bluuebunny/crossref_metadata_2025_split huggingface dataset:
Optimizing nurse practitioner productivity within the Veterans Health Administration
Authors: Peacock Michelle , Rybacki Diane , Dixon Brooke , Haslam Aaron , Wirtz Rugen Kathryn , Jensen Penny Kaye , Colandrea Maria 
Published: December 2024

ABSTRACT

Background:
Nurse practitioners (NPs) provide high-quality, comprehensive health care at Veterans Health Administration (VHA) medical centers in various practice settings. Accurately determining the productivity of NPs is essential to understanding their overall contribution to veteran care. There is a lack of understanding of the contributors to the variability among VHA medical centers regarding their processes for capturing these data. Using benchmark data from the VHA Support Service Center Capital Assets application, this quality improvement (QI) initiative implemented a series of plan-do-study-act (PDSA) cycles to determine whether increased education regarding billing and coding, along with person classification and labor mapping accuracy, could increase NP productivity.

Local problem:
The problem identified through an analysis of NP productivity revealed variability across multiple VHA facilities.

Methods:
The PDSA method was employed in this QI project. The QI team compared the total workload relative value units (wRVU) for NPs in each participating facility pre and post a three-phase intervention.

Interventions:
Nurse practitioners' person classification and labor mapping accuracy was evaluated at each site. An educational program regarding billing and coding was developed and delivered to the NP frontline staff. The QI team compared the total wRVUs for the NPs at each facility pre- and postintervention.

Results:
An increase in the wRVUs was observed following the intervention across six facilities. Five of the seven facilities displayed stability in relative value unit improvement postintervention.

Conclusion:
Educating frontline NPs on billing, coding, person classification, and labor mapping can improve NP productivity.
Risk factors for early liver recurrence after pancreatic cancer resection
Authors: Shirai Yoshihiro , Kimura Nana , Tanaka Haruyoshi , Fukasawa Mina , Muranushi Ryo , Watanabe Toru , Hirano Katsuhisa , Shibuya Kazuto , Yoshioka Isaku , Fujii Tsutomu 
Published: December 2024

Abstract

Background
Liver recurrence after resection is one of the most common types of recurrence and is a risk factor for poor prognosis. The aim of this study was to identify risk factors for initial liver recurrence.

Methods
Total of 109 patients with resectable pancreatic ductal adenocarcinoma who underwent resection between 2015 and 2022 were included. The influence of clinicopathologic variables on liver recurrence was analyzed to create a novel scoring system to predict liver recurrence.

Results
The liver recurrence rate was 24%, with 17% recurrence within one year. Patients with liver recurrence had an extremely poor prognosis within 1 year [MST 12.4 (95% CI 5.7-19.1)]. In multivariate analysis, R-PV, large tumor diameter ≥ 45 mm and venous invasion were independent risk factors for early liver recurrence. When each of these risk factors was scored as 1 point, the 1-year liver recurrence rates by score were 0 (0%), 1 (9%), 2 (30%), and 3 (84%).

Conclusion
The risk factors for postoperative early liver recurrence were R-PV, a tumor diameter ≥ 45 mm and pathological venous invasion. Surgery for pancreatic cancer with these factors may require special treatment, such as hepatic arterial injection.
Circulating biomarkers of macrophage activation in different stages of chronic pancreatitis: A pilot study
Authors: Hagn-Meincke Rasmus , Novovic Srdan , Hadi Amer , Jensen Annette B. , Drewes Asbjørn M. , Kraup Henrik , Frøkjær Jens B. , Park Walter G. , Jørgensen Peter L. , Møller Holger Jon , Deleuran Bent W. , Olesen Søren S. 
Published: December 2024

Abstract

Objectives
Activation of type M2 macrophages has been implicated in the pathogenesis of chronic pancreatitis (CP). In a clinical pilot study, we investigated blood-based markers of macrophage activation at different stages of CP.

Methods
We performed a cross-sectional analysis of prospectively collected plasma samples from healthy controls and patients with suspected or definitive CP according to the M-ANNHEIM criteria. Plasma concentrations of soluble CD163 (sCD163), soluble CD206 (sCD206), and monocyte chemoattractant protein-1 (MCP-1) were analyzed using enzyme-linked immunosorbent assays. Group and pairwise comparisons of analytes were performed using regression models and area under the receiver operating curves (AUC-ROC).

