bluuebunny/crossref_metadata_2025_split huggingface dataset:
Efficacy and safety of Sodium-Glucose-Transporter-2 inhibitors in kidney transplant patients
Authors: Jenssen Trond G. 
Published: September 2021

Purpose of review
This review discusses current evidence and future perspectives for use of SLT2 inhibitors in kidney transplant recipients (KTRs).

Recent findings
Sodium-Glucose-Transporter-2 inhibitors (SGLT2is) lower plasma glucose in patients with type 2 diabetes, and protect against heart failure and progression of chronic kidney disease by a glucose-independent mechanism. Most of the current studies with SGLT2is in kidney transplant patients are however short-term retrospective case studies. These, together with one small randomized clinical trial, show that SGLT2is lower glucose also in KTRs with type 2 diabetes or posttransplant diabetes mellitus. Larger reductions in HbA1c (−0.5 to 1.5% points) are seen only in patients with estimated GFR > 60 ml/min/1.73m2 and HbA1c > 8%. With lower gomerular filtration rate (GFR) or glycated hemoglobin (HbA1c) the glucose-lowering effect is trivial. However, a reduction in body weight, blood pressure and uric acid is also seen, whereas the frequency of side effects (mycotic or urinary tract infections) does not seem to exceed what is seen in nontransplanted patients. Long-term effects on GFR have not been studied in kidney transplanted patients, but SGLT2is induce an early dip in GFR also in these patients. This could signal a beneficial long-term effect on renal hemodynamics.

Summary
SGLT2is lower glucose safely also in patients with single kidney grafts, but long-term kidney function and patient survival are yet to be explored.
Role of chimeric antigen receptor T-cell therapy: bridge to transplantation or stand-alone therapy in pediatric acute lymphoblastic leukemia
Authors: Qayed Muna , Bleakley Marie , Shah Nirali N. 
Published: September 2021

Purpose of review
To discuss the curative potential for chimeric antigen receptor T-cell (CAR-T) therapy, with or without consolidative hematopoietic stem cell transplantation (HCT) in the treatment of children and young adults with B lineage acute lymphoblastic leukemia (B-ALL).

Recent findings
CAR-T targeting CD19 can induce durable remissions and prolong life in patients with relapsed/refractory B-ALL. Whether HCT is needed to consolidate remission and cure relapse/refractory B-ALL following a CD19 CAR-T induced remission remains controversial. Preliminary evidence suggests that consolidative HCT following CAR-T in HCT-naïve children improves leukemia-free survival. However, avoiding HCT-related late effects is a desirable goal, so identification of patients at high risk of relapse is needed to appropriately direct those patients to HCT when necessary, while avoiding HCT in others. High disease burden prior to CAR-T infusion, loss of B-cell aplasia and detection of measurable residual disease by flow cytometry or next-generation sequencing following CAR-T therapy associate with a higher relapse risk and may identify patients requiring consolidative HCT for relapse prevention.

Summary
There is a pressing need to determine when CD19 CAR-T alone is likely to be curative and when a consolidative HCT will be required. We discuss the current state of knowledge and future directions.
Longitudinal Health Status and Quality of Life After Esophageal Atresia Repair
Authors: ten Kate Chantal A. , Rietman André B. , van de Wijngaert Yannick , van Gils‐Frijters Annabel , Gischler Saskia J. , Keyzer‐Dekker Claudia M.G. , Wijnen René M.H. , IJsselstijn Hanneke 
Published: September 2021

