bluuebunny/crossref_metadata_2025_split huggingface dataset:
Factors driving differences in the adoption of quality management practices among hospitals
Authors: Hoogestraat Fenja , Wild Eva-Maria , Winter Vera 
Published: May 2024

Background
Although all hospitals aim to deliver high-quality care, there is considerable variation in their adoption of quality management (QM) practices. Organizational and environmental factors are known to drive strategic decision-making in hospitals, but their impact on the adoption of QM practices remains unclear.

Purpose
Our study aims to identify multiple organizational and environmental factors that explain variation in the adoption of QM practices among hospitals and to explore mechanisms underlying these relationships.

Methodology
We conducted a two-phase, sequential mixed-methods study of German acute care hospitals. The quantitative phase used between-effects regressions to identify factors explaining variation in the number of QM practices adopted by hospitals from 2015 to 2019. The qualitative phase used semistructured interviews with quality managers to gain in-depth insights.

Results
The number of QM practices adopted by a hospital was significantly associated with factors like hospital size and the presence of an emergency department or QM steering committee. Our qualitative findings highlighted potential mechanisms such as the presence of an emergency department serving as a proxy for organizational complexity or urgency of case-mix.

Conclusion
We provide an overview of factors driving QM adoption in hospitals, extending beyond the focus on single factors in previous research. Future studies could explore additional factors highlighted by our interviewees.

Practice Implications
Our results can inform interventions to strengthen QM in hospitals and guide future research on this topic.
Novel Effective Medical Therapy for Acanthamoeba Keratitis
Authors: Di Zazzo Antonio , De Gregorio Chiara , Coassin Marco 
Published: May 2024

Purpose:
To report first clinical use of novel medical treatment for Acanthamoeba keratitis.

Methods:
Interventional observational case series. Two patients with Acanthamoeba keratitis were unsuccessfully treated with polihexanide (PHMB) 0.02% and propamidine 0.1% for 6 weeks, then all were shifted in a compassionate use of PHMB 0.08% with novel standardized protocol. The postinterventional follow-up of patients was at least 7 months.

Results:
PHMB 0.08% eyedrops in a novel standardized protocol improved infection resolution and led to complete healing of the lesion after 4 weeks in the two cases. Corneal opacities and neovascularization decreased slowly, best-corrected visual acuity slightly improved and progressively increased in the further 7 months, and no infection recurrence occurred.

Conclusions:
This preliminary report of two cases shows promising response to polihexanide 0.08% lowering drastically the illness duration, with reduced chance of recurrence, and mostly improving patients' quality of life.
Patients' perspective on the chronic pain classification in the 11th revision of the International Classification of Diseases (ICD-11): results from an international web-based survey
Authors: Korwisi Beatrice , Hay Ginea , Forget Patrice , Ryan Deirdre , Treede Rolf-Detlef , Rief Winfried , Barke Antonia 
Published: May 2024

Abstract
The 11th revision of the International Classification of Diseases and Related Health Problems (ICD-11) aims at improving the lives of persons with the lived experience of chronic pain by providing clearly defined and clinically useful diagnoses that can reduce stigma, facilitate communication, and improve access to pain management, among others. The aim of this study was to assess the perspective of people with chronic pain on these diagnoses. An international web-based survey was distributed among persons with the lived experience of chronic pain. After having seen an information video, participants rated the diagnoses on 8 endorsement scales (eg, diagnostic fit, stigma) that ranged from −5 to +5 with 0 representing the neutral point of no expected change. Overall ratings and differences between participants with chronic primary pain (CPP) and chronic secondary pain (CSP) were analyzed. N = 690 participants were included in the data analysis. The ratings on all endorsement scales were significantly higher than the neutral point of 0. The highest ratings were obtained for “openness” (2.95 ± 1.93) and “overall opinion” (1.87 ± 1.98). Participants with CPP and CSP did not differ in their ratings; however, those with CSP indicated an improved diagnostic fit of the new diagnoses, whereas participants with CPP rated the diagnostic fit of the new diagnoses similar to the fit of their current diagnoses. These results show that persons with the lived experience of chronic pain accept and endorse the new diagnoses. This endorsement is an important indicator of the diagnoses' clinical utility and can contribute to implementation and advocacy.
Primary Cutaneous NUT Carcinoma
Authors: Goto Keisuke , Kukita Yoji , Hishima Tsunekazu , Matsushita Shigeto , Tsuyuki Takuji , Makihara Kosuke , Koga Kaori , Mukumoto Shoko , Honma Keiichiro 
Published: May 2024