Results
In total, 73 subjects with CP (28 suspected CP and 45 definitive CP) and 40 controls were included. Compared to controls, the median plasma concentrations of sCD163 (p = 0.019) and sCD206 (p = 0.033) were elevated in patients with definitive CP. sCD206 was also elevated in patients with definitive CP (p = 0.042). ROC analysis revealed that the optimal sCD163 cutpoint to distinguish definitive CP from controls was 1.84 mg/ml (AUC-ROC 0.65; 95 % confidence interval [CI], 0.54-0.77). The optimal sCD206 cutpoint to distinguish definitive CP from controls was 0.24 mg/ml (AUC-ROC 0.66; 95 % CI 0.54-0.78). The analytes did not significantly discriminate patients with suspected CP from controls. MCP-1 concentrations showed no differences across subgroups.

Conclusion
Our study demonstrates that subjects with definitive CP, sampled during a clinically quiescent phase, exhibited increased levels of sCD163 and sCD206. This indicates the presence of activated M2 macrophages in patients with CP at advanced, but not early, clinical stages.
The Effect of Epidural Analgesia on In-Hospital Outcomes in Patients with Acute Pancreatitis: A Systematic Review and Meta-Analysis of Randomized Clinical Trials
Authors: Moazzami Bobak , Mohammadpour Zinat , Zabala Zohyra E. , Chawla Saurabh 
Published: December 2024

Abstract

Objectives
Acute pancreatitis (AP) can lead to severe complications and high mortality. Previous studies suggest that epidural analgesia (EA) may reduce AP severity and improve outcomes. This systematic review and meta-analysis aimed to evaluate the efficacy of EA on in-hospital outcomes in AP patients.

Method
Electronic databases (PubMed, Medline-Ovid, Scopus, CINAHL, Web of Science) were systematically searched until mid-May 2024 for RCTs comparing EA with other pain management strategies in AP patients. Variables were pooled using weighted mean difference (WMD) or risk ratio (RR) with 95% confidence intervals (CIs). Data analysis employed a random-effects model and the Mantel-Haenszel method. Study heterogeneity was assessed using the I2 statistic.

Results
Five RCTs with 260 participants were included. Meta-analysis showed no significant differences in in-hospital mortality (RR = 0.69, 95% CI [0.29, 1.65], p = 0.40), mechanical ventilation (RR = 0.82, 95% CI [0.61, 1.10], p = 0.19), sepsis events (RR = 0.88, 95% CI [0.42, 1.86], p = 0.74), hospital/ICU stay (WMD = 0.49 days, 95% CI [-1.13, 2.10], p = 0.55), and pain score (WMD = 1.49, 95% CI [-0.42, 3.40], p = 0.13). However, opioid requirements were significantly lower, as reported by one study with morphine milligram equivalent of 15 mg/day compared to 52 mg/day in the control group (p = 0.001). Heterogeneity was low to moderate for most outcomes but high for pain score (I2 = 92%). The overall certainty of evidence was very low due to the small number of studies, risk of bias, and limited sample size.

Conclusions
EA did not significantly improve in-hospital outcomes in AP patients. However, findings indicated reduced opioid consumption in the EA group, suggesting potential benefits in pain management. Further high-quality, large-scale randomized trials are needed to understand the potential benefits of EA in this population.
INVESTIGATION OF GEOSPATIAL DISPARITIES IN CHRONIC PANCREATITIS OUTCOMES
Authors: Kahan Tamara F. , Noriega Marco , Liyen-Cartelle Anabel , Bocchino Rachel , Anderson Kelsey , Zuberi Shaharyar A. , Shah Ishani , Olivares Miriam , Kelly Jill , Freedman Steven D. , Rabinowitz Loren , Chhoda Ankit , Sheth Sunil G. 
Published: December 2024

ABSTRACT

OBJECTIVES
Chronic pancreatitis (CP) is a fibro-inflammatory disorder characterized by abdominal pain and exocrine and endocrine pancreatic insufficiency resulting in significant morbidity. This study evaluates the impact of geospatial parameters, assessed using the Social Vulnerability Index (SVI), a tool comprising sixteen social attributes, on CP outcomes, including opioid use.

