bluuebunny/crossref_metadata_2025_split huggingface dataset:
Measuring subepidermal moisture to detect early pressure ulcer development: a systematic review
Authors: Moore Zena , McEvoy Natalie L , Avsar Pinar , Byrne Sorcha , Vitoriano Budri Aglecia Moda , Nugent Linda , O'Connor Tom , Curley Gerard , Patton Declan 
Published: August 2022

Objective:The aim was to assess evidence related to the measuring of subepidermal moisture (SEM) to detect early, nonvisible development of pressure ulcers (PUs).Method:Using systematic review methodology, all quantitative animal and human research studies written in English were considered. In January 2021, PubMed, CINAHL, SCOPUS, Cochrane and EMBASE databases were searched. The primary outcome of interest was the validity of SEM measurement to detect early PU development. The secondary outcome was time to PU detection, sensitivity and specificity of SEM measurement, and the impact of SEM measurements on PU prevention. Data analysis was undertaken using RevMan and narrative synthesis.Results:A total of 17 articles met the inclusion criteria. In all studies, a consistent abnormal deviation in SEM measurements corresponded with evidence of visual PU development. Time to PU development, explored in four studies, showed earlier detection of PU development using SEM measurement. RevMan analysis identified the mean difference in time to PU development (SEM measurement versus visual skin assessment, VSA) was 4.61 days (95% confidence interval: 3.94–5.28; p=0.0001) in favour of SEM measurements. The sensitivity of SEM measurements was reported in four studies, and scores varied from 48.3% to 100.0%. Specificity was also reported in four studies and scores ranged from 24.4% to 83.0%. The impact of the detection of abnormal SEM measurements on PU prevention was explored by one study. Results showed a 93% decrease in PU rates when staff acted on the results of the SEM readings.Conclusion:The findings of this review identified that SEM measurement detects PU development earlier than VSA. Furthermore, when staff responded to abnormal SEM measurements, prevention strategies were enhanced, with a subsequent reduction in visible PU development. SEM measurement may therefore be a useful addition to PU prevention strategies.Declaration of interest:The School of Nursing & Midwifery, RCSI has a research agreement with Bruin Biometrics. Funding for the study was through an Irish Research Council PhD Enterprise Partnership Scheme with Bruin Biometrics. The authors have no other conflicts of interest.
Use of low-frequency contact ultrasonic debridement with and without polyhexamethylene biguanide in hard-to-heal leg ulcers: an RCT
Authors: Vallejo Alison , Wallis Marianne , McMillan David 
Published: August 2022

Objective: The primary aim of this research was to investigate the combination effect of polyhexamethylene biguanide (PHMB) and low-frequency contact ultrasonic debridement (LFCUD) on the bacterial load in hard-to-heal wounds in adults, compared with ultrasonic debridement alone. Secondary outcomes included wound healing, quality of life (QoL) and pain scores. Method: In this single-blinded, randomised, controlled trial participants were randomised to two groups. All participants received LFCUD weekly for six weeks, plus six weeks of weekly follow-up. The intervention group received an additional 15-minute topical application of PHMB post-LFCUD, at each dressing change and in a sustained dressing product. The control group received non-antimicrobial products and the wounds were cleansed with clean water or saline. Wound swabs were taken from all wounds for microbiological analysis at weeks 1, 3, 6 and 12. Results: A total of 50 participants took part. The intervention group (n=25) had a lower bacterial load at week 12 compared with the control group (n=25) (p<0.001). There was no difference in complete wound healing between the groups (p=0.47) or wound-related QoL (p=0.15). However, more wounds deteriorated in the control group (44%) compared with the intervention group (8%, p=0.01). A higher proportion of wounds reduced in size in the intervention group (61% versus 12%, p=0.019). Pain was lower in the intervention group at week six, compared with controls (p=0.04). Conclusion: LFCUD without the addition of an antimicrobial agent such as PHMB, cannot be recommended. Further research requires longer follow-up time and would benefit from being powered sufficiently to test the effects of multiple covariates.
The role of mast cells in cellular modifications evoked by Exendin-4 in treated wounds: a preclinical study
Authors: Paroli Gaia , Murciano Nicoletta , Mancini Caterina , Soldaini Marta , Rijli Sarah , DeSiena Gaetano , Bacci Stefano 
Published: August 2022

