bluuebunny/crossref_metadata_2025_split huggingface dataset:
Quality of life and spiritual health in motorcycle accident survivors: An analysis using the SF-36 Questionnaire and Spiritual Scale
Authors: Huang Ching-Ya , Peng Shu-Hui , Lin Hui-Ping , Hsu Shiun-Yuan , Hsieh Ching-Hua 
Published: July 2024

Abstract

Background
Motorcycle traffic accidents rate remained high in Taiwan letting posttrauma care an imperative issue. This study investigates the spiritual, psychological, and physical impacts of motorcycle traffic accidents in Taiwan, focusing on the role of the Injury Severity Score (ISS) in influencing quality of life (QOL) and spiritual well-being outcomes, aiming to enhance holistic recovery strategies for trauma survivors.

Materials and Methods
A prospective study was conducted from April 2022 to March 2024 in a level I trauma center. Patients aged 20 and above with trauma from motorcycle accidents were enrolled and divided into major (ISS ≥ 16) and nonmajor (ISS < 16) trauma groups. QOL and spiritual health were assessed using 36-item short-form general health survey measures (SF-36) and spiritual scale before discharge and 6 months later.

Results
Of 98 patients, we observed significant postdischarge declines in both physical and mental QOL scores, regardless of ISS. However, spiritual scores improved significantly after discharge, with notable enhancements in interpersonal relationships and adversity transcendence observed in patients with ISS < 16, but not in those with ISS ≥ 16. SF-36 analysis revealed that nonreligious groups experienced significant declines in mental health scores postdischarge, unlike religious groups, which remained stable. In addition, religious individuals showed significant postdischarge improvements in interpersonal relationships and adversity transcendence, while nonreligious showed no improvement. This suggests a beneficial link between religious adherence and enhanced spiritual well-being.

Conclusions
Motorcycle accidents reduce QOL and heighten spiritual needs for survivors, regardless of accident severity categorized by ISS score. Integrating spirituality into rehabilitation processes can positively impact overall well-being. Holistic care, addressing physical, psychological, social, and spiritual needs, is vital for optimizing long-term recovery and improving prognosis in trauma survivors, especially in regions with high rates of traffic accidents like Taiwan.
Enhancing Mortality Probability Model II (MPM II) Predictive Accuracy with the Lethal Triad in ICU Trauma Patients
Authors: Huang Ching-Ya , Kuo Pao-Jen , Yang Johnson Chia-Shen , Su Wei-Ti , Hsieh Ching-Hua 
Published: July 2024

Abstract

Introduction
The Mortality Probability Model II (MPM II) is a well-recognized predictive tool in the intensive care unit (ICU) scoring system. The presence of a lethal triad, including hypothermia, acidosis, and coagulopathy, is associated with a worse outcome for trauma patients. This study aimed to assess whether integrating the lethal triad could enhance the MPM II predictive accuracy for trauma patients in the ICU.

Methods
The study conducted a retrospective analysis of adult trauma patients admitted to an ICU from January 1, 2016, to December 31, 2022, in a Level I trauma center in southern Taiwan. It assessed the impact of the lethal triad variables incorporated into MPM II scores using the area under the receiver operating characteristic curve (AUC of ROC).

Results
Of the 3,410 patients included, 257 had the lethal triad and 3,153 do not. The mortality rate was significantly higher in patients presenting the lethal triad than those without (46.7% vs. 8%, p < 0.001). However, there was no significant improvement in predictive accuracy with both the MPM II with or without incorporating the variable of lethal triad having an area under the Receiver Operating Characteristic curve of 0.893.

Conclusion
While the lethal triad is important for understanding trauma-induced physiological changes, straight inclusion into MPM II has no substantial prognostic value. These findings indicate that the existing variables in the MPM II may already be indirectly capturing the impacts of the lethal triad, emphasizing the intricate interplay of physiological components in trauma patients. This underscores the importance of continued study in improving the prognostic modeling to ultimately predicting outcomes for trauma patients.
Long-term outcome and risk stratification in compensated advanced chronic liver disease after HCV-cure
Authors: Semmler Georg , Alonso López Sonia , Pons Monica , Lens Sabela , Dajti Elton , Griemsmann Marie , Zanetto Alberto , Burghart Lukas , Hametner-Schreil Stefanie , Hartl Lukas , Manzano Marisa , Rodriguez-Tajes Sergio , Zanaga Paola , Schwarz Michael , Gutierrez María L. , Jachs Mathias , Pocurull Anna , Polo Benjamín , Ecker Dominik , Mateos Beatriz , Izquierdo Sonia , Real Yolanda , Balcar Lorenz , Carbonell-Asins Juan A. , Gschwantler Michael , Russo Francesco P. , Azzaroli Francesco , Maasoumy Benjamin , Reiberger Thomas , Forns Xavier , Genesca Joan , Bañares Rafael , Mandorfer Mattias 
Published: July 2024