METHODS
We conducted a retrospective analysis of CP patients with available addresses followed at our pancreas center. We reviewed demographics, clinical variables including number of CP flares, local complications, pancreatic function, and healthcare-resource utilization (HRU) including imaging, endoscopic procedures, and surgeries, and outpatient opioid prescriptions measured in morphine milligram equivalents (MME). Regression analysis was performed to assess the association between outcomes and SVI [divided into 4 quartiles (I-IV; IV being most vulnerable].

RESULTS
Among 324 CP patients followed over 8 years, we noted trends of higher dependence on governmental insurance or no insurance among patients in higher SVI quartiles (III/IV vs. I/II) but no differences in demographics, comorbidities, or etiology of CP. In patients residing in more vulnerable SVI quartiles, we noted significantly higher frequency of hospitalizations for CP flares and lower daily MME. Rates of exocrine and endocrine pancreatic dysfunction and HRU were similar across all SVI quartiles.

CONCLUSIONS
Despite multidisciplinary guideline-based care, residence in the most vulnerable neighborhoods may be associated with less opioid use and more frequent CP flares, suggesting possible inadequate pain control in these patients. These findings should guide prospective investigation of the impact of geospatial social determinants of health in CP and efforts to mitigate the above disparities.
The Efficacy of Virtual Reality–Based Interventions on Pain, Anxiety, Depression, and Quality of Life Among Patients With Cancer: A Meta-analysis of Randomized Controlled Trials
Authors: Chen Yang , Chen Xiaoli , Li Linna , Li Yunhuan , Yan Qianwen , Hu Xiaolin 
Published: December 2024

Background
Although cancer patients are living longer, the numerous physical and psychological outcomes of cancer can still be burdensome. Pain, anxiety, depression, and decreased quality of life are symptoms that are highly impacted by cancer. The availability of modalities to cope with these symptoms is critical. Virtual reality–based interventions have been used among patients with cancer, but their effects on pain, anxiety, depression, and quality of life remain unclear.

Objective
To determine the efficacy of virtual reality–based interventions on pain, anxiety, depression, and quality of life among cancer patients and to assess the efficacy of different contents and duration.

Methods
Nine databases were retrieved from inception to July 31, 2024. The methodological quality was evaluated via the Cochrane Risk of Bias 2.0 tool. Data synthesis was conducted with Stata version 16.0, and sensitivity analysis and subgroup analysis were also performed.

Results
Virtual reality–based interventions can soothe pain and anxiety. Subgroup analysis revealed that interventions focused on playing games and watching videos were effective at reducing pain. In addition, enjoying landscapes, receiving treatment-related health education, and watching videos were effective at decreasing anxiety; moreover, short-term (≤6 weeks) interventions were effective at relieving pain.

Conclusions
Virtual reality–based interventions are effective at decreasing pain and anxiety. The contents and duration of the intervention had an impact on their effectiveness.

Implications for Nursing Practice
Symptom management is a paramount aspect of clinical cancer care. In daily oncology nursing, we encourage nurses to utilize the benefits of virtual reality–based interventions to improve cancer patients’ experience with medical treatment.
The Effects of Symptom Distress and Depression on Quality of Life in Patients With Terminal Cancer: The Mediating Role of Meaning in Life and Spiritual Well-being
Authors: Kang Kyung-Ah , Song Inhye , Lee Myung-Nam 
Published: December 2024

Background
Terminal cancer patients experience worsening physical symptoms, psychological challenges, and spiritual difficulties. Improving the quality of life (QOL) and reconstructing the meaning of life (MIL) for these patients ensure a dignified end-of-life experience. Spiritual well-being is necessary to promote effective end-of-life coping strategies.

Objective
This study aimed to construct and verify the suitability of a model that explains the impact of physical and psychological factors on the QOL of patients with terminal cancer using MIL and spiritual well-being as mediating factors.

Methods
The participants were patients with terminal cancer 25 years or older hospitalized in 40 nationally designated hospices. A total of 172 patients were included in the final analysis. Data analysis was performed using structural equation modeling.

