bluuebunny/crossref_metadata_2025_split huggingface dataset:
Management of Muscle Relaxation With Rocuronium and Reversal With Neostigmine or Sugammadex Guided by Quantitative Neuromuscular Monitoring
Authors: Thilen Stephan R. , Sherpa James R. , James Adrienne M. , Cain Kevin C. , Treggiari Miriam M. , Bhananker Sanjay M. 
Published: May 2023

BACKGROUND:
The optimal pharmacological reversal strategy for neuromuscular blockade remains undefined even in the setting of strong recommendations for quantitative neuromuscular monitoring by several national and international anesthesiology societies. We evaluated a protocol for managing rocuronium blockade and reversal, using quantitative monitoring to guide choice of reversal agent and to confirm full reversal before extubation.

METHODS:
We conducted a prospective cohort study and enrolled 200 patients scheduled for elective surgery involving the intraoperative use of rocuronium. Providers were asked to adhere to a protocol that was similar to local practice recommendations for neuromusculalr block reversal that had been used for >2 years; the protocol added quantitative monitoring that had not previously been routinely used at our institution. In this study, providers used electromyography-based quantitative monitoring. Pharmacological reversal was accomplished with neostigmine if the train-of-four (TOF) ratio was 0.40 to 0.89 and with sugammadex for deeper levels of blockade. The primary end point was the incidence of postoperative residual neuromuscular blockade (PRNB), defined as TOF ratio <0.9 at time of extubation. We further evaluated the difference in pharmacy costs had all patients been treated with sugammadex.

RESULTS:
A total of 189 patients completed the study: 66 patients (35%) were reversed with neostigmine, 90 patients (48%) with sugammadex, and 33 (17%) patients recovered spontaneously without pharmacological reversal. The overall incidence of residual paralysis was 0% (95% CI, 0–1.9). The total acquisition cost for all reversal drugs was United States dollar (USD) 11,358 (USD 60 per patient) while the cost would have been USD 19,312 (USD 103 per patient, 70% higher) if sugammadex had been used in all patients.

CONCLUSIONS:
A protocol that includes quantitative monitoring to guide reversal with neostigmine or sugammadex and to confirm TOF ratio ≥0.9 before extubation resulted in the complete prevention of PRNB. With current pricing of drugs, the selective use of sugammadex reduced the total cost of reversal drugs compared to the projected cost associated with routine use of sugammadex for all patients.
The Timing of Initiating Hydrocortisone and Long-term Mortality in Septic Shock
Authors: Zhang Luming , Gu Wan-Jie , Huang Tao , Lyu Jun , Yin Haiyan 
Published: May 2023

BACKGROUND:
Previous studies on the association between the timing of corticosteroid administration and mortality in septic shock focused only on short-term mortality and produced conflicting results. We performed a retrospective review of a large administrative database of intensive care unit (ICU) patients to evaluate the association between the timing of hydrocortisone initiation and short- and long-term mortality in septic shock. We hypothesized that a longer duration between the first vasopressor use for sepsis and steroid initiation was associated with increased mortality.

METHODS:
Data were extracted from the Medical Information Mart in the Intensive Care-IV database. We included adults who met Sepsis-3 definition for septic shock and received hydrocortisone. The exposure of interest was the time in hours from vasopressor use to hydrocortisone initiation (>12 as late and ≤12 as early). The primary outcome was 1-year mortality. Secondary outcomes included 28-day mortality, 90-day mortality, in-hospital mortality, and length of hospital stay. Cox proportional hazard models were used to estimate the association between exposure and mortality. Competing risk regression models were used to evaluate the association between exposure and length of hospital stay.

RESULTS:
A total of 844 patients were included in this cohort: 553 in the early group and 291 in the late group. The median time to hydrocortisone initiation was 7 hours (interquartile range, 2.0–19.0 hours). After multivariable Cox proportional hazard analysis, we found that hydrocortisone initiation >12 hours after vasopressor use was associated with increased 1-year mortality when compared with initiation <12 hours (adjusted hazard ratio, 1.39; 95% confidence interval, 1.13–1.71; P = .002, E-value = 2.13). Hydrocortisone initiation >12 hours was also associated with increased 28-day, 90-day, and in-hospital mortality and prolonged length of hospital stay.

