bluuebunny/crossref_metadata_2025_split huggingface dataset:
776 Importance of Adequate Nutrition Support in Severely Burned Patients
Authors: Stone Amanda 
Published: May 2023

Abstract

Introduction
The importance of optimal nutrition for burned patients has been well established through research. Provision of adequate nutrition is believed to improve healing outcomes, reduce complications and overall length of stay for burned patients. Enteral Nutrition (EN) support is the favored method of feeding for a severely burned patient, however timing of initiation of feeding and ability to meet estimated nutritional needs throughout a hospital stay still needs to be further established. The objective of this study was to evaluate not only the timing of initiation of EN for severely burned patients, but also the adequacy of the nutritional provisions the patients received.

Methods
Patients admitted to a Regional Burn Center with a burn ≥20% TBSA, intubated and started on EN support were eligible for the inclusion in this retrospective review. Specific variables that were assessed included time for burn team to consult Registered Dietitian (RD), time from consult until RD assessed patient, time from admission to initiation per order, total tube feed volume (in mL) actually infused per RN documentation, and percentage of EN received compared to order.

Results
Forty-two patients were included in this retrospective review. All patients had EN initiated within 24 hours of admission. Out of twenty-five patients that specific EN initiation time (by the minute) was able to be identified, the average time for EN to start was 9.5 hours. Average time for enteral nutrition to reach RD recommended goal rate was 26.2 hours, with 59% of patients reaching goal rate in ≤24 hours. Average amount of EN formula (in mL) patients actually received compared to what was ordered was 80.9%. Some complications observed for those patients whose EN did not reach goal rate in ≤24 hours or those who received a lower percentage of EN formula included difficulties with GI tolerance, high residuals, and incidence of ileus. However, these complications were only seen in 19% of patients included in the study.

Conclusions
The average time for initiation of EN support was within the SCCM/ASPEN guidelines for the critically ill patient. Additionally, more than half the patients reached the RD recommended EN goal rate in ≤24 hours. The investigator found that early initiation of EN and aggressive advancement to goal, as tolerated, to be safe.

Applicability of Research to Practice
A standard of practice for timing of EN initiation and advancing to goal would be beneficial, with possibility of reaching EN goal rates faster helping to increase the provisions of total EN received during admission and therefore closer meeting estimated nutritional needs. The effects of adequate nutrition in relation to overall burn healing / graft acceptance, complications, length of stay and mortality all warrant further studies prior to implementation of early EN/aggressive advancement to goal into practice.
777 Food Swamps, Food Deserts, and Wound Healing in Burn Patients at an Urban Academic Center
Authors: Donovan Brienne , Wiese Daniel , Wu Jingwei , Rae Lisa , Anderson Jeffrey , Henry Kevin 
Published: May 2023

Abstract

Introduction
Many victims of burn injury live in food deserts or food swamps. Food deserts are low-income areas with minimal or no access to nutritious foods while food swamps are areas with much greater access to unhealthy, high-calorie foods. We examined the relationship between residency in a food swamp or food desert by census tract and wound healing.

Methods
We performed a retrospective review of burn patients who underwent split-thickness skin grafting at an ABA verified urban academic burn center between September 2018 and August 2022. Inclusion criteria were burn area less than 20% total body surface area (TBSA), age ≥ 18, and single operation for split-thickness skin grafting. Patient residential locations were used in conjunction with Modified Retail Food Environment Index (mREFI) data to classify residency in food deserts and food swamps. The primary outcome was time to donor site healing. Time-to-event Cox proportional regression analysis was performed to evaluate risk factors for poor wound healing.

Results
A total of 238 patients were included in the study, of whom 110 (46.2%) were female and 128 (53.8%) were male. Mean age was 48, BMI was 28.5, TBSA 3.7, and average days to donor site healing was 26. In categorizing residency by mREFI data, 45 (18.9%) individuals had good access, 11 (4.6%) resided in food deserts, and 182 (76.5%) resided in food swamps. Although time to healing was longer on average in the food desert (25.8 days) and food swamp (26.4 days) groups compared to the group with good access to food within ½ mile (22.9 days), this difference was not statistically significant. Not having diabetes was found to be associated with shorter time to wound healing (HR=1.68, 95% CI [1.15, 2.47], p=0.007). Living in a good access area was associated with faster wound healing (compared to swamp: HR=1.23, 95% CI [0.86, 1.75], compare to desert: HR=1.06, 95% CI [0.51, 2.20]), however this association was not statistically significant.

