bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Shieh Score as a Risk Assessment Instrument for Reducing Hospital-Acquired Pressure Injuries
Authors: Shieh David , Sevilla Mia , Palmeri Anthony , Ly An H. , Shi Jiaxiao M. , Berringer Christine , Resurreccion Juji 
Published: July 2023

PURPOSE:
The purpose of this study was to evaluate the Shieh Score's effectiveness in decreasing the rate of hospital-acquired pressure injuries when combined with an early warning notification system and standard order set of preventative measures.

DESIGN:
This was a prospective cohort study.

SUBJECTS AND SETTING:
This target population was nonpregnant, adult, hospitalized patients on inpatient and observation status at a tertiary hospital (Kaiser Permanente, Baldwin Park, California) during the 2020 year of the COVID-19 pandemic.

METHODS:
A new, risk assessment instrument, the Shieh Score, was developed in 2019 to predict hospitalized patients at high risk for pressure injuries. Data collection occurred between January 21, 2020, and December 31, 2020. When a hospital patient met the high-risk criteria for the Shieh Score, a provider-ordered pink-colored sheet of paper titled “Skin at Risk” was hung at the head of the bed and a standard order set of pressure injury preventative measures was implemented by nursing staff.

RESULTS:
Implementation of the program (Shieh Score, early warning system, and standard order set for preventive interventions) resulted in a 38% reduction in the annual hospital-acquired pressure injury rate from a mean incidence rate of 1.03 to 0.64 hospital-acquired pressure injuries per 1000 patient-days measured for the year 2020.

CONCLUSION:
The Shieh Score is a pressure injury risk assessment instrument, which effectively identifies patients at high risk for hospital-acquired pressure injuries and decreases the hospital-acquired pressure injury rate when combined with an early warning notification system and standard order set.
Double‐donor surrogacy and the intention to parent
Authors: Baron Teresa 
Published: July 2023

AbstractAssisted reproduction often involves biological contributions by third parties such as egg/sperm donors, mitochondrial DNA donors, and surrogate mothers. However, these arrangements are also characterised by a biological relationship between the child and at least one intending parent. For example, one or both intending parents might use their own eggs/sperm in surrogacy, or an intending mother might conceive using donor sperm or gestate a donor embryo. What happens when this relationship is absent, as in the case of 'double‐donor surrogacy' arrangements (DDS)? Here, a child is conceived using both donor eggs and sperm, carried by a surrogate, and raised by the commissioning parents. In this paper, I critically examine proposals to allow DDS in the United Kingdom, and the intentionalist justification for treating this practice distinctly (morally and legally speaking) from private adoption. I argue that the intentionalist approach cannot plausibly justify such a distinction and that other approaches to moral parenthood are also unlikely to succeed.
Discussion on “Optimal Test Procedures for Multiple Hypotheses Controlling the Familywise Expected Loss” by Willi Maurer, Frank Bretz, and Xiaolei Xun
Authors: Benjamini Yoav , Heller Ruth , Krieger Abba , Rosset Saharon 
Published: July 2023

Abstract
We discuss three issues. In the first part, we discuss the criteria emphasized by Maurer, Bretz, and Xun, warning that it modifies the per comparison error rate that does not address the concerns raised by multiple testing. In the second part, we strengthen the optimality results developed in the paper, based on our recent results. In the third part, we highlight the potentially important role that the use of weights may have in practice and discuss the difficulties in assigning weights that convey the importance in the gain and loss functions, especially as it pertains to multiple endpoints.
Respiratory sinus arrhythmia (RSA) dynamics matter for children's emotion regulation: RSA inertia and instability within a stress task
Authors: Xu Jianjie , Wang Hui , Morrow Kayley Elizabeth , Xu Yang , Gao Mengyu Miranda , Hu Yueqin , Suveg Cynthia , Han Zhuo Rachel 
Published: July 2023

AbstractThe present study employed two key dynamic indicators (i.e., inertia and instability) to the psychophysiological research of child emotion regulation (ER) and examined whether respiratory sinus arrhythmia (RSA) dynamics were associated with child ER during a stress task. Eighty‐nine Chinese school‐age children (Mage = 8.77 years, SD = 1.80 years; 46.1% girls) and their primary caregivers participated in the study. After controlling for RSA static reactivity, multiple regression analyses indicated that lower RSA inertia was related to fewer in‐task negative emotions rated by children and their caregivers, and higher RSA instability was associated with better child trait ER. This study introduces physiological indicators of the dynamic aspects of parasympathetic activity to the study of child ER.
The effect of maternal position on placental blood flow and fetoplacental oxygenation in late gestation fetal growth restriction: a magnetic resonance imaging study
Authors: Jani Devanshi , Clark Alys , Couper Sophie , Thompson John M. D. , David Anna L. , Melbourne Andrew , Mirjalili Ali , Lydon Anna‐Maria , Stone Peter R. 
Published: July 2023

