bluuebunny/crossref_metadata_2025_split huggingface dataset:
In vitro analysis of clinically relevant aspects of a polymer-coated phacoemulsification tip vs a traditional tip
Authors: Zacharias Jaime 
Published: July 2023

Purpose:
To compare the in vitro incisional temperature, acoustic energy, transient cavitation, and turbulence of the polymer-coated hybrid phacoemulsification tip with the balanced tip.

Setting:
Pasteur Ophthalmology Clinic, Vitacura, Santiago, Chile.

Design:
Laboratory study.

Methods:
The Centurion Vision System with Active Sentry handpiece was used with tips operated in torsional mode, and stroke was normalized. For thermal measurements, controlled loads were applied over the tip sleeve simulating the pressure applied at the expected level of the corneal incision. Heat generated was recorded on a blackbody filmstrip using infrared imaging. A directional hydrophone provided 360° mapping of acoustic pressure. Cavitation patterns with increasing ultrasound power were imaged with high-speed video recording. Particle image velocimetry was used to evaluate turbulence, streaming, and bubble formation.

Results:
The temperature rise for the hybrid and balanced tips was lower than with the control mini-flared Kelman tip (P ≤ .0001). The hybrid tip generated reduced acoustic output compared with the balanced tip. Ultrasound threshold for cavitation was higher for the hybrid vs balanced tip (55% vs 25%). Fluid turbulence was more evident with the balanced tip compared with the hybrid tip at all flow conditions when normalized for stroke at 60% and 80% power for balanced and hybrid tip, respectively.

Conclusions:
The polymer-coated hybrid tip showed reduced heat generation compared with the control mini-flared Kelman tip and had lower acoustic output, lower cavitation, and lower turbulence compared with the balanced tip, suggesting potential for improved clinical safety.
Opportunities Missed: Cervix Cancer Screening Failures in Women Aged 65 and Older
Authors: Ing Brandon I. , Scott Marla E. , Lentz Scott E. 
Published: July 2023

Objectives
This study aimed to determine the screening history and associated outcomes of women diagnosed with cervical cancer after age 65.

Methods
All patients from 2012 to 2021 diagnosed with squamous, adenocarcinoma, neuroendocrine, or adenosquamous cervical cancer after age 65 in a single managed care organization (MCO) were included in this retrospective cohort study. Demographic, medical, screening, pathologic, follow-up, and treatment data were extracted. Statistical analysis was done using chi-square test and logistic regression. Cancer-specific survival was estimated using the Kaplan-Meier method.

Results
Of 2,175 patients screened, 209 met inclusion criteria. Only 26.3% of patients had appropriate cervical cancer screening and 41% of patients died of their disease. Managed care organization membership duration of more than 5 years positively correlated with proper cervical cancer screening (p < .001); however, 64% of the long-term members still did not meet criteria to end screening at age 65, with 42.6% of these patients having more than 25 physician visit opportunities to address screening. Increased physician visits correlated with earlier stage at diagnosis of cervical cancer (p = .012). Median cancer-specific survival was significantly better in properly screened patients at 68 vs 30 months, respectively (p = .03).

Conclusions
Most patients diagnosed with cervical cancer after age 65 did not have adequate previous screening, including those who were MCO members for more than 5 years. There were many missed opportunities for screening, despite multiple provider touchpoints. The authors’ data suggest that adequate screening confers a survival benefit secondary to earlier stage at diagnosis. Further study in this age group is needed to redefine the criteria to end cervix cancer screening.
Multifaceted Intervention to Improve Patient Safety Incident Reporting in Intensive Care Units
Authors: Griffeth Elaine M. , Gajic Ognjen , Schueler Nicole , Todd Austin , Ramar Kannan 
Published: July 2023

Objectives
Patient safety incident reporting in our institution’s intensive care units (ICUs) had fallen 30% below national benchmarks during the COVID-19 pandemic. Underreporting diminishes awareness of risks and precludes organizational learning from near misses. We aimed to increase the ICU number of patient safety incident reports by 30% from 27 to 35 reports/1000 patient-days without negatively impacting culture of safety as measured by patient-care staff surveys.

