bluuebunny/crossref_metadata_2025 huggingface dataset:
Italian Jewish Enlightenment
Authors: Bregoli Francesca
Published: January 2024

Evolving definitions of the “Italian Jewish Enlightenment” are key to surveying scholarly output on this theme and will be reflected in the bibliographic overview presented here, which primarily focuses on Italian lands in the eighteenth century. Some early works identified an “Italian Haskalah” (Jewish Enlightenment) in the fifteenth and sixteenth centuries, equating this phenomenon with broad processes of Jewish “acculturation” and “modernization.” The Hebrew term “Haskalah,” however, is first and foremost associated with 18th- and 19th-century articulations of the Jewish Enlightenment in Ashkenazi lands; the application of the term to a much earlier Italian reality homogenized it to a Germano-centric model. Shifting away from the Germano-centrism of earlier research, more recent studies have moved beyond such an understanding, turning instead to investigating the ways in which Italian Jews engaged with and were affected by 18th-century Enlightenment thought and practices. These studies have redirected attention specifically to trends occurring at the same time as the European Enlightenment movements were developing, often steering away from the use of the term “Haskalah” to depict the Italian Jewish Enlightenment. Instead, they have drawn points of comparison and difference between particular Italian Jewish models and understandings of Enlightenment and other European maskilic experiences, thereby striving to differentiate rather than homogenize Jewish Enlightenment developments. Starting in the 1980s, authors have focused on the patchy reception and circulation of the Prussian Haskalah in Italian lands, a research direction that has further evolved to include the impact of enlightened absolutist reforms on Italian Jewish communities. As a result, it is also common in studies devoted to Italian Jews and the Enlightenment to discuss the topic of legal and political emancipation, from the process of civil inclusion taking place in Habsburg lands to the application of French principles of liberty and equality after the arrival of Napoleon’s troops in 1796. A significant number of studies has been devoted to three northern-Italian figures conventionally recognized as protagonists of the Italian Jewish Enlightenment, Benedetto Frizzi, Elia Morpurgo, and the younger Isacco Samuele Reggio. But more recent research has additionally investigated instances of reception of French Enlightenment culture among Italian Jews and manifestations of enlightened thought by Jewish scholars unconnected to the master example of the Berlin Haskalah, thereby reclaiming a native Italian Jewish understanding of the ethos and demands of the Age of Enlightenment. Most studies remain local or regional in scope, reflecting the divided nature of the Italian lands during the Ancien Régime.
Designing Interrogations
Authors: Ispano Alessandro , Vida Péter
Published: January 2024

We provide a model of interrogations with two-sided asymmetric information. The suspect knows his status as guilty or innocent and the likely strength of the law enforcer’s evidence, which is informative about the suspect’s status and may also disprove lies. We compare prosecution errors in the equilibrium of the one-shot interrogation and in the optimal mechanism under full commitment. We describe a back-and-forth interrogation with disclosure of the evidence that implements the optimum in equilibrium without any commitment.
Credit risk, debt overhang, and the life cycle of callable bonds
Authors: Becker Bo , Campello Murillo , Thell Viktor , Yan Dong
Published: January 2024

We show that callable bonds have both higher yields and lower market prices than matched non-callable bonds of the same issuer-time, reflecting the value of call features to issuers and investors. This “value of callability” as well as the inclusion and the exercise of call rights are jointly determined by issuer credit quality. Critically, our agency-based theoretical and empirical analyses show that callability reduces debt overhang in corporate mergers. Our results help explain the value and increasing prevalence of callable bonds in credit markets.
Sown Without Care: Dutch Eugenicists and their Call for Optimising Developmental Conditions, 1919–1939
Authors: van der Meer Martijn
Published: January 2024

This paper explains the coexistence of concerns about hereditary degeneration and opposition to reproductive intervention such as sterilisation in Dutch eugenic discourse during the interwar years. Based on an analysis of textbooks, periodical publications and printed lectures, I will show how eugenicists positioned themselves within the domain of public health by framing their domain of inquiry as a pivotal addition to curative medicine and sanitary reform. Dutch eugenicists rendered this symbiotic relationship conceptually plausible by combining criticism of genetic determinism and Lamarckian viewpoints on heredity. This paper explains how this conceptual constellation enabled Dutch eugenicists to claim that the combination of proper (eugenic) education and a healthy environment would stimulate individuals to behave socially responsibly and restrain from reproducing. By doing so, this essay contributes to the historiographical trend to comparatively analyse eugenics as a transnational phenomenon.
FTO‐mediated m6A modification of serum amyloid A2 mRNA promotes podocyte injury and inflammation by activating the NF‐κB signaling pathway
Authors: Lang Yating , Wang Qimeng , Sheng Qinghao , Lu Shangwei , Yang Meilin , Kong Zhijuan , Gao Ying , Fan Xiaoting , Shen Ning , Wang Rong , Lv Zhimei
Published: January 2024

