bluuebunny/crossref_metadata_2025_split huggingface dataset:
Invisible voices: experiences and perceptions of mothers and grandmothers caring for newborns with neonatal abstinence syndrome
Authors: Lao Amberly , Li Tessa , Battaglia Sarah , Berry Jessica , Artigas Valarie , Cong Xiaomei 
Published: January 2023

Abstract

Objective:
This study was designed to give mothers with opioid use disorder (OUD) and their families a “voice” in sharing their experiences surrounding the relationship with health care staff in the care of their newborn with neonatal abstinence syndrome (NAS) and aimed to identify their perceptions of the care received during their newborn’s hospitalization.

Methods:
A cross-sectional study was administered through Qualtrics online survey software. The survey questions with quantitative and qualitative components were developed and validated by the researchers to explore perceptions and experiences regarding the care the mother and the infant received, and their feelings about whether they were adequately educated and prepared to care for themselves and infant with NAS. A convenience sampling method was used to recruit mothers (18 years old and above) who gave birth to infants with NAS as well as their family members from the Department of Behavioral and Community Health in the Northeastern United States. Descriptive analysis methods were used to describe the quantitative survey data and thematic content analysis approach was used to explore the qualitative narrative data.

Results:
Twenty mothers were eligible for the study and a total of 10 mothers and 3 grandmothers participated in the final study. Primary outcomes for quantitative results from mothers were frustration based on how they were treated, the belief that the newborn required the neonatal intensive care unit, and the conclusion that they were treated inferiorly compared with mothers without OUD. Four major themes identified by the mothers were: judgment by the health care providers, trying to be a good mother, education needs of mothers to receive more information about NAS, and not understood by the health care providers and the need for training specified to caring for OUD during pregnancy and NAS. Results of the grandmothers’ study demonstrated a deficiency in personal knowledge about caring for an infant with NAS, and a belief that the mother was treated poorly due to her history.

Conclusions:
Women with OUD are blamed and stigmatized for their decisions and experience a lack of knowledge in caring for their infants. While further research is warranted in exploring these topics, the disparities between this population and health care providers may increase health risks for both the mother and newborn.
Compensation for Vitreous Chamber Elongation in Infancy and Childhood
Authors: Mutti Donald O. , Sinnott Loraine T. , Zadnik Karla ,   for the BIBS Study Group and the CLEERE Study Group
Published: January 2023

ABSTRACT

SIGNIFICANCE
The ratios of diopters of change in refractive error produced per millimeter of eye elongation (D/mm) are rarely those predicted from geometric optics because of changes in other ocular components. Quantifying this optical compensation in millimeters instead of ratios reveals some important principles about eye growth and refractive error.

PURPOSE
The study purpose was to sort total vitreous chamber elongation into millimeters that either contributed (uncompensated) or did not contribute to change in refractive error (compensated).

METHODS
Participants were infants in the Berkeley Infant Biometry Study (n = 271, ages 3 months to 6 years) or schoolchildren in the Collaborative Longitudinal Evaluation of Ethnicity and Refractive Error (n = 456 emmetropes and 522 myopes, ages 6 to 14 years). Refractive error was measured using cycloplegic retinoscopy in infants (cyclopentolate 1%) and cycloplegic autorefraction in schoolchildren (tropicamide 1% or combined with cyclopentolate 1%). Axial dimensions were assessed using A-scan ultrasonography. Uncompensated millimeters were estimated from ratios of change in refractive error per millimeter of elongation using Gullstrand eye models. Compensated millimeters were the difference between measured elongation and uncompensated millimeters.

RESULTS
Compensated millimeters exceeded uncompensated millimeters in emmetropic children across ages, but uncompensated millimeters exceeded compensated millimeters in myopic children. Compensated millimeters were highest in infancy and decreased with age, reaching less than 0.10 mm per year by age 10 years in both myopic and emmetropic children. There were no statistically significant differences in compensated millimeters between myopic and emmetropic children between ages 8 and 14 years (P values from .17 to .73).