Conclusions
Residency in a food swamp or food desert does not significantly influence time to healing in burn injured patients. However, not having diabetes was associated with a shorter time to wound healing. This is the first study to compare residency in food deserts or food swamps by census tract level data with time to wound healing in an urban burn population.

Applicability of Research to Practice
Wound healing is a complex and important process known to be affected by malnutrition. Our data contributes to the current body of literature on nutrition and wound healing.
778 Epidemiology of Food Access in an Urban Burn Population
Authors: Donovan Brienne , Wiese Daniel , Wu Jingwei , Henry Kevin , Rae Lisa , Anderson Jeffrey 
Published: May 2023

Abstract

Introduction
Poverty is a known risk factor for burn injury and is associated with residency in food deserts and food swamps. Food deserts are areas with low or no access to nutritious, healthy foods while food swamps are areas with much higher access to high-calorie, unhealthy foods than to foods with good nutritious value. The purpose of our investigation was to determine the prevalence of residency in food deserts and food swamps in burn patients evaluated at an urban academic center and to determine the relationship between residency in these areas and the presence of patient comorbidities.

Methods
We performed a retrospective chart review of patients with burn injuries seen at an ABA verified urban academic center between January 2016 and January 2022. All patients over age 18 seen in the emergency department or admitted to the burn service were included in the study. Patient residential locations were used in conjunction with the Modified Retail Food Environment Index (mREFI) data to classify residency in food deserts and food swamps. Patient demographics and comorbidities were also recorded. Chi square and ANOVA analyses were completed to determine differences between the food desert, food swamp, and good access groups.

Results
A total of 3064 subjects were included in the study, of these 1370 (44.7%) were female and 1694 (55.3%) were male. In terms of access, 96 (3.1%) individuals lived in food deserts, 477 (15.6%) lived in good access areas, and 2490 (81.3%) resided in food swamps. This difference was found to be statistically significant (p &lt; 0.0001). Age, sex, and BMI did not differ significantly between the three groups. A significantly higher percentage of food swamp residents had a diagnosis of diabetes (15.0%) as compared to subjects living in good food access areas (11.7%) and food deserts (8.3%), (p &lt; 0.043). Hypertension was also found to be more prevalent in food swamps (24.8%) than food deserts (20.8%) and good access areas (19.3%), (p &lt; 0.028). Finally, smoking was more common in food swamps (45.3%) than good access areas (40.4%) and food deserts (27.9%), (p &lt; 0.0028).

Conclusions
A majority of burn patients reside in food swamps and residency in these areas is associated with a higher prevalence of hypertension, diabetes, and tobacco smoking. This is the first study to investigate the epidemiology of food access in an urban burn population.

Applicability of Research to Practice
Nutrition is known to be important to overall health and to wound healing in the setting of an acute injury. Our data contributes to the current literature on the role of nutrition in burns.
A revision of JPOS/JASCC clinical guidelines for delirium in adult cancer patients: a summary of recommendation statements
Authors: Matsuda Yoshinobu , Tanimukai Hitoshi , Inoue Shinichiro , Hirayama Takatoshi , Kanno Yusuke , Kitaura Yuichi , Inada Shuji , Sugano Koji , Yoshimura Masafumi , Harashima Saki , Wada Saho , Hasegawa Takaaki , Okamoto Yoshiaki , Dotani Chikako , Takeuchi Mari , Kako Jun , Sadahiro Ryoichi , Kishi Yasuhiro , Uchida Megumi , Ogawa Asao , Inagaki Masatoshi , Okuyama Toru 
Published: May 2023

Abstract

Objective
The Japanese Psycho-Oncology Society and the Japanese Association of Supportive Care in Cancer have recently revised the clinical practice guidelines for delirium in adult cancer patients. This article reports the process of developing the revised guidelines and summarizes the recommendations made.

