bluuebunny/crossref_metadata_2025_split huggingface dataset:
Referral Order: Requiring Attendance at Panel
Authors: Ashford Mark , Branston Gareth , Redhouse Naomi 
Published: May 2024

Abstract
This chapter provides an overview of the requirement to attend meetings of the youth offender panel when the court makes a referral order, contained in s 90 of the Sentencing Code (SC). When a parent required to attend a meeting is unable to do so, the panel can refer the parent to the youth court for consideration of the making of a parenting order. Further guidance on the failure to comply lies within section 93 of the SC. The chapter also sets out the provision for making a parenting order where the parent or guardian of an offender fails to attend meetings of the youth offender panel.
Addressing the escalating heat index in the Philippines: a call to action
Authors: Rogayan Danilo V 
Published: May 2024

Abstract
This correspondence responds to a recently published editorial by highlighting the interconnectedness of science, policy, politics and activism in addressing the escalating heat index in the Philippines. It underlines the importance of a complete strategy that incorporates scientific information into evidence-based policy, navigates the political environment and encourages grassroots activity to address the complex effects of extreme heat on public health. This paper highlights the necessity of multidisciplinary collaboration among stakeholders in developing effective measures for minimizing the negative health consequences of rising temperatures while also promoting climate resilience and health justice in the Philippines.
Deep learning-based liver cyst segmentation in MRI for autosomal dominant polycystic kidney disease
Authors: Chookhachizadeh Moghadam Mina , Aspal Mohit , He Xinzi , Romano Dominick J , Sharbatdaran Arman , Hu Zhongxiu , Teichman Kurt , Ng He Hui Yi , Sattar Usama , Zhu Chenglin , Dev Hreedi , Shimonov Daniil , Chevalier James M , Goel Akshay , Shih George , Blumenfeld Jon D , Sabuncu Mert R , Prince Martin R 
Published: May 2024

Abstract

Background
Autosomal dominant polycystic kidney disease (ADPKD) can lead to polycystic liver disease (PLD), characterized by liver cysts. Although majority of the patients are asymptomatic, massively enlarged liver secondary to PLD can cause discomfort, and compression on adjacent structures requiring cyst aspiration/fenestration, partial liver resection, or liver transplantation. Monitoring PLD by measuring liver volume fails to track the early stages when liver cyst volume is too small to affect liver volume.

Purpose
To improve PLD assessment in the early stages by automating detection and segmentation of liver cysts using deep learning (DL) models.

Materials and Methods
A self-configured UNet-based platform (nnU-Net) was trained with 40 ADPKD subjects with liver cysts annotated by a radiologist. Internal (n = 7), External (n = 10), and test-retest reproducibility (n = 17) validations included macro- and micro-level performance metrics: patient-level Dice scores (PDice), along with voxel-level true positive rates (VTPR), as well as analysis of time saved in a model-assisted scenario. Additionally, we assessed human-level reliability in liver cyst segmentation and evaluated the model’s test-retest reproducibility. We further compared liver volume vs cyst volume for tracking disease in a subject with 16+ years follow-up.

Results
The model achieved an 82% ± 11% PDice and a 75% ± 15% VTPR on the internal test sets (n = 7 patients), and 80% ± 12% Dice score and a 91% ± 7% VTPR on the external test sets (n = 10 patients). It excelled particularly in detecting small liver cysts, a challenging task for manual annotation. This efficiency translated to a median of 91% (IQR: 14%) reduction in annotation time compared to manual labeling. Test-retest assessment demonstrated excellent reproducibility, with coefficients of variation of 94% for liver cyst fraction and 92% for cyst count.

Conclusion
DL automation of liver cyst segmentations demonstrates potential to improve tracking of liver cyst volume in polycystic liver disease.
Who Are the Hand-to-Mouth?
Authors: Aguiar Mark , Bils Mark , Boar Corina 
Published: May 2024

