bluuebunny/crossref_metadata_2025_split huggingface dataset:
Evaluation of alternative fabrication specifications to increase gross value of pork carcasses
Authors: Bryan Erin E , Overholt Martin F , Kim Gap Don , Dilger Anna C , Boler Dustin D 
Published: February 2018

Abstract
Modifying fabrication specifications of domestic pork carcasses to reflect product specifications in key export markets may increase gross value for U.S. pork. Changes in specifications may also yield value-added cuts that increase demand for U.S. pork in both export and domestic markets. The objective was to evaluate differences in value of carcasses fabricated using either typical U.S. cutting specifications, or alternative specifications. Paired left and right sides (30 sides total; n = 15) were weighed and cut into primal and subprimal pieces according North American Meat Institute (NAMP, DOM) or alternative-style specifications (ALT). Alternative-style carcasses were separated into shoulder (4th/5th rib separation), loin, belly, and ham (sirloin-on) primals. Alternative-style shoulders were fabricated into a cellar-trimmed (CT) butt, triceps brachii (cushion), boneless picnic, and a brisket. Carcass values for all three pricing scenarios were calculated using the USDA Agriculture Marketing Service Carlot Report values from the weeks of April 5, 2013, to April 7, 2017. Value for the pork brisket was estimated based on relative value of the beef brisket compared to the beef shoulder clod (NAMP #114) resulting in a value of $2.485/kg for the pork brisket. Comparisons between fabrication styles and value of each side were made using a paired T-test. Whole bone-in loin yields of ALT carcasses were 6.23 units less (P &lt; 0.0001) than DOM carcasses. Similarly, yields from trimmed and squared bellies of ALT carcasses were 0.83 units less than (P ≤ 0.01) DOM carcasses. In contrast, trimmed shoulders of ALT carcasses were 3.81 units greater (P &lt; 0.0001) and hams were 3.39 units greater (P &lt; 0.0001) than DOM carcasses. Despite reductions in yield of loins and bellies, ALT carcasses were numerically $1.29 (P = 0.17) and $0.66 (P = 0.56) more valuable than DOM carcasses in the 4 yr average and best pricing scenarios, respectively. Alternative-style carcasses were $1.99 (P = 0.03) more valuable than DOM carcass when using the most depressed pricing scenario. Fabricating pork carcasses using alternative-style specifications reduced the yield, and therefore the value, of the loin and belly compared with DOM carcasses. However, added value from the pork brisket and CT butt recuperated this value. Therefore, alternative-style fabrication methods may increase gross carcass value in some pricing scenarios.
PA program characteristics and diversity in the profession
Authors: Coplan Bettie , Bautista Tara G. , Dehn Richard W. 
Published: February 2018

ABSTRACT

Objectives:
The primary objective of this study was to identify PA program characteristics that may be associated with higher or lower percentages of underrepresented minority students in PA programs.

Methods:
Data from the Physician Assistant Education Association (PAEA) 2002-2003 and 2012-2013 annual surveys were analyzed. Bivariate correlation coefficients and multiple regression modeling were used to identify relationships between program characteristics and percentages of black and Hispanic students.

Results:
The percentage of white matriculants in PA programs increased from 76.5% in 2002-2003 to 81.8% in 2012-2013; the percentage of black students decreased from 6.2% to 4.4%. Multiple linear regression revealed a modest negative relationship between master's degree and percentage of underrepresented minority students and a modest positive relationship between percentages of underrepresented minority employees and underrepresented minority students.

Conclusions:
Further research is needed to identify strategies to increase underrepresented minority participation in healthcare professions programs.
IDENTIFICATION OF POSTERIOR SEGMENT PATHOLOGY WITH EN FACE RETINAL IMAGING USING MULTICOLOR CONFOCAL SCANNING LASER OPHTHALMOSCOPY
Authors: Feng Henry L. , Sharma Sumit , Stinnett Sandra , Asrani Sanjay , Mruthyunjaya Prithvi 
Published: February 2018

Purpose:
To assess posterior segment findings on multicolor confocal scanning laser ophthalmoscopy by correlation with spectral domain optical coherence tomography (SD-OCT) and to quantify agreement between these imaging modalities.

Methods:
Retrospective review of 159 eyes of 96 consecutive patients who underwent concurrent imaging with multicolor confocal scanning laser ophthalmoscopy and SD-OCT. Positive percent agreement and negative percent agreement were calculated for each finding identified on infrared, green, blue, and multicolor reflectance images using SD-OCT as a comparator.