CONCLUSIONS
The ability of the ocular components, primarily crystalline lens, to compensate for vitreous elongation is independent of the higher demands of myopic eye growth. The limited compensation after age 10 years suggests the target for elongation in myopia control needed to arrest myopia progression may be that seen in emmetropes or less.
One-year Efficacy of the Defocus Incorporated Multiple Segment Lens in Chinese Myopic Children
Authors: Long Wen , Chen Kezhe , Yu Shuiming , Liang Ziqi , Zheng Bingru , Zeng Junwen , Cui Dongmei 
Published: January 2023

SIGNIFICANCE
These data demonstrate that defocus incorporated multiple segment (DIMS) lens reduces myopia progression in children during the first year of use.

PURPOSE
This study aimed to investigate the efficacy of DIMS myopia control spectacle lens in Chinese myopic children aged 6 to 15 years.

METHODS
This is a retrospective study of 1-year longitudinal data. A total of 180 Chinese myopic children were selected from patients at Zhongshan Ophthalmic Center, Sun Yat-sen University, from February 2018 to January 2021. One group consisted of 90 children aged 6 to 15 years, with spherical equivalent refraction −0.50 to −7.75 D (−3.82 ± 1.57 D) and fitted with the DIMS lens. The other group consisted of 90 children fitted with single-vision spectacle lenses and matched with the DIMS group for age, sex, refraction, and progression of myopia in the previous year. One-year myopia progression was measured retrospectively in two groups. Unpaired t test was used to compare the myopia progression between the DIMS group and the control group. Pearson correlation was used to explore the relationship between myopia progression, age, and baseline refraction.

RESULTS
After 1 year of DIMS lens wear, myopia progression was significantly lower in the DIMS group (−0.51 ± 0.50 vs. −0.85 ± 0.51 D, P < .001). Myopia progression was positively correlated with age in both groups. The difference between the DIMS and control groups was more pronounced for children aged 10 to 15 years than for children aged 6 to 9 years.

CONCLUSIONS
This study confirms that the DIMS lens reduces myopia progression during the first year of use. Efficacy seems to increase with age.
Improvements in disability and function in people with lower-limb amputation one year after prosthesis osseointegration
Authors: Davis-Wilson Hope C. , Christiansen Cory L. , Gaffney Brecca M. M. , Lev Guy , Enabulele Eseosa , Stoneback Jason W. 
Published: January 2023

Background:
People with lower-limb amputation (LLA) are routinely prescribed a socket prosthesis; however, many socket prosthesis users experience severe complications with the fit of their prosthesis including residual limb wounds and pain. Osseointegration is a procedure that creates a direct connection between the bone and prosthetic limb through a bone-anchored prosthesis, eliminating the need for a socket interface. It is offered as a secondary procedure to people with LLA who experience significant complications with socket prostheses.

Objectives:
To evaluate change in disability and function 1 year postosseointegration compared with preosseointegration in people with LLA.

Study design:
Single group, pretest, and post-test.

Methods:
Twelve participants (9 transfemoral and 3 transtibial amputations, age: 44 ± 10 years, 7 female participants, 14 ± 12 years since amputation) with unilateral LLA underwent osseointegration with press-fit implants. Disability was measured with the World Health Organization Disability Assessment Schedule 2.0, and function was measured with both Prosthetic Limb Users Mobility Survey and the Activities-Specific Balance Confidence Scale. Questionnaires were administered preosseointegration and 1 year postosseointegration. Paired t tests assessed change in outcomes between time points.

Results:
Postosseointegration, participants demonstrated reduced disability measured with World Health Organization Disability Assessment Schedule 2.0 (%Δ = −52.6, p = 0.01), improved mobility measured with Prosthetic Limb Users Mobility Survey (%Δ = 21.8, P < 0.01), and improved balance confidence measured with the Activities-Specific Balance Confidence Scale (%Δ = 28.4, P < 0.01).