CONCLUSIONS:
In patients with septic shock, initiating hydrocortisone >12 hours after vasopressor use was associated with an increased risk of both short-term and long-term mortality, and a prolonged length of hospital stay.
The Intimacy of Labor
Authors: Resnick Elana 
Published: May 2023

Abstract
This essay rethinks writing on “intimate labor” to ethnographically explore the intimacy of labor by attending to how Romani women waste workers in Bulgaria assert workplace friendships to lay claim to public space and cultivate life-sustaining solidarities. Under conditions of racialized and degrading labor, they play with their uniformed hypervisibility, catcall white men on city streets, and temporarily unsettle normative expectations of womanhood. With this disruptive power of workplace intimacy, street sweepers use humor and play to create collective pleasure for themselves and one another. As they explain that they “die so that white Bulgarians can live,” they also use their friendships to generate pleasurable forms of living, what they term “anything else.”
Body Art in China: Yang Zhichao's Diary from a Psychiatric Ward
Authors: Strafella Giorgio , Berg Daria 
Published: May 2023

Abstract
This study aims to trace how artists in postsocialist China have adopted the discourse of body art and reshaped its import of sociopolitical criticality. In this article, “body art” implies the use of the human body as the primary material of artistic creation and the performance of actions of cruelty, modification, and endangerment on the artist's body. Through an engagement with theories of embodiment, biopolitics, and postsocialism, this article argues that body art represents one way in which the corporeal assumes a new centrality in China's post-1978 avant-garde and popular culture, as both a reappropriated territory of self-expression and an alienated object of consumption and surveillance. To do so, it discusses body art by Yang Zhichao 杨志超 (b. 1962), focusing in particular on a performance artwork titled Jiayuguan 嘉峪关 (Jiayu Pass, 1999 – 2000) and its documentation by the artist. As a result, this article shows how body art encapsulates the tension between dystopian negativity and regenerative potential at the heart of the postsocialist condition.
Flow Diverter Performance in Aneurysms Arising From the Posterior Communicating Artery: A Systematic Review and Meta-Analysis
Authors: Vivanco-Suarez Juan , Rodriguez-Calienes Aaron , Kan Peter T. , Wakhloo Ajay K. , Pereira Vitor M. , Hanel Ricardo , Lopes Demetrius Klee , Galecio-Castillo Milagros , Anil Susan , Farooqui Mudassir , Puri Ajit S. , Ortega-Gutierrez Santiago 
Published: May 2023

BACKGROUND:
Flow diverters (FDs) have demonstrated a safe and effective profile. However, the use of FDs for posterior communicating artery (PComA) aneurysms remains controversial.

OBJECTIVE:
To evaluate the safety and effectiveness of FDs for PComA aneurysms using a systematic review and meta-analysis of the literature.

METHODS:
We performed a systematic search from inception until June 2022 for flow diversion in PComA aneurysms. Primary effectiveness was the rate of complete aneurysm occlusion defined by Raymond-Roy class 1. Primary safety outcomes were treatment-related ischemic/hemorrhagic (composite) events causing morbidity and mortality. Secondary safety was PComA patency at follow-up. Random-effects meta-analyses were used to calculate proportions, and statistical heterogeneity was assessed.

RESULTS:
A total of 13 studies with 397 patients harboring 403 aneurysms were included. Mean age was 48 years, and the mean aneurysm size was 5.3 mm. Most aneurysms were unruptured (65%). Complete occlusion at final follow-up was 73% (CI 66%-79%), and adjunctive coils were used in 10% of aneurysms. Retreatment rate was 2% (CI 0%-9%). The primary safety composite outcome was 4% (CI 3%-7%), and mortality was 1%. PComA patency at final follow-up was 76% (CI 57%-89%). Subgroup analysis, patients with fetal PComAs had a lower complete occlusion rate (42% fetal PComA vs 77%, p

subgroup

difference = <.01).