ABSTRACTObjectives:To longitudinally evaluate self‐reported and proxy‐reported health status (HS) and quality of life (QoL) of school‐aged children born with esophageal atresia (EA).Methods:We obtained Pediatric Quality of Life Inventory (HS) and DUX‐25 (QoL) questionnaires from children born with EA between 1999 and 2011 at 8 and/or 12 years old. Children completed self‐reports during neuropsychological assessments in a prospective longitudinal follow‐up program. Parents filled out proxy‐reports at home. Total and subscale scores were evaluated longitudinally and compared with sex‐specific reference norms.Results:In total, 110 participants (62% boys) were included. Self‐reported HS improved significantly between 8 and 12 years for both boys (mean difference [md] 4.35, effect size [ES] 0.54, P = 0.009) and girls (md 3.26, ES 0.63, P = 0.004). Proxy‐reported HS tended to improve over time, while self‐reported and proxy‐reported QoL tended to decline. Self‐reported HS at 8 years was below normal for both boys (md −5.44, ES −0.35, P < 0.001) and girls (md −7.61, ES −0.32, P < 0.001). Girls’ self‐reported QoL was below normal at 8 (md −5.00, ES −0.18, P = 0.019) and 12 years (md −10.50, ES −0.26, P = 0.001). Parents reported normal HS at both ages, whereas they rated the QoL of their daughters below normal at 12 years (md −10.00, ES −0.16, P = 0.022). All above results are total scores.Conclusions:Self‐reported and proxy‐reported HS of children with EA improved between 8 and 12 years, while their QoL tended to decline. We recommend to consider HS and QoL as two separate concepts and to measure both simultaneously and longitudinally when evaluating the burden of disease.
20‐Year Follow‐up Study of Celiac Patients Identified in a Mass School Screening
Authors: Cozzi Giorgio , Gabbana Eleonora , Zanchi Chiara , Giudici Fabiola , De Leo Luigina , Ziberna Fabiana , Bramuzzo Matteo , Di Leo Grazia , Not Tarcisio 
Published: September 2021

ABSTRACTObjectives:To investigate the compliance to the gluten‐free diet in a cohort of adult celiac patients 20 years after the diagnosis, received in childhood through a mass screening.Methods:This is an observational historic cohort follow‐up study. It was carried out at the Institute for Maternal and Child Health IRCCS Burlo Garofolo, Trieste, Italy. Two matched cohorts of adult celiac patients, diagnosed in childhood through a mass screening or for symptoms were enrolled. Adherence to the gluten free‐diet and development of autoimmune diseases were investigated through a questionnaire administrated in the course of a phone interview.The primary study outcome was the adherence to the gluten‐free diet, measured through the Biagi questionnaire, in the two cohorts of celiac patients.Results:We contacted 25 patients (mean age 28 years, 19 females) diagnosed with screening and 34 patients (mean age 25 years, 26 females) diagnosed in the same period for symptoms. After 20 years, in the cohort diagnosed with screening and in the cohort diagnosed for symptoms the adherence to the gluten‐free diet was optimal in 14 (56%) and 26 (81%), improvable in 5 (20%) and 3 (9%), inadequate in 6 (24%) and 3 (9%), respectively. In the two cohorts, four patients (16%) and six patients (18%) developed other autoimmune diseases.Conclusions:Twenty years after the diagnosis, near half of the patients diagnosed in a mass screening, does not have an optimal adherence to the gluten‐free diet and a remarkable proportion of them have developed another autoimmune disease.
Meckel's Masquerade
Authors: Callanan Deborah L. , O'Brien Megan M. 
Published: September 2021

Abstract
Children with abdominal pain are frequently seen in emergency departments. Physicians and parents worry about appendicitis; physicians are also concerned about intussusception and bowel obstruction in patients with previous surgical procedures. Sometimes the patient is ill, and the diagnosis is elusive. In a 6-month period at our pediatric emergency department with an annual census of 57,400 patients, we cared for 4 patients who presented with abdominal pain due to complications of Meckel’s diverticulum. None presented with painless rectal bleeding, the complication of which physicians are most aware. We are reporting these patients to raise awareness of Meckel’s diverticulum as a cause of acute abdomen in children. Meckel’s diverticulum may masquerade as appendicitis, an abdominal mass, intussusception, or a complication of severe constipation.
A Systematic Review of Approaches for Continuous Quality Improvement Capacity-Building
Authors: Loper Audrey C. , Jensen Todd M. , Farley Amanda B. , Morgan Jenille D. , Metz Allison J. 
Published: September 2021

Context:
Continuous quality improvement (CQI) has become prominent in public health settings; yet, little consolidated guidance exists for building CQI capacity of community-based organizations.

Objective:
To synthesize relevant literature to identify guiding principles and core components critical to building the capacity of organizations to adopt and use CQI.