Abstract
Many households hold little wealth. In standard precautionary savings models, these households should not only display higher marginal propensities to consume (MPCs) but also higher future consumption growth. In contrast, we see from the Panel Study of Income Dynamics that such “hand-to-mouth” households do not display higher growth in spending. They also exhibit greater volatility of spending and adjust their spending to a greater extent through the number of categories consumed. Consistent with a role for preference heterogeneity, the panel data show that it is persistent differences across households, not current assets, that predict low consumption growth and other spending differences for the hand-to-mouth households. To identify the extent of preference heterogeneity, we consider the model of Kaplan and Violante with both liquid and illiquid assets, but allow heterogeneity in preferences. To match the data, many poor hand-to-mouth must be relatively impatient and have a high inter-temporal elasticity of substitution. The model shows that preferences predominantly explain the higher MPCs for low-asset households. Preference heterogeneity notably increases the spending impact of fiscal transfers, but only if targeted, while reducing that from interest rate cuts.
Demystifying the virtualization process: A call for standard reporting of virtual modifications to evidence-based psychotherapies, using the FRAME model
Authors: Boykin Derrecka M , Smith Tracey L , Rakel Barbara , Rodrigues Merlyn , Embree Jennie , Woods Ken , Chaison Angelic D , Dindo Lilian 
Published: May 2024

Abstract
The sudden onset of the coronavirus disease led to a rapid expansion of video telehealth to deliver mental healthcare. Although video telehealth was not a new clinical practice, there was limited guidance on how best to modify evidence-based psychotherapies (EBPs) for virtual delivery (a process also referred to as virtualization). The virtualization process for EBPs remains unclear as newly emerging reports on this topic do not consistently report modification decisions. This commentary calls attention to the need to improve documentation practices to allow a greater understanding of modifications needed to maximize the positive effects of EBPs transported to a virtual format. We used the Framework for Reporting Adaptations and Modifications-Expanded (FRAME) to capture details about the nature, process, and outcomes of intervention modifications across a given clinical setting or population. To illustrate the use of the FRAME, we present a case example describing our experiences with transporting a 1-day in-person Acceptance and Commitment Therapy group workshop to a virtual format. Workshop modifications primarily involved changes to the delivery format, administration procedures, and content. The case example walks through how, why, and by whom specific modifications were made as well as the degree to which fidelity was maintained. In the wake of the telemedicine revolution, further investigation into the virtualization process for EBPs is warranted. Improving reporting practices by using the FRAME or a similar adaptation framework will promote a more rigorous study of virtual modifications to EBPs that inform future guidelines and best practices.
Designing a Mentorship Program for APRNs in Specialty Palliative Care Practice
Authors: Fedel Patrice 
Published: May 2024

ABSTRACT:
As advanced practice registered nurses (APRNs) enter practice, support is crucial for success. Formal mentorship has been shown to improve employee turnover, job satisfaction, and clinical competence. In the wake of the COVID-19 pandemic, an APRN team specializing in palliative care experienced an unprecedented rate of staff turnover. As a result, the team decided to create a formal mentorship program to support newly hired colleagues and assist their transition to practice. A subcommittee of APRNs within the palliative care practice met to establish a mentorship practice framework, expectations for the program, and a methodology for matching mentors and mentees. The mentorship program was implemented with two cohorts comprising a total of five mentors and six mentees. It was evaluated by participants using surveys asking open-ended, qualitative questions. Both mentors and mentees reported finding the program valuable. Mentees felt the program helped their transition to practice, created a forum for peer support, and improved their clinical competence. Mentors said the program furthered their own professional development, advanced their clinical growth, and fostered a connection to colleagues. Employee engagement and alignment improved, and staff turnover decreased. Further work is needed to improve on the program framework and analyze the outcomes of mentorship.
Letters of Reference in the Current Era
Authors: Gottlieb Michael , Boatright Dowin , Landry Adaira 
Published: May 2024

Abstract
Letters of reference (LORs) are a common component of the application process for residency training programs. With the United States Medical Licensing Examination Step 1 transitioning to pass/fail grading and with the increasing use of holistic review, the potential role of LORs is rising in importance. Among some key benefits are the ability to provide a broader and more holistic view of applicants, which can include highlighting elements of experiences or skills that could be missed in their application, as well as providing a third-party assessment of the applicant external to their rotation experiences. However, LORs also face issues, including variation in quality, challenges with comparability, and risk of bias. In this article, the authors discuss the unique benefits, limitations, and best practice recommendations for LORs in academic medicine. The authors also discuss future directions, including the role of artificial intelligence, unblinded, and co-created LORs.
Cardiopulmonary Resuscitation Without Aortic Valve Compression Increases the Chances of Return of Spontaneous Circulation in Out-of-Hospital Cardiac Arrest: A Prospective Observational Cohort Study
Authors: Chu Sheng-En , Huang Chun-Yen , Cheng Chiao-Yin , Chan Chun-Hsiang , Chen Hsuan-An , Chang Chin-Ho , Tsai Kuang-Chau , Chiu Kuan-Ming , Ma Matthew Huei-Ming , Chiang Wen-Chu , Sun Jen-Tang 
Published: May 2024