Conclusions:
Participants report less disability and greater function in their prosthesis postosseointegration. Osseointegration is a novel procedure for people experiencing complications with their socket prosthesis, and this study is the first to show improvements in disability postosseointegration.
Brief Report: Detection of Urine Lipoarabinomannan Is Associated With Proinflammatory Innate Immune Activation, Impaired Host Defense, and Organ Dysfunction in Adults With Severe HIV-Associated Tuberculosis in Uganda
Authors: Cummings Matthew J. , Bakamutumaho Barnabas , Jain Komal , Price Adam , Owor Nicholas , Kayiwa John , Namulondo Joyce , Byaruhanga Timothy , Muwanga Moses , Nsereko Christopher , Nayiga Irene , Kyebambe Stephen , Che Xiaoyu , Sameroff Stephen , Tokarz Rafal , Wong Wai , Postler Thomas S. , Larsen Michelle H. , Lipkin W. Ian , Lutwama Julius J. , O'Donnell Max R. 
Published: January 2023

Background:
The immunopathology of disseminated HIV-associated tuberculosis (HIV/TB), a leading cause of critical illness and death among persons living with HIV in sub-Saharan Africa, is incompletely understood. Reflective of hematogenously disseminated TB, detection of lipoarabinomannan (LAM) in urine is associated with greater bacillary burden and poor outcomes in adults with HIV/TB.

Methods:
We determined the relationship between detection of urine TB-LAM, organ dysfunction, and host immune responses in a prospective cohort of adults hospitalized with severe HIV/TB in Uganda. Generalized additive models were used to analyze the association between urine TB-LAM grade and concentrations of 14 soluble immune mediators. Whole-blood RNA-sequencing data were used to compare transcriptional profiles between patients with high- vs. low-grade TB-LAM results.

Results:
Among 157 hospitalized persons living with HIV, 40 (25.5%) had positive urine TB-LAM testing. Higher TB-LAM grade was associated with more severe physiologic derangement, organ dysfunction, and shock. Adjusted generalized additive models showed that higher TB-LAM grade was significantly associated with higher concentrations of mediators reflecting proinflammatory innate and T-cell activation and chemotaxis (IL-8, MIF, MIP-1β/CCL4, and sIL-2Ra/sCD25). Transcriptionally, patients with higher TB-LAM grades demonstrated multifaceted impairment of antibacterial defense including reduced expression of genes encoding cytotoxic and autophagy-related proteins and impaired cross-talk between innate and cell-mediated immune effectors.

Conclusions:
Our findings add to emerging data suggesting pathobiological relationships between LAM, TB dissemination, innate cell activation, and evasion of host immunity in severe HIV/TB. Further translational studies are needed to elucidate the role for immunomodulatory therapies, in addition to optimized anti-TB treatment, in this often critically ill population.
ARTERIAL HYPEROXIA AND MORTALITY IN PATIENTS UNDERGOING VENOARTERIAL EXTRACORPOREAL MEMBRANE OXYGENATION
Authors: Celińska-Spodar Małgorzata , Załęska-Kocięcka Marta , Banaś Sławomir , Kołsut Piotr , Kowalik Ilona , Kuśmierczyk Mariusz , Kuśmierski Krzysztof , Litwiński Paweł , Sitkowska-Rysiak Ewa , Szymański Jarosław , Stępińska Janina 
Published: January 2023

ABSTRACT

Background: Venoarterial extracorporeal membrane oxygenation (VA-ECMO) can easily lead to supranormal oxygenation. The impact of hyperoxygenation beyond the early VA-ECMO support phase is unexplored. We sought to investigate its association with short- and long-term mortality. Methods: A total of 10,615 arterial blood gases of 179 patients undergoing VA-ECMO between 2013 and 2018 in our cardiosurgical tertiary center were analyzed for partial pressure of oxygen (PaO2) and its association with in-hospital, 90-day, and 1-year mortality. Patients were stratified into terciles (T) based on PaO2. Results: The median systemic PaO2 during VA-ECMO was 122 mm Hg (Q1–Q3, 111–158 mm Hg) and was significantly higher in 90-day nonsurvivors versus survivors (134 mm Hg [Q1–Q3, 114–175 mm Hg] vs. 114 mm Hg [Q1–Q3, 109–136 mm Hg]; P < 0.001). The incidence of mortality increased at all time points tested after VA-ECMO implantation along with the increasing terciles of PaO2. The lowest mortality rates were noted for patients with median PaO2 values of <115 mm Hg (T1), whereas patients with median PaO2 values of >144 mm Hg (T3) had the highest mortality rates. Bonferroni multiple testing analysis found the T3 of PaO2 to be a predictor of decreased 90-day survival in comparison with T1 (P < 0.001) and T2 (P = 0.002). Multivariable Cox regression analyses for in-hospital, 90-day, and 1-year mortality showed a significant association of the T3 compared with the T2 and the T1 of PaO2 to mortality across all endpoints. Conclusion: Hyperoxygenation during VA-ECMO might be associated with increased all-cause mortality. The results of our study further document the known toxicity of hyperoxygenation in general critical care patients and mark the need to focus specifically on VA-ECMO patients.
Cost Effectiveness of Concurrent Midurethral Sling at the Time of Prolapse Repair: Results From a Randomized Controlled Trial
Authors: Wang Rui , Tulikangas Paul , Sappenfield Elisabeth C. 
Published: January 2023