Design:
We employed a systematic review approach to assess guiding principles and core components for CQI capacity-building as outlined in the literature.

Eligibility Criteria:
Studies meeting the following criteria were eligible for review: (1) empirical, peer-reviewed journal article, evaluation study, review, or systematic review; (2) published in 2010 or later; and (3) capacity-building activities were described in enough detail to be replicable. Studies not including human subjects, published in a language other than English, or for which full text was not available were excluded.

Study Selection:
The initial return of records included 6557 articles, of which 1455 were duplicates. The research team single-screened titles and abstracts of 5102 studies, resulting in the exclusion of 4842 studies. Two hundred sixty-two studies were double-screened during full-text review, yielding a final sample of 61 studies from which data were extracted.

Main Outcome Measures:
Outcome measures of interest were operationalized descriptions of guiding principles and core components of the CQI capacity-building approach.

Results:
Results yielded articles from medical education, health care, and public health settings. Findings included guiding principles and core components of CQI capacity-building identified in current practice, as well as infrastructural and contextual elements needed to build CQI capacity.

Conclusions:
This consolidation of guiding principles and core components for CQI capacity-building is valuable for public health and related workforces. Despite the uneven distribution of articles from health care, medical education, and public health settings, our findings can be used to guide public health organizations in building CQI capacity in a well-informed, systematic manner.
Experimental Effects of Tweets Encouraging Social Distancing: Effects of Source, Emotional Appeal, and Political Ideology on Emotion, Threat, and Efficacy
Authors: Vaala Sarah E. , Ritter Matthew B. , Palakshappa Deepak 
Published: September 2021

Context:
Public health officials and celebrities use social media to provide guidance to reduce the spread of COVID-19. Messages apply different promotional strategies to motivate behavior change, likely yielding divergent reactions from partisan audiences. The Extended Parallel Process Model (EPPM) suggests that perceived threat for a negative outcome should impact perceived need for the advocated health behavior, which should be more appealing to an audience if perceived it to be efficacious and feasible.

Objective:
This study examines the interactive effects of Tweet source, message emotional appeal, and audience political affiliation on US adults' perceptions of COVID-19 threat and social distancing efficacy during early months of the pandemic.

Design and Setting:
This online survey experiment applies the EPPM to assess US adults' reactions to tweets encouraging social distancing. The experiment tests 3 emotional appeals (fear, humor, and neutral) and 2 sources (Centers for Disease Control and Prevention [CDC] and celebrity) on adults' emotional reactions and perceptions of COVID-19 threat and social distancing efficacy.

Participants:
The final sample included 415 US adults (242 Democrat and 173 Republican) recruited through Amazon's Mechanical Turk.

Main Outcome Measures:
Outcome measures were adapted from the EPPM and include perceived susceptibility to and severity of COVID-19, and response efficacy and self-efficacy regarding social distancing. Each was measured through the survey on a 7-point response scale.

Results:
Humor and fear appeal messages evoked less fear and guilt responses than a neutral tweet from the CDC. Fear and guilt emotions predicted greater perceived threat, while hope and pride predicted efficacy constructs in relationships moderated by political ideology.

Conclusions:
Public health messages targeting a bipartisan audience through social media may increase perceived threat by inducing fear of COVID-19 infection. EPPM theory suggests boosting efficacy is also critical to message acceptance and behavior change; thus, inducing feelings of hope and pride in addition to fear may be particularly effective.
Double Eyelid Tape as a Treatment Option for Severe Ptosis in Patients With Myotonic Dystrophy Type 1
Authors: Jeong Sangah , Choi Eunseok , Lee Sook Joung 
Published: September 2021