Results
In the effect analysis of the final model, the variables affecting QOL were depression (β = −.62, P < .001), symptom distress (β = −.33, P = .001), and spiritual well-being (β = .36, P = .002), and a significant indirect effect of MIL was found in the depression–MIL–spiritual well-being and depression-MIL-QOL paths.

Conclusions
Spiritual interventions that help people find their MIL can serve as an important component of optimal hospice and palliative care for patients with terminal cancer.

Implications for Practice
In clinical practice, interventions that increase the MIL and spiritual well-being of patients with terminal cancer are needed. Additionally, the practice will see other benefits including enhanced patient care, psychological support, effective treatment planning, family caregiver support, and further research advancement.
Effect of Exercise Intervention on Chemotherapy-Induced Peripheral Neuropathy Symptoms in Cancer Patients: A Meta-analysis
Authors: Wu Nan , Cao Hongshi , Du Shiyuan , Chen Yulu , Wang Xinxin , Li Jiong , Peng Xin 
Published: December 2024

Background
Exercise has been widely used to improve chemotherapy-induced peripheral neuropathy symptoms in cancer patients in recent years; however, there is insufficient evidence to support the effectiveness of exercise intervention in cancer patients.

Objective
This review aims to comprehensively evaluate the effectiveness of exercise intervention in the management of chemotherapy-induced peripheral neuropathy symptoms in cancer patients and to explore effective exercise intervention characteristics by comparing the effects of different exercise prescriptions.

Methods
Ten databases were systematically searched from published up to May 2024. The studies that met the inclusion criteria were included. The risk of bias was assessed using the Cochrane Collaboration tool. The statistical analyses were performed in Stata 17.0.

Results
A total of 21 studies with 775 participants were included. The pooled results showed that exercise significantly reduced the severity of chemotherapy-induced peripheral neuropathy symptoms; relieved neuropathic pain; enhanced balance function, muscle strength, physical flexibility, and physical endurance; and improved the quality of life of cancer patients with chemotherapy-induced peripheral neuropathy, both compared with patients in the usual care group and with patients’ baseline symptoms before exercise. However, no significant improvement in fear of falling was observed.

Conclusions
Exercise is an effective way of managing chemotherapy-induced peripheral neuropathy symptoms. The patient’s age, exercise cycles, and frequency can affect the effect of the intervention.

Implications for Practice
Oncology nurses can significantly manage chemotherapy-induced peripheral neuropathy symptoms in cancer patients through exercise intervention. Further research is necessary to explore the most suitable characteristics of exercise intervention to achieve optimal intervention effectiveness.
End-to-Side Cross-face Nerve Graft for Mental Nerve Reconstruction after Segmental Mandibulectomy
Authors: PU Jane J. , CHANG Tommy N-J , SU Yu-xiong 
Published: December 2024

SUMMARY:
The traditional technique for mental never reconstruction after segmental mandibulectomy is to bridge the gap between the proximal end of the inferior alveolar nerve (IAN) and the mental nerve stump. However, it often presents significant challenges. In cases of proximal IAN stump is close to skull base or kept inside the remaining mandible body and ramus, approaching the proximal end of the IAN can be very challenging.
To overcome the limitation, a novel technique of cross-face mental nerve re-innervation with end-to-side coaptation to the contralateral mental nerve has been developed. This procedure involves preparing the recipient site before mandibulectomy, harvesting a donor nerve, preparing the contralateral mental nerve for end-to-side neurorrhaphy, and performing cross-face reinnervation after flap inset. The technique utilizes end-to-side coaptation to connect the nerve graft to the contralateral mental nerve.
This new technique overcomes challenges posed by traditional methods, offering advantages such as shorter nerve grafts, easier coaptation due to superficial nerve position, and reduced risk of interference with second-stage dental surgeries. Initial outcomes have been promising, with all patients showing sensation recovery above S3 and no significant interference with contralateral mental nerve function.
This innovative approach provides a solution for patients undergoing segmental mandibulectomy and has potential applications in restoring sensation lost due to various causes. It opens new possibilities for nerve rehabilitation and warrants further investigation through larger clinical trials to validate its efficacy and explore its potential in other nerve repair scenarios.
Modelling the interaction between silver(I) ion and proteins with the 12-6 Lennard-Jones potential: a bottom-up parameterization approach
Authors: Manciocchi Luca , Bianchi Alexandre , Mazan Valérie , Potapov Mark , Fromm Katharina M. , Spichty Martin 
Published: December 2024