Diabetic kidney disease (DKD) is one of the severe complications of diabetes mellitus, yet there is no effective treatment. Exploring the development of DKD is essential to treatment. Podocyte injury and inflammation are closely related to the development of DKD. However, the mechanism of podocyte injury and progression in DKD remains largely unclear. Here, we observed that FTO expression was significantly upregulated in high glucose‐induced podocytes and that overexpression of FTO promoted podocyte injury and inflammation. By performing RNA‐seq and MeRIP‐seq with control podocytes and high glucose‐induced podocytes with or without FTO knockdown, we revealed that serum amyloid A2 (SAA2) is a target of FTO‐mediated m6A modification. Knockdown of FTO markedly increased SAA2 mRNA m6A modification and decreased SAA2 mRNA expression. Mechanistically, we demonstrated that SAA2 might participate in podocyte injury and inflammation through activation of the NF‐κB signaling pathway. Furthermore, by generating podocyte‐specific adeno‐associated virus 9 (AAV9) to knockdown SAA2 in mice, we discovered that the depletion of SAA2 significantly restored podocyte injury and inflammation. Together, our results suggested that upregulation of SAA2 promoted podocyte injury through m6A‐dependent regulation, thus suggesting that SAA2 may be a therapeutic target for diabetic kidney disease.
Initiatives Targeting Health Care Professionals
Authors: Yarycky Laney , Castillo Louise I. R. , Gagnon Michelle M. , Hadjistavropoulos Thomas
Published: January 2024

Objectives:

Pain is often undertreated in older adult populations due to factors such as insufficient continuing education and health care resources. Initiatives to increase knowledge about pain assessment and management are crucial for the incorporation of research evidence into practice. Knowledge translation (KT) studies on pain management for older adults and relevant knowledge users have been conducted; however, the wide variety of KT program formats and outcomes underscores a need to evaluate and systematically report on the relevant literature.

Methods:

Using a systematic review methodology, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), MEDLINE, PsycInfo, and Web of Science databases were searched from inception to June 2023. Pain-related KT programs targeted towards older adults, their informal caregivers and health care professionals were examined. Initiatives focusing on health care professionals are the focus of this review. Initiatives focusing on older adults are reported elsewhere.

Results:

From an initial 21,669 search results, 172 studies met our inclusion criteria. These studies varied widely in focus and delivery format but the majority were associated with significant risk of bias. In this report, we are focusing on 124 studies targeting health care professionals; 48 studies involving initiatives targeting older adults are reported elsewhere. Moreover, most programs were classified as knowledge mobilization studies without an implementation component. Across all studies, knowledge user satisfaction with the initiative and suitability of material presented were most commonly assessed. Patient outcomes, however, were underemphasized in the literature.

Discussion:

Patient and clinical outcomes must be a focus of future research to fully conceptualize the success of KT programs for older adult patients. Without implementation plans, disseminated knowledge does not tend to translate effectively to practice.
Successful immunotherapy with PD-1 Iinhibitor for advanced pancreatic cancer: report of two cases and review of literature
Authors: Qiu Lijie , Liu Chen , Li Heping
Published: January 2024

Pancreatic cancer is a highly malignant tumor, and most patients are diagnosed at an advanced stage. Unfortunately, due to the immunosuppressive tumor microenvironment of pancreatic cancer, the benefits of immunotherapy for patients with advanced pancreatic cancer are still unclear. Here, we present two cases of advanced pancreatic cancer being controlled by immunotherapy, with pathological diagnoses of ductal adenocarcinoma and acinar cell carcinoma, respectively. Next-generation sequencing (NGS) of both patients is high tumor mutation burden (tumor mutation burden—High) and microsatellite stable. The patient with pancreatic ductal adenocarcinoma was diagnosed as a locally advanced disease (stage III). She received irreversible electroporation, used the programmed death receptor-1 (PD-1) inhibitor (pembrolizumab) combined with chemotherapy (S-1), and then used only the PD-1 inhibitor as a maintenance treatment. As a result, the patient’s lesion was significantly reduced, with a partial response time of up to 31 months. The patient with acinar cell carcinoma was diagnosed as a metastatic disease (stage IV), next-generation sequencing revealed mutations in SMAD4 and KMT2D, and two chemotherapy regimens were used unsuccessfully. Then, the combination of chemotherapy with PD-1 (tislelizumab) and vascular endothelial growth factor/vascular endothelial growth factor receptor (anlotinib) inhibitors were used, and the lesions of the patient were significantly reduced, and the progression-free survival after immunotherapy was 19 months. In advanced pancreatic cancer, a prognosis of this magnitude is rare. Our cases reveal the potential of immunotherapy as a cornerstone treatment in the management of advanced pancreatic cancer.
Single agent vs combination immunotherapy in advanced melanoma: a review of the evidence
Authors: Benhima Nada , Belbaraka Rhizlane , Langouo Fontsa Mireille D.
Published: January 2024

Purpose of review

The aim of this review is to outline the current landscape of advanced melanoma treatment options, provide insights on selecting combination therapies within different clinical scenarios, capture clinical relevance of anti-programmed cell death protein 1 (PD-1) monotherapy, and explore the unmet needs with immune check-point inhibitors (ICI) in advanced melanoma.

Recent findings

ICI based treatment consisted of single agent ICI or dual combination ICI-ICI is the standard of care of front-line treatment of metastatic or unresectable melanoma. PD-1 inhibitors (Pembrolizumab and Nivolumab) improved progression free survival (PFS) and overall survival (OS) compared to chemotherapy and cytotoxic T-lymphocyte associated protein 4 (CTLA-4) inhibitors (Ipilimumab and Tremelimumab). The dual ICI combination (Nivolumab and Ipilimumab) provided profound and durable responses better than monotherapy, and the longest overall survival ever achieved in advanced disease, including in patients with murine sarcoma viral oncogene homolog B (BRAF)-mutated disease, but at the cost of a high risk of severe toxicity. The new dual blockage of LAG-3 and PD-1 (Nivolumab-Relatlimab) emerges as a valid option with promising efficacy outcomes and a favourable toxicity profile. Mature survival data is still needed to capture the real benefit.