WHO Classification of Skin Tumors, fifth edition (2023) has newly described primary cutaneous NUT carcinoma; however, information on this cancer type remains scarce. Herein, we performed clinicopathologic and genetic analyses of 4 cases. Four elderly women (median age 77 y, range: 68 to 82 y) were included. The median tumor size was 12.5 (10 to 40 mm). Tumors were located on the scalp, temple, thigh, and palm. Two (50%) patients presented with regional lymph node metastases. Neither distant metastasis nor mortality was observed during patient follow-up of 10.5 (3 to 15) months. Sanger, panel DNA and whole-exome RNA sequencing revealedBRD3::NUTM1(n=2) andBRD4::NUTM1(n=2) fusions. Histology ofBRD3-rearranged tumors revealed an epidermal connection, relatively small tumor nests, and ductal or intracytoplasmic luminal formation, whereas that ofBRD4-rearranged tumors revealed large solid nests comprising discohesive tumor cells. NUT, cytokeratins, p63, EMA, TRPS1, c-MYB, CD56, and INSM1 were immunoexpressed to varying degrees in all (100%) tumors. Furthermore, diffuse SOX10 expression was common (3/4, 75%). The literature review of five previously described cases revealed women predominance, no recurrence, frequentBRD3::NUTM1fusions, and histology of ductoglandular structures. Our study findings and literature suggest elderly women predominance, relatively frequentBRD3::NUTM1fusions, histopathologic ductoglandular differentiation, absence of abrupt keratinisation, and a characteristic immunoprofile in primary cutaneous NUT carcinoma, unlike in that of other organ. No distant metastasis or disease-associated mortality was seen in all cases with limited follow-up.
Balanced Solution Versus Normal Saline in Predicted Severe Acute Pancreatitis
Authors: Ke Lu , Ye Bo , Huang Mingfeng , Chen Tao , Doig Gordon , Li Chao , Chen Yingjie , Zhang Hongwei , Zhao Lijuan , Chen Guobing , Tu Shumin , Fu Long , Xia Honghai , Yang Dongliang , Wu Bin , Ye Baohua , Zhang Guoxiu , Yang Mei , Li Qiang , Chen Xiaomei , Pan Xinting , Mao Wenjian , Buxbaum James , Jaber Samir , Tong Zhihui , Liu Yuxiu , Windsor John , Bellomo Rinaldo , Li Weiqin ,   for the Chinese Acute Pancreatitis Clinical Trials Group (CAPCTG)
Published: May 2024

Objective:
To compare the effect of balanced multielectrolyte solutions (BMESs) versus normal saline (NS) for intravenous fluid on chloride levels and clinical outcomes in patients with predicted severe acute pancreatitis (pSAP)

Background:
Isotonic crystalloids are recommended for initial fluid therapy in acute pancreatitis, but whether the use of BMES in preference to NS confers clinical benefits is unknown.

Methods:
In this multicenter, stepped-wedge, cluster-randomized trial, we enrolled patients with pSAP (acute physiology and chronic health evaluation II score ≥8 and C-reactive protein >150 mg/L) admitted within 72 hours of the advent of symptoms. The study sites were randomly assigned to staggered start dates for a one-way crossover from the NS phase (NS for intravenous fluid) to the BMES phase (sterofudin for intravenous fluid). The primary endpoint was the serum chloride concentration on trial day 3. Secondary endpoints included a composite of clinical and laboratory measures.

Results:
Overall, 259 patients were enrolled from 11 sites to receive NS (n = 147) or BMES (n = 112). On trial day 3, the mean chloride level was significantly lower in patients who received BMES [101.8 mmol/L (SD: 4.8) vs 105.8 mmol/L (SD: 5.9), difference -4.3 mmol/L (95% CI: -5.6 to -3.0 mmol/L) ;P < 0.001]. For secondary endpoints, patients who received BMES had less systemic inflammatory response syndrome (19/112, 17.0% vs 43/147, 29.3%, P = 0.024) and increased organ failure-free days [3.9 days (SD: 2.7) vs 3.5 days (SD: 2.7), P < 0.001] by trial day 7. They also spent more time alive and out of the intensive care unit [26.4 days (SD: 5.2) vs 25.0 days (SD: 6.4), P = 0.009] and hospital [19.8 days (SD: 6.1) vs 16.3 days (SD: 7.2), P < 0.001] by trial day 30.

Conclusions:
Among patients with pSAP, using BMES in preference to NS resulted in a significantly more physiological serum chloride level, which was associated with multiple clinical benefits (Trial registration number: ChiCTR2100044432).
Overlapping Surgery Verbiage in Informed Consent Documents
Authors: Mitchell Margaret B. , Lin George , Prasad Kavita , Habib Daniel R. S. , Langerman Alexander 
Published: May 2024

Objective:
To assess informed consent documents from United States (US) institutions for verbiage regarding overlapping surgery.