Abstract
Myotonic dystrophy is a systemic disorder associated with progressive muscle weakness of the limbs and multiorgan dysfunction. This condition commonly affects the levator palpebrae superioris muscle, which leads to ptosis and eventually affects patients’ activities of daily living. The effects of ptosis on activities of daily living are usually overlooked; therefore, the importance of treatment is underestimated, and surgical procedures are considered infeasible in patients with preexistent levator palpebrae superioris muscle weakness. This case report describes the case of a middle-aged man with myotonic dystrophy type 1, who presented with ptosis, which significantly restricted his participation in rehabilitation and activities of daily living secondary to a limited visual field. He was evaluated by an ophthalmologist; however, surgery was contraindicated in view of the high risk of complications, such as exposure keratitis and corneal ulcer. Double eyelid tapes were used as a nonsurgical intervention, which significantly increased the palpebral fissure height and improved the visual field, with a higher modified functional index score. Double eyelid tapes may serve as an effective, safe, and reliable therapeutic option for severe ptosis in patients with myotonic dystrophy.
Quantitative Sensory Changes Related to Physical Activity in Adult Populations
Authors: Baehr Laura A. , Frey-Law Laura A. , Finley Margaret 
Published: September 2021

Abstract
Exercise-induced hypoalgesia related to physical activity produces sensory adaptations, but its mechanism remains unclear. Quantitative sensory testing is an effective measurement tool to identify sensory changes, but the extent of evidence linking quantitative sensory testing and physical activity has not been explored. The purpose of this scoping review is to synthesize the evidence on using quantitative sensory testing to evaluate psychophysical changes related to physical activity in adult populations. The researchers developed a comprehensive search strategy with a Health Sciences Librarian using the Arksey and O’Malley Methodological framework. Four databases (Medline [PubMed], CINAHL, Web of Science, and Embase) were searched for peer-reviewed primary research. After 2790 articles were evaluated, 196 studies were included for final review. More than half of studies used randomized controlled trial design (50.5%), followed by quasi-experimental (24.0%) and observational (25.5%) strategies. Healthy adults (42.9%) and individuals with chronic health conditions (20.9%) were examined most frequently. Aerobic (27.6%) and strength (21.4%) physical activity types were most commonly studied. Static quantitative sensory testing measures of pressure pain threshold (84%) were used most frequently. The findings of this scoping review demonstrate available evidence for quantitative sensory testing as a measurement tool of neuromodulation related to physical activity in adult populations. A systematic review is warranted to examine outcomes and recommendations.
Development of a Cadaver Laboratory Curriculum for Interventional Spine Procedures for Physical Medicine and Rehabilitation Residents
Authors: Berlin Evan , Khan Samir , Roehmer Christian , Sherwood David , Yang Aaron 
Published: September 2021

Abstract
There is no standardized curriculum for teaching interventional spine procedures during residency. The objective of this protocol was to share a curriculum using a cadaver laboratory for teaching Physical Medicine and Rehabilitation residents interventional spine procedures, which can be an effective and safe medium to train residents. This protocol provides a checklist that can guide the residents while they are in the cadaver laboratory with a focus on some of the most common lumbar procedures. Twelve physical medicine and rehabilitation resident’s confidence in their ability to maneuver the x-ray image intensifier (C-arm), identify spine anatomy under fluoroscopy, and drive the needle improved after the training curriculum (P < 0.005). Although the cadaver laboratory curriculum is not a replacement for the required Accreditation Council for Graduate Medical Education training, it may serve as a tool to improve resident preparedness for spine procedures.
Strength of Improvement Recommendations From Injurious Fall Investigations: A Retrospective Multi-Incident Analysis
Authors: Paulik Olivia , Hallen Jamie , Lapkin Samuel , Green Heidi , Fernandez Ritin 
Published: September 2021

Objectives
The aim of this study was to examine the strength of improvement recommendations proposed after investigation of fall incidents in health care facilities that result in major injuries.

Methods
This study was conducted using a retrospective multi-incident analysis design. The study setting was 4 tertiary teaching hospitals, 1 subacute rehabilitation facility, and a residential aged care facility in a metropolitan health district in New South Wales, Australia. Ninety-eight injurious fall incidents during a 2-year period (2015–2016) were investigated. Recommendations were grouped into 3 categories: strong (including environmental modifications, equipment, workflow or process redesign), medium (including changes in communication or documentation processes, staffing numbers and/or skill mix, education to address identified knowledge deficits), and weak (including alerts/warning/labels or expected practice without any associated policy or procedure).