AbstractFetal growth restriction (FGR) and maternal supine going‐to‐sleep position are both risk factors for late stillbirth. This study aimed to use magnetic resonance imaging (MRI) to quantify the effect of maternal supine position on maternal‐placental and fetoplacental blood flow, placental oxygen transfer and fetal oxygenation in FGR and healthy pregnancies. Twelve women with FGR and 27 women with healthy pregnancies at 34–38 weeks’ gestation underwent MRI in both left lateral and supine positions. Phase‐contrast MRI and a functional MRI technique (DECIDE) were used to measure blood flow in the maternal internal iliac arteries (IIAs) and umbilical vein (UV), placental oxygen transfer (placental flux), fetal oxygen saturation (FO2), and fetal oxygen delivery (delivery flux). The presence of FGR, compared to healthy pregnancies, was associated with a 7.8% lower FO2 (P = 0.02), reduced placental flux, and reduced delivery flux. Maternal supine positioning caused a 3.8% reduction in FO2 (P = 0.001), and significant reductions in total IIA flow, placental flux, UV flow and delivery flux compared to maternal left lateral position. The effect of maternal supine position on fetal oxygen delivery was independent of FGR pregnancy, meaning that supine positioning has an additive effect of reducing fetal oxygenation further in women with FGR, compared to women with appropriately grown for age pregnancies. Meanwhile, the effect of maternal supine positioning on placental oxygen transfer was not independent of the effect of FGR. Therefore, growth‐restricted fetuses, which are chronically hypoxaemic, experience a relatively greater decline in oxygen transfer when mothers lie supine in late gestation compared to appropriately growing fetuses.
imageKey points
Fetal growth restriction (FGR) is the most common risk factor associated with stillbirth, and early recognition and timely delivery is vital to reduce this risk.
Maternal supine going‐to‐sleep position is found to increase the risk of late stillbirth but when combined with having a FGR pregnancy, maternal supine position leads to 15 times greater odds of stillbirth compared to supine sleeping with appropriately grown for age (AGA) pregnancies.
Using MRI, this study quantifies the chronic hypoxaemia experienced by growth‐restricted fetuses due to 13.5% lower placental oxygen transfer and 26% lower fetal oxygen delivery compared to AGA fetuses.
With maternal supine positioning, there is a 23% reduction in maternal‐placental blood flow and a further 14% reduction in fetal oxygen delivery for both FGR and AGA pregnancies, but this effect is proportionally greater for growth‐restricted fetuses.
This knowledge emphasises the importance of avoiding supine positioning in late pregnancy, particularly for vulnerable FGR pregnancies.
Polymyoclonus, ventricular fibrillation and Takotsubo after accidental spinal injection of tranexamic acid
Authors: Costa Laura , Costa Marina , Martins José , Castro Rui 
Published: July 2023

Several factors have been identified as contributing to medication administration errors, including look-alike, sound-alike (LASA) errors. LASA errors are important causes of serious adverse events arising from spinal injection of tranexamic acid, which can be confused with ampoules of local anaesthesia.We present a case of accidental injection of 250 mg of tranexamic acid rather than prilocaine during spinal anaesthesia. The patient developed lower extremities myoclonus, followed by generalised convulsions and ventricular fibrillation, that was reverted within 6 min. Severe cardiogenic shock requiring both inotropic and vasopressor therapy followed, along with a classic apical ballooning pattern on echocardiography and elevated myocardial injury markers, indicating Takotsubo cardiomyopathy. The patient’s condition progressively improved to full recovery, and she was discharged from hospital after 1 month with no neurological deficit or cardiac dysfunction.To our knowledge, this is the 28th reported case of accidental spinal injection of tranexamic acid. We present a brief review of previously published cases.
WGC and WCC for charged black holes with quintessence and cloud of strings
Authors: Alipour Mohammad Reza , Sadeghi Jafar , Shokri Mehdi 
Published: July 2023