Summary background data:
Overlapping surgery remains a controversial practice. Recent guidance from the Senate Finance Committee and American College of Surgeons emphasizes transparency with patients regarding this practice through the informed consent process, but it remains unclear how many institutions adopted their recommendations.

Methods:
Informed consent documents were collected from a national sample of 104 institutions and assessed for verbiage regarding overlapping surgery and/or attending absence during a surgical case. The verbiage of these forms was further analyzed for inclusion of key terms (e.g., “overlapping surgery,” “critical portions”) as well as transparency regarding surgeon absence.

Results:
Thirty (29%) forms included verbiage regarding overlapping surgery and/or surgeon absence during a case. Most of these 30 utilized the terms “overlapping surgery” or “critical portions” (18 [60%] and 25 [83%], respectively), although only 3 (10%) explicitly stated that portions of the procedure that may be performed in the absence of the attending surgeon. Six forms (20%) specifically stated who may perform the procedure without the attending present, and 3 forms (10%) had patients acknowledge this section of the consent form with an additional signature or initial. Only 2 of the forms (7%) fulfilled all of the criteria set forth by the SFC.

Conclusion:
Detailed information regarding overlapping surgery is infrequently included in hospitals’ procedure informed consent documents. Forms that include this information rarely provide explicit statements of attending presence and trainee participation, raising concerns regarding surgeon-patient transparency.
Hospital Volume for Rectal Cancer Resection Plays a Pivotal Role in Improving Outcomes
Authors: van Walle Lien , Silversmit Geert , Debucquoy Annelies , Van Eycken Liesbet , d’Hoore André , Haustermans Karin , Wolthuis Albert 
Published: May 2024

Objective:
Assessing the association between hospital surgical volume (SV) and outcomes after rectal cancer surgery (RCS), using national population-based data.

Summary Background Data:
For RCS, the association of higher SV with improved short- and/or long-term outcomes remains controversial.

Methods:
National cancer registry data and administrative data were used to select patients diagnosed with stage I-III rectal cancer in 2009-2018 and who underwent RCS. The average annual SV of RCS was categorised as low (<15; LV), medium (15-29; MV) or high (≥30; HV). The association between SV and 90-day and 1-year excess postoperative mortality (90DPM and 1YEPM) and 5-year observed survival (5YOS) was evaluated.

Results:
From the 11,519 patients , RCS was performed in LV (4,088; 36%), MV (2,795; 24%) or HV (4,636; 40%) hospitals. Observed 90DPM was significantly better in HV (2.3% 95%CI[1.9,2.8]) than in LV (3.7% 95%CI[3.2,4.4]) and MV (3.5% 95%CI[2.9,4.3]) with adjusted OR 1.4, P<0.0001. Continuous regression analysis showed significantly higher 90DPM in annual SV <35 compared to ≥35 (OR 1.6 95%CI[1.21,2.11]; P=0.0009). Observed 1YEPM was significantly better in HV (2.9% 95%CI[2.2,3.6]) compared to LV (4.7% 95%CI [3.9,5.6]) with adjusted excess HR 1.31 95%CI[1.00,1.73] and P=0.05, and to MV (5.0% 95%CI[4.0,6.1]) with adjusted excess HR 1.45 95%CI[1.09,1.94] and P=0.01. The 5YOS was significantly better in HV (75.9% 95%CI[74.6,77.2]) than in LV (70.3% 95%CI[68.8,71.8]) and MV (71.5% 95%CI[69.7,73.2]) with adjusted HR 1.4 in both LV and MV versus HV, P≤0.003.

Conclusions:
This population-based study identified robustly superior outcomes at 90-days, 1-year and 5-years after RCS in hospitals with higher volumes.
Assessing the Impact of Overactive Bladder Medications on Cognition
Authors: Vargas Maldonado Darlene , Schulte Phillip J. , Latuche Laureano Rangel , Vassilaki Maria , Petersen Ronald C. , Occhino John A. , Linder Brian J. 
Published: May 2024

Importance
Emerging literature has associated the use of anticholinergic medications to cognitive decline.

Objective
The aim of this study was to evaluate the association of overactive bladder medications on cognitive function with prospective longitudinal cognitive assessments.

