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Article ; Online: Response to Letter to the Editor: "The Shieh Score as a Risk Assessment Instrument for Reducing Hospital-Acquired Pressure Injuries".

Shieh, David

Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society

2024 Volume 51, Issue 1, Page(s) 16

MeSH term(s)	Humans ; Pressure Ulcer/prevention & control ; Risk Assessment ; Hospitals
Language	English
Publishing date	2024-01-12
Publishing country	United States
Document type	Journal Article
ZDB-ID	1188388-1
ISSN	1528-3976 ; 1071-5754
ISSN (online)	1528-3976
ISSN	1071-5754
DOI	10.1097/WON.0000000000001052
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Article ; Online: Diagnostic and Therapeutic Challenges.

Shieh, David / Paul, Samantha K / Beckman, Madeline / Kurup, Shree K

Retina (Philadelphia, Pa.)

2024

Language	English
Publishing date	2024-04-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	603192-4
ISSN	1539-2864 ; 0275-004X
ISSN (online)	1539-2864
ISSN	0275-004X
DOI	10.1097/IAE.0000000000004123
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Article ; Online: The Shieh Score as a Risk Assessment Tool for Hospital-Acquired Pressure Injuries: A Retrospective Cohort Study.

Shieh, David / Li, Qiaowu / Shi, Jiaxiao M / Tovar, Stephanie

Advances in skin & wound care

2021 Volume 34, Issue 3, Page(s) 132–138

Abstract: Objective: To design a new risk assessment tool to identify patients at high risk for hospital-acquired pressure injuries.: Methods: The researchers developed the Shieh Score using retrospective data of 406,032 hospital admissions from January 2014 ... ...

Abstract	Objective: To design a new risk assessment tool to identify patients at high risk for hospital-acquired pressure injuries. Methods: The researchers developed the Shieh Score using retrospective data of 406,032 hospital admissions from January 2014 to December 2016 with 1,299 pressure injury cases from the pressure injury registry. A decision tree and best subset logistic regression were used to select predictors from demographic and clinical candidate variables, which were then used to construct the Shieh Score. Results: The final Shieh Score included the following measures: sex, age, diabetes, glomerular filtration rate, albumin level, level of function, use of IV norepinephrine, mechanical ventilation, and level of consciousness. The Shieh Score had a higher Youden Index, specificity, and positive predictive value than the Braden Scale. However, the Braden Scale had a higher sensitivity compared with the Shieh Score. Conclusions: The Shieh Score is an alternative risk assessment tool that may effectively identify a smaller number of patients at high risk for hospital-acquired pressure injuries with a higher specificity and positive predictive value than the Braden Scale.
MeSH term(s)	Adult ; Aged ; Cohort Studies ; Female ; Hospitalization/statistics & numerical data ; Humans ; Iatrogenic Disease/epidemiology ; Iatrogenic Disease/prevention & control ; Logistic Models ; Male ; Middle Aged ; Pressure Ulcer/classification ; Pressure Ulcer/prevention & control ; Retrospective Studies ; Risk Assessment/methods ; Risk Assessment/standards ; Risk Assessment/statistics & numerical data ; Risk Factors ; Severity of Illness Index
Language	English
Publishing date	2021-01-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	2012792-3
ISSN	1538-8654 ; 1527-7941
ISSN (online)	1538-8654
ISSN	1527-7941
DOI	10.1097/01.ASW.0000732736.89356.cb
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ab Jg. 2022: Lesesaal (EG)

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Article ; Online: The Shieh Score as a Risk Assessment Instrument for Reducing Hospital-Acquired Pressure Injuries: A Prospective Cohort Study.

Shieh, David / Sevilla, Mia / Palmeri, Anthony / Ly, An H / Shi, Jiaxiao M / Berringer, Christine / Resurreccion, Juji

Journal of wound, ostomy, and continence nursing : official publication of The Wound, Ostomy and Continence Nurses Society

2023 Volume 50, Issue 5, Page(s) 375–380

Abstract: 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.: ... ...

