bluuebunny/crossref_metadata_2025_split huggingface dataset:
Plastic additive components of PM2.5 increase corrected QT interval: Screening for exposure markers based on airborne exposome
Authors: Liu Xiaotu , Wang Yanwen , Fang Jianlong , Chen Renjie , Sun Yue , Tang Shuqin , Wang Minghao , Kan Haidong , Li Tiantian , Chen Da 
Published: November 2023

Abstract
The impact of industrial chemical components of ambient fine particles (e.g. PM2.5) on cardiovascular health has been poorly explored. Our study reports for the first time the associations between human exposure to complex plastic additive (PA) components of PM2.5 and prolongation of heart rate–corrected QT (QTC) interval by employing a screening-to-validation strategy based on a cohort of 373 participants (136 in the screening set and 237 in the validation set) recruited from 7 communities across China. The high-throughput airborne exposome framework revealed ubiquitous occurrences of 95 of 224 target PAs in PM2.5, totaling from 66.3 to 555 ng m−3 across the study locations. Joint effects were identified for 9 of the 13 groups of PAs with positive associations with QTC interval. Independent effect analysis also identified and validated tris(2-chloroisopropyl) phosphate, di-n-butyl/diisobutyl adipate, and 3,5-di-tert-butyl-4-hydroxybenzaldehyde as the key exposure markers for QTC interval prolongation and changes of selected cardiovascular biomarkers. Our findings highlight the important contributions of airborne industrial chemicals to the risks of cardiovascular diseases and underline the critical need for further research on the underlying mechanisms, toxic modes of action, and human exposure risks.
An intervention study investigating the effectiveness of contextualizing multimodal strategy on improving hand hygiene at a tertiary hospital in Nigeria
Authors: Yaqub Yahaya , Tanko Zainab Lamido , Aminu Aliyu , Umar Usman Yahya , Ejembi Joan 
Published: November 2023

Abstract

Background
Hand hygiene (HH) is a proven low-cost means to curtail the problem of hospital-acquired infection (HAI). However, a low HH compliance rate of 17.1% was found among surgical health workers at Ahmadu Bello University Teaching Hospital (ABUTH) in Zaria, Nigeria.

Methods
This was an intervention study conducted utilizing mixed methods to investigate the effectiveness of the World Health Organization (WHO) multimodal strategy to improve the HH compliance rate of doctors at ABUTH Zaria. The study was conducted between June and August 2022 and included delivering a behavioural change HH workshop to doctors followed by data collection in the surgical wards that had received environmental modification through the provision of an alcohol-based hand rub (ABHR), HH posters and nurses for visual and/or verbal reminders.

Results
The cumulative HH compliance rate was 69% (n=1774) and was significantly different from the baseline HH compliance rate of 17.1% (confidence interval 45.5 to 57.7, p&lt;0.001). Observed HH was highest in the ward with both visual and verbal reminders (78%) and lowest (59%) where neither visual nor verbal reminders were provided (n=444 per ward). All respondents reported motivation to perform HH with the presence of ABHR.

Conclusions
The WHO multimodal strategy is good for enhancing HH among health workers in the context of low- and middle-income countries. More research is needed to understand how much of a reduction in HAI is directly associated with efficient HH by health workers.
Social Protection amid a Crisis: New Evidence from South Africa’s Older Person’s Grant
Authors: Alloush Mo , Bloem Jeffrey R , Malacarne J G 
Published: November 2023

Abstract
This study estimates the effects of South Africa’s Older Person’s Grant on well-being amid the COVID-19 pandemic. With household-level data collected before and during the pandemic, it leverages the age-eligibility threshold of the grant to estimate its effects on households in both periods. Prior to the pandemic, this study finds that grant receipt substantially improves economic well-being and decreases adult hunger at the household level. During the first 18 months of the pandemic, this study finds larger effects on both economic well-being and hunger than prior to the pandemic. In particular, recipient households were less likely to report running out of money for food and hunger among either adults or children. These results, which are stronger when pandemic-related lockdown policies are in place and for more vulnerable households, provide critical insight into the effectiveness of one of the world’s most well-known cash-transfer programs during a massive global health crisis.
Priorities for Well Child Care of Families Affected by Parental Opioid Use Disorder
Authors: Goyal Neera K. , Sood Erica , Gannon Meghan A. , Harris Grace , Hand Dennis J. , Abatemarco Diane J. , Short Vanessa L. 
Published: November 2023

