bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effects of supplementation rate of an extruded dried distillers’ grains cube fed to growing heifers on voluntary intake and digestibility of bermudagrass hay
Authors: Adams Jordan M , Robe Jeff , Grigsby Zane , Rathert-Williams Abigail , Major Mike , Lalman David L , Foote Andrew P , Tedeschi Luis O , Beck Paul A 
Published: March 2022

Abstract
Our objectives were to 1) investigate the difference in chemical composition and disappearance kinetics between loose dried distillers’ grains (DDG) and extruded DDG cubes and 2) evaluate the effects of supplementation rate of extruded DDG cubes on voluntary dry matter intake (DMI), rate and extent of digestibility, and blood parameters of growing beef heifers offered ad libitum bermudagrass (Cynodon dactylon) hay. To characterize the changes in chemical composition during the extrusion process, loose and extruded DDG were evaluated via near-infrared reflectance spectroscopy, and dry matter (DM) disappearance kinetics were evaluated via time point in situ incubations. Extruded DDG cubes had greater (P ≤ 0.01) contents of fat, neutral detergent insoluble crude protein, and total digestible nutrients, but lower (P ≤ 0.01) neutral and acid detergent fiber than loose DDG. Additionally, the DM of extruded DDG cubes was more immediately soluble (P &lt; 0.01), had greater (P &lt; 0.01) effective degradability and lag time, and tended (P = 0.07) to have a greater disappearance rate than loose DDG. In the 29-d supplementation rate study, 23 Charolais-cross heifers were randomly assigned to one of four supplemental treatments: 1) control, no supplement; 2) low, 0.90 kg DDG cubes per d; 3) intermediate, 1.81 kg DDG cubes per d; or 4) high, 3.62 kg DDG cubes per d. Titanium dioxide was used as an external marker to estimate fecal output and particulate passage rate (Kp). Blood was collected from each animal to determine supplementation effects on blood metabolites. Indigestible neutral detergent fiber was used as an internal marker to assess the rate and extent of hay and diet DM digestibility (DMD). Increasing supplementation rate increased Kp and total diet DMI linearly (P &lt; 0.01), yet linearly decreased (P &lt; 0.01) hay DMI. Hay DMD decreased quadratically (P &lt; 0.01), while total diet DMD increased linearly (P &lt; 0.01) with increased DDG cube inclusion. Supplemented heifers had greater (P = 0.07) blood urea nitrogen concentrations than control animals 4 h post-supplementation. Intermediate and high rates of supplementation resulted in lower (P &lt; 0.01) serum nonesterified fatty acid concentrations post-supplementation than control heifers. Concentrations of serum glucose and lactate were greatest (P ≤ 0.06) 8 h post-supplementation. Our results suggest that extruded DDG cubes may be an adequate supplement for cattle consuming moderate-quality forage, and further research is warranted.
Pleomorphic adenoma gene 1 (PLAG1) promotes proliferation and inhibits apoptosis of bovine primary myoblasts through the PI3K-Akt signaling pathway
Authors: Wang Jian , Huang Yongzhen , Xu Jiawei , Yue Binglin , Wen Yifan , Wang Xiao , Lei Chuzhao , Chen Hong 
Published: March 2022

Abstract
Pleomorphic adenoma gene 1 (PLAG1) is a transcription factor involved in various cellular processes in organismal growth and development. However, its role in muscle function is unclear. This work investigated the roles of PLAG1 in muscle development and explored its regulatory mechanisms. The PLAG1 was proved to promote the proliferation of bovine primary myoblasts using the cell counting kit 8 (CCK-8) assay (P &lt; 0.001), 5-ethynyl-2’-deoxyuridine (EdU) proliferation assay (P = 0.005), quantitative real-time polymerase chain reaction (qRT-PCR) (P = 0.028), western blot, and flow cytometry (P &lt; 0.05), and to inhibit apoptosis of bovine primary myoblasts using qRT-PCR (P = 0.038), western blot, and flow cytometry (P &lt; 0.001). Chromatin immunoprecipitation sequencing (ChIP-seq) and western blot showed PLAG1 upregulated phosphorylated (p)-PI3K, PI3K, p-Akt, Akt, Cyclin D1, and CDK2 and inhibited the expression of p21 and p27 to enhance myoblast proliferation, and increased expression of Bcl-2, and Bcl-xL to inhibit apoptosis. Additionally, PLAG1 was identified as a target of miR-1 using dual-luciferase assay (P &lt; 0.001), qRT-PCR (P &lt; 0.001), and western blot. Furthermore, miR-1 might be a potential mediator of the positive feedback regulation relationship between PLAG1 and the PI3K-Akt signaling pathway.
T3 Pharmacogenetic Gene-drug Associations in Pediatric Burn and Surgery Patients
Authors: Grimsrud Kristin N , Davis Ryan , Tepper Clifford , Palmieri Tina L 
Published: March 2022