Abstract	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.
MeSH term(s)	Adult ; Humans ; Pressure Ulcer/epidemiology ; Pressure Ulcer/prevention & control ; Pressure Ulcer/etiology ; Prospective Studies ; Pandemics ; Risk Assessment ; Hospitals
Language	English
Publishing date	2023-07-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	1188388-1
ISSN	1528-3976 ; 1071-5754
ISSN (online)	1528-3976
ISSN	1071-5754
DOI	10.1097/WON.0000000000000997
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Zs.A 2157: Show issues

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Article ; Online: One-Month Postoperative Horizontal Strabismus Surgery Outcomes Using Adjustable and Nonadjustable Sutures.

Liu, Dan / Kumar, Aman / Shieh, David / Bhargava, Siddharth / Zobal-Ratner, Jitka / Simon, John W

Journal of binocular vision and ocular motility

2020 Volume 70, Issue 3, Page(s) 94–97

Abstract: Introduction: Previous series suggest adjustable sutures (AS) in adult strabismus surgery yield improved ocular alignment and better success rates compared to nonadjustable sutures (NAS). We questioned whether these differences are clinically ... ...

Abstract	Introduction: Previous series suggest adjustable sutures (AS) in adult strabismus surgery yield improved ocular alignment and better success rates compared to nonadjustable sutures (NAS). We questioned whether these differences are clinically significant and whether they justify the added time and discomfort required for AS. Methods: We reviewed all available records of adults undergoing horizontal strabismus surgery by the last two authors between 2000 and 2014. Independently, the two surgeons developed a preference for NAS midway through the study period, permitting comparisons between two treatment groups. Results were assessed at one to two months postoperatively. The primary outcome was alignment in primary position at one to two months postoperatively. The secondary outcome was success rate, defined as <10PD residual or consecutive deviation. Results: We included 184 patients, 68 with AS and 116 with NAS. No significant difference in primary position alignment at 1-2 months was noted between AS and NAS for esotropia ( Discussion: Although we acknowledge limitations in this retrospective study, our results suggest that AS overall was not associated with improved alignment or success rates, compared to NAS, at 1- to 2- months postoperatively. Conclusions: Although adjustable sutures represent a valuable surgical option at the discretion of individual surgeons and their patients, we no longer routinely use AS in all adult cases. A prospective study to evaluate long-term outcomes would be helpful.
MeSH term(s)	Adult ; Female ; Follow-Up Studies ; Humans ; Male ; Middle Aged ; Oculomotor Muscles/surgery ; Ophthalmologic Surgical Procedures ; Postoperative Period ; Refraction, Ocular/physiology ; Retrospective Studies ; Strabismus/physiopathology ; Strabismus/surgery ; Suture Techniques ; Sutures ; Treatment Outcome ; Vision, Binocular/physiology
Language	English
Publishing date	2020-06-08
Publishing country	United States
Document type	Comparative Study ; Journal Article
ISSN	2576-1218
ISSN (online)	2576-1218
DOI	10.1080/2576117X.2020.1776567
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Inhibition of cell–cell adhesion impairs directional epithelial migration on micropatterned surfaces

Worley, Kathryn E / Shieh, David / Wan, Leo Q

Integrative biology. 2015 May 11, v. 7, no. 5

2015

Abstract: The development of the vertebrate body plan with left-right (LR) asymmetry (also known as handedness and chirality) requires the emerging chiral morphogenesis of epithelial cells at specific embryonic stages. In this process, cell–cell adhesions ... ...

