comorbidity combinations is unknown. Our objectives were to (1) characterize the distribution of procedures, comorbidities, and outcomes for older patients undergoing EGS; and (2) apply a data‐driven approach (association rule mining) to identify comorbidity combinations associated with disproportionately high mortality.DESIGN, SETTING, AND PARTICIPANTSCross‐sectional study of patients 65 years and older who underwent one of the seven procedures previously cited, taken from the 2011 Nationwide Inpatient Sample. A total of 280 885 patient encounters were identified.MEASUREMENTSIn‐hospital mortality, procedures, and comorbidities based on the Elixhauser Comorbidity Index.RESULTSOverall mortality was 5.6%. The most common procedures were gallbladder (33.7%), ulcer surgery (21.5%), and adhesiolysis (21.0%). Mortality increased for all procedures as patients aged. Comorbidities associated with the highest mortality included coagulopathy (adjusted odds ratio [aOR] = 3.74; 95% confidence interval [CI] = 3.41–4.11; p < .001), fluid and electrolyte disorders (FED) (aOR = 2.89; 95% CI = 3.66–3.14; p < .001), and liver disease (aOR = 1.89; 95% CI = 1.61–2.22; p < .001). Three‐way comorbidity combinations most highly associated with mortality were coagulopathy, FED, and peripheral vascular disease (aOR = 5.10; 95% CI = 4.17–6.24; p < .001), and coagulopathy, FED, and chronic pulmonary disease (aOR = 4.83; 95% CI = 4.00–5.82; p < .001).CONCLUSIONFor older patients, combinations of comorbidities portend additional risk beyond single comorbidities, and the associated risk burden is driven by the specific constellation of comorbidities present. Future work must continue to examine the effect of co‐occurring diseases to provide personalized and realistic prognostication for older patients undergoing EGS. J Am Geriatr Soc 67:503–510, 2019.
Fighting Words: Antiblackness and Discursive Violence in an American High School
Authors: Smalls Krystal A. 
Published: December 2018

In the United States, discourses of “black‐on‐black” violence are pervasive in news media and everyday interactions. These discourses are often indexicalized along various contextual scales and draw upon several ideological wellsprings in their interdiscursive iterations. By examining a specific discourse about tensions between African transnational and African American young people in the Philadelphia area, this article considers how students and educators at a large suburban high school, local community members, and news media sustain and contest a notion of black‐on‐black violence by sometimes using the entextualized phrasing but, more often, by tacitly indexing or eroding its epistemic underpinnings. In the analysis, these underpinnings are presented as anti‐black epistemes that construct black people as immanently and exceptionally violent, and African Americans especially so. Ethnographic discourse analysis conducted over several years suggests that such epistemes help to not only rationalize the criminalization and disciplining of black youth regardless of national origin (and thus engender a multifaceted practice of “discursive violence” that can produce actual violence), but also help prop up the contextual frames through which African transnational youth discursively perform nonthreatening selves in contradistinction to their African American peers, even as they may undermine anti‐black epistemes.
Teachers' Perceived and Desired Roles in Nutrition Education
Authors: Metos Julie M. , Sarnoff Kelan , Jordan Kristine C. 
Published: December 2018