CONCLUSION:
The performance of FDs in PComA aneurysms is comparable with outcomes found in other subtypes of supraclinoid aneurysms. Effectiveness was acceptable and safety favorable. However, effectiveness was suboptimal in patients with fetal-type PComAs; alternative treatments should be considered in these cases.
Adipose triglyceride lipase promotes prostaglandin-dependent actin remodeling by regulating substrate release from lipid droplets
Authors: Giedt Michelle S. , Thomalla Jonathon M. , White Roger P. , Johnson Matthew R. , Lai Zon Weng , Tootle Tina L. , Welte Michael A. 
Published: May 2023

ABSTRACT
Lipid droplets (LDs), crucial regulators of lipid metabolism, accumulate during oocyte development. However, their roles in fertility remain largely unknown. During Drosophila oogenesis, LD accumulation coincides with the actin remodeling necessary for follicle development. Loss of the LD-associated Adipose Triglyceride Lipase (ATGL) disrupts both actin bundle formation and cortical actin integrity, an unusual phenotype also seen when the prostaglandin (PG) synthase Pxt is missing. Dominant genetic interactions and PG treatment of follicles indicate that ATGL acts upstream of Pxt to regulate actin remodeling. Our data suggest that ATGL releases arachidonic acid (AA) from LDs to serve as the substrate for PG synthesis. Lipidomic analysis detects AA-containing triglycerides in ovaries, and these are increased when ATGL is lost. High levels of exogenous AA block follicle development; this is enhanced by impairing LD formation and suppressed by reducing ATGL. Together, these data support the model that AA stored in LD triglycerides is released by ATGL to drive the production of PGs, which promote the actin remodeling necessary for follicle development. We speculate that this pathway is conserved across organisms to regulate oocyte development and promote fertility.
Impacts of ocean acidification and warming on post-larval growth and metabolism in two populations of the great scallop (Pecten maximus)
Authors: Harney Ewan , Rastrick Samuel P. S. , Artigaud Sebastien , Pisapia Julia , Bernay Benoit , Miner Philippe , Pichereau Vianney , Strand Øivind , Boudry Pierre , Charrier Gregory 
Published: May 2023

ABSTRACT
Ocean acidification and warming are key stressors for many marine organisms. Some organisms display physiological acclimatization or plasticity, but this may vary across species ranges, especially if populations are adapted to local climatic conditions. Understanding how acclimatization potential varies among populations is therefore important in predicting species responses to climate change. We carried out a common garden experiment to investigate how different populations of the economically important great scallop (Pecten maximus) from France and Norway responded to variation in temperature and PCO2 concentration. After acclimation, post-larval scallops (spat) were reared for 31 days at one of two temperatures (13°C or 19°C) under either ambient or elevated PCO2 (pH 8.0 and pH 7.7). We combined measures of proteomic, metabolic and phenotypic traits to produce an integrative picture of how physiological plasticity varies between the populations. The proteome of French spat showed significant sensitivity to environmental variation, with 12 metabolic, structural and stress-response proteins responding to temperature and/or PCO2. Principal component analysis revealed seven energy metabolism proteins in French spat that were consistent with countering ROS stress under elevated temperature. Oxygen uptake in French spat did not change under elevated temperature but increased under elevated PCO2. In contrast, Norwegian spat reduced oxygen uptake under both elevated temperature and PCO2. Metabolic plasticity allows French scallops to maintain greater energy availability for growth compared with Norwegian spat. However, increased physiological plasticity and growth in French spat may come at a cost, as they showed reduced survival compared with Norwegian scallops under elevated temperature.
Diagnostic application of intraoral ultrasonography to assess furcation involvement in mandibular first molars
Authors: Tanaka Ray , Lau Katherine , Yeung Andy WK , Leung Wai Keung , Hayashi Takafumi , Bornstein Michael M. , Tonetti Maurizio S. , Pelekos George 
Published: May 2023