Abstract	The development of the vertebrate body plan with left-right (LR) asymmetry (also known as handedness and chirality) requires the emerging chiral morphogenesis of epithelial cells at specific embryonic stages. In this process, cell–cell adhesions coordinate cellular organization and collective cell migration, and are critical for the directional looping of developing embryonic organs. However, the underlying biophysical mechanism is not yet well understood. Here we modeled normal and delayed epithelial LR symmetry breaking with patterned epithelial chiral morphogenesis on microscale lines with various widths. The patterned cells exhibited biased migration wherein those on opposing boundaries migrated in different directions. Disrupting adherens junctions with ethylene glycol tetraacetic acid (EGTA) resulted in a decrease in velocity difference in opposing boundaries as well as the associated biased cell alignment, along with an increase in the overall random motion. Altering the distance between the opposing boundaries did not significantly alter alignment, but significantly disturbed the velocity profile of the cell migration field. Further examination of cell polarity indicated that disruption of adherens junctions did not affect cell polarization on the boundaries, but decreased the transmission of chiral bias into the interior region of the epithelial cell sheet. Overall, our results demonstrated the dependence of the scale of collective cell migration on the strength of cell–cell adhesion, and its effects on the chirality of a multicellular structure through mediating cell polarity in the vicinity of geometric boundaries. This study demonstrated that our 2D microscale system provides a simple yet effective tool for studying the influence of collective cell migration on LR symmetry breaking, and possibly for fetal drug screening to prevent birth defects related to alteration in cell–cell adhesion.
Keywords	adherens junctions ; asymmetry ; cell adhesion ; cell movement ; cell polarity ; drugs ; epithelial cells ; epithelium ; ethylene glycol tetraacetic acid ; geometry ; morphogenesis ; optical isomerism ; screening ; vertebrates
Language	English
Dates of publication	2015-0511
Size	p. 580-590.
Publishing place	The Royal Society of Chemistry
Document type	Article
ZDB-ID	2480063-6
ISSN	1757-9708 ; 1757-9694
ISSN (online)	1757-9708
ISSN	1757-9694
DOI	10.1039/c5ib00073d
Database	NAL-Catalogue (AGRICOLA)

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Article ; Online: Inhibition of cell-cell adhesion impairs directional epithelial migration on micropatterned surfaces.

Worley, Kathryn E / Shieh, David / Wan, Leo Q

Integrative biology : quantitative biosciences from nano to macro

2015 Volume 7, Issue 5, Page(s) 580–590

Abstract	The development of the vertebrate body plan with left-right (LR) asymmetry (also known as handedness and chirality) requires the emerging chiral morphogenesis of epithelial cells at specific embryonic stages. In this process, cell-cell adhesions coordinate cellular organization and collective cell migration, and are critical for the directional looping of developing embryonic organs. However, the underlying biophysical mechanism is not yet well understood. Here we modeled normal and delayed epithelial LR symmetry breaking with patterned epithelial chiral morphogenesis on microscale lines with various widths. The patterned cells exhibited biased migration wherein those on opposing boundaries migrated in different directions. Disrupting adherens junctions with ethylene glycol tetraacetic acid (EGTA) resulted in a decrease in velocity difference in opposing boundaries as well as the associated biased cell alignment, along with an increase in the overall random motion. Altering the distance between the opposing boundaries did not significantly alter alignment, but significantly disturbed the velocity profile of the cell migration field. Further examination of cell polarity indicated that disruption of adherens junctions did not affect cell polarization on the boundaries, but decreased the transmission of chiral bias into the interior region of the epithelial cell sheet. Overall, our results demonstrated the dependence of the scale of collective cell migration on the strength of cell-cell adhesion, and its effects on the chirality of a multicellular structure through mediating cell polarity in the vicinity of geometric boundaries. This study demonstrated that our 2D microscale system provides a simple yet effective tool for studying the influence of collective cell migration on LR symmetry breaking, and possibly for fetal drug screening to prevent birth defects related to alteration in cell-cell adhesion.
MeSH term(s)	Adherens Junctions ; Animals ; Biophysics ; Cell Adhesion ; Cell Culture Techniques ; Cell Movement/physiology ; Cell Polarity ; Dogs ; Egtazic Acid/chemistry ; Epithelial Cells/cytology ; Madin Darby Canine Kidney Cells ; Microscopy, Fluorescence ; Microscopy, Phase-Contrast ; Morphogenesis ; Surface Properties
Chemical Substances	Egtazic Acid (526U7A2651)
Language	English
Publishing date	2015-05
Publishing country	England
Document type	Journal Article ; Research Support, Non-U.S. Gov't ; Research Support, U.S. Gov't, Non-P.H.S.
ZDB-ID	2480063-6
ISSN	1757-9708 ; 1757-9694
ISSN (online)	1757-9708
ISSN	1757-9694
DOI	10.1039/c5ib00073d
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article ; Online: Dramatic Reduction in Hospital-Acquired Pressure Injuries Using a Pink Paper Reminder System.