Study design
A population-based cohort of individuals 50 years and older who had serial validated cognitive assessment, in accordance with the Mayo Clinic Study of Aging, was evaluated from October 2004 through December 2021. Anticholinergic overactive bladder medications were grouped by traditional anticholinergic medications and central nervous system (CNS)- sparing anticholinergic medications and compared to no medication exposure. A linear mixed effects model with time-dependent exposures evaluated the association between overactive bladder anticholinergic medication exposure and subsequent trajectories of cognitive z-scores.

Results
We included 5,872 participants with a median follow-up of 6.4 years. Four hundred forty-three were exposed to traditional anticholinergic medications, 60 to CNS-sparing medications, and 5,369 had no exposure. On multivariable analyses, exposure to any anticholinergic overactive bladder medication was significantly associated with deterioration in longitudinal cognitive scores in the language and attention assessments compared to the control cohort. Traditional anticholinergic medication exposure was associated with worse attention scores than nonexposed participants. Exposure to CNS-sparing anticholinergic medications was associated with a deterioration in the language domain compared to those unexposed. Among women, traditional anticholinergic medication exposure was associated with worse global and visuospatial scores than nonexposed participants, but this association was not identified in the CNS-sparing group.

Conclusion
Exposure to anticholinergic overactive bladder medications was associated with small but significantly worse decline in cognitive scoring in the language and attention domains when compared to nonexposed individuals.
Validity of Administrative Coding for Nonarteritic Ischemic Optic Neuropathy
Authors: Hamedani Ali G. , Kim Dale S. , Chaitanuwong Pareena , Gonzalez Lizbeth A. , Moss Heather E. , DeLott Lindsey B. 
Published: May 2024

Background:
Administrative claims have been used to study the incidence and outcomes of nonarteritic ischemic optic neuropathy (NAION), but the validity of International Classification of Diseases (ICD)-10 codes for identifying NAION has not been examined.

Methods:
We identified patients at 3 academic centers who received ≥1 ICD-10 code for NAION in 2018. We abstracted the final diagnosis from clinical documentation and recorded the number of visits with an NAION diagnosis code. We calculated positive predictive value (PPV) for the overall sample and stratified by subspecialty and the number of diagnosis codes. For patients with ophthalmology or neuro-ophthalmology visit data, we recorded presenting symptoms, examination findings, and laboratory data and calculated PPV relative to case definitions of NAION that incorporated sudden onset of symptoms, optic disc edema, afferent pupillary defect, and other characteristics.

Results:
Among 161 patients, PPV for ≥1 ICD-10 code was 74.5% (95% CI: 67.2%–80.7%). PPV was similar when restricted to patients who had visited an ophthalmologist (75.8%, 95% CI: 68.4%–82.0%) but increased to 86.8% when restricted to those who had visited neuro-ophthalmologists (95% CI: 79.2%–91.9%). Of 113 patients with >1 ICD-10 code and complete examination data, 37 (32.7%) had documented sudden onset, optic disc swelling, and an afferent pupillary defect (95% CI: 24.7%–42.0%). Of the 76 patients who did not meet these criteria, 54 (71.0%) still received a final clinical diagnosis of NAION; for most (41/54, 75.9%), this discrepancy was due to lack of documented optic disc edema.

Conclusions:
The validity of ICD-10 codes for NAION in administrative claims data is high, particularly when combined with provider specialty.
The global fish and invertebrate abundance value of mangroves
Authors: Ermgassen Philine zu , Worthington Thomas A. , Gair Jonathan R. , Garnett Emma E. , Mukherjee Nibedita , Longley-Wood Kate , Nagelkerken Ivan , Abrantes Kátya , Aburto-Oropeza Octavio , Acosta Alejandro , da Rocha Araujo Ana Rosa , Baker Ronald , Barnett Adam , Beitl Christine M. , Benzeev Rayna , Brookes Justin , Castellanos-Galindo Gustavo A. , Chong Ving Ching , Connolly Rod M. , Cunha-Lignon Marília , Dahdouh-Guebas Farid , Diele Karen , Dwyer Patrick G. , Friess Daniel A. , Grove Thomas , Hoq M. Enamul , Huijbers Chantal , Hutchinson Neil , Johnson Andrew F. , Johnson Ross , Knight Jon , Krumme Uwe , Kuguru Baraka , Lee Shing Yip , Lobo Aaron Savio , Lugendo Blandina R. , Meynecke Jan-Olaf , Munga Cosmas Nzaka , Olds Andrew D. , Parrett Cara L. , Reguero Borja G. , Rönnbäck Patrik , Safryghin Anna , Sheaves Marcus , Taylor Matthew D. , Mendonça Jocemar Tomasino , Waltham Nathan J. , Wolff Matthias , Spalding Mark D. 
Published: May 2024

