bluuebunny/crossref_metadata_2025_split huggingface dataset:
Exploration of individual variability to better predict the nutrient requirements of gestating sows1
Authors: Gaillard Charlotte , Gauthier Raphaël , Cloutier Laetitia , Dourmad Jean-Yves 
Published: October 2019

AbstractSows often receive the same feed during gestation even though their nutrient requirements vary during gestation and among sows. The objective of this study was to report the variability in nutrient requirement among sows and during gestation, in order to develop a precision feeding approach. A data set of 2,511 gestations reporting sow characteristics at insemination and their farrowing performance was used as an input for a Python model, adapted from InraPorc, predicting nutrient requirement during gestation. Total metabolizable energy (ME) requirement increased with increasing litter size, gestation weeks, and parity (30.6, 33.6, and 35.5 MJ/d for parity 1, 2, and 3 and beyond, respectively, P &lt; 0.01). Standardized ileal digestible lysine (SID Lys) requirement per kg of diet increased from weeks 1 to 6 of gestation, remained stable from weeks 7 to 10, and increased again from week 11 until the end of gestation (P &lt; 0.01). Average Lys requirement increased with increasing litter size (SID Lys: 3.00, 3.27, 3.50 g/kg for small, medium and large litters, P &lt; 0.01) and decreased when parity increased (SID Lys: 3.61, 3.17, 2.84 g/kg for parity 1, 2, and 3++, P &lt; 0.01). Standardized total tract digestible phosphorus (STTD-P) and total calcium (Total-Ca) requirements markedly increased after week 9, with litter size, and decreased when parity increased (STTD-P: 1.36 vs. 1.31 g/kg for parity 1 and parity 3 and beyond; Total-Ca: 4.28 vs. 4.10 g/kg for parity 1 and parity 3 and beyond, P &lt; 0.01). Based on empirical cumulative distribution functions, a 4-diets strategy, varying in SID Lys and STTD-P content according to parity and gestation period (P1 from weeks 0 to 11, P2 from weeks 12 to 17), may be put forward to meet the requirements of 90% of the sows (2 diets for multiparous sows: P1: 2.8 g SID Lys/kg and 1.1 g STTD-P/kg; P2: 4.5 g SID Lys/kg and 2.3 g STTD-P/kg; and 2 diets for primiparous sows: P1: 3.4 g SID Lys/kg and 1.1g STTD-P/kg; P2: 5.0 g SID Lys/kg, 2.2 g STTD-P/kg). Better considering the high variability of sow requirement should thus make it possible to optimize their performance whilst reducing feeding cost and excretion. Feeding sows closer to their requirement may initially be achieved by grouping and feeding sows according to gestation week and parity, and ultimately by feeding sows individually using a smart feeder allowing the mixing of different feeds differing in their nutrient content.
Prosecuting Starvation under International Criminal Law
Authors: Ventura Manuel J 
Published: October 2019

Abstract
Historically, international criminal tribunals have not included a specific provision criminalizing the use of starvation within their respective statutes or founding legal documents. In light of this, and after clarifying what material/objective and mental/subjective elements characterize starvation, the present article seeks to explore whether it can be adjudicated as a crime against humanity or as an act of genocide and how this could be accomplished within the existing framework of international criminal law. In this respect, it is submitted that the general absence of an explicit reference to a crime of starvation in the statutes of international criminal tribunals is not a legal bar to the prosecution of the corresponding behaviour. Furthermore, this article briefly considers starvation as a war crime, particularly pursuant to Article 8(2)(b)(xxv) of the International Criminal Court (ICC) Statute — which criminalizes starvation in international armed conflicts at the ICC — and the conspicuous absence of a corresponding and parallel provision that would criminalize starvation as a war crime in non-international armed conflicts.
Anomaly detection based on one-class intelligent techniques over a control level plant
Authors: Jove Esteban , Casteleiro-Roca José-Luis , Quintián Héctor , Simić Dragan , Méndez-Pérez Juan-Albino , Luis Calvo-Rolle José 
Published: October 2019