Abstract

Introduction
Management of critically ill patients requires simultaneous administration of many medications. These patients may have co-morbidities and drug-drug interactions which may result in decreased drug efficacy or increased risk of adverse reactions. Children are of particular concern as they may be even more sensitive to adverse drug reactions. Current practices rely on a one-size-fits-all approach for most medication dosing. Alternatively, precision medicine evaluates an individual’s genetic profile and adjusts individual therapeutic dosing. Pharmacogenetic testing is not generally implemented but is reserved for addressing an established problem rather than being used proactively to optimize clinical care. A greater understanding of the frequency of clinically significant genetic variants in drug pathways and identification of the drugs most commonly impacted by genetic makeup is needed to incorporate pharmacogenetics into medical care. We hypothesize several patients will have one or more genetic variants in drug metabolizing pathways used by one or more medications administered during hospitalization. The aims of this study are to determine the frequency of abnormal genetic variants in the primary drug pathways and assess what medications may be impacted.

Methods
Genetic data from 30 pediatric burn and surgery patients was collected to identify genetic variants in drug metabolizing pathways. We also evaluated drugs potentially impacted by these variants that were administered during the hospitalization. 19 whole exome and 11 whole genome sequencing datasets were analyzed using Aldy allelic decomposition software to identify haplotypes in cytochrome P450 (CYP) metabolizing enzyme genes.

Results
17 patients were identified with predicted altered function in 1 or more of the following CYP genes: 2C9, 2C19, 2D6, 3A4 and 3A5. The majority had decreased function, except for several patients with CYP2C19 variants with rapid or ultrarapid phenotypes. Drugs administered during hospitalization that rely on these pathways for primary metabolism include hydrocodone, oxycodone, methadone, ibuprofen, ketorolac, celebrex, diazepam, famotidine, diphenhydramine and glycopyrrolate.

Conclusions
This research demonstrates that approximately 1/4 to 1/3 of patients have functionally impactful haplotypes in the primary drug metabolizing pathways. There is great need for future clinical research to further evaluate the clinical relevance of these haplotypes and the additional impact of drug-drug interactions and other clinical confounders that additionally impact drug efficacy.
12 The Influence of Female Sex Hormones on Outcomes After Burn Injury
Authors: Corona Kassandra K , Song Juquan , De La Tejera Giovanna , Huang Lyndon G , Wermine Kendall , Gotewal Sunny , Efejuku Tsola A , Joglar Alejandro A , Keys Phillip H , Villarreal Elvia L , Chokshi Shivan N , Chaij Jasmine M , Palackic Alen , El Ayadi Amina , Golovko George , Wolf Steven E 
Published: March 2022

Abstract

Introduction
The pathophysiological response to major trauma has gender dimorphism in outcomes associated with sex hormones levels. However, little is known of the effects of female hormones on outcomes in burn patients. Previous studies demonstrated exogenous estrogen alleviates hyper-inflammation after burn. We thus posit that female patients have fewer comorbidities depending on female hormone levels. We had two objectives: to investigate the role of female hormones on outcomes after burn and to investigate potential protective properties of exogenous hormone treatment on burned post-menopausal women.