Background and Aims:
Around 750,000 patients per year will be cured of HCV infection until 2030. Those with compensated advanced chronic liver disease remain at risk for hepatic decompensation and de novo HCC. Algorithms have been developed to stratify risk early after cure; however, data on long-term outcomes and the prognostic utility of these risk stratification algorithms at later time points are lacking.

Approach and Results:
We retrospectively analyzed a cohort of 2335 patients with compensated advanced chronic liver disease (liver stiffness measurement≥10 kPa) who achieved HCV-cure by interferon-free therapies from 15 European centers (median age 60.2±11.9 y, 21.1% obesity, 21.2% diabetes).
During a median follow-up of 6 years, first hepatic decompensation occurred in 84 patients (3.6%, incidence rate: 0.74%/y, cumulative incidence at 6 y: 3.2%); 183 (7.8%) patients developed de novo HCC (incidence rate: 1.60%/y, cumulative incidence at 6 y: 8.3%), with both risks being strictly linear over time.
Baveno VII criteria to exclude (FU-liver stiffness measurement <12 kPa and follow-up platelet count >150 g/L) or rule-in (FU-liver stiffness measurement ≥25 kPa) clinically significant portal hypertension (CSPH) stratified the risk of hepatic decompensation with proportional hazards. Estimated probability of CSPH discriminated patients developing versus not developing hepatic decompensation in the gray zone (ie, patients meeting none of the above criteria).
Published HCC risk stratification algorithms identified high-incidence and low-incidence groups; however, the size of the latter group varied substantially (9.9%–69.1%). A granular “HCC-sustained virologic response” model was developed to inform an individual patient’s HCC risk after HCV-cure.

Conclusions:
In patients with compensated advanced chronic liver disease, the risks of hepatic decompensation and HCC remain constant after HCV-cure, even in the long term (>3 y). One-time post-treatment risk stratification based on noninvasive criteria provides important prognostic information that is maintained during long-term follow-up, as the hazards remain proportional over time.
Regional Workshop on Optimization of Protection in Pediatric Interventional Radiology in Latin American and Caribbean Countries
Authors: Ubeda Carlos , Vano Eliseo , del Rosario Perez María , Ramirez Raúl , Nader Alejandro , Miranda Patricia , Fernandez José Miguel , Pérez-Peña Mar 
Published: July 2024

Abstract
The purpose of this article is to describe the activities developed within the framework “Regional Workshop on Optimization of Protection in Pediatric Interventional Radiology in Latin American and Caribbean countries,” developed between October 16th and 19th of the year 2023 in the city of San José, Costa Rica. The workshop was carried out as part of a joint work between the Pan American Health Organization (PAHO) and the World Health Organization (WHO), in cooperation with the International Atomic Energy Agency (IAEA). The main objective of the regional workshop was to gather the experiences and future work planning among participants in the Optimization of Protection in Pediatric Interventional Radiology in Latin America and the Caribbean (OPRIPALC) program. It involved professionals from 14 centers across 11 countries in the region, along with 4 experts from PAHO/WHO/IAEA. The work modalities during the workshop consisted of keynote presentations, individual presentations, group work, and general discussions. An online survey was carried out after the workshop, with the objective of knowing the opinion of the event participants and determining the impact and projection of the OPRIPALC program. During the workshop the centers had to present their experiences: the use of the DOLQA dose management system was presented and work was done on the consensus document on good practices. The activities, topics and organization of the workshop were valued positively by the participants. There is unanimity among the centers that the OPRIPALC program has had a positive impact and they wish to continue actively participating in the next biennium.
Association of Social Determinants of Health With the Likelihood of Treatment With Laser Trabeculoplasty in a US Database
Authors: Huang Bonnie B. , Tanna Angelo P. 
Published: July 2024

Précis:
Among 1861 adults with ocular hypertension or mild or moderate primary open angle glaucoma, those with Medicaid or no insurance had a statistically significantly lower likelihood of receiving laser trabeculoplasty compared with those with other insurance.