Results:
Infrared reflectance best detected outer retinal and choroidal findings such as choroidal lesions, retinal pigment epithelium atrophy, peripapillary atrophy, and drusen (positive percent agreement 100, 92, 92, and 67%, respectively). Inner retinal changes including epiretinal membrane, lamellar macular hole, and inner retinal alterations were best detected on blue reflectance (positive percent agreement 94, 50, and 100%, respectively). Composite multicolor reflectance most effectively detected conditions with retinal elevation, including pigment epithelial detachment, intraretinal fluid, and subretinal fluid (positive percent agreement 65, 49, and 54%, respectively). Multicolor confocal scanning laser ophthalmoscopy detected intraretinal and subretinal hemorrhages, which were not detected on SD-OCT (negative percent agreement 87 and 97%, respectively).

Conclusion:
Multicolor confocal scanning laser ophthalmoscopy is capable of identifying posterior segment pathology at various anatomical depths and may be a useful adjunct to SD-OCT for detecting or monitoring certain retinal conditions.
Recognition of Fungal Keratitis in Boston Type I Keratoprosthesis: Importance of Awareness and Novel Identification of Exophiala phaeomuriformis
Authors: Machen Lindsay , Chau Felix Y. , de la Cruz Jose , Sugar Joel , Cortina Maria Soledad 
Published: February 2018

Purpose:
To present a case of Exophiala phaeomuriformis fungal keratitis to demonstrate the heightened concern for fungal infection in patients with a keratoprosthesis and to highlight the rare involvement of Exophiala phaeomuriformis.

Methods:
Case report.

Results:

Exophiala phaeomuriformis was identified in a susceptible patient 7 years after Boston type I keratoprosthesis (KPro) implantation.

Conclusions:
Although fungal infiltration after KPro placement does not represent a novel clinical infection, identification of the rare Exophiala species in a patient with a KPro has not been reported and provides an opportunity for reflection on fungal identification, prophylaxis, and prevention in this vulnerable patient population.
Switching Between Antibiotics Among Danish Children 0–4 Years of Age
Authors: Reilev Mette , Thomsen Reimar W. , Aabenhus Rune , Sydenham Rikke V. , Hansen Jens Georg , Pottegård Anton 
Published: February 2018

Background:
In Denmark, the use of amoxicillin is widespread among children, despite phenoxymethylpenicillin being recommended as first-line therapy. The reason for this apparent discrepancy is not fully understood. We aimed at evaluating prescribing patterns of antibiotics among Danish children 0–4 years of age, with emphasis on incidence of treatment episodes, choice of initial antibiotic treatment and switching patterns between different types of antibiotics.

Methods:
We identified all children ≤4 years of age who filled a prescription of antibiotics from 2000 to 2015 according to the nationwide Danish National Prescription Registry. We estimated the incidence rate of episodes treated with antibiotics and the choice of initial antibiotic treatment over time. Further, we assessed the cumulative risk of switching within 0–3 days after initiating therapy.

Results:
We identified 3,481,684 antibiotic treatment episodes issued to 0- to 4-year-olds from 2000 to 2015. The incidence rate was stable until 2011 both among children 0–1 years of age (approximately 880/1000) and among children 2–4 years of age (approximately 610/1000), after which it dropped. Phenoxymethylpenicillin and, increasingly, amoxicillin were most frequently used as initial treatments (39% vs. 44%). Few switched from amoxicillin (1%) or phenoxymethylpenicillin (4.7%) within the first 3 days. Of those who switched from phenoxymethylpenicillin, 64% received amoxicillin as second-line treatment.

Conclusions:
The incidence of episodes treated with antibiotics among Danish children 0–4 years of age has decreased considerably since 2011. In contrast to guideline recommendations, amoxicillin is the most frequently used initial treatment. Early switching between antibiotics is uncommon. Initiatives should address the extensive use of amoxicillin.
Longitudinal Changes in Body Composition by Dual-energy Radiograph Absorptiometry Among Perinatally HIV-infected and HIV-uninfected Youth
Authors: Sharma Tanvi S. , Somarriba Gabriel , Arheart Kristopher L. , Neri Daniela , Mathew M. Sunil , Graham Patricia L. , Scott Gwendolyn B. , Miller Tracie L. 
Published: February 2018

Background:
Combination antiretroviral therapy has allowed youth with perinatal HIV infection (PHIV+) to live into adulthood, but many youth may experience metabolic and body composition changes that predispose to greater cardiovascular disease (CVD) risk. This longitudinal study evaluated changes in body composition measured by dual-energy radiograph absorptiometry (DXA) in a cohort of PHIV+ youth compared with HIV− controls over a 7-year period.

