bluuebunny/crossref_metadata_2025_split huggingface dataset:
Comparison of Five Inservicing Methods in an Intensive Care Nursery
Authors: Zenk Karin E. , Lloyd W. Chris 
Published: April 2023

Objective Communicating to nurses new information on therapeutics or pharmacy procedures is a frequent challenge faced by most hospital pharmacists. Pharmacists should use the most efficient and effective methods to inservice nursing staff. The purpose of this study was to compare five methods of inservicing in a neonatal intensive care unit (NICU) to determine which method resulted in the greatest knowledge retention as assessed by a ten-question quiz. Design Various combinations of written guideline alone, verbal discussion by a pharmacist with and without a written guideline, and verbal discussion by a nurse with and without a written guideline were used to introduce nurses to the use of caffeine for apnea/bradycardia of the newborn. Each nurse completed a quiz to assess knowledge retention. The written guideline and quiz were prepared by a pharmacist. Participants Forty-eight nurses participated in the study: (1) group 1 (n=11) received the written guideline only (no verbal discussion); (2) group 2 (n=14) received verbal discussion by a pharmacist plus a written guideline; (3) group 3 (n=9) received verbal discussion by a nurse-educator plus a written guideline; (4) group 4 (n=9) received verbal discussion by a pharmacist (no written guideline); and (5) group 5 (n=5) received verbal discussion by a nurse-educator (no written guideline). Main Outcome Measures Mean quiz scores for all groups were compared and assessed using the Irwin-Fisher test for equality of binomial probabilities on all possible pairs of groups. Results Mean quiz scores for groups 1 and 3 were 10; for group 2, 8.6; for group 4, 9; and for group 5, 9.2. Using the Irwin-Fisher tests for equality of binomial probabilities on all possible pairs of groups, the probability of obtaining a perfect score on the quiz was the highest for groups 1 and 3 (p≤0.05). Conclusions Within the limitations and the setting of this study, the two most effective methods of nursing inservice were a pharmacist-prepared written guideline followed by a quiz, and the written guideline plus a verbal discussion by a nurse-educator followed by a quiz. Use of these methods can reduce pharmacist inservice time and improve medication knowledge of the nurses and possibly reduce errors in the NICU.
Administration of Bromocriptine by the Vaginal Route in Women Intolerant of Oral Therapy
Authors: Natrajan Rebecca , Miller Jeffrey L. , Rose Leslie I. 
Published: April 2023

Objective To assess the use of intravaginal bromocriptine mesylate in women intolerant of orally administered bromocriptine. Participants Two consecutive women of reproductive age with prolactin-secreting pituitary microadenomas who were intolerant of oral bromocriptine. Results Normoprolactinemia with eumenorrhea was obtained using intravaginal bromocriptine. Conclusions Intravaginal bromocriptine is recommended as an alternative route of administration in women intolerant of oral therapy.
Assessing the Appropriateness of Physician Prescribing for Geriatric Outpatients
Authors: Lipton Helene Levens , Bird Joyce Adair , Bero Lisa Anne , McPhee Stephen J. 
Published: April 2023

Objective In a randomized, controlled trial evaluating the impact of clinical pharmacists’ consultations on physicians’ prescribing decisions, a seven-member physician/pharmacist panel developed an instrument to characterize and quantify the full range of drug-prescribing problems. The instrument was tested for validity and reliability. Sample The instrument was applied in reviewing prescribing for 236 geriatric outpatients. Methods To ensure internal validity of the instrument, five panel meetings were devoted to reaching a consensus on procedures, categories, criteria, and scoring. Each case was evaluated independently by two reviewers and each drug in the regimen was evaluated for drug-drug interactions, dosage, schedule, allergic reactions, therapeutic duplication, use of drugs without established diagnoses, and inappropriate drugs for the patient's clinical conditions; discrepancies were adjudicated by the panel chairperson. Self-reported adverse effects of 60 study patients who were interviewed, and hospital readmissions of all study patients were used to test the external validity of the instrument. Results Inter-rater reliability improved over time, reaching a high of 97.1 percent after six months. A positive association was determined between the prescribing scores and the number of reported adverse effects (rho=0.28, p=0.02). Although the number of patients with drug-related hospital readmissions was too few to establish a significant association between the prescribing scores and readmissions, the findings were expected. Conclusions Given current requirements for drug utilization reviews in hospitals, health maintenance organizations, and Medicaid programs, this instrument may prove to be very useful.
Synthetic Human Calcitonin in the Treatment of Hypercalcemia of Malignancy
Authors: Linette Donna Carr , Hunter Sheila G. , Bennett Teresa A. 
Published: April 2023

Objective To determine whether synthetic human calcitonin is a safe and effective treatment for hypercalcemia of malignancy. Data Sources Journal articles published between 1978 and 1992; manufacturers’ package inserts. Study Selection Articles containing pertinent information concerning the therapeutic use and effects of calcitonin products, particularly those of salmon or human origin. Data Extraction Resources were evaluated independently by the authors and information was collaboratively extracted. Data Synthesis No studies could be located comparing human calcitonin with salmon calcitonin in the treatment of hypercalcemia. Two studies found human calcitonin to be effective for this indication. Conclusions Human calcitonin cannot be recommended over the salmon product in the treatment of hypercalcemia of malignancy until additional comparative studies have been performed.
Evolution of the Duty to Warn—One State's Experience
Authors: Williams Karl G. 
Published: April 2023