Methods
This study obtained data from the TriNetX research network with electronic medical records of de-identified patients. Both male and female patients who suffered burns were included from 2002-2020. The population was stratified to only include women over 45 on estrogen or progestin hormones taken within 6 months prior to injury and 1 month after injury to assure a menopausal state which occurs at age 45-55. Outcomes for mortality, sepsis, acute myocardial infarction, and acute kidney injury were measured within one day of injury to one month following injury. Odds ratios, risk difference, and risk ratios were calculated for outcome analysis after propensity-matched for race and ethnicity. A z-test for risk difference was performed. Statistical significance was defined at p &lt; 0.05.

Results
Compared to males, females grossly had a 28% risk reduction of 30-day mortality and a relative risk reduction for sepsis (26%), acute kidney failure (30), and myocardial infarction (29%) (p&lt; .05). Additionally, female burns younger than the age 45 had risk reductions for mortality 5.4-fold within 3 months, 2.9-fold lower for sepsis, 17.5-fold lower for myocardial infarction, and 7.7-fold lower for acute kidney injury (p&lt; .001). TriNetX identified 169,566 female burn patients, of which 2,683 were on estrogen and progestin and above 45 years old. Women over 45 on exogenous hormones had a 37% significant risk reduction in acute kidney failure when compared to the women over 45 not prescribed estrogen or progestin (p&lt; .05).

Conclusions
Female burn patients had better outcomes, while women over 45 had worse outcomes indicating the role of female sex hormone correlated to burn patient progress. The administration of estrogen and progestins for females above age 45 resulted in reduced risks for acute kidney failure after burn injury.
14 Prognostic Factors for In-hospital Mortality of Geriatric Burns from the US National Inpatient Sample 2016-2018
Authors: Yi Yangtian , Vrouwe Sebastian Q , Gottlieb Lawrence J , Rubin Daniel S 
Published: March 2022

Abstract

Introduction
Older adults experience a disproportionately higher rate of hospitalization and mortality due to burns. However, national estimates of in-hospital mortality in geriatric patients with acute burns outside of the recognized burn centers are lacking. The purpose of this study is to characterize such national estimates and identify the prognostic factors associated with in-hospital mortality in elderly patients with acute burn injuries.

Methods
Patients ≥50 years with an acute burn diagnosis in the United States National Inpatient Sample from 2016 to 2018 were identified by using International Classification of Diseases, Tenth Revision, Clinical Modification codes (T20.0-T31; initial encounters only). Trend weights were used from the Agency for Healthcare Research and Quality to generate national estimates. Factors associated with in-hospital mortality were evaluated by multivariable logistic regression.

Results
A total of 60,515 weighted discharges met inclusion criteria. For age groups 50-64 (reference category), 65-74, 75-84, and ≥85, the numbers of discharges were 33,100, 15,295, 7,880, and 4,240, respectively; the in-hospital mortality rates were 3.3%, 5.3%, 6.6%, and 9.9%, respectively. The full list of significant variables of the multivariable regression can be seen in Table 1. Specifically, variables associated with increased in-hospital mortality include age 75-84 (odds ratio [OR], 3.91; p&lt; 0.001), age ≥85 years (OR, 11.94; p&lt; 0.001), total body surface area (%TBSA) 10-19% (OR, 2.93; p=0.017), and %TBSA ≥20% (OR, 27.78; p&lt; 0.001). Intentional burns were associated with an increased risk of mortality (OR, 7.86; p=0.005), whereas hot liquids and vapor burns were associated with a decreased risk of mortality (OR, 0.33; p=0.043). Respiratory distress/failure (OR, 5.78; p&lt; 0.001), aspiration pneumonia/pneumonitis (OR, 5.01; p=0.004), shock (OR, 4.58; p=0.004), and acute renal failure (OR, 2.85; p=0.005) were associated with an increased risk of mortality. One or more surgical excisions were associated with a reduced risk of mortality (OR, 0.26; p&lt; 0.001).