Background and Objectives
Parenting women in treatment for opioid use disorder (OUD) report a lack of family centeredness and anticipatory guidance within well child care (WCC), and WCC utilization is low among affected children. We explore priorities for WCC visit content to inform primary care recommendations for this population.

Methods
This study is a qualitative study of parenting women from one urban, academic OUD treatment program and pediatric primary care clinicians from a nearby affiliated pediatric practice. Eligible parent participants had a child ≤2 years old and were English speaking. Semistructured interviews elicited perspectives on WCC, with questions and prompts related to visit content. Inductive thematic analysis was led by 2 investigators using open coding procedures.

Results
Among 30 parent participants, the majority were White (83%) and unmarried (90%). Approximately 60% reported their child received pharmacotherapy for neonatal opioid withdrawal syndrome. Of 13 participating clinicians, 9 were attending pediatricians. Five themes emerged from parental and clinician interviews: (1) improving knowledge and confidence related to child development, behavior, and nutrition; (2) mitigating safety concerns; (3) addressing complex health and subspecialty needs through care coordination; (4) acknowledging parental health and wellbeing in the pediatric encounter; and (5) supporting health education and care related to neonatal opioid withdrawal syndrome. Parents and clinicians expressed difficulty comprehensively addressing such issues due to time constraints, social determinants of health, and significant informational needs.

Conclusions
Parenting women in treatment for OUD and pediatric clinicians share multiple priorities for anticipatory guidance within WCC visits and barriers to addressing them comprehensively.
Transorbital Endoscopic Approach to the Pterygopalatine Fossa: A Less Invasive Alternative to Traditional Access
Authors: Osias Ethan A. , Roelofs Kelsey A. , Leibowitz Steven , Goldberg Robert A. , Rootman Daniel B. 
Published: November 2023

Purpose:
The purpose of this article and accompanying video is to demonstrate a transorbital endoscopic approach for accessing the pterygopalatine fossa (PPF). This technique does not require a skin incision, avoids dissection of critical neurovascular structures, and utilizes a comparatively small osteotomy. The 2 cases presented in this article highlight the utility of a transorbital endoscopic approach for accessing an anatomic region that has traditionally required more invasive techniques to reach.

Methods:
Description of surgical technique with 2 illustrative clinical cases and accompanying surgical video.

Results:
Surgical technique: A trans-conjunctival approach is taken to the inferior orbital rim, and a subperiosteal dissection is propagated posteriorly. The bone of the posterior orbital floor is then deroofed, and the superior portion of the posterior wall of the maxillary sinus is removed, allowing access to the PPF for an incisional biopsy.

Case 1:
A 76-year-old male with a history of left cheek squamous cell carcinoma presented with progressive V2 paresthesia and an abnormally enhancing lesion in the left PPF on MRI.

Case 2:
A 58-year-old male with no significant medical history presented with left facial numbness (V1-V3), ptosis, an abduction deficit, and decreased hearing. Contrast-enhanced MRI demonstrated an abnormally enhanced lesion in the left PPF extending to Meckel’s cave.
The transorbital approach described was used to successfully obtain a diagnostic biopsy in both cases.

