bluuebunny/crossref_metadata_2025_split huggingface dataset:
What variables should inform needle length choice for deltoid intramuscular injection? A systematic review
Authors: Kearns Ciléin , Houghton Claire , Dickinson Emily , Hatter Lee , Bruce Pepa , Krishnamoorthy Srinidhi , Weatherall Mark , Hills Thomas , Doppen Marjan , Ali Mirjalili Seyed , Beasley Richard 
Published: January 2023

Objectives(1) Assess the distribution of skin-to-deltoid-muscle distance (SDMD) at the deltoid intramuscular (IM) injection site; (2) its relationship with demographic and anthropometric variables and (3) Consider the findings in relation to clinical guidance on IM injection, such as COVID-19 vaccines.DesignSystematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Data sourcesMEDLINE, EMBASE, ClinicalTrials.gov, Cochrane Library, CINAHL and SCOPUS between June and July 2021 with no publication date limit.Eligibility criteriaStudies reporting measurements of the SDMD in living adults aged 16 years and older, at the deltoid IM injection site, published in English were considered.Data extraction and synthesisTwo independent reviewers performed each stage of screening, data extraction and quality assessments using the Joanna Briggs Institute Critical Appraisal Checklist for analytical cross sectional studies.Results16 105 papers were identified, of which 11 studies were suitable for review, representing 1414 participants. Heterogeneity in the definition of the deltoid IM injection site, locations measured and methods of measurement precluded meta-analysis. Evidence from ultrasound SDMD measurements demonstrated some patients in all but ‘underweight’ body mass index (BMI) categories, may require needles longer than 25 mm for successful IM injection. Calliper measurements overestimated SDMD compared with ultrasound. Female sex, higher BMI categories and greater weight in women were associated with greater SDMD.ConclusionsThe reviewed evidence was insufficient to inform definitive needle length ‘cut points’ for IM injection based on demographic or anthropomorphic variables. Contemporary clinical guidance currently based on this evidence, including the site of injection and choice of needle length, may result in subcutaneous administration in a small proportion of recipients, particularly if obese or of female sex.PROSPERO registration numberCRD42021264625.
Reporting of patient involvement: a mixed-methods analysis of current practice in health research publications using a targeted search strategy
Authors: Weschke Sarah , Franzen Delwen Louise , Sierawska Anna Karolina , Bonde Lea-Sophie , Strech Daniel , Schorr Susanne Gabriele 
Published: January 2023

ObjectivesTo evaluate the extent and quality of patient involvement reporting in examples of current practice in health research.DesignMixed-methods study. We used a targeted search strategy across three cohorts to identify health research publications that reported patient involvement: original research articles published in 2019 in the British Medical Journal (BMJ), articles listed in the Patient-Centered Outcomes Research Institute (PCORI) database (2019), and articles citing the GRIPP2 (Guidance for Reporting Involvement of Patients and Public) reporting checklist for patient involvement or a critical appraisal guideline for user involvement. Publications were coded according to three coding schemes: ‘phase of involvement’, the GRIPP2-Short Form (GRIPP2-SF) reporting checklist and the critical appraisal guideline.Outcome measuresThe phase of the study in which patients were actively involved. For the BMJ sample, the proportion of publications that reported patient involvement. The quality of reporting based on the GRIPP2-SF reporting guideline. The quality of patient involvement based on the critical appraisal guideline. Quantitative and qualitative results are reported.ResultsWe included 86 publications that reported patient involvement. Patients were most frequently involved in study design (90% of publications, n=77), followed by study conduct (71%, n=61) and dissemination (42%, n=36). Reporting of patient involvement was often incomplete, for example, only 40% of publications (n=34) reported the aim of patient involvement. While the methods (57%, n=49) and results (59%, n=51) of involvement were reported more frequently, reporting was often unspecific and the influence of patients’ input remained vague. Therefore, a systematic assessment of the quality and impact of patient involvement according to the critical appraisal guideline was not feasible across samples.ConclusionsAs patient involvement is increasingly seen as an integral part of the research process and requested by funding bodies, it is essential that researchers receive specific guidance on how to report patient involvement activities. Complete reporting builds the foundation for assessing the quality of patient involvement and its impact on research.
Team training program’s impact on medication administration, teamwork and patient safety culture in an ambulance service (TEAM-AMB): a longitudinal multimethod study protocol
Authors: Vifladt Anne , Ballangrud Randi , Myhr Kjetil , Grusd Eystein , Porthun Jan , Mæhlum Pål Anders , Aase Karina , Sollid Stephen J M , Odberg Kristian Ringsby 
Published: January 2023