Conclusions
Age ≥75 years, %TBSA ≥10%, intentional burn as the mechanism of injury, and certain comorbidities and complications were significant risk factors for in-hospital mortality in geriatric burn patients.
19 Minced Skin Grafts Can Be Expanded up to 500 Times to Re-epithelialize Full-thickness Burns
Authors: Nuutila Kristo , Varon David E , Broomhead Michael , Eriksson Elof 
Published: March 2022

Abstract

Introduction
Deep and large burns require hospitalization and, without exception, surgical treatment. Skin graft expansion in major burns currently is restricted to a 1:6 expansion ratio (possibly 1:9) by current methods. For this reason, skin transplants are limited by donor site availability for patients with extensive burns, who may have only small areas of healthy skin for use as donor sites. The objective of this project is to demonstrate the efficacy of pixel grafting, to produce split-thickness skin grafts (STSG) and dermal grafts which can be expanded at least 100 times (1 cm2 donor skin will cover 100 cm2). Pixel grafts are skin grafts that are prepared from split-thickness donor skin that is 0.3 mm (12/1000 of an inch) thick and minced into pieces that are 0.3 x 0.3 mm. The methodology relies on mincing a small area of donor skin using a hand-held mincer to create uniform skin pieces, each of which will serve as a small center of skin regeneration.

Methods
Deep partial-thickness burns were created on the dorsum of Yorkshire pigs. Three days post injury the burns were debrided and grafted with epidermal/dermal and dermal pixel grafts using expansion ratios from 1:2 to 1:500. The pixel grafts were prepared by harvesting 0.3 mm thick skin grafts from the same donor site going down in depth (Layer 1: STSG; Layer 2: dermal graft). Subsequently, the grafts were minced to 0.3 x 0.3 x 0.3 mm pixel grafts, suspended in a small volume of hydrogel and transplanted onto debrided porcine burn wounds. Healing was monitored up to 28 days and biopsies were collected on days 6, 10 and 14. The wounds were excised and fixed in formalin for histologic analysis. In addition, to measure wound area reduction and wound depth, wound images were taken. Multiple wound healing parameters were used to assess the quality of healing and the results were compared to STSG (standard of care treatment).

Results
Histology demonstrated that when both STSG pixel grafts and dermal grafts were transplanted onto porcine full-thickness wounds in a 1:2 ratio they were able to fully re-epithelialize the wounds in 14 days. At day 14, re-epithelialization-% using other expansion ratios varied from 46 % (1:500) to 64 % (1:10) and by day 28 all the wounds were fully re-epithelialized. Wound images obtained at different time points showed that by day 28 all the pixel graft grafted wounds had reduced in area efficiently, from 70 % (dermal pixel grafts 1:50) to 81% (STSG 1:100). No statistically significant differences were observed between the pixel graft study groups and STSG (standard of care).

Conclusions
This study concluded that both epidermal/dermal and dermal pixel grafts can be suspended in a hydrogel and transplanted onto wounds regardless of orientation (dermal side up or down), making the transplantation greatly simplified.
25 The Association Between Pain and Sleep Post-burn Injury: A Preschool LIBRE1-5 Study
Authors: Surette Kate E , Rodríguez-Mercedes Silvanys L , Ni Pengsheng , Patel Khushbu F , Rencken Camerin A , McGwin Madeleine , Fabia Renata , Tully Carrie , Palmieri Tina L , Romanowski Kathleen S , Warner Petra , Stoddard Frederick J J , Schneider Jeffrey C , Kazis Lewis E , Ryan Colleen M 
Published: March 2022

Abstract

Introduction
Quality sleep is an essential part of post-injury recovery. Sleep deprivation, including that due to pain, may hinder and slow recovery progression. Therefore, it is vital to assess long-term sleep outcomes post-burn injury. This study examined the association of sleep items with the severity of pain in pediatric burn survivors one to five years of age, using Preschool LIBRE1-5 (Life Impact Burn Recovery Evaluation) parent-reported data.

Methods
The Preschool LIBRE1-5 was administered to 426 parents of burn survivors during field-testing. Three sleep-specific items within the psychological domain were assessed: “My child had frightening dreams or nightmares,” “My child had trouble staying asleep,” and “My child had trouble falling asleep at night.” Each item was scored on a 5-point Likert scale from 0 = never to 4 = always. Pain was assessed on a 4-point severity scale, from 0 = not severe to 3 = very severe and dichotomized (1= not severe and 0 = mild, moderate, and very severe). For sleep items, higher scores denote better functioning. Odds ratios for each of the three items were calculated using logistic regression to measure the association between pain severity with sleep. Lower odds ratios denote that greater pain severity is associated with more sleep problems. The multiple logistic and linear regression analysis included covariates for age at time of survey, gender, race, total body surface area burned (TBSA), Hispanic (yes/no), wound dressings, and burns to critical areas (hands, face, foot). Multiple imputations were used for missing values.