Methods
The guidelines were developed in accordance with the Medical Information Network Distribution Service creation procedures. The guideline development group, consisting of multi-disciplinary members, created three new clinical questions: non-pharmacological intervention and antipsychotics for the prevention of delirium and trazodone for the management of delirium. In addition, systematic reviews of nine existing clinical questions have been updated. Two independent reviewers reviewed the proposed articles. The certainty of evidence and the strength of the recommendations were graded using the grading system developed by the Medical Information Network Distribution Service, following the concept of The Grading of Recommendations Assessment, Development, and Evaluation system. The modified Delphi method was used to validate the recommended statements.

Results
This article provides a compendium of the recommendations along with their rationales, as well as a short summary.

Conclusions
These revised guidelines will be useful for the prevention, assessment and management of delirium in adult cancer patients in Japan.
BRSK2 in pancreatic β cells promotes hyperinsulinemia-coupled insulin resistance and its genetic variants are associated with human type 2 diabetes
Authors: Xu Rufeng , Wang Kaiyuan , Yao Zhengjian , Zhang Yan , Jin Li , Pang Jing , Zhou Yuncai , Wang Kai , Liu Dechen , Zhang Yaqin , Sun Peng , Wang Fuqiang , Chang Xiaoai , Liu Tengli , Wang Shusen , Zhang Yalin , Lin Shuyong , Hu Cheng , Zhu Yunxia , Han Xiao 
Published: May 2023

Abstract
Brain-specific serine/threonine-protein kinase 2 (BRSK2) plays critical roles in insulin secretion and β-cell biology. However, whether BRSK2 is associated with human type 2 diabetes mellitus (T2DM) has not been determined. Here, we report that BRSK2 genetic variants are closely related to worsening glucose metabolism due to hyperinsulinemia and insulin resistance in the Chinese population. BRSK2 protein levels are significantly elevated in β cells from T2DM patients and high-fat diet (HFD)-fed mice due to enhanced protein stability. Mice with inducible β-cell-specific Brsk2 knockout (βKO) exhibit normal metabolism with a high potential for insulin secretion under chow-diet conditions. Moreover, βKO mice are protected from HFD-induced hyperinsulinemia, obesity, insulin resistance, and glucose intolerance. Conversely, gain-of-function BRSK2 in mature β cells reversibly triggers hyperglycemia due to β-cell hypersecretion-coupled insulin resistance. Mechanistically, BRSK2 senses lipid signals and induces basal insulin secretion in a kinase-dependent manner. The enhanced basal insulin secretion drives insulin resistance and β-cell exhaustion and thus the onset of T2DM in mice fed an HFD or with gain-of-function BRSK2 in β cells. These findings reveal that BRSK2 links hyperinsulinemia to systematic insulin resistance via interplay between β cells and insulin-sensitive tissues in the populations carrying human genetic variants or under nutrient-overload conditions.
Introduction to the suite: Symposium on Philip Kitcher’s The Main Enterprise of the World: Rethinking Education
Authors: Bakhurst David 
Published: May 2023

Abstract
This paper introduces a suite of articles devoted to Philip Kitcher’s The Main Enterprise of the World: Rethinking Education (Oxford University Press, 2021). The suite opens with a paper by Kitcher, which presents the central themes of his important book. This is followed by an assessment of the work as whole by John White, and four commentaries discussing in detail various aspects of Kitcher’s position by Ben Kotzee (on science education), Alexis Gibbs (on arts education), Sheron Fraser-Burgess (on deliberative democracy and inclusivity), and Nigel Tubbs (on Kitcher’s ‘Deweyan Society’). In the final contribution, Kitcher replies to his critics. The introduction sketches the character of Kitcher’s project and comments on his pragmatist method.
An Electronic Algorithm to Identify Vancomycin-Associated Acute Kidney Injury
Authors: Cherian Jerald P , Jones George F , Bachina Preetham , Helsel Taylor , Virk Zunaira , Lee Jae Hyoung , Fiawoo Suiyini , Salinas Alejandra , Dzintars Kate , O'Shaughnessy Elizabeth , Gopinath Ramya , Tamma Pranita D , Cosgrove Sara E , Klein Eili Y 
Published: May 2023

Abstract

Background
The burden of vancomycin-associated acute kidney injury (V-AKI) is unclear because it is not systematically monitored. The objective of this study was to develop and validate an electronic algorithm to identify cases of V-AKI and to determine its incidence.