IntroductionMedication administration errors (MAEs) have the potential for significant patient harm, and the frequency of MAEs in the ambulance services is not well known. Effective teamwork is paramount for providing safe and effective patient care, especially in a time-sensitive, high-risk environment such as the ambulance services. Team Strategies and Tools to Enhance Performance and Patient Safety (TeamSTEPPS) is an evidence-based team training programme that, to our knowledge, has not been studied in the ambulance services previously. TeamSTEPPS is based on the five principles: team structure, communication, leadership, situation monitoring and mutual support. This study aims to advance the knowledge of the medication administration process in the ambulance services and study the impact of a team training programme on the frequency of MAEs, and the perception of teamwork, and patient safety culture.Methods and analysisThis study uses a longitudinal multimethod design to evaluate medication administration and the implementation of the team training programme TeamSTEPPS in an ambulance service. A review of electronic patient journals 6 months prior to the intervention, and 12 months after the intervention will provide data on the frequency of MAEs. Focus group interviews and questionnaires will be carried out before and after the intervention to describe the perception of teamwork and patient safety culture among ambulance professionals. Observations, individual interviews and a review of guidelines will be conducted in the first and second quarters of 2022 to study the medication administration process in ambulance services.Ethics and disseminationThe study protocol was reviewed by the Regional Committees for Medical and Health Research Ethics Central Norway and approved by the Hospital Trust data protection officer, and the head of the Prehospital Division at the Hospital Trust. The data material will be managed confidentially and stored according to regulations. The results will be disseminated through scientific papers, reports, conference presentations, popular press, and social media.Trial registration numberNCT05244928.
Data mining techniques for detecting signals of adverse drug reaction of cardiac therapy drugs based on Jinan adverse event reporting system database: a retrospective study
Authors: Guan Yuyao , Qi Yingmei , Zheng Lei , Yang Jing , Zhang Mingzhu , Zhang Qiuhong , Ji Lei 
Published: January 2023

ObjectiveCardiac therapy drugs are widely used in the treatment of heart disease. However, the concern regarding adverse events (AEs) of cardiac therapy drugs have been rising. This study aimed to analyse cardiac therapy drug-related AEs using the Jinan adverse event reporting system (JAERS) database mining and conduct a comprehensive evaluation to provide safe medication information for patients.DesignRetrospective observational study.SettingIn this study, cardiac therapy drug-related AEs were detected using the JAERS database from January 2000 to March 2022.MethodsReports of cardiac therapy drug-related AEs were extracted from JAERS database, and the basic information of patients, reports and common AEs were analysed. Four disproportionality analysis methods, proportional reporting ratio (PRR), reporting odds ratio (ROR), Bayesian Confidence Propagation Neural Network (BCPNN), Medicines and Healthcare products Regulatory Agency (MHRA), were used to detect cardiac therapy drug-related signals. We further checked whether the detected signals exist on drug labels in China and two developed countries, the USA and Japan.ResultsIn total, 168 314 AEs were reported, of which 4788 were associated with cardiac therapy drugs. Using the PRR, ROR, MHRA and BCPNN method, we detected 52 signals, 52 signals, 33 signals and 43 signals, respectively. Among the 52 signals, 14 were not included on the drug labels of China. One (isosorbide mononitrate—head bilges) was not included on the drug labels of the three countries.ConclusionWe identified 14 new cardiac therapy drug signals that did not appear on drug labels in China and 1 new signal that did not appear on drug labels in 3 counties. A causal link between cardiac therapy drugs and AEs should be evaluated in further studies.
Impact of acute moderate-intensity aerobic exercise on circulating extracellular vesicles in pregnant and non-pregnant women
Authors: Abolbaghaei Akram , Mohammad Shuhiba , da Silva Danilo Fernandes , Hutchinson Kelly Ann , Myette Robert L. , Adamo Kristi B. , Burger Dylan 
Published: January 2023