Objective: To assess the response of cellular infiltration in wounds treated with Exendin-4. Method: In this study, 16 mice were used. On each mouse, two wounds were produced, one above the other, in order to study the effects of the various treatments carried out. The wounds then received an intradermal injection of either saline (20μl; Group 1) or Exendin-4 (Exe4, 62ng; Group 2) in the upper and lower wounds, respectively. The mice were euthanised in order to collect the wounds at time of abrasion (T0), at 48 hours (T1), 96 hours (T2) and 144 hours (T3). The expression of the glucagon-like peptide-1 receptor (GLP-1R) was evaluated by Western blot in wound lysates. Histological and histochemistry methods were applied in cryosections. Results: In T2 and T3 treated wounds, the mast cells degranulation index increased while GLP-1R expression, tumour necrosis factor (TNF)-α, or heat shock protein (HSP)47 antigens were detected in their cytoplasm. These cells interacted with dendritic cells, vessels or granulocytes. The density of dendritic cells increased progressively, and intercellular connections were found between these cells and vessels. Among the dendritic cells at T2, only M2 macrophages increased. However, M1 cells expressed transforming growth factor (TGF)-β and both interacted with either fibroblasts or with vessels. The number of plasmacytoid dendritic cells increased and established close contacts with regulatory T cells. Conclusion: We propose that after treatment with Exe4, early activation of mast cells is critical in wound healing acceleration. This is crucial in understanding the potential effect of this drug for viable clinical therapies.
Wound tissue segmentation by computerised image analysis of clinical pressure injury photographs: a pilot study
Authors: Li Dan , Mathews Carol , Zamarripa Cecilia , Zhang Fei , Xiao Qian 
Published: August 2022

Objective: Wound tissues can provide ample information about the wound development and healing process. However, the manual identification and measurement of wound tissue types is time-consuming and challenging due to the complexities of pressure injuries (PI). This study aims to develop an image analysis algorithm to automatically identify and differentiate wound tissue types from PI wound beds. Method: This was a cross-sectional algorithm development study. PI photographs were obtained from a western Pennsylvania hospital. We used our previously developed wound bed segmentation tool to identify PI wound beds. We then used the k-means clustering method to classify the subzones on the wound beds. Finally, the support vector machine classifier was used to identify the classified subzones to certain types of wound tissue. Results: An image analysis algorithm was developed, using 64 selected PI photographs, to automatically identify different wound tissues for PIs. Conclusion: Validation of the wound tissue identification of the PIs by image analysis algorithm demonstrated that our image analysis algorithm is a reliable and objective approach to monitoring wound healing progress through clinical PI photographs, and offers new insight into PI evaluation and documentation.
Fetal macrosomia, fetal insulin, and insulin-like growth factor- 1 among neonates in Lagos, Nigeria: A case-control study
Authors: Akinmola Olukayode O. , Okusanya Babasola O. , Olorunfemi Gbenga , Okpara Henry C. , Azinge Elaine C. 
Published: August 2022

Purpose
Fetal macrosomia is associated with perinatal injuries. The purpose of this study was to assess the relationship between fetal insulin, insulin-like Growth factor-1(IGF-1), and macrosomia in a resource-limited setting.

Method
This was a case-control study at tertiary and secondary health facilities in Lagos, Nigeria. One hundred and fifty mother-neonate pairs were recruited, and their socio-demographic and obstetric history was recorded. Fetal cord venous blood was collected at birth, and neonatal anthropometry was measured within 24hrs of life. Insulin and IGF-1 assay were measured with Enzyme-Linked Immunosorbent Assay (ELISA). Pearson’s Chi-square was used to assess the association between categorical variables and macrosomia. Spearman’s rank correlation of insulin, IGF-1, and fetal anthropometry was performed. Multivariable logistic regression was used to evaluate the association of insulin and IGF-1 with fetal birth weight. A statistically significant level was set at P-value < 0.05.