Methods:
PHIV+ youth and HIV− controls were prospectively enrolled in a single-site study to assess nutrition and CVD risk. Anthropometrics and DXA scans were longitudinally obtained to assess percent body fat and regional fat distribution. Using general linear models, we analyzed differences in body composition and anthropometric measures by sex between PHIV+ youth and controls over time.

Results:
Two hundred thirty-five participants (156 PHIV+ and 79 HIV− controls) with at least 1 DXA performed since study enrollment were included for analysis. During the study period, 471 DXAs were obtained in the PHIV+ group and 95 in HIV− controls. PHIV+ females demonstrated greater increase in weight and body mass index over time compared with HIV− females, and significant increases in total percent body fat [estimate = 1.212 (95% confidence interval: 0.837–1.587) percent per year; P < 0.001) and percent trunk fat [1.3818 (95% confidence interval: 0.922–1.84); P < 0.001] compared with HIV− females and PHIV+ males.

Conclusions:
PHIV+ females demonstrate an unfavorable change in fat redistribution and percent body fat over time that exceeds the pattern seen in PHIV+ males or HIV− females. Providers should have heightened awareness of body composition changes of PHIV+ females that may eventually lead to increased CVD risk.
Severity of Illness Measures for Pediatric Inpatients
Authors: Hessels Amanda J. , Liu Jianfang , Cohen Bevin , Shang Jingjing , Larson Elaine L. 
Published: February 2018

ABSTRACT

Introduction:
Severity of illness (SOI) measures are commonly used in adults for comparison of treatment and outcomes in similar populations. Less is known about the psychometric properties of measures available to providers and healthcare systems caring for pediatric patients. The purpose of this study was to (1) identify SOI measures used for pediatric patients admitted to acute care hospitals and (2) compare the ability of two SOI measures to predict mortality and length of stay (LOS).

Methods:
Twelve instruments were identified through literature search and one, the pediatric chronic complex condition (CCC), was retained. The CCC and the Charlson/Deyo comorbidity score were applied to an 8-year retrospective, multi-institutional data set using logistic and zero-truncated negative binomial regression models.

Results:
Records from 199,001 children were examined. The CCC performed better for predicting mortality (odds ratio = 3.36; 95% confidence interval [CI]: 3.20–3.53) and LOS (incidence rate ratio = 2.24; 95% CI: 2.22–2.26).

Conclusions:
The CCC may be preferable for predicting outcomes among pediatric inpatients. Pediatric SOI measures are not extensively developed and tested nor widely and freely available. The use of the CCC can predict mortality and LOS to guide care, resource allocation, and research for the pediatric population.
Management of Early Cervical Stromal Invasion FIGO Stage 1A1 When Margins Are Involved With Cervical Intraepithelial Neoplasia
Authors: Nicholson Rachel C. , Twigg Jeremy , Roberts Alison , Angelopoulos Georgios , Cruickshank Derek 
Published: February 2018

Objective
Women with International Federation of Gynecology and Obstetrics stage 1A1 cervical carcinoma were evaluated to determine whether repeat excision for large loop excision transformation zone margins positive with cervical intraepithelial neoplasia (CIN) had been undertaken according to the National Health Service Cervical Screening Programme guidelines and if deviations from guidelines adversely affected patient outcome.

Materials and Methods
We retrospectively studied patients with 1A1 cervical carcinoma treated in our service between May 2010 and July 2015 to determine whether NHSCSP guidelines (May 2010) were followed. This states that if the invasive disease is excised but CIN extends to the excision margin, then a repeat large loop excision transformation zone should be undertaken to exclude further invasive disease and to confirm excision of CIN.

Results
Seventeen patients were identified. In one, neither the invasive lesion nor CIN was fully excised. In 5, the lesion and CIN were fully excised. In eleven, the invasive lesion was excised, but CIN was present at a margin. Of these 11 patients, none opted for a repeat excision. All 11 patients had negative cytology at first follow-up (negative up to 4 years [median = 2 years]).