Exercise improves cardiovascular and metabolic health in pregnancy and may represent a non-pharmacological approach to improving pregnancy outcomes. Extracellular vesicles (EVs) are emerging biomarkers of endothelial dysfunction and offer the potential for evaluating vascular health non-invasively during pregnancy. The purpose of this study was to investigate changes in circulating EV levels after an acute bout of moderate-intensity aerobic exercise in healthy pregnant and non-pregnant women. We studied plasma samples from pregnant ( N = 13, 13–28 weeks) and non-pregnant ( N = 17) women. A pre-exercise blood sample was obtained followed by a 30 min bout of moderate-intensity treadmill-based exercise. Immediately following the exercise, a post-exercise blood draw was collected. Large EVs were isolated from plasma by differential centrifugation and characterized by Western blot and electron microscopy. We quantified circulating EVs by nanoscale flow cytometry. Endothelial EVs were identified as VE-Cadherin+, platelet EVs as CD41+, and leukocyte EVs as CD45+ events. Acute exercise was associated with a significant reduction in levels of circulating endothelial EVs in the non-pregnant group ( p = 0.0232) but not in the pregnant group ( p = 0.2734). A greater proportion of non-pregnant women (13/17, 76.47%) exhibited a reduction in endothelial EVs compared with their pregnant counterparts (4/13, 30.76%, p < 0.05). We also observed a positive association between measures of fitness (average speed) and baseline levels of platelet ( r = 0.5816, p = 0.0159) and total EVs ( r = 0.5325, p = 0.0296) in the non-pregnant group but not in pregnant individuals. Collectively, our study highlights that after a matched acute exercise, changes to circulating EV levels differ depending on pregnancy status.
CWD2GAN: Generative Adversarial Network of Chronic Wound Depth Detection for Predicting Chronic Wound Depth
Authors: Chin Chiun-Li , Li Chieh-Yu , Lai Yan-Ming , Chen Ting , Sun Tzu-Yu , Lin Jun-Cheng 
Published: January 2023

Clinically, for observing the healing of the patient’s wound, doctors need to insert a cotton swab into the deepest part of the wound to detect the depth of the wound. This measurement method will cause discomfort to the patient. Therefore, obtaining wound depth information directly from wound images is very important for doctors to understand the degree of wound healing. In this paper, we propose the generative adversarial network of chronic wound depth detection (CWD2GAN) to generate wound depth maps of four different shades of color according to the changes of the wound area in the chronic wound image. In CWD2GAN, the generator, which can generate the wound depth map, is composed of three parts: encoder, decoder, and concatenation. And, the discriminator uses the concept of cGAN. It can not only judge whether the generator produces an image but also know that this image is a depth map. In experimental results, the accuracy, sensitivity, specificity, and precision of CWD2GAN are 84.8%, 84.6%, 84.9%, and 86.3%, respectively. The results indicate that our proposed method can accurately generate the different depths layer in a chronic wound image, and reduce the pain caused by invasive testing for patients.
Quasimorphisms on surfaces and continuity in the Hofer norm
Authors: Khanevsky Michael 
Published: January 2023

There are a number of known constructions of quasimorphisms on Hamiltonian groups. We show that on surfaces many of these quasimorphisms are not compatible with the Hofer norm in a sense they are not continuous and not Lipschitz. The only exception known to the author is the Calabi quasimorphism on a sphere [M. Entov and L. Polterovich, Calabi quasimorphism and quantum homology, Int. Math. Res. Not. 2003 (2003) 1635–1676] and induced quasimorphisms on genus-zero surfaces (e.g. [P. Biran, M. Entov and L. Polterovich, Calabi quasimorphisms for the symplectic ball, Commun. Contemp. Math. 6 (2004) 793–802]).
Calculation of Cathodic Limiting Current Density in Weak Acids: Part I. Aqueous CO2 Solutions
Authors: Nesic Srdjan , Madani Sani Fazlollah 
Published: January 2023

The limiting current density for the hydrogen evolution reaction in aqueous saturated carbon dioxide solutions needed revisiting, as the basic understanding of the underlying reaction mechanism in weak acids has changed over the past few years. We now know that the direct reduction of undissociated carbonic acid on a metal surface in aqueous carbon dioxide solutions is not significant, as was thought before, and that there is only a single dominant pathway for hydrogen evolution: reduction of free hydrogen ions. The main role of weak carbonic acid is to provide additional hydrogen ions via buffering. Therefore, a new mathematical model was needed for calculation of the limiting current density for hydrogen ion reduction, that accounts for both hydrogen ion diffusion in the boundary layer and simultaneous buffering provided by dissociation of weak carbonic acid. The new model relies on analytically solving the co-diffusion of hydrogen ions and carbonic acid in the mass transfer boundary layer, with simultaneous homogenous chemical reactions. The new expression for the limiting current density takes the form:

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Outcomes of heart-lung transplantation in Eisenmenger syndrome compared to primary pulmonary hypertension
Authors: Sainathan Sandeep , Ryan John , Said Sameh , Mullinari Leonardo , Sanchez Pablo 
Published: January 2023