Shieh, David C / Berringer, Christine M / Pantoja, Roselyn / Resureccion, Juji / Rainbolt, Joria M / Hokoki, Amena

Advances in skin & wound care

2018 Volume 31, Issue 3, Page(s) 118–122

Abstract: Objective: The goal of this quality improvement project was to reduce the number of hospital-acquired pressure injuries (HAPIs) by flagging extremely high-risk patients with a pink paper reminder system and implementing a pressure injury prevention ... ...

Abstract	Objective: The goal of this quality improvement project was to reduce the number of hospital-acquired pressure injuries (HAPIs) by flagging extremely high-risk patients with a pink paper reminder system and implementing a pressure injury prevention order set. Methods: The pink paper reminder system is an innovative, cost-neutral, simple approach to identify patients at highest risk of pressure injury development who meet specific criteria. There are 2 steps to this intervention. First, study authors developed a new risk assessment tool, the pink paper criteria. When a patient met the specified criteria, a pink piece of paper titled "SKIN AT RISK" in a large font was hung at the head of his/her bed to reinforce preventive strategies. Next, a set of pressure injury preventive measures was ordered. Patients: This quality improvement project included all adult hospitalized patients of all specialties based in 2 Kaiser Permanente hospitals. Results: There was a 67% reduction in HAPI incidences following the initiation of the pink paper reminder system, from a mean rate of 1.2 to 0.4 incidence of HAPIs per 1000 patient-days measured over 4 years. Conclusions: Identifying and flagging patients who are at extremely high risk of pressure injuries and implementing an order set of pressure injury preventive measures dramatically reduced the rate of HAPIs per 1000 patient-days.
MeSH term(s)	Adult ; California ; Cohort Studies ; Cost-Benefit Analysis ; Female ; Hospitalization/statistics & numerical data ; Humans ; Incidence ; Male ; Monitoring, Physiologic/methods ; Pressure Ulcer/epidemiology ; Pressure Ulcer/prevention & control ; Primary Prevention/methods ; Quality Improvement ; Reminder Systems/economics ; Reminder Systems/utilization ; Retrospective Studies
Language	English
Publishing date	2018-02-07
Publishing country	United States
Document type	Journal Article ; Multicenter Study
ZDB-ID	2012792-3
ISSN	1538-8654 ; 1527-7941
ISSN (online)	1538-8654
ISSN	1527-7941
DOI	10.1097/01.ASW.0000527966.72494.61
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Article ; Online: Imaging Cleared Embryonic and Postnatal Hearts at Single-cell Resolution.

Shaikh Qureshi, Wasay M / Miao, Lianjie / Shieh, David / Li, Jingjing / Lu, Yangyang / Hu, Saiyang / Barroso, Margarida / Mazurkiewicz, Joseph / Wu, Mingfu

Journal of visualized experiments : JoVE

2016 , Issue 116

Abstract: Single clonal tracing and analysis at the whole-heart level can determine cardiac progenitor cell behavior and differentiation during cardiac development, and allow for the study of the cellular and molecular basis of normal and abnormal cardiac ... ...