These new plethora of options pose new challenges not only for optimal treatment sequencing strategies but especially for management of adverse effects, endorsing the need to integrate a holistic and personalized approach for patient care.
Therapeutic Drug Monitoring of Voriconazole in Patients with End-Stage Liver Disease
Authors: Wu Zhenyu , Jiang Min , Yan Miao , Li Guangdi , Zeng Zhihao , Zhang Xiangling , Li Naiping , Jiang Yongfang , Gong Guozhong , Zhang Min
Published: January 2024

Background:

This study aimed to identify the factors that influence voriconazole (VCZ) plasma concentrations and optimize the doses of VCZ in patients with end-stage liver disease (ESLD).

Methods:

Patients with ESLD who received a VCZ maintenance dose of 100 mg twice daily (group A, n = 57) or the VCZ maintenance dose of 50 mg twice daily (group B, n = 37), orally or intravenously, were enrolled in this study. Trough plasma concentrations (Cmin) of VCZ between 1 and 5 mg/L were considered within the therapeutic target range.

Results:

The VCZ Cmin was determined in 94 patients with ESLD. The VCZ Cmin of patients in group A was remarkably higher than those in group B (4.85 ± 2.53 mg/L vs 2.75 ± 1.40 mg/L; P < 0.001). Compared with group A, fewer patients in group B had VCZ Cmin outside the therapeutic target (23/57 vs. 6/37, P = 0.021). Univariate and multivariate analyses suggested that both body weight and Model for End-Stage Liver Disease scores were closely associated with the VCZ Cmin in group B.

Conclusions:

These data indicate that dose optimization based on body weight and Model for End-Stage Liver Disease scores is required to strike an efficacy–safety balance during VCZ treatment in patients with ESLD.
ASSESSMENT OF SIMULATED SURGICAL DEXTERITY AFTER MODIFIABLE EXTERNAL EXPOSURES AMONG NOVICE VERSUS EXPERIENCED VITREORETINAL SURGEONS
Authors: Roizenblatt Marina , Gehlbach Peter L. , Marin Vitor D. G. , Roizenblatt Arnaldo , Saraiva Vinicius da S. , Nakanami Mauricio H. , Noia Luciana da C. , Watanabe Sung E. S. , Yasaki Erika S. , Passos Renato M. , Junior Octaviano Magalhães , Fernandes Rodrigo A. B. , Stefanini Francisco R. , Caiado Rafael , Jiramongkolchai Kim , Farah Michel E. , Junior Rubens Belfort , Maia Mauricio
Published: January 2024

Purpose.

To evaluate novice and senior vitreoretinal surgeons after various exposures. Multiple comparisons ranked the importance of these exposures for surgical dexterity based on experience.

Methods.

This prospective cohort study included 15 novice and 11 senior vitreoretinal surgeons (<2 and >10 years’ practice, respectively). Eyesi-simulator tasks were performed after each exposure. Day 1, placebo, 2.5 mg/kg caffeine, and 5.0 mg/kg caffeine; day 2, placebo, 0.2 mg/kg propranolol, and 0.6 mg/kg propranolol; day 3, baseline simulation, breathalyzer readings of 0.06%-0.10% and 0.11%-0.15% blood-alcohol concentrations; day 4, baseline simulation, push-up sets with 50% and 85% repetitions maximum; and day 5, 3-hour sleep deprivation. Eyesi-generated score (0-700, worst-best), out-of-tolerance tremor (0-100, best-worst), task completion time (minutes), and intraocular pathway (mm) were measured.

Results.

Novice surgeons performed worse after caffeine (-29.53, 95% confidence interval [CI]: -57.80 to -1.27, p=0.041), and alcohol (-51.33, 95% CI: -80.49 to -22.16, p=0.001). Alcohol caused longer pathways (212.84 mm, 95% CI: 34.03 to 391.65 mm, p=0.02) and greater tremor (7.72, 95% CI: 0.74 to 14.70, p=0.003) among novices. Sleep deprivation negatively affected novice performance time (2.57 minutes, 95% CI: 1.09 to 4.05 minutes, p=0.001) and tremor (8.62, 95% CI: 0.80 to 16.45, p=0.03); however, their speed increased after propranolol (-1.43 minutes, 95% CI: -2.71 to -0.15 minutes, p=0.029). Senior surgeons’ scores deteriorated only following alcohol (-47.36, 95% CI: -80.37 to -14.36, p=0.005).

Conclusion.

Alcohol compromised all participants despite their expertise level. Experience negated the effects of caffeine, propranolol, exercise, and sleep deprivation on surgical skills.
The impact of bilateral vision status on vision-related quality of life in people with diabetes mellitus
Authors: Lin Zushun , Li Dong , Lin Wei , Wen Liang , Wang Yu , Lin Zhong
Published: January 2024

Purpose:

To assess the impact of bilateral vision status on vision-related quality of life (VR-QOL) in patients with type 2 diabetes in a Chinese cohort.

Methods:

Patients with presenting visual acuity (PVA) and VR-QOL data from the Fushun Diabetic Retinopathy Cohort Study were included. VR-QOL was assessed using the National Eye Institute Visual Function Questionnaire-25 (VFQ-25). Monocular PVA (Snellen) was categorized into 3 levels for both the better-seeing eye (BSE) and worse-seeing eye (WSE): 1) High PVA (H, > 6/18); 2) Moderate PVA (M, 6/18–6/60); and 3) Low PVA (L, < 6/60). Based on the monocular PVAs, 6 categories of bilateral vision status were defined (H-H, H-M, H-L, M-M, M-L, L-L). The parameters of VR-QOL were analyzed between the groups.