Conclusions:
These cases highlight the utility of a transorbital endoscopic approach to the PPF as a less morbid alternative to traditional access. Patient selection is key to identifying appropriate cases.
A novel remnant liver-first strategy for liver autotransplantation in patients with end-stage hepatic alveolar echinococcosis: a retrospective case series
Authors: Lv Tao , Xu Gang , Xu Xi , Wu Gang , Wan Chen-Fei , Song Jiu-Lin , Yang Jian , Zhou Yong-Jie , Luo Kui , Wu Hong , Ye Cheng-Jie , Yan Lv-Nan , Lau Wan-Yee , Yang Jia-Yin 
Published: November 2023

Background:

Ex vivo liver resection combined with autotransplantation is an effective therapeutic strategy for unresectable end-stage hepatic alveolar echinococcosis (HAE). However, ex vivo liver resection combined with autotransplantation is a technically demanding and time-consuming procedure associated with significant morbidity and mortality. The authors aimed to present our novel remnant liver-first strategy of in vivo liver resection combined with autotransplantation (IRAT) technique for treating patients with end-stage HAE.

Methods:
This retrospective study included patients who underwent IRAT between January 2014 and December 2020 at two institutions. Patients with end-stage HAE were carefully assessed for IRAT by a multidisciplinary team. The safety, feasibility, and outcomes of this novel technique were analyzed.

Results:
IRAT was successfully performed in six patients, with no perioperative deaths. The median operative time was 537.5 min (range, 501.3–580.0), the median anhepatic time was 59.0 min (range, 54.0–65.5), and the median cold ischemia time was 165.0 min (range, 153.8–201.5). The median intraoperative blood loss was 700.0 ml (range, 475.0–950.0). In-hospital complications occurred in two patients. No Clavien–Dindo grade III or higher complications were observed. At a median follow-up of 18.6 months (range, 15.4–76.0) , all patients were alive. No recurrence of HAE was observed.

Conclusion:
The remnant liver-first strategy of IRAT is feasible and safe for selected patients with end-stage HAE. The widespread adoption of this novel technique requires further studies to standardize the operative procedure and identify patients who are most likely to benefit from it.
Utility of the international society on thrombosis and hemostasis-bleeding assessment tool in the diagnosis of patients who suspected of platelet function disorders
Authors: Shahbazi Massoumeh , Ahmadinejad Minoo , Teimourpour Amir 
Published: November 2023

The ISTH-BAT is a structured bleeding assessment tool to record and help diagnose patients with possible bleeding disorders. However, a few studies evaluated the utility of ISTH-BAT in diagnosing patients with platelet function defects (PFDs).
In this study, we evaluated the diagnostic utility of ISTH-BAT in predicting PFDs among patients suspected of PFDs.
Forty patients suspected of PFDs and 21 normal healthy controls were evaluated by the ISTH-BAT scoring system, light transmission aggregometry (LTA), ATP-releasing assays (lumi-aggregometry), and expression of CD62P for diagnosis of PFDs.
Among 40 patients suspected of PFDs, 10 were diagnosed as PFDs using lumiaggregometry and CD62P. The ISTH-BAT score in patients suspected of PFDs [(6, interquartile range (IQR) 1–8] and patients with PFDs was significantly higher than the control group (0; IQR 0–0) (P < 0.001). Receiver operating characteristic curves indicate that ISTH-BAT is not able to discriminate patients with PFDs from those without PFDs (areas under the curve of 0.620 (95% confidence interval 0.415–0.825). The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of the ISTH-BAT in predicting the presence of PFDs, respectively, were 40, 73.3, 33.3, and 78.6% in the cut-off ISTH-BAT at least 4 in adult men, at least 6 in adult women, and at least 3 in children (age < 18).
The ISTH-BAT scoring system has good discriminatory power in diagnosing patients with PFDs from healthy controls but is ineffective in differentiating them from those without PFDs.
Clot waveform analysis in acute promyelocytic leukemia
Authors: Terras Malek , El Borgi Wijden , Betbout Wafa , Jaied Rabeb , Lakhal Fatma Ben , Salem Sarra Fekih , Ghali Ons , Gouider Emna 
Published: November 2023