Methods
Adults and children admitted to 1 of 5 health system hospitals from January 2018 to December 2019 who received at least 1 dose of intravenous (IV) vancomycin were included. A subset of charts was reviewed using a V-AKI assessment framework to classify cases as unlikely, possible, or probable events. Based on review, an electronic algorithm was developed and then validated using another subset of charts. Percentage agreement and kappa coefficients were calculated. Sensitivity and specificity were determined at various cutoffs, using chart review as the reference standard. For courses ≥48 hours, the incidence of possible or probable V-AKI events was assessed.

Results
The algorithm was developed using 494 cases and validated using 200 cases. The percentage agreement between the electronic algorithm and chart review was 92.5% and the weighted kappa was 0.95. The electronic algorithm was 89.7% sensitive and 98.2% specific in detecting possible or probable V-AKI events. For the 11 073 courses of ≥48 hours of vancomycin among 8963 patients, the incidence of possible or probable V-AKI events was 14.0%; the V-AKI incidence rate was 22.8 per 1000 days of IV vancomycin therapy.

Conclusions
An electronic algorithm demonstrated substantial agreement with chart review and had excellent sensitivity and specificity in detecting possible or probable V-AKI events. The electronic algorithm may be useful for informing future interventions to reduce V-AKI.
Screen time and preschool children: Promoting health and development in a digital world
Authors: Ponti Michelle 
Published: May 2023

Abstract
COVID-19 transformed the family media environment and spurred research on the effects of screen media exposure and use on young children. This update of a 2017 CPS statement re-examines the potential benefits and risks of screen media in children younger than 5 years, with focus on developmental, psychosocial, and physical health. Four evidence-based principles—minimizing, mitigating, mindfully using, and modelling healthy use of screens—continue to guide children’s early experience with a rapidly changing media landscape. Knowing how young children learn and develop informs best practice for health care providers and early years professionals (e.g., early childhood educators, child care providers). Anticipatory guidance should now include child and family screen use in (and beyond) pandemic conditions.
Fiduciary duties and the 1985 Hague Trusts Convention
Authors: Van Der Veen Rachel 
Published: May 2023

Abstract
This article considers the ongoing work and application of the Hague Conference on Private International Law (HCCH) Convention of 1 July 1985 on the Law Applicable to Trusts and on their Recognition (Trusts Convention). The article analyses fiduciary duties found across the trusts legislation and draft legislation of selected common and civil law jurisdictions. The commonalities of fiduciary duties across jurisdictions are presented here to provide a foundation for discussion among legal experts regarding their possible future inclusion in the HCCH Trusts Convention or in supporting materials developed by the HCCH as a list of fiduciary duties. Such a list of duties would foster certainty and predictability for those involved in legal relationships created by trusts.
An advanced sequence clustering and designation workflow reveals the enzootic maintenance of a dominant West Nile virus subclade in Germany
Authors: Santos Pauline Dianne , Günther Anne , Keller Markus , Homeier-Bachmann Timo , Groschup Martin H , Beer Martin , Höper Dirk , Ziegler Ute 
Published: May 2023