Results:

A total of 1717 patients were enrolled. For BSEs in the same PVA level, the VFQ-25 composite score decreased significantly with declining PVA in the WSE (H-M vs H-L: 80.5±17.9 vs. 73.6±22.5, P=0.01; M-M vs M-L: 78.7±19.6 vs. 69.1±26.4, P=0.01). Conversely, for WSEs in the same PVA level, there was no significant difference in the VFQ-25 composite score as PVA changed in the BSE (H-M vs M-M, 80.5±17.9 vs. 78.7±19.6, P=0.30; H-L vs. M-L: 73.6±22.5 vs. 69.1±26.4, P=0.25).

Conclusion:

The PVA of the WSE in bilateral vision has a greater impact on VR-QOL in diabetic patients. Priority treatment may be considered for the WSE for diabetic patients with different bilateral vision statuses, to better improve VR-QOL.
Exploring the Location of Corneal Pigmented Arc and Myopia Control Efficacy in Orthokeratology-Treated Children Using Pentacam Measurements
Authors: Kuo Yu-Kai , Chuang Lan-Hsin , Lai Chi-Chun , Wu Pei-Chang , Chen Shin-Yi , Chen Hung-Chi , Yeung Ling , Wang Nan-Kai , Hwang Yih-Shiou , Liu Chun-Fu
Published: January 2024

Objectives:

To determine the location and intensity of the corneal pigmented arc in orthokeratology (ortho-k)-treated children and its relationship with annual axial length (AL) change using Pentacam.

Methods:

This retrospective cohort study enrolled children aged 9 to 15 years who had been followed up for at least one year after ortho-k treatment for myopia control. A Pentacam was used to determine the location and intensity of pigmented arc after lens wear. Annual AL changes were further used as the outcome measurement to determine their relationships with the location and intensity of pigmented arc using generalized estimating equations (GEE).

Results:

In total, 62 eyes from 33 patients (mean age 10.9 years) were included in our final analysis. The mean follow-up time was 30.6 months. The mean annual AL changes were 0.10 mm. Age statistically correlated with annual AL change (GEE, P=0.033). In addition, the annual AL change was negatively associated with the relative vertical distance of the lowest density of pigmented arc point based on the visual center, pupil center, and corneal thinnest point after adjustment with age (P=0.005, P=0.004, and P<0.001, respectively).

Conclusions:

Pentacam could be a useful tool for evaluating the location and intensity of the corneal pigmented arc. In addition, there was a negative correlation between the vertical distance of the pigmented arc and annual AL change. These findings may provide important information regarding myopia control, next-generation ortho-k design, and prescription.
Trends in Childhood Glaucoma Prevalence and Incidence in South Korea, 2002–2019: A Nationwide Population-Based Study
Authors: Baek Sung Uk , Kim Su Hwan , Ha Ahnul , Kim Jin-Soo , Yoon Hyung-Jin , Kim Young Kook
Published: January 2024

Précis:

This nationwide analysis identified the prevalence and incidence of childhood glaucoma for an 18-year period. The prevalence and incidence of primary congenital glaucoma showed increasing trends. Juvenile open angle glaucoma, meanwhile, showed a decreasing tendency.

Purpose:

We aimed to determine the trends in the prevalence and incidence of childhood glaucoma in the entire population of South Korea.

Patients and Methods:

A nationwide retrospective cohort study was performed with an age-specific and sex-specific population of South Korea. The Korean National Health Insurance Service claims database for 2002 to 2019 was accessed to identify cases of ophthalmologist-confirmed primary childhood glaucoma [ie, primary congenital glaucoma (PCG) and juvenile open angle glaucoma (JOAG)]. Incidence for PCG was estimated for a same-birth-year population, while that for JOAG was estimated using age-specific and sex-specific population figures. To verify the glaucoma cases, we also analyzed the diagnostic codes as well as any information on medication prescriptions and/or ocular-surgery history.

Results:

During the 18-year observational period, totals of 505 and 7538 patients were diagnosed with PCG and JOAG, respectively. The mean prevalences of PCG and JOAG were 3.96±0.72 and 14.17±5.18, respectively. The prevalence of PCG showed an overall increasing trend during the study period, but the pattern was not significant (β=0.049, P=0.143); that of JOAG, meanwhile, showed a significant decreasing tendency (β=−0.713, P=0.001). PCG prevalence showed no difference between urban and rural areas, but JOAG showed a higher prevalence in rural areas (P<0.001). As for mean incidence, the rates for PCG and JOAG were 1.54±0.49 and 5.02±1.95 (per 100,000 person-years), respectively, and were higher in males (P<0.001 and P=0.013).

Conclusion:

This study identified childhood glaucoma prevalence and incidence in a general population of East Asian ethnicity. This data could help to promote a better understanding of the typical epidemiological features and clinical courses of childhood glaucoma patients.
Diet Quality Mediates the Relationship Between Chronic Stress and Inflammation in Patients With Metabolic Syndrome
Authors: Kang JungHee , Moser Debra K. , Lennie Terry A. , Chung Misook L. , Thomas D. Travis , Biddle Martha J.
Published: January 2024

Background

Chronic stress is associated with promotion of inflammation and development of metabolic syndrome, as well as deterioration of diet quality. Inflammation can be modified by changes in dietary intake.

Objective

The aim of this study was to test the hypothesis that diet quality mediates the relationship of chronic stress with inflammation in patients with metabolic syndrome.