Importance
The relative cost per improvement in quality of life can help guide decisions about adding a midurethral sling at the time of prolapse surgery.

Objective
This study aimed to assess the cost-effectiveness of prophylactic midurethral slings placed at the time of prolapse surgery to reduce de novo urinary incontinence based on a randomized controlled trial.

Study Design
Costs and effectiveness were collected as part of a planned secondary analysis from the Outcomes following vaginal Prolapse repair and mid Urethral Sling (OPUS) trial, where 337 women without symptomatic stress urinary incontinence were randomly assigned to a midurethral sling or sham incisions during vaginal prolapse surgery. Within-trial cost-effectiveness analysis was performed from the societal perspective. Effectiveness was measured in quality-adjusted life-years (QALYs) and de novo urinary incontinence. We calculated incremental cost-effectiveness ratios and cost-effectiveness acceptability curves.

Results
Within-trial societal costs were higher for the sling group than for the control group ($18,170 [95% confidence interval (CI), $16,420–$19,920] vs $15,700 [95% CI, $14,110–$17300], P = 0.041). The changes in QALY were 0.04 (95% CI, 0.02–0.06) versus 0.03 (95% CI, 0.02–0.05; P = 0.54). The incremental cost-effectiveness ratio for prophylactic sling was $309,620/QALY. This is above the generally accepted range of willingness-to-pay thresholds of $50,000 to $150,000/QALY. At 1 year, urinary incontinence was more common in the control group, and the cost to prevent 1 case was $91. The probability that prophylactic sling is cost-effective is 24%.

Conclusions
Prophylactic sling placed during vaginal prolapse surgery reduced the rate of de novo urinary incontinence, but was not cost-effective.
Exploring Patient Perspectives Surrounding Telemedicine Versus In-Person Preoperative Visits
Authors: Davenport Abigail , Brunn Elizabeth , Creswell Michael , Sholklapper Tamir , Ringel Nancy , Gutman Robert 
Published: January 2023

Importance
Telemedicine was increasingly used to provide patients with an alternative to in-office visits during the COVID-19 pandemic. While previous studies have described the role of telemedicine for preoperative visits for other surgical specialties, the role of this modality in preoperative visits for gynecologic surgery has not been thoroughly explored.

Objectives
The aims of the study are to explore and compare patient experience, decision making, and satisfaction among women undergoing telemedicine or in-person preoperative visits.

Study Design
This was a qualitative study of women who underwent a preoperative appointment with a urogynecologic surgeon or minimally invasive gynecologic surgeon at a single academic institution from April to May of 2021. Data were collected using semistructured phone interviews, which focused on visit content, visit type decision making, surgical preparedness/confidence, and past surgical experiences. Interviews were thematically analyzed until theoretical saturation was achieved in accordance with grounded theory.

Results
Theoretical saturation occurred with 20 interviews. Participants were evenly divided between in-person and telemedicine visits. Major themes included visit content, experience/quality, surgeon perception, and surgical preparedness. Advantages of telemedicine visits were convenience and safety. Advantages of in-person visits were social factors, perceived medical or surgical severity, and preoperative physical examination. Disadvantages for telemedicine visits included technology concerns and difficulty accessing preoperative materials. The disadvantage of an in-person visit was the inability to have family present because of COVID hospital policy restrictions. Participants in both groups felt prepared for surgery and reported high satisfaction with their care.