ABSTRACTBACKGROUNDElementary teachers have the potential to influence children's eating habits. This study examined teacher views and practices regarding nutrition education.METHODSAn online survey was administered to K‐6 teachers (N = 628) in 55 public elementary schools in a large city in the western United States. Three indices were created based on responses. Indices included: (1) attitudes and beliefs about nutrition education; (2) self‐efficacy regarding nutrition education; and (3) personal health behaviors. Relationships between indices, classroom practices, and teacher characteristics were tested. Teacher comments were categorized into themes.RESULTSMost teachers agreed they can make a difference in the eating behaviors of their students (68%). Correlations between hours of nutrition taught and teachers' attitudes and beliefs (r = .37, p < .01), nutrition self‐efficacy (r = .38, p < .01), and personal health practices (r = .15, p < .01) were weak, yet statistically significant. Number of years teaching was inversely related to frequency of food rewards (r = −119, p < .01). Few teachers (21%) agreed they have support to teach nutrition in the classroom.CONCLUSIONTeachers understand the importance of nutrition education but provision is limited by competing demands. Teachers suggest tailored nutrition materials, qualified nutrition personnel, and school stakeholder support to promote nutrition education.
School‐Based Weight Management Program Curbs Summer Weight Gain Among Low‐Income Hispanic Middle School Students
Authors: Reesor Layton , Moreno Jennette P. , Johnston Craig A. , Hernandez Daphne C. 
Published: December 2018

ABSTRACTBACKGROUNDResearch shows that elementary students gain weight over the summer. It is unknown if these findings apply to Hispanic adolescents. We evaluated school and summer standardized body mass index (zBMI) changes in Hispanic middle school students.METHODSHispanic middle school students were randomly assigned to a weight management program (N = 230) or control condition (N = 195). Paired sample t‐tests compared zBMI change scores during the school year versus summer when not enrolled in a weight management program (eg, control group). We used 2 × 2 repeated measures analysis of variances to determine program group differences in zBMI scores across school versus summer periods separately for normal and overweight/obese students.RESULTSIn the control group, students' zBMI change scores decreased during the school year, but increased during summer for both normal weight and overweight/obese students. Program effects on zBMI indicated school year decreases and summer increases for both normal and overweight/obese students. However, zBMI scores did not differ by program status for normal weight students. Overweight/obese students in the program compared to the control group increased zBMI to a lesser extent over the summer.CONCLUSIONFor all students, zBMI increased during the summer. A school‐based weight management program protected overweight/obese students against potentially greater summer weight gain.
QIM, CATA, and Word Association methods for quality assessment of flathead gray mullet (Mugil cephalus): Going beyond the trained panel
Authors: Tiyo de Godoy Nathália , Veneziano Andre Luis , da Cunha Rodrigues Larissa , Schoffen Enke Dariane B. , Lapa‐Guimarães Judite 
Published: December 2018

AbstractThis study aimed to verify how untrained assessors would perform the quality evaluation of the flathead gray mullet (Mugil cephalus) using Check‐All‐That‐Apply (CATA) (n = 44) and Word Association (WA) (n = 112) methods by comparing the results with those from trained assessors (n = 5–9), using the Quality Index Method (QIM). Descriptors from QIM were adapted and used as CATA descriptors for the evaluation of fish with 3, 8, 10, 15, and 17 days of storage in ice. Images of fish with 3, 6, 10, 15, and 19 days of ice storage were used as stimuli for WA. The quality indices obtained from QIM and CATA presented a high correlation with r = .94 (p = .018). Multiple Factor Analysis revealed a high similarity between CATA and QIM sample configurations. Appropriate descriptors were selected in CATA for fish stored for different periods. This resulted in a better discrimination of samples in comparison with WA. M. cephalus, with 15 days of storage in ice, was rated unacceptable for consumption by both trained and untrained assessors. These findings showed that even untrained assessors were able to evaluate fish freshness, and thus emphasize the importance of actions aimed at maintaining the quality of raw fish from capture to commercialization.Practical applicationsThe evaluation of fish quality by consumers has been considered tricky. Only more experienced fish consumers have confidence in their ability to judge the freshness of fish. However, our study showed that untrained individuals, confronted with the task of evaluating fish quality using both the CATA and the Word Association methods, performed very well. This allowed us to conclude that they were clearly able to evaluate freshness. Untrained individuals were neither stricter, nor more lenient than trained assessors in determining the shelf life of the flathead gray mullet. Our study joined many others that have concluded that CATA method—thanks to its easiness to perform—resulted in the discrimination of samples similar to that obtained with trained panels. These findings demonstrate that CATA and WA methods, designed to be applicable with untrained panels, were effective in the evaluation of fish freshness, thus providing a solution when trained assessors are not available. In addition, the importance of trading fish with high quality is clear, so that the consumers can receive value for their money and feel satisfied.
Insulin and incretin responses to grazing in insulin‐dysregulated and healthy ponies
Authors: Fitzgerald Danielle M. , Walsh Donald M. , Sillence Martin N. , Pollitt Christopher C. , de Laat Melody A. 
Published: December 2018