Purpose:
To determine whether social determinants of health are associated with undergoing treatment with laser trabeculoplasty (LTP) among individuals with ocular hypertension (OHT) or mild or moderate primary open angle glaucoma (POAG).

Methods:
In this cross-sectional study, we included patients with OHT or mild or moderate POAG from the National Institutes of Health All of Us Research Program, a diverse US nationwide data set. Logistic regression was performed to study the association between LTP treatment status and 7 covariates (diagnosis severity, age, gender, race/ethnicity, income, insurance status, and education).

Results:
A total of 1861 subjects were included (median age of 72 y). In univariable logistic regression, diagnosis severity, older age, higher income, and insurance (non-Medicaid) were associated with LTP treatment. On multivariable logistic regression models, those with mild POAG (OR, 3.49; 95% CI: 2.12–5.87) and moderate POAG [OR, 7.15 (4.49–11.8)] were still more likely than OHT patients to have received LTP. Moreover, compared with participants with Medicaid or no insurance, participants with other insurance (eg, employer-provided, Medicare) were still more likely to have received LTP [OR, 2.24 (1.08–5.29)]. There was no significant difference in the LTP treatment likelihood based on race/ethnicity.

Conclusions:
After controlling for confounders, the likelihood of receiving LTP appears to be driven primarily by insurance rather than income or race/ethnicity. Potential reasons for decreased utilization of LTP among Medicaid patients include higher rates of declining the procedure, or LTP may have been offered less frequently due to Medicaid’s lower levels of reimbursement and longer reimbursement delays.
Percutaneous transluminal angioplasty and stenting for severe stenosis of the intracranial carotid artery and its branches: Comparison of the Wingspan stent vs the Credo stent
Authors: Lin Te-Ming , Wu Chia-Hung , Chung Chih-Ping , Yu Kai-Wei , Tai Wei-An , Luo Chao-Bao , Lirng Jiing-Feng , Chang Feng-Chi 
Published: July 2024

Background:
Despite the widespread use of the Wingspan stent system for treating severe medically refractory intracranial artery stenosis (SMR-ICAS), a new Credo stent system was approved because it could integrate stent delivery within the balloon catheter. However, the therapeutic outcomes of these two systems have not been compared. This preliminary study aimed to compare the results of percutaneous angioplasty and stenting (PTAS) in SMR-ICAS patients treated with either Wingspan or Credo stents within the anterior cerebral circulation.

Methods:
SMR-ICAS patients with >70% stenosis in the anterior circulation who underwent PTAS using either the Wingspan or Credo stent system were retrospectively analyzed. We evaluated the technical success, safety, and outcomes of the two-stent systems.

Results:
A total of 29 patients were analyzed, including 17 patients treated with Wingspan stents and 12 with Credo stents. The outcomes of the Wingspan stent vs Credo stent were as follows: technical success (16/17 [94%] vs 11/12 [92%], p = 1.00); periprocedural intracranial hemorrhage (2/17 [12%] vs 0/12 [0%], p = 0.50); silent embolic ischemic lesions on periprocedural magnetic resonance imaging (MRI) (13/17 [76%] vs 7/12 [58%], p = 0.42); and significant (>50%) in-stent restenosis in 1 year (4/17 [24%] vs 2/12 [17%], p = 1.00). No recurrent stroke or mortality was noted within 30 days after the procedures or during the 1-year follow-up period.

Conclusion:
The technical success, safety, and outcomes of the Credo stent system were comparable to those of the Wingspan stent system in the management of SMR-ICAS patients. Further large-scale studies are warranted to substantiate these findings.
True lumen expansion but no aortic remodeling following thoracic endografting and distal bare stent for subacute complicated type B aortic dissection
Authors: Chen I-Ming , Kuo Tzu-Ting , Huang Chun-Yang , Chen Po-Lin , Shih Chun-Che 
Published: July 2024

Background:
The effects of thoracic endovascular aneurysm repair (TEVAR) with additional distal bare metal stents (BMSs) in patients with subacute complicated type B aortic dissection (cTBAD) are unclear and are investigated in this retrospective study.