Abstract
West Nile virus (WNV) is the most widespread arthropod-borne (arbo) virus and the primary cause of arboviral encephalitis globally. Members of WNV species genetically diverged and are classified into different hierarchical groups below species rank. However, the demarcation criteria for allocating WNV sequences into these groups remain individual and inconsistent, and the use of names for different levels of the hierarchical levels is unstructured. In order to have an objective and comprehensible grouping of WNV sequences, we developed an advanced grouping workflow using the ‘affinity propagation clustering’ algorithm and newly included the ‘agglomerative hierarchical clustering’ algorithm for the allocation of WNV sequences into different groups below species rank. In addition, we propose to use a fixed set of terms for the hierarchical naming of WNV below species level and a clear decimal numbering system to label the determined groups. For validation, we applied the refined workflow to WNV sequences that have been previously grouped into various lineages, clades, and clusters in other studies. Although our workflow regrouped some WNV sequences, overall, it generally corresponds with previous groupings. We employed our novel approach to the sequences from the WNV circulation in Germany 2020, primarily from WNV-infected birds and horses. Besides two newly defined minor (sub)clusters comprising only three sequences each, Subcluster 2.5.3.4.3c was the predominant WNV sequence group detected in Germany from 2018 to 2020. This predominant subcluster was also associated with at least five human WNV infections in 2019–20. In summary, our analyses imply that the genetic diversity of the WNV population in Germany is shaped by enzootic maintenance of the dominant WNV subcluster accompanied by sporadic incursions of other rare clusters and subclusters. Moreover, we show that our refined approach for sequence grouping yields meaningful results. Although we primarily aimed at a more detailed WNV classification, the presented workflow can also be applied to the objective genotyping of other virus species.
Identification of nurse shark VNAR single‐domain antibodies targeting the spike S2 subunit of SARS‐CoV‐2
Authors: Buffington Jesse , Duan Zhijian , Kwon Hyung Joon , Hong Jessica , Li Dan , Feng Mingqian , Xie Hang , Ho Mitchell 
Published: May 2023

AbstractSARS‐CoV‐2 is the etiological agent of the COVID‐19 pandemic. Antibody‐based therapeutics targeting the spike protein, specifically the S1 subunit or the receptor binding domain (RBD) of SARS‐CoV‐2, have gained attention due to their clinical efficacy in treating patients diagnosed with COVID‐19. An alternative to conventional antibody therapeutics is the use of shark new antigen variable receptor domain (VNAR) antibodies. VNARs are small (<15 kDa) and can reach deep into the pockets or grooves of the target antigen. Here, we have isolated 53 VNARs that bind to the S2 subunit by phage panning from a naïve nurse shark VNAR phage display library constructed in our laboratory. Among those binders, S2A9 showed the best neutralization activity against the original pseudotyped SARS‐CoV‐2 virus. Several binders, including S2A9, showed cross‐reactivity against S2 subunits from other β coronaviruses. Furthermore, S2A9 showed neutralization activity against all variants of concern (VOCs) from alpha to omicron (including BA1, BA2, BA4, and BA5) in both pseudovirus and live virus neutralization assays. Our findings suggest that S2A9 could be a promising lead molecule for the development of broadly neutralizing antibodies against SARS‐CoV‐2 and emerging variants. The nurse shark VNAR phage library offers a novel platform that can be used to rapidly isolate single‐domain antibodies against emerging viral pathogens.
The biomechanics of four guided growth plates
Authors: Wilson Nicholas , Litsky Alan S. , Iobst Christopher A. 
Published: May 2023

Background:
Guided growth using the eight-plate is the most common method to correct angular deformities in children. We compared the properties of four plate constructs (two-hole guided-growth plates, four-hole guided-growth plates, locking guided-growth plates, and one-third tubular plates) using a three-point bending model.

Methods:
A three-point bending model was constructed to test strength of four plates. An osteotomy was made in a Sawbones Cylinder. The plate was then fixed across the osteotomy site using the appropriate screws designed for the plate. A 5 N preload was applied, and a linearly applied force was applied under displacement control. Constructs were loaded to failure.

Results:
For an angular correction of 8.5 degrees, the four-hole guided-growth plates required the most force (40.9 N) followed by two-hole guided-growth plates (36.6 N). Locking plates and one-third tubular plates required less force to achieve the same correction (28.0 N and 23.0 N P<0.001), respectively. The four-hole plate was the stiffest construct (1.87 N/mm). Load to failure for the four-hole plates (46.0 N), two-hole plates (42.8 N). locking plates (32.1 N), and one-third tubular plates (25.5 P<0.001) followed similar trends as the force required for angular correction, with the four-hole plate requiring the most force.

Conclusions:
Despite the addition of two extra screws in the four-hole plate, this construct was only 10% stiffer than the two-hole plate. There is limited benefit to the use of a four-hole plate over a two-hole plate. The one-third tubular plate had the lowest load to failure of the four tested constructs.

Level of Evidence:
NA (biomechanical)