OBJECTIVES:
Following current cardiopulmonary resuscitation (CPR) guidelines, which recommend chest compressions at “the center of the chest,” ~50% of patients experiencing out-of-hospital cardiac arrest (OHCA) undergo aortic valve (AV) compression, obstructing blood flow. We used resuscitative transesophageal echocardiography (TEE) to elucidate the impact of uncompressed vs. compressed AV on outcomes of adult patients experiencing OHCA.

DESIGN:
Prospective observational cohort study.

SETTING:
Single center.

PATIENTS:
This study included adult OHCA patients undergoing resuscitative TEE in the emergency department. Patients were categorized into AV uncompressed or AV compressed groups based on TEE findings.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
The primary outcome was sustained return of spontaneous circulation (ROSC). The secondary outcomes included end-tidal co
2 (Etco
2) during CPR, any ROSC, survival to ICU and hospital discharge, post-resuscitation withdrawal, and favorable neurologic outcomes at discharge. Additional analyses on intra-arrest arterial blood pressure (ABP) were also conducted. The sample size was pre-estimated at 37 patients/group. From October 2020 to January 2023, 76 patients were enrolled, 39 and 37 in the AV uncompressed and AV compressed groups, respectively. Intergroup baseline characteristics were similar. Compared with the AV compressed group, the AV uncompressed group had a higher probability of sustained ROSC (53.8% vs. 24.3%; adjusted odds ratio [aOR], 4.72; p = 0.010), any ROSC (56.4% vs. 32.4%; aOR, 3.30; p = 0.033), and survival to ICU (33.3% vs. 8.1%; aOR, 6.74; p = 0.010), and recorded higher initial diastolic ABP (33.4 vs. 11.5 mm Hg; p = 0.002) and a larger proportion achieving diastolic ABP greater than 20 mm Hg during CPR (93.8% vs. 33.3%; p < 0.001). The Etco
2, post-resuscitation withdrawal, and survival to discharge revealed no significant intergroup differences. No patients were discharged with favorable neurologic outcomes. Uncompressed AV seemed critical for sustained ROSC across all subgroups.

CONCLUSIONS:
Absence of AV compression during OHCA resuscitation is associated with an increased chance of ROSC and survival to ICU. However, its effect on long-term outcomes remains unclear.
The Impact of Common Variations in Sequential Organ Failure Assessment Score Calculation on Sepsis Measurement Using Sepsis-3 Criteria: A Retrospective Analysis Using Electronic Health Record Data
Authors: Alrawashdeh Mohammad , Klompas Michael , Rhee Chanu 
Published: May 2024

OBJECTIVES:
To assess the impact of different methods of calculating Sequential Organ Failure Assessment (SOFA) scores using electronic health record data on the incidence, outcomes, agreement, and predictive validity of Sepsis-3 criteria.

DESIGN:
Retrospective observational study.

SETTING:
Five Massachusetts hospitals.

PATIENTS:
Hospitalized adults, 2015 to 2022.

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
We defined sepsis as a suspected infection (culture obtained and antibiotic administered) with a concurrent increase in SOFA score by greater than or equal to 2 points (Sepsis-3 criteria). Our reference SOFA implementation strategy imputed normal values for missing data, used Pao
2/Fio
2 ratios for respiratory scores, and assumed normal baseline SOFA scores for community-onset sepsis. We then implemented SOFA scores using different missing data imputation strategies (averaging worst values from preceding and following days vs. carrying forward nonmissing values), imputing respiratory scores using Spo
2/Fio
2 ratios, and incorporating comorbidities and prehospital laboratory data into baseline SOFA scores. Among 1,064,459 hospitalizations, 297,512 (27.9%) had suspected infection and 141,052 (13.3%) had sepsis with an in-hospital mortality rate of 10.3% using the reference SOFA method. The percentage of patients missing SOFA components for at least 1 day in the infection window was highest for Pao
2/Fio
2 ratios (98.6%), followed by Spo
2/Fio
2 ratios (73.5%), bilirubin (68.5%), and Glasgow Coma Scale scores (57.2%). Different missing data imputation strategies yielded near-perfect agreement in identifying sepsis (kappa 0.99). However, using Spo
2/Fio
2 imputations yielded higher sepsis incidence (18.3%), lower mortality (8.1%), and slightly lower predictive validity for mortality (area under the receiver operating curves [AUROC] 0.76 vs. 0.78). For community-onset sepsis, incorporating comorbidities and historical laboratory data into baseline SOFA score estimates yielded lower sepsis incidence (6.9% vs. 11.6%), higher mortality (13.4% vs. 9.6%), and higher predictive validity (AUROC 0.79 vs. 0.75) relative to the reference SOFA implementation.