Results
The majority of the incidents (34.7%; n = 34) occurred between 1300 and 1859 hours, 65.3% (n = 64) occurred in the patient’s room, and 79.4% (n = 81) of the injuries were fractures. There were 224 recommendations made for 79 incidents, and 19 incidents did not have any recommendations. The average number of improvement recommendations proposed per incident investigation was 2.3 (SD, 2.1; range, 0–9). Nineteen (8.5%), 80 (35.7%), and 125 (55.8%) recommendations were classified as strong, medium, and weak, respectively. Half of the investigative teams included representatives from more than one professional group. There were a significantly greater number of medium recommendations made by multi-disciplinary teams compared with single-disciplinary teams (odds ratio, 1.83; 95% confidence interval, 1.05–3.21). There was no significant difference in the number of strong and weak recommendations made between the 2 teams.

Conclusions
This study found that only 8.5% of recommendations were classified as strong. This suggests that a major challenge lies in formulating robust recommendations; hence, efforts should focus on enhancing the strength of improvement recommendations.
Working Experience of Managers Who Are Responsible for Promoting and Monitoring Patient Safety in South Korea: Focusing on Small- and Medium-Sized Hospitals
Authors: Yoon Yea Seul , Lee Won , Kang Sunjoo , Kim In Sook , Jang Seung Gyeong 
Published: September 2021

Objectives
This study explored the working experience of patient safety managers (PSMs) in small- and medium-sized hospitals (SMHs).

Methods
A qualitative study comprising 3 focus group discussions (6 people each) was conducted. Patient safety managers working in SMHs—hospitals with 100 to 300 beds—were included. Researchers analyzed the transcribed script, and a conventional content analysis was performed to describe PSMs’ working experience.

Results
All the PSMs were nurses and with an average (SD) work experience of 1.51 (1.02) years. Five core themes and 17 subthemes were derived. The PSMs reported that it was difficult to perform patient safety tasks alone and cooperate with other departments. Because of members who did not acknowledge PSMs’ authority as experts, PSMs experienced identity confusion. Lack of an established patient safety culture in SMHs hindered the PSMs from performing patient safety–related duties. The government continues to train PSMs and provide materials; however, they are not suitable for SMHs and thus cannot be used. The PSMs hoped to overcome the system’s initial phase and become professionals.

Conclusions
Patient safety managers faced difficulties because of the lack of guidelines, training, and systems. Nevertheless, they have attempted to overcome these problems themselves, so they can be recognized as professionals. This study’s findings can be used as basic data to provide differentiated support for PSMs, based on hospital size.
Impact of a Review of a Smart Infusion Pump Library in Hematology/Oncology: Tailoring Content to Meet Specialty Needs
Authors: Misko Jeanie , Rawlins Matthew , Ridley Breigh 
Published: September 2021

Objectives
Errors involving chemotherapy or intravenous medications may cause serious patient harm. Dose error reduction software (DERS) for “smart” infusion pumps offers additional safety protection for their administration. Our institution uses DERS software hospital-wide; however, the hematology/oncology areas were noted to have reduced compliance with DERS recommendations. In response, we sought to review the DERS content and survey hematology/oncology end users’ satisfaction with the software.

Methods
A multidisciplinary working group was formed to review the current DERS entries for medications, fluids, and blood products. The review included details such as dose, rate, and concentrations. Dose error reduction software compliance was determined using vendor-supplied Continuous Quality Improvement software. An electronic survey assessing clinicians’ satisfaction with the current DERS library and any challenges in its use was conducted before and after the review.

Results
Ninety-one changes were made to 71 medications by the working group. Compliance with the DERS library went from 81.5% before the review to 87.3% after the review (P = 0.257). Fifty-eight survey responses were received (30 prereview and 28 postreview) with improvements in staff satisfaction with the DERS library (83.3%–92.8%, P < 0.05). Near-miss events changed after the review from 2 to 0, and the number of alerts caused by values outside the DERS library reduced from 8788 before the review to 3383 after the review (P ≤ 0.05).

Conclusions
Review of a hematology/oncology DERS library found improvements that better met the needs of end users. Engagement with relevant stakeholders, in conjunction with ongoing communication and review, is required to improve compliance and satisfaction with DERS.