Methods
Single-institution prospective interventional study with 9 ICUs receiving a multifaceted intervention developed using quality improvement methodology during February–April 2022. Study intervention involved creation of patient safety peer-leadership role, feedback process, interactive dashboards for patient safety data, and education resources accessible via quick response codes. Primary outcome was patient safety incident reports/1000 patient-days. Intensive care unit patient-care staff culture of safety was assessed with surveys.

Results
Intensive care unit patient safety incident reporting increased by 48% after intervention (40 versus 27 reports/1000 patient-days [P = 0.136]). Near misses were the most common incident report. Intensive care unit patient-care staff ratings of patient safety did not change; 80% rated patient safety as good or better after intervention versus 78% at baseline (P = 0.465). However, significant improvement was observed for subcomponents related to learning culture and support for staff involved in patient safety incidents. Most reports (>80%) were submitted by nurses.

Conclusions
This multifaceted quality improvement intervention increased patient safety incident reporting in the ICUs. Increases in ratings of learning culture and support for staff underline the importance of a well-functioning patient safety incident reporting system in an institutional culture of safety.
Machine learning-based prediction of pregnancy outcomes in couples with non-obstructive azoospermia using micro-TESE for ICSI: a retrospective cohort study
Authors: Jia Lei , Chen Pei-Gen , Chen Li-Na , Fang Cong , Zhang Jing , Chen Pan-Yu 
Published: July 2023

Objective:
To develop a clinically applicable tool for predicting clinical pregnancy, providing individualized patient counseling, and helping couples with nonobstructive azoospermia (NOA) decide whether to use fresh or cryopreserved spermatozoa for oocyte insemination before microdissection testicular sperm extraction (mTESE).

Methods:
A total of 240 couples with NOA who underwent mTESE-ICSI were divided into two groups based on the type of spermatozoa used for intracytoplasmic sperm injection (ICSI): the fresh and cryopreserved groups. After evaluating several machine learning algorithms, logistic regression was selected. Using LASSO regression and 10-fold cross-validation, the factors associated with clinical pregnancy were analyzed.

Results:
The area under the curves (AUCs) for the fresh and cryopreserved groups in the Logistic Regression-based prediction model were 0.977 and 0.759, respectively. Compared with various modeling algorithms, Logistic Regression outperformed machine learning in both groups, with an AUC of 0.945 for the fresh group and 0.788 for the cryopreserved group.

Conclusion:
The model accurately predicted clinical pregnancies in NOA couples.
Nursing Management of Abdominal Wound Dehiscence of an Infant With Severe Undernutrition and Peristomal Moisture-Associated Dermatitis After Ileostomy Closure
Authors: Xu Xiaofeng , Zhou Yiwen , Huang Ying , Le Qian , Lin Lili , Yu Zhuowen 
Published: July 2023

BACKGROUND:
Abdominal wound dehiscence (AWD) is a costly postoperative complication; its management is particularly challenging for WOC nurses when it occurs secondary to an ostomy closure.

CASE:
We present a case of AWD secondary to ileostomy closure in Baby Q, a 9-month 19-day-old female infant. A silver wound contact dressing was used on her dehisced wound followed by negative pressure wound therapy and adhesive tape to pull the wound edge together and promote granulation. We used a combination of enteral nutrition, parenteral nutrition, total parenteral nutrition, and total enteral nutrition adjusting the feeding plan stepwise according to her nutritional status.

CONCLUSIONS:
Malnutrition and severe peristomal skin complications may contribute to the risk of AWD in infants undergoing reversal of a temporary ostomy. Assessing and treating nutritional status and peristomal skin is imperative before performing ostomy closure.
Benefits of a Single-Session, In-Hospital Preoperative Education Program for Patients Undergoing Ostomy Surgery
Authors: Yeo Hyunjung , Park Hyojung 
Published: July 2023

PURPOSE:
The purpose of this study was to compare the effects of a 45-minute session of video-based preoperative ostomy education on self-care knowledge, self-care proficiency, anxiety, depression, length of hospital stay, and ostomy-related complications to a control group who received 3 postoperative educational sessions.