Results
The sample characteristics included: mean age of 3.1 + 1.4 years, mean time since burn injury of 1.2 + 1.3 years, mean TBSA of 4.2 + 7.9, 55.2% male, and 74.2% white. In the multiple logistic regression analyses, burn survivors with severe pain had significant trouble falling asleep (OR = 0.44, 95% CI [0.24, 0.81]) and staying asleep at night (OR = 0.45, 95% CI [0.24, 0.83]). No association was found with pain severity and frightening dreams or nightmares (OR = 0.8, 95% CI (0.37, 1.75). The multiple linear regression analysis showed that higher scores on pain scales were associated with poor sleep outcomes (R²= 9.5%, p = 0.0016). As pain scores increased, the sleep summed score decreased by 0.46 standard deviation.

Conclusions
There are important associations between pain severity and sleep outcomes. Pain management and interventions for sleep improvement may lead to better outcomes in the pediatric burn population.
26 Opioid Prescription in Burns: A Large Database Analysis from 1990 to 2021
Authors: Villarreal Elvia L , Wolf Steven E , Golovko George , Wermine Kendall , Gotewal Sunny , Huang Lyndon G , Corona Kassandra K , Bagby Shelby P , Keys Phillip H , Joglar Alejandro A , De La Tejera Giovanna , Chokshi Shivan N , Song Juquan , El Ayadi Amina 
Published: March 2022

Abstract

Introduction
The use of opioids in the medical field has contributed to the growing opioid epidemic. Nonetheless, opioids remain imperative in the treatment for pain management in burns. While some studies have addressed the use of opioids in surgery, a comprehensive analysis of the pattern of opioids use in burns has not been investigated. This study aims to identify trends of opioid use and investigate the risk of opioid related disorders in burn patients.

Methods
Data was obtained from TriNetX, a national research database that provides medical records of de-identified patients. The study population includes patients that were prescribed an opioid, ICD-10 code CN101, on or after any instance of burn between January 1st, 1990 and September 19th, 2021. Patient population was further stratified by the decade in which patients received opioids for pain following burn injury: 1990-1999, 2000-2009, 2010-2019, and 2020-September 19th, 2021. Five outcomes were investigated: opioid related disorders, opioid dependence, opioid abuse, intentional self-harm, and mental and behavioral disorders due to psychoactive substance use. Cohorts were matched for age at index, sex, and race. Statistical analysis used risk ratios with a 95% confidence interval, and p&lt; 0.05 was considered significant.

Results
We identified 8,421 patients that were prescribed an opioid between 1990-1999, 30,846 patients from 2000-2009, 169,991 patients from 2010-2019, and 30,966 patients from 2020-present. When compared to the 2000s cohorts, the 1990s patients had a 47% decrease in risk of opioid related disorders, with a 53% decrease in risk of opioid dependence, 45% decrease in risk in opioid abuse, 11% decrease in risk of mental and behavioral disorders due to psychoactive substance use, and 63% reduced risk of intentional self-harm.
Comparison of the 2000-2009 to 2010-2019 cohorts showed increased risk of opioid related disorders (RR= 1.912), opioid dependence (RR=1.569), opioid abuse (RR=1.677), mental and behavioral disorders (RR =1.733), and intentional self-harm (RR=2.027). When compared to 2020-present, the 2010-2019 patient cohort had 10 times the risk of developing opioid-related disorders, with 3 times the risk for opioid dependence and behavioral disorders, and 5 times the risk for opioid abuse and intentional self-harm.

Conclusions
The risk of opioid related disorders in the 1990s was lower compared to the 2000s. Since 2000, the risk of opioid related disorders has significantly increased. Recognizing the risks of opioid prescriptions in burn patients is imperative when addressing the role of physicians in controlling the constantly growing opioid epidemic.