Objective Heart-Lung Transplantation (HLTX) is required both in primary pulmonary hypertension (PPH) and Eisenmenger syndrome (ES) when there is associated end-stage heart disease. Although PPH is associated with an otherwise structurally normal heart, ES is associated with congenital heart defects, which may increase the complexity of the operation. This study analyzes if the diagnosis (PPH vs. ES) is related to short-term outcomes after HLTX. Methods Patients ≥18 years of age with PPH and ES who underwent HLTX were identified in the United Network for Organ Sharing database from 2005 to 2021. Patients were propensity score matched on heart and lung listing status at the time of transplant. Univariable, multivariable, and Kaplan–Meir survival analyses were performed. Results The unmatched cohort had 128 PPH and 44 ES patients, and the matched cohort had 44 patients in each group. PPH patients had lower waitlist times and PA pressures but higher FEV1, heart, and lung listing status and ECMO bridge. There were no differences in immediate postoperative outcomes such as dialysis, stroke, and airway dehiscence. PPH patients had a higher treatment rejection in the first year. The 30-day, 1-year, and 3-year survival were better in the PPH group. However, a landmark analysis excluding deaths within 30 days eliminated differences in survival between the groups. Post-transplant dialysis and postoperative mechanical ventilation >5 days were risk factors for 1-year mortality in ES. Conclusion The short-term outcomes of HLTX are inferior in ES compared to PPH and much of the attrition in ES occurs in the immediate postoperative period.
Side Effects and Its Management in Adjuvant Endocrine Therapy for Breast Cancer: A Matter of Communication and Counseling
Authors: Johnsson Aina , Fugl-Meyer Kerstin , Bordas Pal , Åhman Janet , Von Wachenfeldt Anna 
Published: January 2023

Objective: Women with a newly diagnosed hormone receptor-positive breast cancer are offered adjuvant endocrine therapy (AET). Although the treatment reduces the risk of relapse and death not all women are adherent to it. Many factors, including the therapy’s menopausal side effects, can adversely affect adherence to the treatment. This study explores the extent to which women treated with AET perceived that health care providers addressed their side effects. Methods: Ten focus groups were set up, containing between four to nine women. In total, 58 women participated in the study—45 from the Stockholm metropolitan region and 13 from the scarcely populated Norrbotten region. The interviews were analyzed using qualitative content analysis with an inductive approach. Results: The women were usually satisfied with the care they received from the health care providers. However, their experiences were more complex when it came to their satisfaction with the care in terms of the menopausal side effects of therapy, sexuality in particular. The participants reported that their healthcare providers rarely asked about sex life-related side effects of the treatment. Conclusions: Health care providers need to communicate and consult about issues related to their patients’ sex lives following their breast cancer diagnosis and during their treatment.
Minimisation for the design of parallel cluster-randomised trials: An evaluation of balance in cluster-level covariates and numbers of clusters allocated to each arm
Authors: Martin James , Middleton Lee , Hemming Karla 
Published: January 2023

Background: Cluster-randomised trials often use some form of restricted randomisation, such as stratified- or covariate-constrained randomisation. Minimisation has the potential to balance on more covariates than blocked stratification and can be implemented sequentially unlike covariate-constrained randomisation. Yet, unlike stratification, minimisation has no inbuilt guard to maintain close to a 1:1 allocation. A departure from a 1:1 allocation can be unappealing in a setting with a small number of allocation units such as cluster randomisation which typically include about 30 clusters. Methods: Using simulation (10,000 per scenario), we evaluate the performance of a range of minimisation procedures on the likelihood of a 1:1 allocation of clusters (10–80 clusters) to treatment arms, along with its performance on covariate imbalance. The range of minimisation procedures includes varying: the proportion of clusters allocated to the least imbalanced arm (known as the stochastic element) – between 0.7 and 1, percentage of first clusters allocated completely at random (known as the bed-in period) – between 0% and 20% and adding ‘number of clusters allocated to each arm’ as a covariate in the minimisation algorithm. We additionally include a comparison of stratifying and then minimising within key strata (such as country within a multi country cluster trial) as a potential aid to increasing balance. Results: Minimisation is unlikely to result in an exact 1:1 allocation unless the stochastic element is set higher than 0.9. For example, with 20 clusters, 2 binary covariates and setting the stochastic element to 0.7: only 41% of the possible randomisations over the 10,000 simulations achieved a 1:1 allocation. While typical sizes of imbalance were small (a difference of two clusters per arm), allocations as extreme as of 10:10 were observed. Adding the ‘number of clusters’ into the minimisation algorithm reduces this risk slightly, but covariate imbalance increases slightly. Stratifying and then minimising within key strata improve balance within strata but increase imbalance across all clusters, both on the number of clusters and covariate imbalance. Conclusion: In cluster trials, where there are typically about 30 allocation units, when using minimisation, unless the stochastic element is set very high, there is a high risk of not achieving a 1:1 allocation, and a small but nonetheless real risk of an extreme departure from a 1:1 allocation. Stratification with minimisation within key strata (such as country) improves the balance within strata although compromises overall balance.