Methods:
The medical records of 67 patients who received TEVAR due to subacute cTBAD were reviewed. Areas of true lumen (TL) and false lumen at five levels—pulmonary artery (PA), diaphragm, renal artery (RA), middle of the infrarenal aorta, and aortic bifurcation—were measured using computed tomography before and 3, 6, and 12 months after surgery. The TL ratio (TL area/total aortic area) and total aortic area at each time point were compared between the TEVAR + BMS (n = 37) and TEVAR-only (n = 30) groups. The effects of BMS use and time were evaluated using generalized estimating equations and generalized linear regression models.

Results:
Baseline characteristics, remodeling types, and clinical outcomes did not differ significantly between the two groups. Postoperative TL ratios at the diaphragm and RA were significantly higher in the TEVAR + BMS group than in the TEVAR-only group (p < 0.05). BMS use and time had significant interaction effects at the PA, diaphragm, and RA (all p < 0.05), but effects on total aortic area were not significant at any of the five parts. TL ratios at the diaphragm and RA exhibited greater improvement in the TEVAR + BMS group than in the TEVAR-only group at postoperative months 6 and 12 (all p < 0.001). Aortic diameters at all five parts were significantly smaller in the TEVAR + BMS group than in the TEVAR-only group (all p < 0.05).

Conclusion:
In patients with subacute cTBAD, TEVAR with BMS implantation effectively expands the TL from the thoracic aorta to the RA but neither enhances aortic remodeling nor elicits any change in total aortic area in whole dissected aorta relative to TEVAR only.
A Pragmatic Approach to Assessing Supervisor Leadership Capability to Support Healthcare Worker Well-Being
Authors: Dyrbye Liselotte N. , Satele Daniel , West Colin P. 
Published: July 2024

Goal:
We sought to build upon previous studies that have demonstrated how healthcare workers’ ratings of their immediate supervisor’s leadership capabilities relate to their well-being and job satisfaction.

Methods:
In 2022, we analyzed cross-sectional data from 1,780 physicians and 39,896 allied health professionals (collected in 2017) and 729 residents (collected in 2019), as well as longitudinal data from 1,632 physicians (collected from 2015 to 2017), to identify a psychometrically strong, broadly applicable, actionable, and low-burden approach to assessing supervisor leadership capability to support healthcare worker well-being.

Principal Findings:
The magnitude of association between our 1-, 2-, 3-, and 9-item leadership indexes and burnout, and between our 1-, 2-, 3-, and 9-item leadership indexes and satisfaction with the organization were similar to each other in the cross-sectional and longitudinal cohorts and across diverse groups of healthcare workers, including physicians, residents, and allied health professionals. The likelihood ratio for a high leadership score increased with an increasing score for each leadership measure. The area under the receiver operating characteristic curve for the 1-, 2-, and 3-item measures for a high leadership score was 0.9349, 0.9672, and 0.9819, respectively.

Practical Applications:
A single item assessing perceptions of leadership capability efficiently provides useful information about leadership qualities of healthcare workers’ immediate supervisors. The inclusion of this item in healthcare worker surveys may be useful for evaluating interventions and galvanizing organizational action to support healthcare worker well-being.
Leadership to Accelerate Healthcare’s Digital Transformation: Evidence From 33 Health Systems
Authors: Lemak Christy Harris , Pena Dalton , Jones Douglas A. , Kim Dae Hyun , Guptill Janet 
Published: July 2024

SUMMARY

Goal:
The COVID-19 pandemic, healthcare market disruptors, and new digital healthcare technologies have made a substantial impact on the delivery of healthcare services, highlighting the critical roles of leaders in hospitals and health systems. This study sought to understand the evolving roles of CEOs, CIOs, and other executive leaders in the postpandemic era and highlight the adaptability and strategic vision of executives in shaping the future of healthcare delivery.

Methods:
Between October 2022 and May 2023, 51 interviews were conducted with CEOs, CIOs, and other executives responsible for delivering technology solutions for 33 nonprofit health systems in the United States. They were asked to describe their backgrounds; how information solutions and technologies were viewed within their organizations’ strategy, operations, and governance; and the key characteristics of executive leaders.

Principal Findings:
The study has found that effective CEOs have an authentic belief in technology’s role in achieving their organization’s mission and that contemporary CIOs are strategic executive partners who align strategy with culture to improve care. This study examines how healthcare systems are creating digitally savvy executive leadership teams that operate in a new, integrated model that unites previously siloed functions.