Results
Macrosomic neonates had mean fetal weight, fetal length, and occipitofrontal circumference (OFC) of 4.15±0.26kg, 50.85±2.09cm and 36.35± 1.22cm respectively. The median Insulin (P = 0.023) and IGF-1 (P < 0.0001) were significantly higher among macrosomic neonates as compared to normal weight babies. Maternal BMI at birth (p = 0.003), neonate’s gender (p < 0.001), fetal cord serum IGF-1 (p < 0.001) and insulin assay (P-value = 0.027) were significant predictors of fetal macrosomia. There was positive correlation between cord blood IGF-1 and birth weight (r = 0.47, P-value < 0.001), fetal length (r = 0.30, P-value = 0.0002) and OFC (r = 0.37, P-value < 0.001).

Conclusion
Among participating mother-neonate dyad, maternal BMI at birth, neonate’s gender, and fetal cord serum IGF-1 and serum insulin are significantly associated with fetal macrosomia.
In-hospital outcomes of SARS-CoV-2-infected health care workers in the COVID-19 pandemic first wave, Quebec, Canada
Authors: Darwish Ilyse , Harrison Luke B. , Passos-Castilho Ana Maria , Labbé Annie-Claude , Barkati Sapha , Luong Me-Linh , Kong Ling Yuan , Tutt-Guérette Marc-Antoine , Kierans James , Rousseau Cécile , Benedetti Andrea , Azoulay Laurent , Greenaway Christina 
Published: August 2022

Background
Health care workers (HCW), particularly immigrants and ethnic minorities are at increased risk for SARS-CoV-2 infection. Outcomes during a COVID-19 associated hospitalization are not well described among HCW. We aimed to describe the characteristics of HCW admitted with COVID-19 including immigrant status and ethnicity and the associated risk factors for Intensive Care unit (ICU) admission and death.

Methods
Adults with laboratory-confirmed community-acquired COVID-19 hospitalized from March 1 to June 30, 2020, at four tertiary-care hospitals in Montréal, Canada were included. Demographics, comorbidities, occupation, immigration status, country of birth, ethnicity, workplace exposures, and hospital outcomes (ICU admission and death) were obtained through a chart review and phone survey. A Fine and Gray competing risk proportional hazards model was used to estimate the risk of ICU admission among HCW stratified by immigrant status and region of birth.

Results
Among 1104 included persons, 150 (14%) were HCW, with a phone survey participation rate of 68%. HCWs were younger (50 vs 64 years; p<0.001), more likely to be female (61% vs 41%; p<0.001), migrants (68% vs 55%; p<0.01), non-White (65% vs 41%; p<0.001) and healthier (mean Charlson Comorbidity Index of 0.3 vs 1.2; p<0.001) compared to non-HCW. They were as likely to be admitted to the ICU (28% vs 31%; p = 0.40) but were less likely to die (4% vs. 17%; p<0.001). Immigrant HCW accounted for 68% of all HCW cases and, compared to Canadian HCW, were more likely to be personal support workers (PSW) (54% vs. 33%, p<0.01), to be Black (58% vs 4%) and to work in a Residential Care Facility (RCF) (59% vs 33%; p = 0.05). Most HCW believed that they were exposed at work, 55% did not always have access to personal protective equipment (PPE) and 40% did not receive COVID-19-specific Infection Control (IPAC) training.

Conclusion
Immigrant HCW were particularly exposed to COVID-19 infection in the first wave of the pandemic in Quebec. Despite being young and healthy, one third of all HCW required ICU admission, highlighting the importance of preventing workplace transmission through strong infection prevention and control measures, including high COVID-19 vaccination coverage.
Barriers, enablers and acceptability of home-based care following elective total knee or hip replacement at a private hospital: A qualitative study of patient and caregiver perspectives
Authors: Wallis Jason A. , Gearon Emma , Naylor Justine , Young Kirby , Zayontz Shay , Risbey Phillipa , Harris Ian A. , Buchbinder Rachelle , O’Connor Denise 
Published: August 2022

Background
To facilitate implementation of home-based care following an elective total knee or hip replacement in a private hospital, we explored patient and caregiver barriers and enablers and components of care that may increase its acceptability.

Method
Thirty-one patients (mean age 71 years, 77% female) and 14 caregivers (mean age 69 years, 57% female) were interviewed. All themes were developed using thematic analysis, then categorised as barriers or enablers to uptake of home-based care or acceptable components of care. Barrier and enabler themes were mapped to the Theoretical Domains Framework.