AbstractOne of the important problems with the existence of weak gravity conjecture (WGC) is the violation of the cosmic censorship. Such a cosmic phenomena is important and consistent in general relativity. It means that for a charged black hole in four dimensions and in the normal state, the WGC cannot hold due to the violation of the weak cosmic censorship conjecture (WCCC). But in this paper, in order to eliminate such a violation, we try to consider RN black hole at two cases, with quintessence, quintessence and cloud of strings in asymptotically flat and non-asymptotically flat. By using such metric background and applying restrictions on its parameters, we show that there will be a good compatibility between WGC and WCCC. Here, we can also see that quintessence case has less freedom in establishing compatibility than quintessence and cloud of strings. Because in the second case, the number of parameters is more and there is a degree of freedom to better establish the compatibility of two theories. Also, here we explain charged black hole in presence of quintessence and cloud of string for $$Q>M$$

Q
>
M

and use some interesting figures we show the corresponding the black hole has an event horizon.
Multiparametric Magnetic Resonance Imaging and Magnetic Resonance Elastography to Evaluate the Early Effects of Bariatric Surgery on Nonalcoholic Fatty Liver Disease
Authors: Tan Hong Chang , Shumbayawonda Elizabeth , Beyer Cayden , Cheng Lionel Tim-Ee , Low Albert , Lim Chin Hong , Eng Alvin , Chan Weng Hoong , Lee Phong Ching , Tay Mei Fang , Kin Stella , Chang Jason Pik Eu , Bee Yong Mong , Goh George Boon Bee 
Published: July 2023

Background. Bariatric surgery is the most effective treatment for morbid obesity and reduces the severity of nonalcoholic fatty liver disease (NAFLD) in the long term. Less is known about the effects of bariatric surgery on liver fat, inflammation, and fibrosis during the early stages following bariatric surgery. Aims. This exploratory study utilises advanced imaging methods to investigate NAFLD and fibrosis changes during the early metabolic transitional period following bariatric surgery. Methods. Nine participants with morbid obesity underwent sleeve gastrectomy. Multiparametric MRI (mpMRI) and magnetic resonance elastography (MRE) were performed at baseline, during the immediate (1 month), and late (6 months) postsurgery period. Liver fat was measured using proton density fat fraction (PDFF), disease activity using iron-correct T1 (cT1), and liver stiffness using MRE. Repeated measured ANOVA was used to assess longitudinal changes and Dunnett’s method for multiple comparisons. Results. All participants (Age

45.1
±
9.0

years, BMI

39.7
±
5.3

kg
/

m

2

) had elevated hepatic steatosis at baseline (PDFF >5%). In the immediate postsurgery period, PDFF decreased significantly from

14.1
±
7.4
%

to 8

.9
±
4.4
%

(

p
=
0.016

) and cT1 from

826.9
±
80.6

ms

to

768.4
±
50.9

ms

(

p
=
0.047

). These improvements continued to the later postsurgery period. Bariatric surgery did not reduce liver stiffness measurements. Conclusion. Our findings support using MRI as a noninvasive tool to monitor NAFLD in patient with morbid obesity during the early stages following bariatric surgery.
Associations between Ambient Air Pollutants and Clonal Hematopoiesis of Indeterminate Potential
Authors: Leiser Claire L. , Whitsel Eric A. , Reiner Alexander , Rich Stephen S. , Rotter Jerome I. , Taylor Kent D. , Tracy Russel P. , Kooperberg Charles , Smith Albert Vernon , Manson JoAnn E. , Mychaleckyj Josyf C. , Bick Alexander G. , Szpiro Adam A. , Kaufman Joel D. 
Published: July 2023

Abstract

Background:
Clonal hematopoiesis of indeterminate potential (CHIP) is an age-related somatic mutation associated with incident hematologic cancer. Environmental stressors which, like air pollution, generate oxidative stress at the cellular level, may induce somatic mutations and some mutations may provide a selection advantage for persistence and expansion of specific clones.

Methods:
We used data from the Multi-Ethnic Study of Atherosclerosis (MESA) N = 4,379 and the Women's Health Initiative (WHI) N = 7,701 to estimate cross-sectional associations between annual average air pollution concentrations at participant address the year before blood draw using validated spatiotemporal models. We used covariate-adjusted logistic regression to estimate risk of CHIP per interquartile range increases in particulate matter (PM2.5; 4 μg/m3) and nitrogen dioxide (NO2; 10 ppb) as ORs (95% confidence intervals).

Results:
Prevalence of CHIP at blood draw (variant allele fraction &gt; 2%) was 4.4% and 8.7% in MESA and WHI, respectively. The most common CHIP driver mutation was in DNMT3A. Neither pollutant was associated with CHIP: ORMESA PM2.5 = 1.00 (0.68–1.45), ORMESA NO2 = 1.05 (0.69–1.61), ORWHI PM2.5 = 0.97 (0.86–1.09), ORWHI NO2 = 0.98 (0.88–1.10); or with DNMT3A-driven CHIP.

