bluuebunny/crossref_metadata_2025_split huggingface dataset:
The effects of dacitic (rhyolitic) tuff breccia and corn distillers’ dried grains with solubles (DDGS) inclusion on pellet mill electrical efficiency, production rate, and subsequent pellet quality
Authors: Badger Patrick A , Otott Haley K , Stark Charles R , Ferrel Jon , Sodak Mike , Shepherd Jerry , Kapetanovich Maks , Coble Kyle , Paulk Chad B 
Published: July 2024

Abstract
Two experiments were conducted to evaluate the effect of Azomite (AZO) and 30% distillers' dried grains with solubles (DDGS) on pellet mill (PM) electrical consumption (kWh/MT), production rate, and pellet quality. Experiment 1 was conducted as a 2 × 2 × 2 factorial with main effects of diet formulation (0% or 30% DDGS), PM (1 or 2), and AZO (0% or 0.25%) with 4 replications per treatment. PMs were equipped with a 4.4 × 39.0-mm (L:D 8.9) or 4.4 × 35.8 mm (L:D 8.2) die with PM production rates held constant at 31.8 metric ton (MT)/h and conditioning temperature was held constant at approximately 82 °C. Experiment 2 was designed as a 2 × 2 factorial of treatments with 4 replicates per treatment to evaluate the impact of AZO and DDGS on PM production rates and pellet quality. PM production rate was adjusted by the feeder screw to maintain 70% motor load, a 4.0 × 35.8-mm (L:D 8.75) PM die was used, and conditioning temperature held constant at approximately 82 °C. For experiment 1, a DDGS × PM interaction (P = 0.040) was observed. Diets containing 30% DDGS had a decreased kWh/MT compared to the control when using PM-1, whereas no differences were observed for kWh/MT between 0% and 30% when using PM-2. A DDGS × PM interaction (P = 0.019) was observed for kWh/MT standard deviation (STD). Diets containing DDGS increased STD compared to the control when pelleted with PM-2; however, there was no evidence of difference between the DDGS and control diets when pelleted with PM-1. There was an AZO × DDGS interaction (P &lt; 0.05) for kWh/ton STD. No differences were observed in kWh/ton STD when pelleting corn–soy diets with or without AZO while AZO reduced kWh/ton STD in 30% DDGS diets. Diets containing AZO had reduced (P &lt; 0.05) kWh/MT and pellet durability index (PDI) compared to diets pelleted without AZO. PDI was improved (P &lt; 0.05) for diets containing DDGS. For experiment 2, diets containing AZO had increased (P &lt; 0.05) PM production rate compared to those without AZO. The inclusion of 30% DDGS reduced (P &lt; 0.05) PM production rate compared to the corn–soy diet. There was a tendency for an AZO × DDGS interaction (P = 0.083) for PDI. Azomite inclusion to corn–soy diets reduced PDI while there was no evidence of difference in diets containing DDGS. In conclusion, the addition of 0.25% AZO to the diet improved PM efficiency; however, this potentially leads to a reduced PDI depending on diet type and PM settings.
Vitamin D Supplementation in Congenital Ichthyosis: A Case Series
Authors: Hemrajani Priyanka , Sharma Mona , B.C. Sharath Kumar , Somkuwar Rajesh 
Published: July 2024