Results
Eight themes emerged as barriers or enablers: feeling unsafe versus confident; caregivers’ willingness to provide support and patients’ unwillingness to seek help; less support and opportunity to rest; positive feelings about home over the hospital; certainty about anticipated recovery; trusting specialist advice over family and friends; length of hospital stay; paying for health insurance. Five themes emerged as acceptable components: home visits prior to discharge; specific information about recovery at home; one-to-one physiotherapy and occupational therapy perceived as first-line care; medical, nursing and a 24/7 direct-line perceived as second-line care for complications; no one-size-fits-all model for domestic support. Theoretical domains relating to barriers included emotion (e.g., feeling unsafe), environmental context and resources (e.g., perceived lack of physiotherapy) and beliefs about consequences (e.g., unwillingness to burden their caregiver). Theoretical domains relating to enablers included beliefs about capabilities (e.g., feeling strong), skills (e.g., practising stairs), procedural knowledge (e.g., receiving advice about early mobility) and social influences (e.g., caregivers’ willingness to provide support).

Conclusions
Multiple factors, such as feeling unsafe and caregivers’ willingness to provide support, may influence implementation of home-based care from the perspectives of privately insured patients and caregivers. Our findings provide insights to inform design of suitable home-based care following joint replacement in a private setting.
THE CITY THROUGH THE PRISM OF LINGUO-CULTURE
Authors: Petrova Elka , Yanev Boryan 
Published: August 2022

A city is an object of reality, having its geographical coordinates and architecture, but it is also an organizational social phenomenon with inherent internal dynamics, pulsating in its rhythm, reflecting and transforming the pattern of civilization and culture. Placed in the context of linguculturalology, the city is defined as a relatively stable structure existing in mass and individual consciousness, a set of emotional-evaluative and rational ideas about a given space, formed based on various sources, and the individual, emotional and practical experience of a person. The purpose of this poster is to present in a synthesized form the results of the complex analysis of the "city", understood as a multifaceted element of human existence, a complete diverse cultural organism, which is characterized by a certain structure, preserves specific symbolism and has its face and spirit. In particular, attention has been paid to the axiological interpretation of the city by the individual, and the outline of its national nuances in the Bulgarian language. Through the prism of linguculturalology, the city is culturally constant, one of the universal concepts of the social structure, which includes a set of images, perceptions, and values, and a fragment of reality, the complete description of which requires turning to the immediate reactions of the individual. This is the reason why we chose the complex approach – directed chain associative experiment. 97 students, aged between 18 and 45, studying in various specialties at Plovdiv University "Paisiy Hilendarski", city of Plovdiv, took part in the associative experiment. During the experiment, the respondents were given the word – stimulus –

city
, to which they had to indicate a minimum of three associations. And then indicate characteristics with which they associate the same stimulus word. The total number of associations given by the respondents is 467, and we can summarize them in 73, which are repeated with different intensities. The results are presented in a synthesized form in this poster. The conducted associative experiment leads us to the conclusion that in the modern image of man, the city is predominantly perceived as a bearer of the negative, has moved aside its main function of identifying the individual, and has taken a particular position of an enemy - repulsive, ugly and alienated.
The authors express sincere gratitude to the Scientific Research Fund at the Ministry of Education and Science and the "Scientific and Project Activity" Division at Plovdiv University "PaisiiHilendarski" for the assistance provided.
A Retrospective Cohort Study of Factors Influencing Lymph Node Metastasis in Patients With Early Gastric Papillary Adenocarcinoma
Authors: Zheng Chang , Xu Guifang , Tang Dehua , Ni Muhan , Cheng Yuqing , Du Mingzhan , Wang Yaohui , Xu Yuejie , Jiang Jingwei , Xiang Ying , Sun Qi , Chen Ling , Fan Xiangshan , Huang Qin , Zhou Yihua , Zou Xiaoping , Wang Lei 
Published: August 2022

INTRODUCTION:
High risk of lymph node metastasis (LNM) in gastric papillary adenocarcinoma causes endoscopists to worry about the suitability of endoscopic resection for early gastric papillary adenocarcinoma (EPAC). We compared risk factors and attempted to establish a scoring system to stratify LNM risk in patients with EPAC.