AbstractMangroves are a critical coastal habitat that provides a suite of ecosystem services and supports livelihoods. We undertake the first global analysis to estimate density and abundance of 37 commercially important fish and invertebrates that are known to extensively use mangroves. Geomorphic mangrove type, sea surface salinity and temperature, and length of mangrove forest edge were important in predicting the density of commercial fish and invertebrates, with deltaic systems supporting the highest densities. The model predicted high densities throughout parts of southeast Asia, the northern coast of South America, the Red Sea, and the Caribbean and Central America. Application of our model onto the global mangrove extent, estimates that mangroves support the annual abundance of nearly 800 billion young-of-year fish and invertebrates contained in our model. Our results confirm the critical role of mangroves globally in supporting fish and fisheries, and further builds the case for their conservation and restoration.
Genetic Explication of Impaired Insulin Resistance in Genesis of Metabolic Diseases
Authors: Soomro Naveed Iqbal , Bakhtiar Syeda Marriam 
Published: May 2024

AbstractThis study aims to investigate the role of impaired insulin resistance in the onset and progression of metabolic diseases such as prediabetes, diabetes, and cardiovascular diseases. Insulin resistance occurs when insulin is unable to effectively stimulate glucose uptake, and if the body is unable to produce sufficient insulin to compensate, type 2 diabetes may develop. This research endeavors to elucidate the molecular and genetic underpinnings of insulin resistance and its association with metabolic disorders. Employing various tools and databases, gene interaction data was procured through GeneMania, and pathway validation was conducted using KEGG. Construction of gene regulatory networks employed GEPHI 0.9.2, with centralities statistical analysis identifying hub genes. Enrichment analysis and literature validation substantiated the significance of these hubs, resulting in the refinement of the initially identified seven genes to five with interaction data. The implicated hub genes were discerned to play roles in inflammation, either directly or indirectly. Future prospects involve further genetic analysis across diverse populations, utilizing PCR to discern the allelic variations of these identified hub genes. Ultimately, this research may shed light on the underlying genetic and molecular mechanisms of insulin resistance and metabolic syndrome, and contribute to the development of targeted treatments for these conditions.
Peromyscus leucopus,Mus musculus, and humans have distinct transcriptomic responses to larvalIxodes scapularisbites
Authors: Bourgeois Jeffrey S. , McCarthy Julie E. , Turk Siu-Ping , Bernard Quentin , Clendenen Luke H. , Wormser Gary P. , Marcos Luis A. , Dardick Kenneth , Telford Sam R. , Marques Adriana R. , Hu Linden T. 
Published: May 2024

AbstractIxodes scapularisticks are an important vector for at least six tick-borne human pathogens, including the predominant North American Lyme disease spirocheteBorrelia burgdorferi. The ability for these ticks to survive in nature is credited, in part, to their ability to feed on a variety of hosts without excessive activation of the proinflammatory branch of the vertebrate immune system. While the ability for nymphal ticks to feed on a variety of hosts has been well-documented, the host-parasite interactions between larvalI. scapularisand different vertebrate hosts is relatively unexplored. Here we report on the changes in the vertebrate transcriptome present at the larval tick bite site using the naturalI. scapularishostPeromyscus leucopusdeermouse, a non-natural rodent hostMus musculus(BALB/c), and humans. We note substantially less evidence of activation of canonical proinflammatory pathways inP. leucopuscompared to BALB/c mice and pronounced evidence of inflammation in humans. Pathway enrichment analyses revealed a particularly strong signature of interferon gamma, tumor necrosis factor, and interleukin 1 signaling at the BALB/c and human tick bite site. We also note that bite sites on BALB/c mice and humans, but not deermice, show activation of wound-healing pathways. These data provide molecular evidence of the coevolution between larvalI. scapularisandP. leucopusas well as expand our overall understanding ofI. scapularisfeeding.SignificanceIxodes scapularistick bites expose humans to numerous diseases in North America. While larval tick feeding enables pathogens to enter the tick population and eventually spread to humans, how larval ticks interact with mammals has been understudied compared to other tick stages. Here we examined the transcriptomic response of a naturalI. scapularisrodent host (Peromyscus leucopus), a non-nativeI. scapularisrodent host (Mus musculus), and an incidental host (humans). We find that there are differences in how all three species respond to larvalI. scapularis, with the natural host producing the smallest transcriptomic signature of a canonical proinflammatory immune response and the incidental human host producing the most robust signature of inflammation in response to the larval tick. These data expand our understanding of the pressures on ticks in the wild and inform our ability to model these interactions in laboratory settings.