The aim of this study was to evaluate the activated partial thromboplastin time (APTT) and prothrombin time (PT)-based clot waveform analysis (CWA) in patients diagnosed with acute promyelocytic leukemia (APL).
APTT-based and PT-based CWA parameters of patients diagnosed with APL were analyzed and compared with healthy volunteers. Four APTT-CWA parameters were noted, maximum velocity corresponding to the first peak of the first derivative (max1), maximum acceleration corresponding to the first peak of the second derivative (max2) and the corresponding peak times of max1 and max2 (Tmax1, Tmax2). For the PT-CWA, two PT-CWA parameters were noted, maximum velocity (max1’) and the corresponding timing (Tmax1’). The results were expressed in medians. Mann–Whitney U test was used to compare the CWA parameters. Correlations were examined using the Spearman correlation test.
Tmax1 and Tmax2 were significantly prolonged in patients with APL in comparison with healthy volunteers. Although max1 and max2 were lower in APL patients compared with healthy volunteers, no significant difference was noted. There was a strong and significant correlation between the DIC score and the parameters max1, max2 and max1’ and a very strong and significant correlation between fibrinogen levels and max1, max2 and max1’. When comparing DIC patients with hypofibrinogenemia and DIC without hypofibrinogenemia, a significant difference was noted in max1, max2, Tmax1 and Tmax2.
The APTT and PT-based CWA analysis is a good tool to evaluate the bleeding tendency in APL, as it offers a novel approach for evaluating global hemostasis, predicting the bleeding risk and delivering improvements to APL patients management.
Construction and validation of the predictive model for gallbladder cancer liver metastasis patients: a SEER-based study
Authors: Zhang Woods , Chen Zhitian , Sa Benzhong 
Published: November 2023

Background
The purpose of this present research was to construct a nomograph model to predict prognosis in gallbladder cancer liver metastasis (GCLM) patients so as to provide a basis for clinical decision-making.

Methods
We surveyed patients diagnosed with GCLM in the Surveillance Epidemiology and the End Results database between 2010 and 2019. They were randomized 7 : 3 into a training set and a validation set. In the training set, meaningful prognostic factors were determined using univariate and multivariate Cox regression analyses, and an individualized nomogram prediction model was generated. The prediction model was evaluated by C-index, calibration curve, ROC curve and DCA curve from the training set and the validation set.

Results
A total of 727 confirmed cases were enrolled in the research, 510 in the training set and 217 in the validation set. Factors including bone metastasis, surgery, chemotherapy and radiotherapy were independent prognostic factors for cancer-specific survival (CSS) rates and were employed in the construction of the nomogram model. The C-index for the training set and validation set were 0.688 and 0.708, respectively. The calibration curve exhibited good consistency between predicted and actual CSS rates. ROC curve and DCA of the nomogram showed superior performance at 6 months CSS, 1-year CSS and 2 years CSS in both the training set and validation set.

Conclusion
We have successfully constructed a nomogram model that can predict CSS rates in patients with GCLM. This prediction model can help patients in counseling and guide clinicians in treatment decisions.
Determination and prospective validation of cut-off values for the diagnosis of liver cirrhosis for point shear-wave elastography/acoustic radiation force impulse imaging using the ACUSON Sequoia ultrasound system
Authors: Meitner-Schellhaas B. , Schüler S. , Vogl T. , Jesper D. , Vetter M. , Waldner M. , Strobel D. 
Published: November 2023

Objectives
Point shear-wave elastography (pSWE) alias acoustic radiation force impulse (ARFI) imaging is a well-established ultrasound-based technique for the non-invasive assessment of liver tissue stiffness. As cut-off values for liver cirrhosis cannot be transferred from one ultrasound system to another, this study aimed at determining cut-off values for the newly developed Siemens ACUSON Sequoia ultrasound system.

Methods
In a pilot study phase, two independent examiners conducted 10 pSWE measurements in an elasticity phantom and 32 healthy individuals for the determination of inter-examiner agreement. Afterwards, 22 cirrhotic patients and 57 patients with chronic liver disease undergoing liver biopsy underwent pSWE. Patient characteristics and stiffness values were compared for individuals with and without liver cirrhosis. Diagnostic accuracies of cut-off values for the diagnosis of liver cirrhosis were calculated using areas under the receiver operating characteristics analysis and Youden’s index. In a subsequent validation study phase, these cut-off values were validated prospectively in 107 cirrhotic and 68 non-cirrhotic patients.