Conclusions:
We did not find evidence that air pollution contributes to CHIP prevalence in two large observational cohorts.

Impact:
This is the first study to estimate associations between air pollution and CHIP.
3D-Laparoscopic transperitoneal pyelolithotomy in a rare case of pelvic cake kidney: case report and review of literature
Authors: Kapoor Ketan K. , Kumar Anup 
Published: July 2023

Abstract
Background
Bilateral ectopic pelvic kidneys are rarely observed, and cake form of fusion is a relatively distinct anomaly. With the presence of aberrant vasculature and risk of injuring surrounding viscera, conventional treatment of symptomatic calculi with percutaneous and retrograde approaches, become challenging for the urologist. 3D Laparoscopic approach is safe, reduces patient morbidity and avoids open surgery.

Case presentation
We herein report a case of 44-year-old female with symptomatic calculi in a pelvic cake kidney, which was adequately managed by 3D laparoscopic transperitoneal pyelolithotomy. Preoperatively, CT imaging and fluoroscopy were performed. The surgery lasted for 156 min, and complete stone clearance was achieved. Postoperative course was uneventful, and patient was discharged in 72 h.

Conclusions
3D Laparoscopic pyelolithotomy is an acceptable and efficient treatment modality for symptomatic calculi in ectopic fused pelvic kidneys with a malrotated orientation.
Persistent high levels of carcinoembryonic antigen after tumor resection are associated with poorer survival outcomes in patients with resected colon cancer
Authors: Muñoz-Montaño Wendy R. , López-Basave Horacio N. , Castillo-Morales Alison , Castillo-Morales Carolina , Sánchez-Trejo Karen , Catalán Rodrigo , Díaz-Romero Consuelo , Lino-Silva Leonardo S. , Maliachi-Díaz Andrea , Ruiz-García Erika , Herrera-Martínez Marytere , Calderillo-Ruíz German 
Published: July 2023

Abstract
Background
Interindividual survival and recurrence rates in cases of locoregional colon cancer following surgical resection are highly variable. The aim of the present study was to determine whether elevated pre-operative and post-operative CEA values are useful prognostic biomarkers for patients with stage I-III colon cancer who underwent surgery with curative intent.

Methods
We conducted a retrospective study in patients with histologically confirmed stage I-III primary colonic adenocarcinoma who underwent radical surgical resection at Mexico’s National Cancer Institute, between January 2008 and January 2020. We determined pre-operative and post-operative CEA and analyzed the association of scores with poorer survival outcomes in patients with resected colon cancer, considering overall survival (OS) and disease-free survival (DFS).

Results
We included 640 patients with stage I-III colon cancer. Pre-operative CEA levels were in the normal range in 460 patients (group A) and above the reference value in the other 180. Of the latter, 134 presented normalized CEA levels after surgery, but 46 (group C) continued to show CEA levels above the reference values after surgery. Therefore, propensity score matching (PSM) was carried out to reduce the bias. Patients were adjusted at a 1:1:1 ratio with 46 in each group, to match the number in the smallest group. Median follow- up was 46.4 months (range, 4.9–147.4 months). Median DFS was significantly shorter in Group C: 55.5 months (95% CI 39.6–71.3) than in the other two groups [Group A: 77.1 months (95% CI 72.6–81.6). Group B: 75.7 months (95% CI 66.8–84.5) (p-value < 0.001)]. Overall survival was also significantly worse in group C [57.1 (95% CI 37.8–76.3) months] than in group A [82.8 (95% CI 78.6–86.9 months] and group B [87.1 (95% CI 79.6–94.5 months] (p-value = 0.002). To identify whether change in CEA levels operative and post-surgery was an independent prognostic factor for survival outcomes, a Cox proportional hazard model was applied. In multivariate analysis, change in CEA level was a statistically significant, independent prognostic factor for overall survival (p-value = 0.031).