CONCLUSIONS:
Common variations in calculating respiratory and baseline SOFA scores, but not in handling missing data, lead to substantial differences in observed incidence, mortality, agreement, and predictive validity of Sepsis-3 criteria.
Frequently asked questions about adverse drug reactions of methylphenidate
Authors: Heerfordt Ida M. , Horwitz Henrik 
Published: May 2024

Summary
This article addresses frequently asked questions about the adverse drug reactions associated with methylphenidate treatment. Methylphenidate is a central nervous system stimulant used primarily for the treatment of attention-deficit/hyperactivity disorder. It utilizes insights from the combined knowledge of pharmacists and physicians who advise healthcare professionals in the Capital Region of Denmark on patient-specific medication queries. The article provides an overview of the clinical challenges and safety considerations associated with methylphenidate use, integrating empirical data and clinical expertise to facilitate informed decision-making by practitioners.
A New Technique for Harvesting Limbal Stem Cell Tissue for Transplantation Using an Automated Microkeratome and a Novel Globe-Fixation System
Authors: Bibak-Bejandi Zahra , Mohammadi Seyed-Farzad , Davoudi Mehdi , Bahmanpour Amirhossein , Asadi-Amoli Fahimeh 
Published: May 2024

Purpose:
To introduce an unprecedented technique, instrumentation, and setup for the superficial limbus harvest from the human cadaver donor whole globe.

Methods:
We studied several superficial limbus harvest alternatives, developed a preferred approach with our available instruments, and optimized it on a handful of (seropositive) cadaver donors of whole globes.

Results/Technique:
The globe was pressurized to about normal intraocular pressure by viscoelastic injection through the optic nerve stump. The globe was then mounted on a dynamic globe fixator that maintained a negative pressure in its stabilizing socket. Exertion of the negative pressure effectively elevated globe intraocular pressure (to over 40 mm Hg) and made the corneoscleral wall tight. The socket was then held tilted to the left side for about 35 to 40 degrees to put the limbal zone horizontally and mildly “chin-up.” Next, the microkeratome was put on the uppermost and exposed limbus of the globe and activated, and the socket was rotated clockwise under the microkeratome head and its oscillating blade, allowing an effective 360-degree revolution of the microkeratome head around the limbal belt (for a right-handed operator and a counterclockwise cut).

Conclusions:
We consistently succeeded in peeling intact 360-degree strips of the smooth superficial limbus by using blades with varying depths. Our method can be further equipped and optimized and be used by the eye banks and the surgeons for keratolimbal grafting as a more efficient limbal stem cell tissue harvest technique.
Collagen-Based Artificial Cornea for Lamellar Keratoplasty: An Early Case Report
Authors: Andreev Andrey Yurevich , Yusef Yusef Naim , Avetisov Sergey Eduardovich , Osipyan Grigory Albertovich , Domogatsky Sergey Petrovich , Osidak Egor Olegovich 
Published: May 2024

Purpose:
The aim of this study was to evaluate Viscoll collagen membrane (VCM) for lamellar keratoplasty.

Methods:
A 54-year-old man with grade 4 recurrent pterygium underwent lamellar keratoplasty using VCM as the graft material. Standard keratoplasty postoperative treatments, including topical antibiotic-corticosteroid and artificial tears, were administered.

Results:
Complete graft epithelialization was achieved after 4 days of the surgery. Follow-up at 9 months showed no pterygium recurrence as well as good integration of the VCM graft into the surrounding tissues with preserved transparency.