Methods

Participants with metabolic syndrome (n = 73, 62 ± 12 years old, 71% female) completed questionnaires on chronic stress (Perceived Stress Scale-10) and diet quality (Healthy Eating Index-2020). The Perceived Stress Scale-10 was dichotomized. The Healthy Eating Index-2020 score was used as a continuous variable, and higher scores indicate better diet quality. Inflammation was assessed using plasma high-sensitivity C-reactive protein (log-transformed). We used PROCESS in SPSS to test the hypothesis.

Results

Patients in the higher stress group had lower Healthy Eating Index-2020 scores (worse diet quality) than those in the lower stress group (57 ± 13 vs 64 ± 10, P = .01). Diet quality mediated the relationship between chronic stress and inflammation (indirect effect, 0.211; 95% bootstrap confidence interval, 0.006–0.496). Higher stress was associated with lower diet quality (effect, −7.152; 95% confidence interval, −13.168 to −1.137) that was associated with increased inflammation (effect, −0.030; 95% confidence interval, −0.052 to −0.007).

Conclusions

Our findings show the important role of diet quality in the relationship of chronic stress with inflammation in patients with metabolic syndrome. Healthcare providers should encourage patients with higher stress to improve diet quality, which can decrease inflammation.
Misplaced Evidence, Missed Opportunities: Protocols for Handling Ballistic Evidence in Pediatric Patients
Authors: Marlor Derek , Crandall Miriam , Elman Meredith , Stewart Shai , Cruz-Centeno Nelimar , Kim Dae , Ginger-Wiley Maria , Juang David
Published: January 2024

BACKGROUND:

Gun-related injury is now the number one cause of death in pediatric trauma patients. Many hospitals lack dedicated forensic nurses or updated protocols for handling ballistic evidence. Evidence not collected, handled improperly, or misplaced may deny a victim the basic human right to justice.

OBJECTIVE:

This article aims to describe an initiative to highlight the importance of proper management of ballistic evidence and to educate medical providers on best practices for the documentation, handling, removal, and transfer of ballistic evidence.

METHODS:

After discovering 24 “orphaned” bullets and bullet fragments in our hospital that had not been turned over to law enforcement, we sought to turn in evidence to the proper authorities and implement protocols to prevent this error in the future. New protocols were written by forensic staff, and education on new protocols was provided via in-person training, grand rounds, emails, and other collaborative initiatives.

RESULTS:

Evidence was matched to police reports using the patient name and date of birth on evidence labels. The median (interquartile range [IQR]) time of lost ballistic evidence was 1,397 (903, 1604) days, with the oldest bullet removed in 2015. All bullets were successfully returned to law enforcement with a median (IQR) time from bullet discovery to collection of 78 (78, 174) days.

CONCLUSIONS:

Ballistic evidence handling protocols are essential for all hospitals. Dedicated, trained forensic staff should be employed to ensure proper evidence handling.
Trauma Center Transition From Paper to Electronic Quality Improvement: Enhancing Trauma Performance Efficiency
Authors: Aplin Amanda , Franks Jennifer , Chagin Laura , Butler Jean , Killian Kim , Whaley Holly , Howard Chandra , Childers Megan , Runkle Kimberly , Cotterman Robert
Published: January 2024

Background:

The American College of Surgeons requires continuous process improvement review to maintain trauma center verification. Paper-based systems to monitor and track performance improvement are commonly used but can be inadequate to monitor concurrent ongoing improvement effectively.

Objective:

To describe the implementation of an electronic process to capture and monitor performance improvement in near real time.

Methods:

In 2020, a Midwestern U.S. Level I adult trauma center and a Level II pediatric trauma center's trauma programs transitioned from a paper to an electronic file-sharing system for performance improvement. We converted our primary, secondary, and tertiary review documentation into a single electronic performance improvement file stored on the institution's virtual hard drive, accessible to designated staff, allowing continuous real-time updates.

Results:

The electronic file-sharing and monitoring process reinvigorated the team and enhanced performance improvement efforts, leading to increased efficiency through documentation and effective loop closure. Real-time monitoring allowed the trauma program to identify opportunities for improvement and enact timely action plans, including targeted performance improvement projects, department education, and ongoing training.

Conclusion:

We found that implementing an electronic file-sharing system enhanced the trauma team's ability to monitor and trend performance improvement in real time.
Emergency Department Pediatric Readiness: A Trauma Center Quality Improvement Initiative
Authors: Tucker Amy , Bailey Teresa , Edwards Courtney , Stewart Amy
Published: January 2024

BACKGROUND:

Most pediatric patients present to general emergency departments, yet maintaining pediatric equipment, skilled staff, and resources remains a challenge for many hospitals. Pediatric readiness assessment is now a requirement for trauma center verification.

OBJECTIVE:

This study aims to assess the impact of a quality improvement initiative to improve emergency department pediatric readiness.

METHODS:

A pre- and poststudy design was used to evaluate a quality improvement initiative to improve the National Pediatric Readiness assessment survey results conducted at a Southwestern United States adult Level I trauma center from September 2022 to April 2023. The multicomponent initiative included implementing a pediatric emergency care coordinator, pediatric-specific policies and procedures, identifying pediatric-specific quality and performance indicators, and educating pediatric-specific staff. Study inclusion criteria were all patients younger than 18 years who presented to the emergency department. The primary outcome measure was the improvement in the weighted Pediatric Readiness Score. Secondary outcomes were throughput, nursing documentation of vital signs, and pain scores.