AbstractSilver(I) ions and organometallic complexes thereof are well established antimicrobial agents. They have been employed in medical applications for centuries. It is also known that some bacteria can resist to silver(I) treatments through an efflux mechanism. However, the exact mechanism of action remains unclear. All-atom force-field simulations can provide valuable structural and thermodynamic insights on the molecular processes of the underlying mechanism. Lennard-Jones parameters of silver(I) have been available for quite some time; their applicability to describe properly the binding properties (affinity, binding distance) between silver(I) and peptide-based binding motifs is, however, still an open question. Here, we demonstrate that the standard 12-6 Lennard-Jones parameters (previously developed to describe the hydration free energy with the TIP3P water model) significantly underestimate the interaction strength between silver(I) and both methionine and histidine. These are two key amino-acid residues in silver(I)-binding motifs of proteins involved in the efflux process. Using free-energy calculations, we calibrated non-bonded fix (NBFIX) parameters for the CHARMM36m force field to reproduce the experimental binding constant between amino acid sidechain fragments and silver(I) ions. We then successfully validated the new parameters on a set of small silver-binding peptides with experimentally known binding constants. In addition, we could monitor how silver(I) ions increase the α-helical content of the LP1 oligopeptide, in agreement with previously reported Circular Dichroism (CD) experiments. Future improvements are outlined. The implementation of these new parameters is straightforward in all simulation packages that can use the CHARMM36m force field. It sets the stage for the modeling community to study more complex silver(I)-binding processes such as the interaction with silver(I)-binding-transporter proteins.
Constraints on freeze-in dark matter from Lyman-
α
forest and 21-cm signal: Single-field models
Authors: Xu Zixuan , Zhou Quan , Zheng Sibo 
Published: December 2024

We report new Lyman-α and 21-cm constraints on freeze-in dark matter (FIDM) which injects energy into the intergalactic medium either through annihilation or decay to photon(s) or electron-positron pair. With respect to Lyman-α we fix the baseline ionization history using low redshift data about astrophysical reionization, whereas for 21-cm signal we adopt the baseline values of 21-cm power spectrum through a standard modeling of star formation developed so far. Using the latest numerical tools, we show that (i) for sterile neutrino FIDM, current Lyman-α data and future sensitivity of SKA-low (1000 hrs) on the 21-cm power spectra excludes the FIDM mass up to 1.8×10−3  GeV at 95% CL and 5.46×10−4  GeV, respectively, and (ii) for millicharged FIDM, current Lyman-α data only excludes the millicharge down to 10−8 within the FIDM mass range of 10−3–1  GeV at 95% CL, suggesting that the surviving parameter space of millicharged FIDM is still intact.

Published by the American Physical Society
2024
Slow molecular beams from a cryogenic buffer gas source
Authors: White A. D. , Popa S. , Mellado-Muñoz J. , Fitch N. J. , Sauer B. E. , Lim J. , Tarbutt M. R. 
Published: December 2024

We study the properties of a cryogenic buffer gas source that uses a low-temperature two-stage buffer gas cell to produce very slow beams of ytterbium monofluoride molecules. The molecules are produced by laser ablation inside the cell and extracted into a beam by a flow of cold helium. We measure the flux and velocity distribution of the beam as a function of ablation energy, helium flow rate, cell temperature, and the size of the gap between the first and second stages of the cell. We also compare the velocity distributions from one-stage and two-stage cells. The one-stage cell emits a beam with a speed of about 82ms−1 and a translational temperature of 0.63 K. The slowest beams are obtained using the two-stage cell at the lowest achievable cell temperature of 1.8 K. This beam has a peak velocity of 56ms−1 and a flux of 9×109 ground-state molecules per steradian per pulse, with a substantial fraction at speeds below 40ms−1. These slow molecules can be decelerated further by radiation pressure slowing and then captured in a magneto-optical trap.

Published by the American Physical Society
2024