BackgroundSupraphysiological insulin and incretin responses to a cereal‐based diet have been described in horses and ponies with insulin dysregulation (ID). However, the hormonal responses to grazing have not yet been described.ObjectivesTo determine if there is a difference in the insulin and incretin responses to grazing pasture between insulin‐dysregulated and healthy ponies.AnimalsA cohort of 16 ponies comprising 5 with normal insulin regulation (NIR), 6 with moderate ID (MID), and 5 with severe ID (SID).MethodsIn this case‐control study, an oral glucose test (OGT) was used to determine the insulin responsiveness of each pony to PO carbohydrate before grazing pasture (4 hours) for 3 consecutive days. Serial blood samples collected during grazing were analyzed for glucose, insulin, glucose‐dependent insulinotropic peptide (GIP) and active glucagon‐like peptide‐1 (aGLP‐1), and compared among pony groups and day of pasture access.ResultsThe area under the insulin curve when grazing increased with ID severity (P < .03). The median (range) maximal insulin concentration was greater in the MID (72.5 [129] μIU/mL) and SID (255 [338.5] μIU/mL) groups, compared to the NIR (11.7 [24.9] μIU/mL) group (P < .03) and occurred within 2‐4 hours of grazing. Postprandial OGT insulin concentration was positively correlated with 2 hours post‐grazing insulin across all 3 grazing days (P ≤ .03). The aGLP‐1 and GIP concentrations increased in response to grazing but did not differ among groups.Conclusions and Clinical ImportanceGrazing pasture provoked an increased insulin and incretin response in insulin‐dysregulated ponies within 4 hours of grazing. The pasture and OGT insulin concentrations were correlated.
Differences in miRNA differential expression in whole blood between horses with sarcoid regression and progression
Authors: Unger Lucia , Jagannathan Vidhya , Pacholewska Alicja , Leeb Tosso , Gerber Vinzenz 
Published: December 2018

BackgroundCurrently no methods are available to predict the clinical outcome of individual horses with equine sarcoid (ES) disease.ObjectiveTo investigate if whole blood microRNA (miRNA) profiles can predict the long‐term development of ES tumors.AnimalsFive horses with regression and 5 with progression of ES lesions monitored over 5‐7 years and 5 control horses free of ES for at least 5 years.MethodsFor this cohort study, RNA extracted from whole blood samples from the regression, progression, and control groups was used for high throughput sequencing. Known and novel miRNAs were identified using miRDeep2 and differential expression analysis was carried out by the DESeq2 algorithm. Target gene and pathway prediction as well as enrichment and network analyses were conducted using TarBase, mirPath, and metaCore from GeneGo.ResultsFourteen miRNAs were differentially expressed between regression and progression groups after accounting for the control condition: 4 miRNAs (28.6%) were upregulated and 10 miRNAs (71.4%) were downregulated with >2‐fold change. Seven of the 10 downregulated miRNAs are encoded in an miRNA cluster on equine chromosome 24, homologous to the well‐known 14q32 cluster in humans. Their target genes show enrichment for pathways involved in viral carcinogenesis.Conclusions and Clinical ImportanceWhole blood miRNA expression profiles are associated with long‐term ES growth in horses and warrant further validation as prognostic biomarkers in a larger study cohort. Deregulation of miRNAs on equine chromosome 24 might represent a trigger for ES development.