METHODS:
A retrospective analysis was performed on 2,513 patients with early gastric carcinoma (EGC) who underwent radical resection in 4 tertiary hospitals in China. Univariate and multivariate analyses were performed to compare the invasiveness in EPAC and other types of EGC and to evaluate potential factors in predicting LNM risk in EPAC groups.

RESULTS:
Three hundred thirty-five patients with EPAC were enrolled in our study, of which 62 patients were found to have LNM. After comparing clinicopathological characteristics of EPAC with and without LNM, the following factors were included in the risk scoring system: 1 point each for lower stomach location and tumor size >2.0 cm, 3 points for lymphovascular invasion, and 4 points for submucosal invasion; the risk scoring system was validated in a small internal validation set with an area under the curve of 0.844.

DISCUSSION:
Our results suggested that EPAC was highly invasive compared with other EGCs, especially differentiated EGC types, and need to be treated more rigorously. This proposed risk scoring system could stratify LNM risk in patients with EPAC, and endoscopic resection may only be performed safely on the groups with a low LNM rate.
Decongestion Models and Metrics in Acute Heart Failure: ESCAPE Data in the Age of the Implantable Cardiac Pressure Monitor
Authors: Paniagua David , Levine Glenn N. , Cornwell Lorraine D. , Jimenez Ernesto , Kar Biswajit , Jneid Hani , Denktas Ali E. , Ma Tony S. 
Published: August 2022

The United States Food and Drug Administration restricts the use of implantable cardiac pressure monitors to patients with New York Heart Association (NYHA) class III heart failure (HF). We investigated whether single-pressure monitoring could predict survival in HF patients as part of a model constructed using data from the ESCAPE (Evaluation Study of Congestive Heart Failure and Pulmonary Artery Catheterization Effectiveness) trial.
We validated survival models in 204 patients, using all-cause 180-day mortality. Two levels of model complexity were tested: 1) a simplified 1-pressure model based on pulmonary artery mean pressure ([PAM]1P) (information obtainable from an implanted intracardiac monitor alone), and 2) a pair of 5-variable risk score models based on right atrial pressure (RAP) + pulmonary capillary wedge pressure (PCWP) ([RAP+PCWP]5V) and on RAP + PAM ([RAP+PAM]5V). The more complex models used 5 dichotomous variables: a congestion index above a certain threshold value, baseline systolic blood pressure of <100 mmHg, baseline blood urea nitrogen level of ≥ 34 mg/dL, need for cardiopulmonary resuscitation or mechanical ventilation, and posttreatment NYHA class IV status. The congestion index was defined as posttreatment RAP+PCWP or posttreatment RAP+PAM, with congestion thresholds of 34 and 42 mmHg, respectively (median pulmonary catheter indwelling time, 1.9 d).
The 5-variable models predicted survival with areas under the curve of 0.868 for the (RAP+PCWP)5V model and 0.827 for the (RAP+PAM)5V model, whereas the 1-pressure model predicted survival with an area under the curve of 0.718. We conclude that decongestion as determined by hemodynamic assessment predicts survival in HF patients and that it may be the final pathway for treatment benefit despite improvements in pharmacologic intervention since the ESCAPE trial.
Applied linguistics from the Global South: way forward to linguistic equality and social justice
Authors: Sultana Shaila 
Published: August 2022

AbstractThe Commentary critically reflects on the papers published in the Special Issue (SI) of Applied Linguistics Review titled ‘Reflection and Reform of Applied Linguistics from the Global South: Power and Inequality in English users from the Global South’. While the papers in the SI add new insights to the recent innovations in the ontology and epistemology of Applied Linguistics based on research studies done in the contexts of Australia, Brazil, Hong Kong, Kazakhstan, Mongolia, and Nepal, the Commentary shows that more research studies on the multi-modal meaning-making processes and the spatiality and temporality of semiotic resources will give a greater understanding of the meaning-making processes. The Commentary also indicates that the politics underlying the governance, policy packages of neoliberalism in education, and hidden linguistic governmentality observable in language policies and practices in both Global South and Global North require further attention. Decoloniality, moreover, requires delinking from the academic practices that give immense importance to northern theories. Minimizing intellectual dependency on northern theories may help gain the intellectual sovereignty of the South. Hence, the Commentary indicates that it is high time to explore what the epistemological South and geographical South have to say about the Global South.