Objectives: The objectives were to clarify if intraoral ultrasonography (USG) is: (1) more accurate than conventional periodontal examinations in detection of furcation involvement, and (2) comparable to conventional periodontal examinations in accurate horizontal classification of furcation involvement in comparison to cone beam computed tomography (CBCT). Methods: The buccal furcation in 61 lower first molars were evaluated with conventional periodontal examinations, intraoral USG and CBCT. The presence and classification of the horizontal depth of furcation involvement were defined clinically by assessment with a Nabers periodontal probe and a periapical radiograph with reference to the bone loss under the fornix. The horizontal depth of furcation involvement was measured in intraoral USG and CBCT images. Based on the measurements, presence diagnosis and horizontal classification were performed. Results from conventional periodontal examinationsand intraoral USG were compared with those from CBCT. Results: κ value (κ) for agreement of presence diagnosis of furcation involvement between intraoral USG and CBCT was 0.792, while agreement with conventional periodontal examinations was 0.225. Diagnostic accuracy of intraoral USG exhibited higher values (sensitivity: 98.3%, accuracy: 98.4 %) than conventional periodontal examinations (81.4% and 81.9 %). Weighted κ statistics showed substantial agreement in the classification between intraoral USG and CBCT (κ = 0.674). High agreement (ICC: 0.914) for the measurement of horizontal depth of furcation involvement was found between intraoral USG and CBCT. Conclusions: Intraoral USG may be a reliable diagnostic tool for assessment of furcation involvement of mandibular molars with a similar performance to CBCT, but without ionizing radiation.
Tranexamic acid for the prevention of postpartum bleeding: Protocol for a systematic review and individual patient data meta-analysis
Authors:   The Anti-fibrinolytics Trialists Collaborators – Obstetric Trialists Group, Ker Katharine , Shakur-Still Haleema , Sentilhes Loïc , Pacheco Luis D. , Saade George , Deneux-Tharaux Catherine , Brenner Amy , Mansukhani Raoul , Ageron François-Xavier , Prowse Danielle , Chaudhri Rizwana , Olayemi Oladapo , Roberts Ian 
Published: May 2023

Background: Tranexamic acid (TXA) reduces the risk of death and is recommended as a treatment for women with severe postpartum bleeding. There is hope that giving TXA shortly before or immediately after birth could prevent postpartum bleeding. Extending the use of TXA to prevent harmful postpartum bleeding could improve outcomes for millions of women; however we must carefully consider the balance of benefits and potential harms. This article describes the protocol for a systematic review and individual patient data (IPD) meta-analysis to assess the effectiveness and safety of TXA for preventing postpartum bleeding in all women giving birth, and to explore how the effects vary by underlying risk and other patient characteristics. Methods: We will search for prospectively registered, randomised controlled trials involving 500 patients or more assessing the effects of TXA in women giving birth. Two authors will extract data and assess risk of bias. IPD data will be sought from eligible trials. Primary outcomes will be life-threatening bleeding and thromboembolic events. We will use a one-stage model to analyse the data. Subgroup analyses will be conducted to explore whether the effectiveness and safety of TXA varies by underlying risk, type birth, maternal haemoglobin (Hb), and timing of TXA. This protocol is registered on PROSPERO (CRD42022345775). Conclusions: This systematic review and IPD meta-analysis will address important clinical questions about the effectiveness and safety of the use of TXA for the prevention of postpartum bleeding that cannot be answered reliably using aggregate data and will inform the decision of who to treat. PROSPERO registration: CRD42022345775 Keywords Anti-fibrinolytics; Tranexamic acid; childbirth; postpartum haemorrhage; meta-analysis
Stakeholder’s perspectives and experiences of patient and public involvement (PPI) in clinical trials in maternal and neonatal healthcare: protocol for a qualitative evidence synthesis
Authors: Hannon Kathleen , Eustace-Cook Jessica , Daly Déirdre , Smith Valerie 
Published: May 2023