AbstractA large part of technological advances, especially in the field of industry, have been focused on the optimization of productive processes. However, the detection of anomalies has turned out to be a great challenge in fields like industry, medicine or stock markets. The present work addresses anomaly detection on a control level plant. We propose the application of different intelligent techniques, which allow to obtain one-class classifiers using real data taken from the correct plant operation. The performance of each classifier is assessed and validated with real created faults, achieving successful overall results.
Dengue, Zika and chikungunya during pregnancy: pre- and post-travel advice and clinical management
Authors: Vouga Manon , Chiu Yen-Chi , Pomar Léo , de Meyer Sara V , Masmejan Sophie , Genton Blaise , Musso Didier , Baud David , Stojanov Milos 
Published: October 2019

AbstractRationale for reviewYoung adults of childbearing age and pregnant women are travelling more frequently to tropical areas, exposing them to specific arboviral infections such as dengue, zika and chikungunya viruses, which may impact ongoing and future pregnancies. In this narrative review, we analyse their potential consequences on pregnancy outcomes and discuss current travel recommendations.Main findingsDengue virus may be associated with severe maternal complications, particularly post-partum haemorrhage. Its association with adverse fetal outcomes remains unclear, but prematurity, growth retardation and stillbirths may occur, particularly in cases of severe maternal infection. Zika virus is a teratogenic infectious agent associated with severe brain lesions, with similar risks to other well-known TORCH pathogens. Implications of chikungunya virus in pregnancy are mostly related to intrapartum transmission that may be associated with severe neonatal infections and long-term morbidity.Travel recommendationsFew agencies provide specific travel recommendations for travelling pregnant patients or couples trying to conceive and discrepancies exist, particularly regarding Zika virus prevention. The risks significantly depend on epidemiological factors that may be difficult to predict. Prevention relies principally on mosquito control measures. Couples trying to conceive and pregnant women should receive adequate information about the potential risks. It seems reasonable to advise pregnant women to avoid unnecessary travel to Aedes spp. endemic regions. The current rationale to avoid travel and delay conception is debatable in the absence of any epidemic. Post-travel laboratory testing should be reserved for symptomatic patients.
Sylvilagus obscurus (Lagomorpha: Leporidae)
Authors: Edelman Andrew J 
Published: October 2019

AbstractSylvilagus obscurus Chapman, Cramer, Dippenaar, and Robinson, 1992, commonly called the Appalachian cottontail, is distinguished from other syntopic leporids by its black spot between the ears, black fur along the anterior edge of the ears, and reddish-gray sides overlaid with a black wash. One of 22 species in the genus, S. obscurus is found across the Appalachian Mountains region, from Pennsylvania to northern Alabama. An inhabitant of habitats with dense woody understory cover such as early successional forests and mature forests with ericaceous shrubs, this rabbit is considered “Near Threatened,” with major threats that include habitat destruction, climate change, and competition with the eastern cottontail, Sylvilagus floridanus.
Interactions between sleep disruption, motor learning, and p70 S6 kinase 1 signaling
Authors: Kam Korey , Kang Mihwa , Eren C Yasemin , Pettibone Ward D , Bowling Heather , Taveras Shantal , Ly Annie , Chen Rebecca K , Berryman Natasha V , Klann Eric , Varga Andrew W 
Published: October 2019

Abstract
Offline gains in motor performance after initial motor learning likely depend on sleep, but the molecular mechanisms by which this occurs are understudied. Regulation of mRNA translation via p70 S6 kinase 1 (S6K1) signaling represents one potential mechanism, as protein synthesis is thought to be increased during sleep compared to wake and is necessary for several forms of long-term memory. Using phosphorylation of ribosomal protein S6 (RpS6) as a readout of S6K1 activity, we demonstrate that a period of 10 h of acute sleep disruption impairs both S6K1 signaling and offline gains in motor performance on the rotarod in adult wild type C57/Bl6 mice. Rotarod motor learning results in increased abundance of RpS6 in the striatum, and inhibition of S6K1 either indirectly with rapamycin or directly with PF-4708671 diminished the offline improvement in motor performance without affecting the initial acquisition of rotarod motor learning when sleep is normal. In sum, S6K1 activity is required for sleep-dependent offline gains in motor performance and is inhibited following acute sleep disruption, while motor learning increases the abundance of striatal RpS6. Thus, S6K1 signaling represents a plausible mechanism mediating the beneficial effects of sleep on motor performance.
Advancing BSNs by 2020: Innovative Educational Progression for Success
Authors: Roberts Melina S. , Gapp DeAnna K. , Burns-Coral Mary , Greaves Valerie D. , Williams Michael L. 
Published: October 2019