DESIGN:
This was a randomized controlled trial.

SAMPLE AND SETTING:
The sample comprised 47 patients scheduled to undergo ostomy surgery for colon or rectal cancer surgery at a tertiary referral hospital in Seoul, South Korea, from November 2018 to May 2019. However, 2 participants in the intervention group and 4 in the control group withdrew from the study and data analysis is based on 41 participants who completed study procedures.

METHODS:
Participants were randomly allocated to an intervention group (n = 21) or a control group (n = 20). The intervention group received a single 45-minute session of video-based preoperative ostomy education along with stoma site marking and postoperative education. The control group underwent stoma site marking and 3 postoperative education sessions Self-care knowledge, anxiety, and depression were assessed by validated instruments. Self-care proficiency was assessed via direct observation using a checklist. Ostomy-related complications were evaluated by a WOC nurse. Length of hospital stay and disease-related characteristics were collected from medical records.

RESULTS:
Compared with the control group, the intervention group showed significant improvements in self-care knowledge (P = .001) and self-care proficiency scores (P = .001). Intervention group participants also had lower anxiety scores (P = .025), depression scores (P = .014), shorter hospital stays (P = .008), and fewer ostomy-related complications (P = .001).

CONCLUSIONS:
In patients undergoing ostomy surgery, a single 45-minute session of preoperative video-based ostomy education improved self-care knowledge and proficiency. This intervention also reduced depression, anxiety, and ostomy-related complications.
Validation of Visual Prostate Symptom Score (VPSS) in Brazilian Sample Population
Authors: Lopes Maria Helena Baena de Moraes , D'Ancona Carlos Arturo Levi , Moretti Tomás Bernardo Costa , Higa Rosangela , Victal Marcella Lima , Camisão Agnês Raquel , Braga Daniel A. , Reis Leonardo Oliveira 
Published: July 2023

PURPOSE:
The aim of the study was to evaluate the reliability and validity of the Visual Prostate Symptom Score (VPSS), its correlation with the International Prostate Symptom Score (IPSS), and the time required and need for help when completing the instrument. We also aimed to identify variables associated with difficulty completing these instruments.

DESIGN:
Longitudinal, prospective correlational study.

SUBJECTS AND SETTING:
The target population was Brazilian men from different cities within the state of São Paulo with lower urinary tract symptoms followed in urological consultation at a university hospital during October 2017. The sample comprised 59 patients with a mean age of 66.53 years.

METHODS:
Reliability of the VPSS was evaluated using a test-retest approach and its convergent validity with the IPSS. Cronbach α coefficient was also calculated. Both questionnaires were self-administered and, in case of difficulty of comprehension, assistance was provided.

RESULTS:
Mean completion time of the IPSS was 6.56 minutes and for VPSS was 5.02 minutes. The variables skin color and educational level were associated with the difficulty in completing the IPSS and for comprehending meaning of the VPSS pictograms. Internal consistency evaluated using Cronbach α coefficient was 0.74 for IPSS and 0.15 for VPSS, respectively. Test-retest reliability testing revealed that both instruments had a high intraclass correlation index (>0.75). There was a significant correlation between the health-related quality of life (QoL) scores of the 2 instruments (0.71, P = .0001) and between the total score of each instrument with its corresponding QoL score.