ABSTRACT
Ichthyosis is a group of genetic keratinization disorders characterized by excessive scaling that is associated with hyperproliferative epidermis and/or cellular retention. Whereas normal outer epidermis thickness is 25 μm, it can be 10-fold greater in patients with ichthyosis. As a result, photoactivation of 7-dehydrocholesterol is impaired, causing systemic vitamin D deficiency.
In this case series, 25 patients with congenital ichthyosis with vitamin D deficiency (<10 ng/mL) were supplemented with 60,000 IU of vitamin D3 for 10 days followed by daily allowance of 400 to 600 IU of vitamin D3 and 40 mg/kg per day of elemental calcium. The authors assessed improvement in cutaneous scaling and body and tested patients’ blood and urine samples at day 1, day 10, 1 month, and 3 months. They also documented patients’ Dermatology Life Quality Index score before and after treatment.
All patients had normal vitamin D levels; supplementation was discontinued for two patients who reached a level of 100 ng/mL within 10 days. Subjective improvement of symptoms (dryness of the skin, allergic rhinitis, tightness of the skin, and scaling) was observed by both the provider and the patients. There was remarkable improvement in symptoms of severe ichthyosis such as lamellar ichthyosis (tightness of the skin and scaling). Marked improvement in Dermatology Life Quality Index score was also noted.
This case series demonstrated remarkable symptomatic relief with vitamin D supplementation in patients with congenital ichthyosis; however, additional research should be conducted with larger sample sizes to support these findings.
Decreasing Intraoperative Skin Damage in Prone-Position Surgeries
Authors: Bates-Jensen Barbara M. , Crocker Jessica , Nguyen Vicky , Robertson Lauren , Nourmand Deborah , Chirila Emily , Laayouni Mohamed , Offendel Ofelia , Peng Kelly , Romero Stephanie Anne , Fulgentes Gerry , McCreath Heather E. 
Published: July 2024

ABSTRACT

OBJECTIVE
To determine if subepidermal moisture (SEM) measures help detect and prevent intraoperative acquired pressure injuries (IAPIs) for prone-position surgery.

METHODS
In this clinical trial of patients (n = 39 preintervention, n = 48 intervention, 100 historical control) undergoing prone-position surgery, researchers examined the use of multidimensionally flexible silicone foam (MFSF) dressings applied preoperatively to patients’ face, chest, and iliac crests. Visual skin assessments and SEM measures were obtained preoperatively, postoperatively, and daily for up to 5 days or until discharge. Electronic health record review included demographic, medical, and surgery data.

RESULTS
Of the 187 total participants, 76 (41%) were women. Participants’ mean age was 61.0 ± 15.0 years, and 9.6% were Hispanic (n = 18), 9.6% were Asian (n = 18), 6.9% were Black or African American (n = 13), and 73.8% were White (n = 138). Participants had a mean Scott-Triggers IAPI risk score of 1.5 ± 1.1. Among those with no erythema preoperatively, fewer intervention participants exhibited postoperative erythema on their face and chest than did preintervention participants. Further, fewer intervention participants had SEM-defined IAPIs at all locations in comparison with preintervention participants. The MFSF dressings overcame IAPI risk factors of surgery length, skin tone, and body mass index with fewer IAPIs in intervention participants.

CONCLUSIONS
Patients undergoing prone-position surgeries developed fewer IAPIs, and SEM measures indicated no damage when MFSF dressings were applied to sites preoperatively. The SEM measures detected more damage than visual assessment.
Blistering Disorders of the Foot
Authors: Swoboda Laura 
Published: July 2024

ABSTRACT
Multiple pathophysiologic and biomolecular processes lead to bullae, including disruption of adhesion molecules, accumulation of cell injury, and traumatic injury. Blistering disorders of the foot can cause symptoms such as pruritus, pain, and drainage and significantly impact quality of life. Microbiologic and histopathologic examination of tissue specimens should be considered for concerns regarding atypical etiology.
This retrospective case series describes patients seen in a community hospital outpatient wound center in southeastern Wisconsin between January 2021 and June 2023 for atypical blistering disorders of the foot. The cases herein describe the history, clinical presentation, and treatment of three atypical blistering disorders of the foot. An 86-year-old man presented complaining of intensely pruritic blistering lesions to both feet. Histopathologic findings indicated eosinophilic infiltrate, and the patient was treated for an eosinophilic drug reaction. A 65-year-old man presented complaining of multiple painful blisters to the plantar aspect of both feet. Histopathologic examination of unroofed blister indicated bullous tinea. Finally, a 44-year-old man with long-standing type 1 diabetes presented complaining of a several-week history of a single blister to his anterior right foot of unknown etiology. The patient was diagnosed with bullosis diabeticorum.
Blistering disorders of the foot are diagnostic challenges; diagnostic clarity is assisted by thorough history, clinical presentation, treatment response, microbial analysis, and histopathologic findings.
Predicting within-city spatiotemporal variations in daily median outdoor ultrafine particle number concentrations and size in Montreal and Toronto, Canada
Authors: Venuta Alessya , Lloyd Marshall , Ganji Arman , Xu Junshi , Simon Leora , Zhang Mingqian , Saeedi Milad , Yamanouchi Shoma , Lavigne Eric , Hatzopoulou Marianne , Weichenthal Scott 
Published: July 2024