Abstract
As we approach 2020, with limited time to meet the Institute of Medicine goal of 80 percent baccalaureate in nursing by 2020, there is a need for additional innovative academic progression models with seamless progression to obtain a BSN. A community college and university created a new model for educational progression that resulted in the Associates Degree in Nursing/Bachelor of Science in Nursing Collaborative Program, the first of its kind in this state. The program utilizes the ADN traditional curriculum during the fall/winter semesters, completing the BSN-based curriculum in the spring/summer semesters at the university.
Reactions of Nursing Students When Faced With Violations of the American Nurses Association Code of Ethics
Authors: Wentworth Katelyn M. , Dorfman Lisette , Taddeo Justine 
Published: October 2019

Abstract
A qualitative study was conducted with 10 nursing students to evaluate how students respond to breaches of standards of practice by clinical nurses. Statements were identified and analyzed with Colaizzi’s method. Three main themes emerged: 1) Violations of the ANA Code of Ethics were witnessed by students (handling medications/equipment incorrectly, failing to comply with infection control, violating patient privacy). 2) Students were upset and felt they should have responded differently when witnessing a violation. 3) Students need preparation on how to react to violations of practice, with proper enforcement of practice within the clinical.
Crossing the Cervicothoracic Junction in Cervical Arthrodesis Results in Lower Rates of Adjacent Segment Disease Without Affecting Operative Risks or Patient-Reported Outcomes
Authors: Ibaseta Alvaro , Rahman Rafa , Andrade Nicholas S. , Uzosike Akachimere C. , Byrapogu Venkata K. , Ramji Alim F. , Skolasky Richard L. , Reidler Jay S. , Kebaish Khaled M. , Riley Lee H. , Sciubba Daniel M. , Cohen David B. , Neuman Brian J. 
Published: October 2019

Study Design:
Retrospective cohort study.

Objective:
To evaluate the risks and benefits of crossing the cervicothoracic junction (CTJ) in cervical arthrodesis.

Summary of Background Data:
Whether the CTJ should be crossed in cervical arthrodesis remains up for debate. Keeping C7 as the distal end of the fusion risks adjacent segment disease (ASD) and can result in myelopathy or radiculopathy. Longer fusions are thought to increase operative risk and complexity but result in lower rates of ASD.

Materials and Methods:
Patients undergoing cervical spine fusion surgery ending at C7 or T1 with ≥1-year follow-up were included. To evaluate operative risk, estimated blood loss (EBL), operative time, and length of hospital stay were collected. To evaluate patient-reported outcomes (PROs), Neck Disability Index (NDI) and SF-12 questionnaires (PCS12 and MCS12) were obtained at follow-up. Revision surgery data were also obtained.

Results:
A total of 168 patients were included and divided into a C7 end-of-fusion cohort (NC7=59) and a T1 end-of-fusion cohort (NT1=109). Multivariate regression analysis adjusting for age, sex, race, surgical approach, and number of levels fused showed that EBL (P=0.12), operative time (P=0.07), and length of hospital stay (P=0.06) are not significantly different in the C7 and T1 end-of-fusion cohorts. Multivariate regression of PROs showed no significant difference in NDI (P=0.70), PCS12 (P=0.23), or MCS12 (P=0.15) between cohorts. Fisher analysis showed significantly higher revision rates in the C7 end-of-fusion cohort (7/59 for C7 vs. 2/109 for T1; odds ratio, 6.4; 95% confidence interval, 1.2–65.1; P=0.01).

Conclusions:
Crossing the CTJ in cervical arthrodesis does not increase operative risk as measured by blood loss, operative time, and length of hospital stay. However, it leads to lower revision rates, likely because of the avoidance of ASD, and comparable PROs. Thus, crossing the CTJ may help prevent ASD without negatively affecting operative risk or long-term PROs.
Early Palliative Care Consultation in the Medical ICU: A Cluster Randomized Crossover Trial
Authors: Ma Jessica , Chi Stephen , Buettner Benjamin , Pollard Katherine , Muir Monica , Kolekar Charu , Al-Hammadi Noor , Chen Ling , Kollef Marin , Dans Maria 
Published: October 2019

Objectives:
To assess the impact of early triggered palliative care consultation on the outcomes of high-risk ICU patients.