Abstract	Single clonal tracing and analysis at the whole-heart level can determine cardiac progenitor cell behavior and differentiation during cardiac development, and allow for the study of the cellular and molecular basis of normal and abnormal cardiac morphogenesis. Recent emerging technologies of retrospective single clonal analyses make the study of cardiac morphogenesis at single cell resolution feasible. However, tissue opacity and light scattering of the heart as imaging depth is increased hinder whole-heart imaging at single cell resolution. To overcome these obstacles, a whole-embryo clearing system that can render the heart highly transparent for both illumination and detection must be developed. Fortunately, in the last several years, many methodologies for whole-organism clearing systems such as CLARITY, Scale, SeeDB, ClearT, 3DISCO, CUBIC, DBE, BABB and PACT have been reported. This lab is interested in the cellular and molecular mechanisms of cardiac morphogenesis. Recently, we established single cell lineage tracing via the ROSA26-Cre
MeSH term(s)	Brain ; Cell Differentiation ; Cell Lineage ; Embryo, Mammalian ; Gene Expression ; Heart ; Imaging, Three-Dimensional/methods
Language	English
Publishing date	2016-10-07
Publishing country	United States
Document type	Journal Article ; Video-Audio Media
ISSN	1940-087X
ISSN (online)	1940-087X
DOI	10.3791/54303
Database	MEDical Literature Analysis and Retrieval System OnLINE

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Article: Imaging cleared embryonic and postnatal hearts at single-cell resolution

Shaikh Qureshi, Wasay M / Miao, Lianjie / Shieh, David / Li, Jingjing / Lu, Yangyang / Hu, Saiyang / Barroso, Margarida / Mazurkiewicz, Joseph / Wu, Mingfu

Journal of visualized experiments. 2016 Oct. 07, , no. 116

2016

Abstract	Single clonal tracing and analysis at the whole-heart level can determine cardiac progenitor cell behavior and differentiation during cardiac development, and allow for the study of the cellular and molecular basis of normal and abnormal cardiac morphogenesis. Recent emerging technologies of retrospective single clonal analyses make the study of cardiac morphogenesis at single cell resolution feasible. However, tissue opacity and light scattering of the heart as imaging depth is increased hinder whole-heart imaging at single cell resolution. To overcome these obstacles, a whole-embryo clearing system that can render the heart highly transparent for both illumination and detection must be developed. Fortunately, in the last several years, many methodologies for whole-organism clearing systems such as CLARITY, Scale, SeeDB, ClearT, 3DISCO, CUBIC, DBE, BABB and PACT have been reported. This lab is interested in the cellular and molecular mechanisms of cardiac morphogenesis. Recently, we established single cell lineage tracing via the ROSA26-CreERT2; ROSA26-Confetti system to sparsely label cells during cardiac development. We adapted several whole embryo-clearing methodologies including Scale and CUBIC (clear, unobstructed brain imaging cocktails and computational analysis) to clear the embryo in combination with whole mount staining to image single clones inside the heart. The heart was successfully imaged at single cell resolution. We found that Scale can clear the embryonic heart, but cannot effectively clear the postnatal heart, while CUBIC can clear the postnatal heart, but damages the embryonic heart by dissolving the tissue. The methods described here will permit the study of gene function at a single clone resolution during cardiac morphogenesis, which, in turn, can reveal the cellular and molecular basis of congenital heart defects.
Keywords	brain ; clones ; genes ; heart ; heart abnormalities ; image analysis ; light scattering ; lighting ; morphogenesis ; opacity ; staining ; stem cells
Language	English
Dates of publication	2016-1007
Size	p. e54303.
Publishing place	Journal of Visualized Experiments
Document type	Article
ZDB-ID	2259946-0
ISSN	1940-087X
ISSN	1940-087X
DOI	10.3791/54303
Database	NAL-Catalogue (AGRICOLA)

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