Conclusions
When assessed collectively, pre-operative and post-operative CEA values are useful biomarkers for predicting survival outcomes in patients with resected colon cancer. Prognoses are worse for patients with elevated pre-operative and post-surgical CEA values, but similar in patients with normal post-surgical values, regardless of their pre-surgery values.
‘A Different Ball Game’: Adaptation of a men’s health program for implementation in rural Australia
Authors: McDonald Matthew D. , Hunt Kate , Moullin Joanna , Kerr Deborah , Ntoumanis Nikos , Quested Eleanor 
Published: July 2023

Abstract
Background
Men residing in rural areas are less likely to participate in weight management interventions than women, and few men-specific programs target rural areas. Aussie-Fans in Training (Aussie-FIT) is an evidence-based weight management intervention that uses professional Australian Football club affiliations and settings as a ‘hook’ to engage urban-residing men. The aim of this study is to report on how findings from rural stakeholder focus groups were used to inform the adaptation of Aussie-FIT for implementation in rural areas.

Methods
Seven focus groups with stakeholders (n = 24) in three rural towns explored existing weight management and physical activity provisions, barriers and facilitators to engaging men, and considerations for adapting Aussie-FIT for implementation in rural contexts. Qualitative data were analysed using the framework approach. Adaptations made to the Aussie-FIT program and strategies to implement the program in rural contexts were reported using a structured framework.

Results
Themes generated from our analysis include limited appealing services for men, Australian Football as a ‘common language’, the influence of the ‘smaller fishpond’(population), considerations for program inclusivity, and the importance of local partner organisations for sustainability. We adapted the recruitment and marketing strategies, delivery settings, football program theme and partnerships for rural implementation. Stakeholders advised that an Australian Football program theme without specific local club affiliations would be important to avoid alienating men with differing club allegiances or non-sporting backgrounds. A multi-component recruitment strategy utilising local trusted sources, and program marketing that aligns with masculine ideals were considered important by stakeholders in small communities where ‘people talk’.

Conclusions
Rural areas were described as ‘a different ball game’ due to limited local services and resources in comparison to metropolitan areas. Study findings have synergies with previous studies undertaken in rural contexts including in relation to the power of word of mouth, the importance of trust, and local partner organisations. Findings have implications for engaging rural men in health interventions in rural contexts where professional sporting contexts are not available. Assessing the extent to which the adapted Aussie-FIT program can reach and engage men in rural Australia, and exploring the barriers and facilitators to delivering the program in rural contexts is required.
Causal effects of COVID-19 on structural changes in specific brain regions: a Mendelian randomization study
Authors: Zhou Shaojiong , Wei Tao , Liu Xiaoduo , Liu Yufei , Song Weiyi , Que Xinwei , Xing Yi , Wang Zhibin , Tang Yi 
Published: July 2023

Abstract
Background
Previous studies have found a correlation between coronavirus disease 2019 (COVID-19) and changes in brain structure and cognitive function, but it remains unclear whether COVID-19 causes brain structural changes and which specific brain regions are affected. Herein, we conducted a Mendelian randomization (MR) study to investigate this causal relationship and to identify specific brain regions vulnerable to COVID-19.

Methods
Genome-wide association study (GWAS) data for COVID-19 phenotypes (28,900 COVID-19 cases and 3,251,161 controls) were selected as exposures, and GWAS data for brain structural traits (cortical thickness and surface area from 51,665 participants and volume of subcortical structures from 30,717 participants) were selected as outcomes. Inverse-variance weighted method was used as the main estimate method. The weighted median, MR-Egger, MR-PRESSO global test, and Cochran’s Q statistic were used to detect heterogeneity and pleiotropy.

Results
The genetically predicted COVID-19 infection phenotype was nominally associated with reduced cortical thickness in the caudal middle frontal gyrus (β = − 0.0044, p = 0.0412). The hospitalized COVID-19 phenotype was nominally associated with reduced cortical thickness in the lateral orbitofrontal gyrus (β = − 0.0049, p = 0.0328) and rostral middle frontal gyrus (β = − 0.0022, p = 0.0032) as well as with reduced cortical surface area of the middle temporal gyrus (β = − 10.8855, p = 0.0266). These causal relationships were also identified in the severe COVID-19 phenotype. Additionally, the severe COVID-19 phenotype was nominally associated with reduced cortical thickness in the cuneus (β = − 0.0024, p = 0.0168); reduced cortical surface area of the pericalcarine (β = − 2.6628, p = 0.0492), superior parietal gyrus (β = − 5.6310, p = 0.0408), and parahippocampal gyrus (β = − 0.1473, p = 0.0297); and reduced volume in the hippocampus (β = − 15.9130, p = 0.0024).

Conclusions
Our study indicates a suggestively significant association between genetic predisposition to COVID-19 and atrophy in specific functional regions of the human brain. Patients with COVID-19 and cognitive impairment should be actively managed to alleviate neurocognitive symptoms and minimize long-term effects.