Results
Inter-examiner agreement was excellent for measurements in the elasticity phantom (intra-class correlation coefficient [ICC] = 0.998; P < 0.001), and good for measurements in patients (ICC = 0.844; P < 0.001). The best cut-off value for the diagnosis of liver cirrhosis was 1.405 m/s with an AUC of 0.872, a sensitivity of 88.2% and a specificity of 88.2% (P < 0.001).

Conclusion
ARFI elastography using the Siemens ACUSON Sequoia showed a good inter-examiner agreement. The optimal cut-off value was lower than the cut-off values described for former generations of ultrasound devices. These preliminary results should be confirmed in larger patient collectives with histology as the reference standard.
Transplantation for colorectal liver metastasis
Authors: Line Pål-Dag , Dueland Svein 
Published: November 2023

Purpose of review
Liver transplantation has emerged as a possible treatment for selected patients with nonresectable colorectal liver metastasis, but controversy still exists regarding optimal selection criteria and acceptable outcomes.

Recent findings
Univariate analysis in the largest cohorts confirms that metachronous disease, Oslo score = 0–1, metabolic tumor volume (MTV) less than 70 cm3, and tumor burden score less than 9 are positive predictive factors for good overall survival outcomes. Some recent trials might suggest that technical resectability is not a valid exclusion criterion for patients with high tumor load and favorable prognostic scores in the transplant evaluation. Recent developments in circulation DNA technology and liquid biopsy may play a future role in the selection and monitoring of patients.

Summary
Evaluation for transplant needs multidisciplinary involvement and should not be delayed until the failure of conventional oncological therapy. Larger data sets are needed to refine the selection criteria for liver transplantation in colorectal liver metastasis (CRLM).
Relaxation as an Educational Strategy for Stress Management and Resiliency
Authors: Mahoney Sarah , Bussard Michelle E. 
Published: November 2023

Background:
Prelicensure nursing students experience higher levels of stress, anxiety, and depression than the remainder of the student body.

Purpose:
The purpose of this study was to identify whether implementation of Stress Management and Resiliency Training (SMART) and a relaxation room decreased perceived stress levels in prelicensure nursing students.

Methods:
This quasi-experimental pre- and posttest interventional study used a within-subjects design. Nursing students were asked to use a relaxation room for 15 minutes following a discussion on stress management and resiliency strategies. The students evaluated their stress level at baseline and at the conclusion of using the relaxation room.

Results:
The self-reported stress levels decreased for nearly 90% of the participants following the use of the interventions.

Conclusions:
Stress management and resiliency interventions during academic hours decreased the reported stress levels of nursing students. The strategies are beneficial options to reduce stress and improve resiliency skills among prelicensure nursing students.
Acquired Symmastia
Authors: Liu Chang , Chen Yuzhe , Wang Zijun , Qu Qi , Fan Yan , Xu Yajuan 
Published: November 2023

Background
Acquired symmastia is a rare complication after breast augmentation that is difficult to fix.

Methods
The medical records of 18 female patients with symmastia treated by our team were reviewed. Data collected included preoperative medical history, implant size, and breast base width. Surgical techniques were systematically reviewed and analyzed based on postoperative follow-up results.

Results
Of the 18 patients, 15 patients had undergone implanted breast augmentation and 3 had injected breast augmentation. All 18 patients underwent comprehensive repair with various surgical techniques. Three patients showed recurrence after operation. Four patients were dissatisfied with postoperative breast size and underwent 2-stage replacement surgery.

Conclusions
Symmastia is an intractable surgical complication. Surgical classification can help assess the difficulty of surgery in advance, and the surgical strategy plan can help the surgeon to control the quality of the repair surgery.