Practical Applications:
Some healthcare CIOs are unprepared for current and future business challenges, and some CEOs are unsure how to leverage digital technologies and C-suite expertise to transform their organizations. This research provides insights into how the nation’s health systems are building and sustaining leadership teams capable of adapting to the healthcare environment and accelerating organizational transformation.
Using Artificial Intelligence in Electronic Health Record Systems to Mitigate Physician Burnout: A Roadmap
Authors: Fawzy Eid Mariam 
Published: July 2024

SUMMARY
Physician burnout, a significant problem in modern healthcare, adversely affects healthcare professionals and their organizations. This essay explores the potential of artificial intelligence (AI) to positively address this issue through its integration into the electronic health record and the automation of administrative tasks. Recent initiatives and research highlight the positive impact of AI assistants in alleviating physician burnout and suggest solutions to enhance physician well-being. By examining the causes and consequences of burnout, the promise of AI in healthcare, and its integration into electronic health record systems, this essay explores how AI can not only reduce physician burnout but also improve the efficiency of healthcare organizations. A roadmap provides a visualization of how AI could be integrated into electronic health records during the previsit, visit, and postvisit stages of a clinical encounter.
Intranasal Delivery of Medications for the Treatment of Neurologic Conditions: A Pharmacology Update
Authors: Shafer Patricia Osborne , Dean Patricia , Brooks Lai , Gidal Barry , Misra Sunita N. , Carrazana Enrique 
Published: July 2024

ABSTRACT

INTRODUCTION: Nurses have a central role in educating patients and families about treatment options and how to integrate them into action plans for neurologic conditions. In recent years, a growing number of intranasal formulations have become available as rescue therapy for neurologic conditions or symptoms including migraine, opioid overdose, and seizures. Rescue therapies do not replace maintenance medications or emergency care but are designed to enable rapid treatment of urgent or disabling conditions in community settings. Yet, discussion of rescue therapies for neurologic conditions remains limited in nursing literature. CONTENT: Intranasal formulations are specifically formulated for delivery and absorption in the nose and have several characteristics that are well suited as rescue therapies for neurologic conditions. Intranasal formulations include triptans for migraine, naloxone and nalmefene for opioid overdose, and benzodiazepines for seizure clusters in patients with epilepsy. Therapeutic attributes discussed here include ease of use in community settings by nonmedical professionals, relatively rapid onset of action, and favorable safety profile and patient experience. This information is critical for nurses to make informed decisions about rescue therapy options, incorporate these into plans of care, and educate patients, care partners, and other healthcare providers. CONCLUSION: Rescue therapies are increasingly important in the care of people with neurologic conditions. Various formulations are available and continue to evolve, offering easy and quick ways for nurses, patients, and nonmedical care partners to administer critical rescue medications. For nurses overseeing medication management, the attributes of intranasal rescue therapies should be considered in the context of providing patients with the right care at the right time.
The Immediate Effect of the Novel Hybrid Passive Spring Damper Ankle-Foot Orthosis on Spatiotemporal Parameters of Walking in Patients with Multiple Sclerosis
Authors: Pourhoseingholi Ensieh , Tafti Nahid 
Published: July 2024

ABSTRACT

Introduction
Patients with multiple sclerosis (PwMS) experience damage to their central nervous system, which can lead to unilateral or bilateral drop foot. The presently utilized ankle-foot orthoses (AFOs) for PwMS have exhibited limited clinical efficacy.

Objective
This current study evaluated the immediate effects of the Novel Hybrid Passive Spring Damper Ankle-Foot Orthosis (HPSDAFO) on walking in PwMS.

Study design
A cohort trial.

Methods
Twelve PwMS suffering of unilateral drop foot took part in this study. They were given the novel HPSDAFO and underwent kinematic assessment including walking along a 10-m walkway at a self-selected speed, both with and without the HPSDAFO.

Results
The novel HPSDAFO device significantly changed gait parameters of ankle range of motion, single limb support duration, and step and stride length of the affected side (P < 0001). Furthermore, the device also improved the symmetry index and resulted in increased walking speed and cadence.

Conclusions
The application of the novel HPSDAFO on the affected side of PwMS resulted in a notable enhancement in the symmetry of spatial parameters, which highlights the need for additional research in this area.

Clinical Relevance
Using the novel HPSDAFO, PwMS can walk without adverse effects, promoting the normalization of their spatiotemporal walking parameters.