Conclusions
Our outcomes suggest that it may not be necessary to perform a repeat excision for CIN present at the excision margin in women with 1A1 cervical carcinoma when CIN is present either at the endocervical, deep stromal, or ectocervical margin, as long as the invasive focus is fully excised, and patients have been fully counseled and have regular cytology follow-up. This may be an alternative for patients wanting to minimize the risks to fertility posed by repeat excision.
Twenty-Five Years of Lamivudine: Current and Future Use for the Treatment of HIV-1 Infection
Authors: Quercia Romina , Perno Carlo-Federico , Koteff Justin , Moore Katy , McCoig Cynthia , St. Clair Marty , Kuritzkes Daniel 
Published: February 2018

Abstract:
Innovation in medicine is a dynamic, complex, and continuous process that cannot be isolated to a single moment in time. Anniversaries offer opportunities to commemorate crucial discoveries of modern medicine, such as penicillin (1928), polio vaccination (inactivated, 1955; oral, 1961), the surface antigen of the hepatitis B virus (1967), monoclonal antibodies (1975), and the first HIV antiretroviral drugs (zidovudine, 1987). The advent of antiretroviral drugs has had a profound effect on the progress of the epidemiology of HIV infection, transforming a terminal, irreversible disease that caused a global health crisis into a treatable but chronic disease. This result has been driven by the success of antiretroviral drug combinations that include nucleoside reverse transcriptase inhibitors such as lamivudine. Lamivudine, an L-enantiomeric analog of cytosine, potently affects HIV replication by inhibiting viral reverse transcriptase enzymes at concentrations without toxicity against human polymerases. Although lamivudine was approved more than 2 decades ago, it remains a key component of first-line therapy for HIV because of its virological efficacy and ability to be partnered with other antiretroviral agents in traditional and novel combination therapies. The prominence of lamivudine in HIV therapy is highlighted by its incorporation in recent innovative treatment strategies, such as single-tablet regimens that address challenges associated with regimen complexity and treatment adherence and 2-drug regimens being developed to mitigate cumulative drug exposure and toxicities. This review summarizes how the pharmacologic and virologic properties of lamivudine have solidified its role in contemporary HIV therapy and continue to support its use in emerging therapies.
High Prevalence of Antithyroid Antibodies in a New Zealand Cohort of Patients With Systemic Sclerosis
Authors: Solanki Kamal K. , Al-Majmuei Mahmood , White Douglas H. N. 
Published: February 2018

Background
Autoimmune thyroid disease affects 1% of the general population, and autoimmune thyroid antibodies are noted in up to 15%.

Objective
We hypothesized systemic sclerosis (SSc) is associated with higher prevalence of antithyroglobulin (anti-Tg) and anti–thyroid peroxidase (anti-TPO) antibodies) to justify monitoring of thyroid function for earlier detection and treatment.

Methods
Waikato Hospital SSc clinic patients were prospectively tested for thyroid function tests and antithyroid antibodies (ATAs).

Results
Of the 75 patients with SSc and 10 patients with SSc overlap syndrome (SOS) followed up in the SSc clinic, anti-Tg and anti-TPO were prospectively tested in 61 (70.6%) of the 85 patients. The cohort comprised 38 patients with limited cutaneous SSc (lcSSc), 15 with diffuse cutaneous SSc, and 8 with SOS.
Anti-Tg and anti-TPO antibodies were found in 34.2% in lcSSc patients and 33.3% in diffuse cutaneous SSc patients, whereas in SOS they were found in 25% (Tg) and in 12.5% (TPO) of patients.
At baseline, 10 patients (11.7%) had thyroid dysfunction: 8 (9.4%) with subclinical hypothyroidism and 1 each (1.2%) with subclinical hyperthyroidism and with clinical hyperthyroidism.
After 18 months, 1 woman with lcSSc, positive for both ATAs, developed clinical hypothyroidism.

Conclusions
There is a higher prevalence of ATAs in SSc and SOS compared with the general population. Screening these patients for ATAs is a reasonable measure.
Online Physician Reviews in Female Pelvic Medicine and Reconstructive Surgery: What Do Patients Really Want?
Authors: Asanad Kian , Parameshwar Pooja S. , Houman Justin , Spiegel Brennan M. , Daskivich Timothy J. , Anger Jennifer T. 
Published: February 2018

Objectives
This study aimed to qualitatively analyze online reviews of Female Pelvic Medicine and Reconstructive Surgery (FPMRS) specialists to better understand patients' experiences and improve patient satisfaction.