Background:
Epidemiological evidence suggests that long-term exposure to outdoor ultrafine particles (UFPs, <0.1 μm) may have important human health impacts. However, less is known about the acute health impacts of these pollutants as few models are available to estimate daily within-city spatiotemporal variations in outdoor UFPs.

Methods:
Several machine learning approaches (i.e., generalized additive models, random forest models, and extreme gradient boosting) were used to predict daily spatiotemporal variations in outdoor UFPs (number concentration and size) across Montreal and Toronto, Canada using a large database of mobile monitoring measurements. Separate models were developed for each city and all models were evaluated using a 10-fold cross-validation procedure.

Results:
In total, our models were based on measurements from 12,705 road segments in Montreal and 10,929 road segments in Toronto. Daily median outdoor UFP number concentrations varied substantially across both cities with 1st–99th percentiles ranging from 1389 to 181,672 in Montreal and 2472 to 118,544 in Toronto. Outdoor UFP size tended to be smaller in Montreal (mean [SD]: 34 nm [15]) than in Toronto (mean [SD]: 44 nm [25]). Extreme gradient boosting models performed best and explained the majority of spatiotemporal variations in outdoor UFP number concentrations (Montreal, R
2: 0.727; Toronto, R
2: 0.723) and UFP size (Montreal, R
2: 0.823; Toronto, R
2: 0.898) with slopes close to one and intercepts close to zero for relationships between measured and predicted values.

Conclusion:
These new models will be applied in future epidemiological studies examining the acute health impacts of outdoor UFPs in Canada’s two largest cities.
Estimating the economic impact of comorbidities in patients with MASH and defining high-cost burden in patients with noncirrhotic MASH
Authors: Younossi Zobair M. , Mangla Kamal Kant , Chandramouli Abhishek Shankar , Lazarus Jeffrey V. 
Published: July 2024

Background:
Metabolic dysfunction–associated steatohepatitis (MASH) is associated with high health care costs. This US study investigated the economic burden of MASH, particularly in patients without cirrhosis, and the impact of comorbidities on health care costs.

Methods:
This retrospective, observational study used data from patients diagnosed with MASH aged ≥18 years from October 2015 to March 2022 (IQVIA Ambulatory electronic medical record-US). Patients were stratified by the absence or presence of cirrhosis. Primary outcomes included baseline characteristics and annualized total health care cost after MASH diagnosis during follow-up. In addition, this study defined high costs for the MASH population and identified patient characteristics associated with increased health care costs among those without cirrhosis.

Results:
Overall, 16,919 patients (14,885 without cirrhosis and 2034 with cirrhosis) were included in the analysis. The prevalence of comorbidities was high in both groups; annual total health care costs were higher in patients with cirrhosis. Patients with a high-cost burden (threshold defined using the United States national estimated annual health care expenditure of $13,555) had a higher prevalence of comorbidities and were prescribed more cardiovascular medications. MASH diagnosis was associated with an increase in cost, largely driven by inpatient costs. In patients without cirrhosis, an increase in cost following MASH diagnosis was associated with the presence and burden of comorbidities and cardiovascular medication utilization.