RESULTS:

A total of N = 2,356 patients met inclusion, of which n = 1,158 (49.2%) were in the preintervention group and n = 1,198 (50.8%) postintervention group. The weighted Pediatric Readiness Score improved by 45.4%. Transfers to a pediatric hospital increased from 4.1% to 8.6% (p = .016). Blood pressure documentation improved slightly from 88.3% to 88.6%. Pain score documentation decreased from 83.9% to 63.1% (p = .008). Pain medication and administration improved from 19.8% to 26.7% (p = .046).

CONCLUSION:

We found that participation in the quality improvement initiative was associated with emergency department pediatric readiness improvements.
Sequential Compression Device Compliance for Venous Thromboembolism in High-Risk Trauma: A Quality Improvement Study
Authors: Mitchell Tammie L. , Duvall Nancy M. , Martin Charles W.
Published: January 2024

Background:

Hospital-acquired, perioperative venous thromboembolism is a recognized patient safety indicator in the adult trauma patient population. Mechanical prophylaxis has been identified as a standard intervention to reduce the incidence of venous thromboembolism when prescribed along with anticoagulation or if anticoagulation is contraindicated in the surgical population. Adherence to consistent mechanical prophylaxis remains a nursing issue impacted by numerous factors in patient care.

Objective:

The purpose of this quality improvement project was to improve the compliance of sequential compression device utilization to decrease the hospital-acquired, perioperative venous thromboembolism rate in the adult hospitalized trauma patient population.

Methods:

A pre- and postintervention quality improvement approach utilized a nurse-led strategy to engage multidisciplinary team members to increase the consistency of sequential compression device utilization on patients within trauma units. The patient safety indicator rate per 1,000 for hospital-acquired, perioperative venous thromboembolism was monitored for improvement.

Results:

The patient safety indicator rate per 1,000 for hospital-acquired, perioperative venous thromboembolism demonstrated a decline from 10.60 to 4.95 rate per 1,000 over 12 months. In the trauma units, sequential compression device compliance increased from an initial direct observation audit of only 12% to an average of 65% compliance rate during the last 16-week audits.

Conclusion:

We found that a multidisciplinary, nurse-driven approach in the trauma units was effective in improving the compliance of sequential compression device utilization and impacted the hospital acquired, perioperative venous thromboembolism rate in the adult trauma patient population.
Percutaneous endoscopic lumbar discectomy in lumbar disc herniation with posterior ring apophysis fracture: A case report in a 15-year-old child
Authors: Zhang Baode , Chen Peikai , Zhong Jiaquan , To Michael Kai-Tsun , Cheung Kenneth Man-Chee , Wu Jianbin
Published: January 2024

Rationale:

Lumbar disc herniation (LDH) with posterior ring apophysis fracture (PRAF) is rather rare in children, and in all age-stratified LDH patients, the incidence of RAF was 5.3% to 7.5%. Interestingly, the incidence of LDH with RAF in children (15%–32%) is several times higher than in adults, the mis-diagnosis of which may lead to delayed treatment.

Patient concerns:

Here, we report a 15-year-old schoolboy who suffered from sudden low back pain and radiating pain in both lower limbs after sport activities. Symptoms persisted after 3 months of conservative treatment. Computer radiography and magnetic resonance imaging indicated central disc herniation with PRAF at L4-5.

Diagnosis:

LDH with PRAF.

Interventions:

The herniated disc and epiphyseal fragments were successfully excised by the percutaneous endoscopic lumbar discectomy minimal-invasive technique.

Outcomes:

Surgery was successful. Symptoms were immediately relieved postoperatively with a wound of only about 7.0 mm. Discharged on the next day. No perioperative complications occurred. Moreover, the imaging and clinical outcomes were also more satisfactory during the post-operative 15 months outpatient follow-up.

Lessons:

Pediatric LDH with PRAF is extremely uncommon, and there is a lack of training among physicians for such cases, which may lead to delayed diagnosis and treatment. Once a diagnosis for LDH with PRAF is established, percutaneous endoscopic lumbar discectomy is a safe and effective minimally invasive treatment to be considered, and we hope that this technique can provide more assistance in the future.
Effects of Kegel exercise combined with rational emotive behavior therapy on pelvic floor muscle function and sexual life quality in patients with total hysterectomy: A retrospective study
Authors: Zhang Man , Zhu Ming , Zhang Xianglian , Ren Juan , Jia Fang
Published: January 2024

To explore the clinical effects of Kegel exercise combined with rational emotive behavior therapy (REBT) on the pelvic floor muscle function, medical coping style, and sexual life quality after total hysterectomy. This was a retrospective cohort study. A total of 91 patients were collected in this study: 39 patients in Kegel group (received Kegel exercise alone) and 52 patients in combination group (received Kegel exercise combined with REBT). Propensity score matching (PSM) with 1:1 ratio was conducted to avoid the selection bias. The female sexual function index (FSFI) was used to evaluate and compare sexual life quality. After PSM, 35 patients were in each group (combination vs Kegel). The normal rate of pelvic floor muscle in combination group was significantly higher than that in Kegel group (88.57% vs 54.29%, P = .041). After surgery, the score of confrontation was higher, while the scores of avoidance and acceptance-resignation were lower in combination group compared with those in Kegel group. The postoperative total FSFI score and the scores of all dimensions were higher in combination group than those in Kegel group. In patients with total hysterectomy, Kegel exercise combined with REBT can significantly improve pelvic floor muscle function, medical coping style and sexual life quality. Therefore, it is worthy of clinical application.
Dual-allele heterozygous mutation of DNAH5 gene in a boy with primary ciliary dyskinesia: A case report
Authors: Shi Yu , Lei Qihong , Han Qing
Published: January 2024

Rationale:

To analyze clinical and imaging features, ciliary structure and family gene mutation loci of a primary ciliary dyskinesia (PCD) boy with a dual-allele heterozygous mutation of DNAH5.