CONCLUSION:
Although time for response of the VPSS was shorter and it demonstrated good test-retest reliability, it more frequently required help to answer. The VPSS showed low internal consistency and low correlation with the IPSS (except for the QoL item).
Low Anterior Resection Syndrome in a Reference North American Sample: Prevalence and Associated Factors
Authors: Moon Jeongyoon , Ehlebracht Alexa , Cwintal Michelle , Faria Julio , Ghitulescu Gabriela , Morin Nancy , Pang Allison , Vasilevsky Carol-Ann , Boutros Marylise 
Published: July 2023

BACKGROUND:
Low anterior resection syndrome (LARS) is a well-described consequence of rectal cancer treatment. Studying the degree to which bowel dysfunction exists in the general population may help to better interpret to what extent LARS is related to disease and/or cancer treatment. Currently, North American LARS normative data are lacking. The aim of this study was to describe the prevalence of bowel dysfunction, as measured by the LARS score, and quality of life (QoL) in a reference North American sample. Quality of life was measured and associations between participant characteristics and LARS were identified.

STUDY DESIGN:
This was a single-institution cross-sectional study of asymptomatic adults who underwent screening and surveillance colonoscopies from 2018 to 2021 with no/benign endoscopic findings. Survey was conducted on select comorbidities, sociodemographic factors, LARS, and QoL. Outcomes were LARS and QoL. Multivariable linear regression accounting for a priori clinical factors associated with bowel dysfunction was performed.

RESULTS:
Of 1,004 subjects approached, 502 (50.0%) participated, and 135 (26.9%) participants had major/minor LARS. On multiple linear regression, female sex (β = 2.15, 95% CI 0.30 to 4.00), younger age (β = –0.10, 95% CI –0.18 to –0.03), White ethnicity (β = 2.45, 95% CI 0.15 to 4.74), and the presence of at least one of the following factors: diabetes, depression, neurologic disorder, or cholecystectomy (β = 3.54, 95% CI 1.57 to 5.51) were independently associated with a higher LARS score. Individuals with LARS had lower global QoL, functional subscales, and various symptom subscale scores.

CONCLUSIONS:
Our study identified the baseline prevalence of LARS in asymptomatic adults who have not undergone a low anterior resection. These normative data will allow for more accurate interpretation of ongoing studies on LARS in North American rectal cancer patients.
Systems Age: A single blood methylation test to quantify aging heterogeneity across 11 physiological systems
Authors: Sehgal Raghav , Markov Yaroslav , Qin Chenxi , Meer Margarita , Hadley Courtney , Shadyab Aladdin H. , Casanova Ramon , Manson JoAnn E. , Bhatti Parveen , Crimmins Eileen M. , Hagg Sara , Assimes Themistocles L. , Whitsel Eric A. , Higgins-Chen Albert T. , Levine Morgan 
Published: July 2023

AbstractIndividuals, organs, tissues, and cells age in diverse ways throughout the lifespan. Epigenetic clocks attempt to quantify differential aging between individuals, but they typically summarize aging as a single measure, ignoring within-person heterogeneity. Our aim was to develop novel systems-based methylation clocks that, when assessed in blood, capture aging in distinct physiological systems. We combined supervised and unsupervised machine learning methods to link DNA methylation, system-specific clinical chemistry and functional measures, and mortality risk. This yielded a panel of 11 system-specific scores– Heart, Lung, Kidney, Liver, Brain, Immune, Inflammatory, Blood, Musculoskeletal, Hormone, and Metabolic. Each system score predicted a wide variety of outcomes, aging phenotypes, and conditions specific to the respective system. We also combined the system scores into a composite Systems Age clock that is predictive of aging across physiological systems in an unbiased manner. Finally, we showed that the system scores clustered individuals into unique aging subtypes that had different patterns of age-related disease and decline. Overall, our biological systems based epigenetic framework captures aging in multiple physiological systems using a single blood draw and assay and may inform the development of more personalized clinical approaches for improving age-related quality of life.
Malignant tumors engender and employ cancer-specific organelles for self-protection and metastasis
Authors: Yi Tingfang , Wagner Gerhard 
Published: July 2023