Conclusions:
Comorbidities, such as cardiovascular disease and type 2 diabetes, are associated with a higher cost burden and may be aggravated by MASH. Prioritization and active management may benefit patients without cirrhosis with these comorbidities. Clinical care should focus on preventing progression to cirrhosis and managing high-burden comorbidities.
Connecting Practice to Data: Implementation Strategies to Increase Collection of Core Outcome Measures in an Inpatient Rehabilitation Facility
Authors: Zalanowski Stacey , Riley Erin , Spaulding Abigail , Hansen Elizabeth , Clooney Debra , Modoono Caitriona , Evans Emily 
Published: July 2024

Objective:
To describe a quality improvement project aimed at increasing collection of a “Core Set” of functional outcome measures in an inpatient rehabilitation facility (IRF), characterize implementation strategies used across 4 study phases, and evaluate program adoption and maintenance.

Setting:
A 30-bed brain injury unit of a 132-bed IRF.

Participants:
Participants included physical therapists (5 full-time, 2 part-time, and 30 hourly as needed) and 764 individuals with traumatic brain injury (TBI) who received care during the project period.

Design:
In this descriptive observational study, we operationalize implementation strategies selected for 4 project phases: Exploration, Preparation, Implementation, and Sustainment. We define each implementation strategy using the Expert Recommendations for Implementing Change and report on program adoption and maintenance.

Main Measures:
Adoption (proportion of TBI-related admissions with completed outcome measures) and maintenance (adoption over 4 years).

Results:
Preparation phase strategies focused on local adaptations, education, environmental preparation, and collaboration with informatics. Implementation phase strategies included reminders, feedback, champions, and iterative adjustments. Sustainment strategies focused on integration into standard practice. Adoption increased postinitiation for all measures except one. Despite improvements, a notable portion of measures remained incomplete. Increases in outcome measure collection were maintained for 2 to 4 years, but a significant decline in paired admission and discharge scores suggests a reduced ability to monitor change over time.

Conclusions:
This study provides an example of a clinically driven quality improvement project and selected implementation strategies used to increase the collection of standard outcome measures in IRF. By leveraging the Expert Recommendations for Implementing Change framework, we aim to enhance comparability with similar efforts elsewhere. The results demonstrate the program’s successes and challenges, highlighting the need for interdisciplinary clinical and research collaboration to support the translation of knowledge between research and clinical practice and inform meaningful improvements in care across TBI rehabilitation.
Intraoperative goal-directed fluid management and postoperative brain edema in patients having high-grade gliomas resections: a randomized trial
Authors: Liu Xiaoyuan , Zhang Xingyue , Fan Yifang , Wang Bo , Wang Jie , Zeng Min , Li Shu , Shen Mi , Zhang Wei , Sessler Daniel I. , Peng Yuming 
Published: July 2024

Introduction:
Patients with high-grade gliomas often have severe brain edema. Goal-directed fluid management protects neurological function, but whether reduces postoperative brain edema remains unknown.

Methods:
Patients having elective resection of supratentorial malignant gliomas were randomly assigned to goal-directed versus routine fluid management. Patients assigned to goal-directed management group were given 3 ml kg-1 hydroxyethyl starch solution when stroke volume variation exceeded 15% for 5 min. Fluid was managed per routine by attending anesthesiologists in reference patients. The primary outcome was cerebral edema volume after surgery as assessed by computerized tomography.

Results:
A total of 480 eligible patients were randomly assigned to the goal-directed (n = 240) or the routine fluid management group (n = 240). The amounts of crystalloid (5.4 vs. 7.0 ml kg-1 hour-1, P < 0.001), colloid (1.1 vs. 1.7 ml kg-1 hour-1, P < 0.001), and overall fluid balance (0.3 vs. 1.9 ml kg-1 hour-1, P < 0.001) were significantly lower in goal-directed fluid management group. There was no significant difference in postoperative brain edema volume between groups (36.0 vs. 38.9 cm3, mean difference: 0.18 cm3, 95% CI: −5.7 to 5.9). Goal-directed patients had lower intraoperative dural tension (risk ratio: 0.63, 95% CI: 0.50–0.80, P < 0.001). There was no significant difference in Karnofsky Performance Status between the two groups at 30 days after surgery.