Patient concerns:

Clinical data of the proband and relatives. Electronic bronchoscopy, transmission electron microscope (TEM) of the cilia and next-generation sequencing (NGS) were performed. PCD-related DNAH5 exon mutation sites were searched.

Diagnoses:

A 10-year and 10-month-old boy was hospitalized due to “recurrent cough, expectoration, sputum and shortness of breathing after activity for over 7 years, and aggravated for 1 week.” Moderate and fine wet rales were detected in bilateral lungs. Clubbing fingers and toes were observed. In local hospitals, he was diagnosed with Mycoplasma pneumoniae infection and Streptococcus pneumoniae was cultured.

Interventions:

Pulmonary function testing showed mixed ventilation dysfunction and positive for bronchial dilation test. Imaging examination and fiberoptic bronchoscopy revealed transposition of all viscera, bilateral pneumonia, and bronchiectasis. TEM detected no loss of the outer dynein arms. NGS identified 2 mutations (c.4360C>T, c.9346C>T) in the DNAH5 gene inherited from healthy parents.

Outcomes:

According to literature review until 2022, among 144 exon gene mutations causing amino acid changes, C>T mutation is the most common in 44 cases, followed by deletion mutations in 30 cases. Among the amino acid changes induced by gene mutation, terminated mutations were identified in 89 cases.

Lessons:

For suspected PCD patients, TEM and NGS should be performed. Prompt diagnosis and treatment may delay the incidence of bronchiectasis and improve clinical prognosis.
Efficacy and safety of once-weekly basal insulin versus once-daily basal insulin in patients with type 2 diabetes: A systematic review and meta-analysis
Authors: Wang Xinxin , Xiao Wei , Liang Zhanpeng , Li Shixiang , Tang Qizhi
Published: January 2024

Background:

Once-weekly insulin is expected to improve treatment compliance and durability and lead to better glycemic control. Several clinical trials on once-weekly insulin have recently been published. We conducted a systematic review and meta-analysis to investigate the efficacy and safety of once-weekly insulin versus once-daily insulin in type 2 diabetes (T2D).

Methods:

The following databases were searched for studies: PubMed, EMBASE, and Cochrane library (From January 1, 1946 to May 9, 2023). All randomized trials comparing weekly versus daily insulin in T2D were eligible for inclusion. Data analysis was performed using STATA 17.0 software (Stata Corporation, College Station, TX). The main outcomes and indexes included reduction in Hemoglobin A1c (HbA1c), fasting plasma glucose and bodyweight, proportion of patients achieving HbA1c < 7%, time-in-range 70 to 180 mg/dL and adverse events.

Results:

This systematic review and meta-analysis included 7 randomized controlled studies involving 2391 patients (1347 receiving 1-week insulin and 1044 receiving 1-day insulin). Once-weekly insulin was not inferior to once-daily insulin in HbA1c change [estimated treatment difference (ETD) = −0.05; 95% confidence intervals (CI): −0.14 to 0.04), HbA1c 
< 7% (odds ratio = 1.14; 95% CI: 0.87–1.50), fasting plasma glucose (ETD = 0.09; 95% CI: −0.19 to 0.36) and body weight loss (ETD = 0.27; 95% CI: −0.36 to 0.91). In terms of time-in-range 70 to 180 mg/dL, weekly insulin was superior to daily insulin (MTD = 3.84; 95% CI: 1.55–6.08). Icodec was associated with higher incidence of all adverse events (odds ratio = 1.20; 95% CI: 1.03–1.48; P = .024), but did not result in high risk of serious and severe adverse events. Moreover, icodec and Basal Insulin Fc did not result in higher incidence of hypoglycemia compared with insulin daily.

Conclusion:

Our meta-analysis found that insulin weekly was well tolerated and effective for glycemic control. Once-weekly insulin was not inferior to once-daily insulin in both efficacy and safety in T2D.
CT-based radiomics analysis to predict local progression of recurrent colorectal liver metastases after microwave ablation
Authors: Hu Hao , Chi Jia Chang , Zhai Bo , Guo Jin He
Published: January 2024

The objective of this study is to establish and validate a radiomics nomogram for prediction of local tumor progression (LTP) after microwave ablation (MWA) for recurrent colorectal liver metastases (CRLM) after hepatic resection. We included 318 consecutive recurrent CRLM patients (216 of training while 102 of validation cohort) with contrast-enhanced computerized tomography images treated with MWA between January 2014 and October 2018. Support vector machine-generated radiomics signature was incorporated together with clinical information to establish a radiomics nomogram. Our constructed radiomics signature including 15 features (first-order intensity statistics features, shape and size-based features, gray level size zone/dependence matrix features) performed well in assessing LTP for both cohorts. With regard to its predictive performance, its C-index was 0.912, compared to the clinical or radiomics models only (c-statistic 0.89 and 0.75, respectively) in the training cohort. In the validation cohort, the radiomics nomogram had better performance (area under the curve = 0.89) compared to the radiomics and clinical models (0.85 and 0.69). According to decision curve analysis, our as-constructed radiomics nomogram showed high clinical utility. As revealed by survival analysis, LTP showed worse progression-free survival (3-year progression-free survival 42.6% vs 78.4%, P < .01). High-risk patients identified using this radiomics signature exhibited worse LTP compared with low-risk patients (3-year LTP 80.2% vs 48.6%, P < .01). A radiomics-based nomogram of pre-ablation computerized tomography imaging may be the precious biomarker model for predicting LTP and personalized risk stratification for recurrent CRLM after hepatic resection treated by MWA.
Effect of psychological care on the prenatal mental state and vaginal delivery in pregnant women during the early stages of the COVID-19 epidemic
Authors: Liu Yanping , Xu Xinai
Published: January 2024