Conclusions
Decision making for selecting an in-person or telemedicine visit is complex and involves balancing multiple advantages and disadvantages. Participant experience was similar for both visit types with high satisfaction.
rhMYDGF Alleviates I/R-induced Kidney Injury by Inhibiting Inflammation and Apoptosis via the Akt Pathway
Authors: Wang Jingwen , Ma Ruiyang , Wang Ying , Zhang Shucong , Wang Jiale , Zheng Jin , Xue Wujun , Ding Xiaoming 
Published: January 2023

Background.
Renal ischemia/reperfusion (I/R) injury is one of the crucial factors affecting the outcome of renal transplantation. In recent years, myeloid-derived growth factor (MYDGF) has received a lot of attention for its extensive beneficial effects on cardiac repair and protection of cardiomyocytes from cell death. Therefore, we hypothesized that the recombinant human MYDGF (rhMYDGF) protein might play an essential role in safeguarding renal I/R injury.

Methods.
In vivo experiments were conducted using a mouse unilateral I/R model. Mice were pretreated with rhMYDGF by intraperitoneal injection to study the potential mechanism of renal protection. In vitro, we established hypoxia/reoxygenation and H2O2 treatment models to pretreat cells with rhMYDGF. The expression levels of oxidative stress, inflammation, and apoptosis-related factors in tissues and cells were detected. Finally, we explored the role of the protein kinase B (Akt) pathway in the renal protective mechanism of rhMYDGF.

Results.
In this study, we found that intraperitoneal injection of 1.25 μg rhMYDGF could significantly improve renal function of I/R mice, and reduce oxidative stress, inflammation, and apoptosis. For the human proximal tubular epithelial cell line and human kidney cell line, pretreatment with 0.3 μg/mL rhMYDGF for 24 h significantly downregulated oxidative stress, inflammation, and apoptosis via the phosphorylation of Akt, which could be ameliorated by LY294002.

Conclusions.
rhMYDGF protects kidney from I/R injury by attenuating oxidative stress, inflammation, and apoptosis through the activation of the Akt pathway.
An Eye on CAUTI Prevention: Bridging the Gap in the Prevention of Catheter-Associated Urinary Tract Infections
Authors: Yeruva Karthik , West Nat , Powell Warseal 
Published: January 2023

AbstractProblemThe United States Healthcare Systems is burdened heavily by healthcare-associated infections (HAI), as they pose significant risks for increased mortality and morbidity. The most common type of HAI is urinary tract infection (UTI), and these infections are preventable (Strassle et al., 2019). According to the CDC (2021), 12-16% of hospitalized adults will at some point require catheterization; and each day an indwelling catheter remains in place increases the patient’s risks of adverse outcomes by 3-7%. CAUTIs have been linked to increased mortality and morbidity rates across the world. The Centers for Disease Control report urinary tract infections (UTI) lead to more than 13,000 deaths each year (Centers for Disease Control [cdc], 2021).ObjectiveThis quality improvement (QI) project will focus on the prevention of hospital-acquired UTIs, specifically those infections related to indwelling devices such as foley catheters. The purpose of this manuscript is to review the current evidence-based literature related to CAUTI prevention, trial an intervention that parallels the literature in a local hospital and evaluate those results.DesignThe researcher focused on the problem of CAUTI, analyzed current evidence-based practices related to prevention, developed a plan to execute a high-value improvement tool, and evaluated its effectiveness.SettingQI project took place in a local community hospital. The focus area was the medical-surgical ICU.ParticipantsThe participants were nursing staff and nursing managers on the medical surgical units, specifically those in positions with unique or direct involvement with insertion, removal, or monitoring of foley catheters. The subjects in this quality improvement project included adult patients hospitalized in the medical surgical intensive care unit (ICU).InterventionsA CAUTI GPS screening tool was used to identify current prevention practices and/or any roadblocks to the prevention of CAUTI within the facility. Then, TAP (targeted assessment for prevention) strategy was implemented, which prompted expedited removal of indwelling catheters and/or the use of external drainage devices where indicated.ResultsThere was a marked increase in attention to and prompt removal of indwelling foleys throughout the critical care unit. The facility had no hospital-acquired CAUTI during the project period.ConclusionsThere must be an impetus to inspire compliance. If healthcare workers adhere to prevention guidelines, CAUTIs are preventable. When leadership team members within hospital systems are enthusiastic about CAUTI prevention, the organization as a whole has increased motivation (Chenoweth et al., 2014).