Conclusions:
Goal-directed fluid therapy substantially reduced intravenous fluid volumes, but did not reduce postoperative brain edema in patients having brain tumor resections.
A Brief but Spectacular Take: Reflecting on Professionalism by Student Physical Therapists
Authors: Stickley Lois A. 
Published: July 2024

Background and Purpose.
Professionalism is an abstract concept that requires reflection for students to generate personal meaning and application. It should be taught explicitly within the academic part of a professional physical therapist education program. The purpose of this case report was to present one unique strategy to increase reflection about professionalism.

Case Description.
Forty-four students enrolled in the first semester of a professional physical therapist education program participated in the case report. All were enrolled in a 1-credit hour course, Professional Issues, in which they developed a 2- to 3-minute video presenting their brief but spectacular take on various professional issues. Students responded in an online discussion tool to 2 of their colleagues' videos, developing a rich conversation. An optional 11-item survey about student satisfaction with the assignment was distributed electronically. A 4-point Likert scale was used for 10 items with the 11 being open ended.

Outcomes.
An analysis of the video presentations identified 4 themes: diversity, equity, and inclusion; self-care; core values; and patient management. Discussions were positive, professional, and encouraging. The optional survey had a 45% response rate. The medians for individual items ranged from 3 (6 items) to 4 (3 items).

Conclusions.
Reflection is essential to provide meaning in the learning process. Creating a video reflection that allowed students to describe their passion for the profession and then to discuss it in an online format was a unique teaching/learning activity. The concept of professionalism was successfully explored using the assignment that was well-received, and most students found it beneficial to their personal growth.
New Pathways in Syphilis Vaccine Development
Authors: Liu Andy , Giacani Lorenzo , Hawley Kelly L. , Cameron Caroline E. , Seña Arlene C. , Konda Kelika A. , Radolf Justin D. , Klausner Jeffrey D. 
Published: July 2024

Abstract
The New Pathways in Syphilis Vaccine Development meeting was held before the start of the STI & HIV 2023 World Congress as a pre-meeting symposium to highlight recent advances in the development of an effective syphilis vaccine and discuss the challenges still faced by investigators. Internationally renowned public health officials, clinical investigators, and basic researchers from academia, government, and community-based organizations met on July 24, 2023, in Chicago, Illinois. Four speakers discussed key research findings in syphilis vaccine development, which included antigen selection, identification of epitopes associated with protective immunity, and delivery platforms, with great emphasis on development of chimeric antigens. Significant progress was also shown on the elucidation of Treponema pallidum genomes from virtually all continents to assess the diversity in vaccine candidates of the syphilis spirochete.
Patient-Engagement Health Information Technology and Quality Process Outcomes in Federally Qualified Health Centers
Authors: Choi Seongwon , Powers Thomas 
Published: July 2024

Background and Objectives:
Health information technology (HIT) for patient-engagement can positively influence the quality and efficiency of health care delivery. Although this topic is of significant importance, it has not been fully addressed in the federally qualified health center (FQHC) context. This research investigates the relationship between the level of patient-engagement HIT and FQHC preventive health care quality outcomes.

Method:
Based on the Uniform Data System (UDS), this study employed multivariable regression analysis to investigate the association between the level of patient-engagement HIT and FQHC preventive health care quality outcomes. FQHCs were placed in 4 mutually exclusive groups based on the level of FQHC use of patient-engagement HIT.

Results:
The results indicate that compared with the most comprehensive patient-engagement HIT at FQHCs, less comprehensive patient-engagement HIT was associated with lower rates of preventive care provision.

Conclusions:
Comprehensive patient-engagement HIT across FQHCs may improve preventive health care quality outcomes. The results support policy incentives for FQHCs with less comprehensive levels of patient-engagement HIT to foster improved preventive care for their patients.