The COVID-19 pandemic has had a profound impact on the lives of people globally, including pregnant women. We aimed to explore the influence of a psychological care intervention based on behavioral change theory on the prenatal mental state and mode of delivery in pregnant women from June 2020 to June 2022 during the early stage of the COVID-19 epidemic in China. A retrospective analysis was conducted of the records of pregnant women who delivered in our hospital from June 2020 to June 2022. They were assigned to an observation and a control group according to the care that they received. The Symptom Checklist-90 (SCL-90) was used to evaluate their negative emotions. The duration of each labor stage and the mode of delivery (cesarean section, spontaneous vaginal delivery, or assisted vaginal delivery) were recorded. A total of 216 women were included in the analysis. Before care, there were no significant differences in the SCL-90 scores between the 2 groups. After delivery, the SCL-90 scores in the observation group were significantly lower than those in the control group. The vaginal delivery rate in the observation group was 92.59%, which was significantly higher than that in the control group (70.39%). The duration of the first stage of labor and the total duration of labor in the observation group were 447.95 ± 53.45 minutes and 498.15 ± 35.14 minutes, respectively, which were significantly lower than those in the control group. The implementation of psychological care based on behavioral change theory in pregnant women during the early stage of the COVID-19 epidemic significantly improved their prenatal psychological state, promoted vaginal delivery, and help shorten the labor process, and reduce the risk of adverse pregnancy outcomes. This intervention is thus worth promoting.
Evaluation of readability levels of online patient education materials for female pelvic floor disorders
Authors: Varli Bulut , Cetindag Elif Nazli , Koyuncu Demir Kazibe , Coban Ulas , Islamova Gunel , Dokmeci Fulya
Published: January 2024

Most women hesitate to seek help from healthcare providers as they find it difficult to share complaints of involuntary leakage or vaginal prolapse. Hence, they often refer to the websites of national and/or international bodies’ patient education materials (PEMs), which are considered the most reliable sources. The crucial factor that determines their usefulness is their readability level, which makes them “easy” or “difficult” to read, and is recommended, not to exceed the sixth grade level. In this study, we aimed to assess the readability levels of Turkish translated PEMs from the websites of the International Urogynecological Association and the European Association of Urology and the PEMs originally written in Turkish from the website of the Society of Urological Surgery in Turkey. All the PEMs (n = 52) were analyzed by online calculators using the Atesman formula, Flesch-Kincaid grade level, and Gunning Fog index. The readability parameters, number of sentences, words, letters, syllables, and readability intervals of these methods were compared among the groups using the Kruskal-Wallis test, or ANOVA test, with post hoc comparisons where appropriate. The readability level of all PEMs is at least at an “averagely difficult” interval, according to both assessment methods. No significant differences were found among the PEM groups in terms of readability parameters and assessment methods (P > .05). Whether original or translated, international or national societies’ PEMs’ readability scores were above the recommended level of sixth grade. Thus, the development of PEMs needs to be revised accordingly by relevant authorities.
The application of cluster nursing to prevent bacterial pneumonia in stroke patients in neurology department
Authors: Hu Die , Zhang Jiuxia
Published: January 2024

The research aims to explore the intervention effect of cluster nursing methods on bacterial pneumonia in stroke patients in neurology. A retrospective analysis is conducted on 120 patients diagnosed with stroke in the hospital from 2020 to 2022, who are diagnosed as stroke patients in the neurology department by doctors. 120 patients are randomly separated into a control group (CG) and a research group (RG) for the experiment, with 60 people in each group. The CG receive normal nursing; The RG adopt cluster nursing methods. Comparison have done in the general information, nursing satisfaction, physical improvement after intervention, and oral hygiene indicators of the 2 groups of patients, and the intervention effect of the 2 nursing methods on patients suffering from bacterial pneumonia is evaluated. When the time reached the 7th day, the nutritional risk screening scores of both groups were (9.53 ± 2.29) and (8.10 ± 2.12), respectively. The serum albumin levels were (36.46 ± 4.80) g/L and (34.16 ± 3.69) g/L, respectively. After simultaneous nursing intervention, there were P < .005 in respiratory rates in the 2nd and 4th months of intervention, as well as after the completion of nursing intervention. The respiratory rates of the RG patients improved toward a larger range of normal respiratory rates, with significant statistical significance (P < .005). As time passed, the number of people with shortness of breath in the CG increased sharply to 46, while those in the RG was only 27, indicating P < .05 between the 2 groups. At the beginning of the 3rd month, the satisfaction rates of the RG and the CG were (92.33 ± 1.17)% and (78.18 ± 1.07)%, respectively, and there was P < .0.05 between the 2 groups of data. The cluster nursing strategy has a significant relieving effect on bacterial pneumonia in stroke patients in the neurology department, which can effectively reduce the probability of pneumonia, improve their physical condition, and enhance their quality of life. It has certain clinical application value.