Design:
Single-center cluster randomized crossover trial.

Setting:
Two medical ICUs at Barnes Jewish Hospital.

Patients:
Patients (n = 199) admitted to the medical ICUs from August 2017 to May 2018 with a positive palliative care screen indicating high risk for morbidity or mortality.

Interventions:
The medical ICUs were randomized to intervention or usual care followed by washout and crossover, with independent assignment of patients to each ICU at admission. Intervention arm patients received a palliative care consultation from an interprofessional team led by board-certified palliative care providers within 48 hours of ICU admission.

Measurements and Main Results:
Ninety-seven patients (48.7%) were assigned to the intervention and 102 (51.3%) to usual care. Transition to do-not-resuscitate/do-not-intubate occurred earlier and significantly more often in the intervention group than the control group (50.5% vs 23.4%; p < 0.0001). The intervention group had significantly more transfers to hospice care (18.6% vs 4.9%; p < 0.01) with fewer ventilator days (median 4 vs 6 d; p < 0.05), tracheostomies performed (1% vs 7.8%; p < 0.05), and postdischarge emergency department visits and/or readmissions (17.3% vs 38.9%; p < 0.01). Although total operating cost was not significantly different, medical ICU (p < 0.01) and pharmacy (p < 0.05) operating costs were significantly lower in the intervention group. There was no significant difference in ICU length of stay (median 5 vs 5.5 d), hospital length of stay (median 10 vs 11 d), in-hospital mortality (22.6% vs 29.4%), or 30-day mortality between groups (35.1% vs 36.3%) (p > 0.05).

Conclusions:
Early triggered palliative care consultation was associated with greater transition to do-not-resuscitate/do-not-intubate and to hospice care, as well as decreased ICU and post-ICU healthcare resource utilization. Our study suggests that routine palliative care consultation may positively impact the care of high risk, critically ill patients.
Using a Multimedia Tool for Informed Consent in Mohs Surgery: A Randomized Trial Measuring Effects on Patient Anxiety, Knowledge, and Satisfaction
Authors: Delcambre Macey , Haynes Dylan , Hajar Tamar , Golden Spring , Bar Anna , Latour Emile , Leitenberger Justin J. 
Published: October 2019

BACKGROUND
Multimedia educational materials have been found to improve aspects of informed consent, although data in the context of Mohs micrographic surgery (MMS) is limited.

OBJECTIVE
To assess whether a preoperative educational video decreases anxiety, increases comprehension, and improves overall satisfaction for patients undergoing same-day office consultation and MMS.

MATERIALS AND METHODS
This single-center randomized controlled trial included patients above the age of 18 years undergoing MMS for skin cancer between October 2015 and December 2015. Patients were randomized to view a short preoperative video on MMS in addition to traditional informed consent versus informed consent without video viewing. Questionnaires were used to assess preoperative anxiety, knowledge, and satisfaction.

RESULTS
From 231 consecutively enrolled subjects, there were no significant differences in anxiety (p = .626) or satisfaction (p = .065) between groups. Subjects receiving the intervention were able to more accurately recognize risks of MMS (88% vs 69% of controls, p < .001) and had improved subject-reported confidence in understanding procedural risks and benefits (89% vs 71% of controls, p = .049). Composite comprehension scores were similar between groups (p = .131).

CONCLUSION
A preoperative MMS educational video increased recognition of procedural risks, but did not improve patient anxiety or satisfaction.
Comparing Rates of Adverse Events and Medical Errors on Inpatient Psychiatric Units at Veterans Health Administration and Community-based General Hospitals
Authors: Cullen Sara W. , Xie Ming , Vermeulen Jentien M. , Marcus Steven C. 
Published: October 2019

Objective:
There is limited knowledge about how general hospitals and Veterans Health Administration (VHA) hospitals fare relative to each other on a broad range of inpatient psychiatry-specific patient safety outcomes.
This research compares data from 2 large-scale epidemiological studies of adverse events (AEs) and medical errors (MEs) in inpatient psychiatric units, one in VHA hospitals and the other in community-based general hospitals.