AbstractCancer is a leading source of human lethality but current therapies have had limited efficacy in many cancers, which highlights an unmet need to assess the underlying mechanisms that govern cancer progressionin vivo.Here we show that, upon malignant transformation, aggressive oncocells generate extracellular membranous compartments, cytocapsulas or cytocapsular tubes (CCTs), to enclose oncocells and engender cytocapsular oncocellsin vivo. Cytocapsular oncocells are universally present in solid cancers and appear in hematologic cancers in the immune organs. Networks of cytocapsular tubes provide membrane-enclosed freeways for protected cancer metastasis. CCT networks interconnect cytocapsular tumors creating cytocapsular tumor network systems. Our findings suggest that cytocapsular oncocells drive membrane-encompassed cancer progression. Thus, interconnected cytocapsular oncocells, CCT networks and cytocapsular tumor network systems coordinate cancer progression in the integrated cytocapsular membrane systems.
Designathons in Health Research: A Global Systematic Review
Authors: Tieosapjaroen Warittha , Chen Elizabeth , Ritchwood Tiarney , Li Chunyan , Conklin Jamie L. , Babatunde Abdulhammed , Ongkeko Arturo , Nwaozuru Ucheoma , Tucker Joseph D. , Ong Jason J. 
Published: July 2023

AbstractBackgroundA designathon is a three-stage participatory activity informed by design thinking and rapid prototyping that includes preparation with end-users, an intensive period of collaborative teamwork, and evaluation of solutions by topic experts or community partners. A few previous systematic reviews have focused on the use of designathons in health. This study synthesised how designathons were organised and implementation-related factors to address health challenges.MethodsWe searched Cochrane Library, Embase, PubMed, Scopus, and the ClinicalTrials.gov registry for peer-reviewed articles until November 29, 2022. The systemic review was registered in PROSPERO (CRD42023389685).ResultsIn total, 4,947 citations were identified, with 38 studies included in this review. Most studies were from high-income countries (26, 68%). The median number of participating teams was eight (IQR 5, 15), and the duration of the intensive collaboration phase ranged from three hours to seven days. The final products (i.e., ideas and prototypes) related to four themes: mobile applications, educational programs, medical devices, and other prototypes. Common evaluation criteria were feasibility, innovation or creativity, and impact. The most common facilitators were including diverse participants and having high-quality mentorship. . The most common barriers related to planning and implementing the designathon, and engaging diverse participants to participate. There were limited data on required resources and further implementation of solutions after designathons and no data on cost-effectiveness.ConclusionDesignathons are a promising tool for fostering innovative and person-centred solutions to address health challenges. Given its adaptability in terms of budget, mode of delivery, and involvement of diverse participants including end-users, designathons can be implemented in a wide range of contexts to address various health issues.
Loss of the mitochondrial carrier,SLC25A1,during embryogenesis induces a unique senescence program controlled by p53
Authors: Kasprzyk-Pawelec Anna , Tan Mingjun , Rahhal Raneen , McIntosh Alec , Fernandez Harvey , Mosaoa Rami , Jiang Lei , Pearson Gray W. , Glasgow Eric , Vockley Jerry , Albanese Christopher , Avantaggiati Maria Laura 
Published: July 2023

ABSTRACTGermline inactivating mutations of the SLC25A1 gene contribute to various human developmental disorders, including combined D/L-2-hydroxyglutaric aciduria (D/L-2HGA), a severe systemic syndrome characterized by the accumulation of both enantiomers of 2-hydroxyglutaric acid (2HG). The mechanisms by which SLC25A1 deficiency leads to this disease and the role of 2HG are unclear and no therapies exist. We now show that mice lacking both Slc25a1 alleles display a spectrum of alterations that resemble human D/L-2HGA. Mechanistically, SLC25A1 loss results in a proliferation defect and activates two distinct senescence pathways, oncogene-induced senescence (OIS) and mitochondrial dysfunction-induced senescence (MiDAS), both involving the p53 tumor suppressor and driven by two discernible signals: the accumulation of 2HG, inducing OIS, and mitochondrial dysfunction, triggering MiDAS. Inhibiting these senescence programs or blocking p53 activity reverses the growth defect caused by SLC25A1 dysfunction and restores proliferation. These findings reveal novel pathogenic roles of senescence in human disorders and suggest potential strategies to correct the molecular alterations caused by SLC25A1 loss.