Conclusions:
This case demonstrated that VCM possesses great potential as an alternative to the human donor cornea for lamellar keratoplasty; however, the application of VCM for lamellar keratoplasty still needs additional evaluation.
Study on the bioactive ingredients and mechanism of Huangqi against diabetic retinopathy based on network pharmacology and experimental verification
Authors: Lin Xiaohui , Bao Min , Zhang Xiaohui , Qirula Sa , Jiao Chenxu , Zhang Dingyi , Han Jing 
Published: May 2024

Background:
Diabetic retinopathy (DR) is one of the most well-known microvascular complications of diabetes mellitus. As a traditional Chinese medicine, Huangqi (HQ), has been used for treating DR for a long time. However, its anti-DR active ingredients and mechanism are still unknown. Therefore, we designed this study to explore the active components and mechanism of HQ against DR via network pharmacology analysis.

Methods:
The ingredients of HQ, and potential targets of HQ and DR were obtained from public databases. We used the protein-protein interaction (PPI) network, Kyoto Encyclopedia of Genes and Genomes (KEGGs) pathway enrichment, and Gene Ontology (GO) analysis to identify core targets and pathways of HQ against DR. Finally, molecular docking and vitro experiments were applied to validate our results.

Results:
A total of 34 potential targets of HQ against DR were obtained. Based on PPI network, VEGFA, PTGS2, Interleukin-6 (IL-6), and CCL2 were considered as core targets. GO analysis involved 692 biological processes, 21 cellular components, and 35 molecular functions. KEGG enrichment analysis manifested that the anti-DR effect of HQ was mainly mediated via the AGE-RAGE signaling pathway in diabetic complications. The molecular docking results indicated that kaempferol had higher affinity with CCL2, IL-6, VEGFA, and PTGS2. The vitro experiments showed that the mRNA expressions of CCL2, IL-6, VEGFA, and PTGS2 in ARPE-19 cells were differentially decreased after kaempferol treatment.

Conclusion:
This study preliminarily unveiled that the therapeutic efficacy of HQ against DR might be attributed to the reduced expression of CCL2, IL-6, VEGFA, and PTGS2.
Magnitude and associated factors of intraoperative hypothermia among pediatric patients undergoing elective surgery at Ayder Comprehensive Specialized Hospital 2023: prospective observational cross-sectional study Tigray, Ethiopia
Authors: Bitsa Yihdego , Belay Aregawi , Mulaw Abera , Hadush Yared , Teferi Molla 
Published: May 2024

Background:
Hypothermia is characterized by a drop in core body temperature of less than 36°C. It occurs frequently throughout the operating period and affects surgical patient outcomes differently in terms of morbidity and mortality. Because of coagulopathy, metabolic acidosis, multiple organ failure, hemodynamic instability, and infections, a core temperature below 34°C is strongly associated with mortality.

Objective:
This study aimed to assess the magnitude and associated factors of intraoperative hypothermia in pediatric patients undergoing elective surgery at the Ayder Comprehensive Specialized Hospital.

Method:
A prospective observational cross-sectional study was conducted on 399 pediatric patients undergoing elective surgery at Ayder Comprehensive Specialized Hospital in Tigray, Ethiopia, from 1 May 2023, to 30 July 2023. Participants in the study were selected by a systematic random sampling technique. The data collection procedure was chart review and intraoperative temperature measurement, and the collected data were analyzed by SPSS version 23. The independent variables were analyzed using binary and multi-logistic regression. The odds ratio, 95% CI, and p value of less than 0.05 were considered statistical significance.

Result:
The magnitude of intraoperative hypothermia was 52.9%. Neonate and infant [adjusted odds ratio (AOR): 6, 95% CI: 3.7, 9.8], (AOR=4.5, 95% CI: 2.9, 7) respectively, volume of fluid administered greater than half-liter [AOR: 4.37, (95% CI, 3, 6.4)], patients who underwent surgery during the morning [AOR: 5.3, (95% CI: 3.8, 7.4)], and duration of surgery and anesthesia greater than 120 minutes [AOR: 2.7, (95% CI, 1.8, 4)] and (AOR=3.4, 95% CI, 2.4, 4.9], respectively, were factors significantly associated with intraoperative hypothermia.

Conclusion and recommendation:
This study revealed a high magnitude of intraoperative hypothermia among pediatric patients. Being neonates and infants, having a cold volume of IV fluid administered greater than half a liter, entering surgery during the morning, the duration of surgery, and the anesthesia time were significantly associated with intraoperative hypothermia. The authors would like to advise anesthetists to use warm intravenous fluids, calculate IV fluids, and maintain room temperature.