Methods
Fifty urologists and urogynecologists were randomly sampled from the Society of Urodynamics, Female Pelvic Medicine, and Urogenital Reconstruction membership website. We evaluated patient ratings and reviews of physicians from 4 websites: Yelp, Healthgrades, Vitals, and UCompareHealthCare. Qualitative data analysis was performed using grounded theory methodology, as described by Charmaz (Constructing Grounded Theory, 2014).

Results
Across the four websites, the mean number of stars per physician ranged from 3.6 to 4.1 and the mean number of reviews per physician ranged from 1.3 to 7.6. Qualitative analysis revealed several preliminary themes: patient–physician experience, medical and surgical treatment, office staff, and analysis of worth. Physicians who developed strong connections with patients through empathetic communication were likely to receive a positive review, regardless of wait times. Bedside manner was found to be multidimensional and included physician competence and understanding patients' concerns. Failure to meet several expectations led to dissatisfaction of care and negative patient reviews.

Conclusions
Patients' perspectives of quality of care in FPMRS are weighted heavily toward establishing personal connections with physicians. Accurate diagnosis and effective management of urological conditions, especially after negative experiences with previous providers, were associated with satisfaction of care. It seems that the concept of good bedside manner is multifactorial and requires the provider to demonstrate not one but several different sets of communication skills.
The effect of mutational robustness on the evolvability of multicellular organisms
Authors: Jiang Pengyao , Kreitman Martin , Reinitz John 
Published: February 2018

AbstractCanalization involves mutational robustness, the lack of phenotypic change as a result of genetic mutations. Given the large divergence in phenotype across species, understanding the relationship between high robustness and evolvability has been of interest to both theorists and experimentalists. Although canalization was originally proposed in the context of multicellular organisms, the effect of multicellularity on evolvability has not been considered by theoreticians. We address this issue using a Boolean population model with explicit representation of an environment in which multicellular individuals with explicit genotype and phenotype evolve. Robustness is described by a single real number between zero and one. We find that high robustness is favored in constant environments, and lower robustness is favored after environmental change. Multicellularity severely constrains robustness: peak evolvability occurs at an absolute level of robustness of about 0.99 compared with values of about 0.5 in a classical neutral network model. Multicellularity results in a sharp peak of evolvability in which the maximum is set by the fact that the fixation of adaptive mutations becomes more improbable as robustness decreases. When robustness is put under genetic control, robustness levels leading to maximum evolvability are selected for, but maximal relative fitness appears to require recombination.
Partial-Width Injuries of the Rat Rotator Cuff Heal with Fibrosis
Authors: Lemmon Elisabeth A. , Locke Ryan C. , Szostek Adrianna K. , Killian Megan L. 
Published: February 2018

ABSTRACTPurposeThe purpose of this study was to identify the healing outcomes following a partial-width, full-thickness injury to the rotator cuff tendon-bone attachment and establish if the adult attachment can regenerate the morphology of the healthy attachment.HypothesisWe hypothesized that a partial-width injury to the attachment would heal via fibrosis and bone remodeling, resulting in increased cellularity and extracellular matrix deposition, reduced bone volume, osteoclast presence and decreased collagen organization compared to shams.Materials and MethodsA biopsy punch was used to create a partial-width injury at the center one-third of the rat infraspinatus attachment, and the contralateral limb underwent a sham operation. Rats were sacrificed at 3- and 8-weeks after injury for analyses. Analyses performed at each time-point included cellularity (Hematoxylin & Eosin), ECM deposition (Masson’s Trichrome), bone volume (micro-computed tomography; microCT), osteoclast activity (Tartrate Resistant Acid Phosphatase; TRAP), and collagen fibril organization (Picrosirius Red). Injured and sham shoulders were compared at both 3- and 8-weeks using paired, two-way ANOVAs with repeated measures and Sidak’s correction for multiple comparisons.ResultsCellularity and ECM deposition increased at both 3- and 8-weeks compared to sham contralateral attachments. Bone volume decreased and osteoclast presence increased at both 3- and 8-weeks compared to sham contralateral limbs. Collagen fibril organization was reduced at 3-weeks after injury compared to 3-week sham attachments.ConclusionsThese findings suggest that a partial-width injury to the rotator cuff attachment does not fully regenerate the native structure of the healthy attachment. The injury model healed via scar-like fibrosis and did not propagate into a full-width tear after 8-weeks of healing.