Method:
Retrospective medical record reviews assessed the prevalence of AEs and MEs in a sample of 4371 discharges from 14 community-based general hospitals (derived from 69,081 discharges at 85 hospitals) and a sample of 8005 discharges from 40 VHA hospitals (derived from 92,103 discharges at 105 medical centers). Rates of AEs and MEs across hospital systems were calculated, controlling for relevant patient and hospital characteristics.

Results:
The overall rate of AEs and MEs in inpatient psychiatric units of VHA hospitals was 7.11 and 1.49 per 100 patient discharges; at community-based acute care hospitals, these rates were 13.48 and 3.01 per 100 patient discharges. The adjusted odds ratio of a patient experiencing an AE and a ME at community-based hospitals as compared with VHA hospitals was 2.11 and 2.08, respectively.

Conclusion:
Although chart reviews may not document the complete nature and outcomes of care, even after controlling for differences in patient and hospital characteristics, psychiatric inpatients at community-based hospitals were twice as likely to experience AEs or MEs as inpatients at VHA hospitals. While community-based hospitals may lag behind VHA hospitals, both hospital systems should continue to pursue evidence-based improvements in patient safety. Future research aimed at changing hospital practices should draw on established strategies for bridging the gap from research to practice in order to improve the quality of care for this vulnerable patient population.
Achieving Disease-Specific Care Joint Commission Certification
Authors: Frost Kristen , Stafos Andrea , Barbay Kathryn , Henderson Kathleen 
Published: October 2019

Purpose:
The aims of this study are to describe a program to achieve disease-specific care (DSC) certification from The Joint Commission and highlight the value of the advanced practice nurse in the certification outcome.

Description of Program:
The expertise in clinical practice, performance improvement, and leadership skills demonstrated by the clinical nurse specialist (CNS) can be instrumental in building a strong foundation for a DSC certification program. As an organization prepares for a DSC on-site review, the CNS can guide the program stakeholders in identifying gaps in care, developing action plans to meet certification standards, and preparing team members for the DSC on-site review.

Outcome:
At this Midwestern, 504-bed facility, The Joint Commission DSC certifications were achieved in 5 separate categories: diabetes, stroke, sepsis, total hip replacement, and total knee replacement.

Conclusion:
By influencing a certain patient population throughout the organization, population-focused CNSs are in a unique role to lead an interprofessional team or serve as an expert consultant in pursuing DSC certification from The Joint Commission.
Top-Down Cortical Control of Acute and Chronic Pain
Authors: Urien Louise , Wang Jing 
Published: October 2019

ABSTRACT
Acute pain has an evolutionary role in the detection of physical harm and the response to it. In some cases, however, acute pain can impair function and lead to other morbidities. Chronic pain, meanwhile, can present as a psychopathological condition that significantly interferes with daily living. Most basic and translational pain research has focused on the molecular and cellular mechanisms in the spinal and peripheral nervous systems. In contrast, the brain plays a key role in the affective manifestation and cognitive control of pain. In particular, several cortical regions, such as the somatosensory cortex, prefrontal cortex, insular, and anterior cingulate cortex, are well known to be activated by acute pain signals, and neurons in these regions have been demonstrated to undergo changes in response to chronic pain. Furthermore, these cortical regions can project to a number of forebrain and limbic structures to exert powerful top-down control of not only sensory pain transmission but also affective pain expression, and such cortical regulatory mechanisms are particularly relevant in chronic pain states. Newer techniques have emerged that allow for detailed studies of central pain circuits in animal models, as well as how such circuits are modified by the presence of chronic pain and other predisposing psychosomatic factors. These mechanistic approaches can complement imaging in human studies. At the therapeutic level, a number of pharmacological and nonpharmacological interventions have recently been shown to engage these top-down control systems to provide analgesia. In this review, we will discuss how pain signals reach important cortical regions and how these regions in turn project to subcortical areas of the brain to exert profound modulation of the pain experience. In addition, we will discuss the clinical relevance of such top-down pain regulation mechanisms.