Background: Patient and public involvement (PPI) has the potential to improve the relevance of trial outcomes and improve participant recruitment within clinical trials. However, the literature on PPI approaches, outcomes, and attitudes towards PPI in specific clinical research areas is limited. We are interested to know the current approaches to and views of PPI within maternal and neonatal clinical trials, from the perspective and experience of involved stakeholders. Methods: A qualitative evidence synthesis (QES) of stakeholders’ perspectives and experiences of PPI will be conducted. Stakeholders will include any individual involved in maternal or neonatal clinical trials with experience of PPI in the area or who expresses their views on PPI. The electronic bibliographic databases CINAHL, MEDLINE, PsycINFO, EMBASE, Web of Science and the Maternity and Infant Care (OVID) will be searched from inception. Qualitative studies, mixed-methods studies where the qualitative data can be extracted independently, and surveys with open-ended qualitative questions, will be included. Aims: The QES seeks to explore stakeholders’, including PPI contributors, trial participants and guardians, and trial researchers, perspectives and experiences of PPI in maternal and neonatal clinical trials. Discussion: THE QES will provide an understanding of how PPI is understood, operationalised and experienced by stakeholders in maternal and neonatal clinical trials, with the aim of identifying good practice and areas for improvement. PROSPERO registration: CRD42023383878 (2nd March 2023)
Carbon pricing, health co-benefits and trade-offs: protocol for a systematic framework synthesis
Authors: Cuevas Soledad , Nachtigall Daniel , Aguilar Jaber Aimee , Belesova Kristine , Falconer Jane , Haines Andy , Whitmee Sarah , Reynolds Tamzin , Green Rosemary 
Published: May 2023

Carbon pricing is considered an important instrument in the fight against climate change (World Bank, 2022). In particular, many experts and stakeholders have called for the implementation of carbon pricing as a part of ambitious climate policy agendas (Hepburn et al., 2020). This requires consideration of the interactions of carbon pricing with other policies, as well as of the societal outcomes of carbon pricing. In particular, carbon pricing has been found to have potentially large health impacts, leading to important co-benefits as well as potentially some trade-offs (Parry et al., 2014), (Hasegawa et al., 2018). Information on health impacts of carbon pricing, their distribution and how they are affected by policy design is necessary in order to progress towards more socially sustainable and politically feasible policy design. Recent reviews have focussed on various aspects of carbon pricing design and outcomes, synthesizing evidence on its effectiveness, equity impacts or societal perception (Boyce, 2018), (Green, 2021), (Maestre-Andrés et al., 2019). Others have reviewed the evidence on health co-benefits of mitigation, but do not analyse specific policies or issues of policy design Gao et al.(2018). This review will narratively synthesize the evidence on the health impacts of carbon pricing between 2010 and 2021 and identify gaps in the literature. We will use a framework synthesis approach to analyse different categories of policy-relevant information in contexts where carbon pricing is implemented as part of wider, coordinated policy agendas or complex policy mixes. This includes for example impacts on health inequalities and how health co-benefits are affected by issues of policy design and policy interactions.
Linked Cardiology records of the children in the Avon Longitudinal Study of Parents and Children (ALSPAC) From The University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) Heart-Suite (HS) dataset
Authors: Mumme Mark , Taylor Kurt , Boyd Andy , Macleod John 
Published: May 2023

This data note describes the linked records of the index children of the Avon Longitudinal Study of Parents and Children (ALSPAC) birth cohort study found within the cardiology records of the University Hospitals Bristol and Weston NHS Foundation Trust (UHBW) Heart-Suite (HS) dataset. It is important to note that ALSPAC only provided details of participants alive after one year of age, and who had allowed their data to be used for linking, which may have excluded a non-trivial, unknown, quantity from linking to the Bristol tertiary cardiac clinic database. These records were extracted from the computerised record system ‘Heart-Suite’ which is maintained by the Bristol Heart Institute (BHI) in UHBW based at Bristol Royal Infirmary (BRI). The Heart-Suite database is the case management system used by the BHI. A data extract was provided by the BHI data team to ALSPAC. The cleaned Heart-Suite records provide a dataset of specialist, clinical records of a subset of the ALSPAC cohort who were referred to the tertiary cardiac team at UHBW. These data can be linked to the wider ALSPAC dataset and made available to approved research users.