Objective There exist, in many jurisdictions, confusion and uncertainty with regard to the legal duty of pharmacists to warn their patients of the potential risks of their medication. Review of the legal evolution of this duty in one state with recent experience is instructive. Data Sources Published opinions of the Tennessee Court of Appeals. Conclusions The cases are consistent with the idea that if the pharmacist warned about risks that had a reasonably foreseeable potential of occurring, then there would be no liability.
Innovative Nuclear Pharmacy Service
Authors: Cheng Kenneth T. , Brown Barry M. , Sheppard Mary Stewart , Haymond David J. 
Published: April 2023

Objective To provide an overview of the investigational nuclear pharmacy service at the Medical University of South Carolina. Data Sources Referencess were selected from published bibliographies of nuclear pharmacy and hospital pharmacy articles and from specific-topic searches of the MEDLINE computerized database (all languages, through 1992). Study Selection Studies of clinical pharmacy functions that were considered relevant to the specialty practice of nuclear pharmacy were chosen. Data Extraction Studies were reviewed for internal consistency and appropriateness. Data Synthesis Data on the clinical impact of nuclear pharmacy services do not exist. Conclusions Based on our experience in establishing an investigational drug service, we conclude that nuclear pharmacists should take an active role in clinical investigations. The outcomes of this kind of involvement are very rewarding.
Afebrile benign convulsions with or without a reversible splenial lesion in two pediatric patients with COVID-19
Authors: Lee Yun Young , Kim Young Ok 
Published: April 2023

Abstract
Background
Seizures in children with coronavirus disease 2019 (COVID-19) were markedly increased during the Omicron variant surge. Most seizures occurred with fever. New-onset afebrile seizures were rarely reported; therefore, their courses are not well-known.

Case presentation
Two patients (7 and 26 months of age, respectively) with COVID-19 showed recurrent afebrile seizures immediately after resolution of a fever lasting for 2–3 days. Bilateral convulsive seizures lasted for approximately 1 min/episode (6 of 7 total episodes) and occurred 3–4 times within 2–3 h. However, the patients were alert between seizures, which is in contrast to seizures occurring with encephalopathy or encephalitis. Only one episode required acute antiseizure medication. Brain magnetic resonance imaging showed a reversible splenial lesion in one patient. The serum uric acid level was slightly increased (7.8 mg/dL) in this patient. Electroencephalography findings were all normal. During the follow-up period, no seizures or developmental problems have been observed.

Conclusions
COVID-19-associated, afebrile benign convulsions with or without a reversible splenial lesion are similar to ‘benign convulsions with mild gastroenteritis’; therefore, continuation of antiseizure medication does not seem necessary.
24 h mortality and its predictors among road traffic accident victims in a resource limited setting; a multicenter cohort study
Authors: Kamabu Kinyamaniyi , La O Soria Jorge , Tumwesigye Deus , Okedi Xaviour Francis , Kyomukama Lauben , Muhumuza Joshua , Musinguzi Brian , Kavuma Daniel , Vivalya Bives Mutume Nzanzu , Loduk Michael , Abdullah Wani Shabani 
Published: April 2023

Abstract
Introduction
The incidence of road traffic accidents (RTAs) is on the rise contributing to the global burden of mortality as a major global health threat. It has been estimated that 93% of RTAs and more than 90% of the resulting deaths occur in low and middle income countries. Though death due to RTAs has been occurring at an alarming rate, there is paucity of data relating to incidence and predictors of early mortality. This study was aimed at determining the 24 h mortality and its predictors among RTA patients attending selected hospitals in western Uganda.

Methods
This was a prospective cohort that consecutively enrolled 211 RTA victims admitted and managed in emergency units of 6 hospitals in western Uganda. All patients who presented with a history of trauma were managed according to the advanced trauma life support protocol (ATLS). The outcome regarding death was documented at 24 h from injury. Data was analyzed using SPSS version 22 for windows.

Results
Majority of the participants were male (85.8%) aged 15–45 years (76.3%). The most common road user category was motorcyclists (48.8%). The 24 h mortality was 14.69%. At multivariate analysis, it was observed that a motorcyclist was 5.917 times more likely to die compared to a pedestrian (P = 0.016). It was also observed that a patient with severe injury was 15.625 times more likely to die compared to one with a moderate injury (P < 0.001).

Conclusion
The incidence of 24 h mortality among road traffic accident victims was high. Being motorcycle rider and severity of injury according to Kampala trauma score II predicted mortality. Motorcyclists should be reminded to be more careful while using the road. Trauma patients should be assessed for severity, and the findings used to guide management since severity predicted mortality.
COVID-19 severity scale for claims data research
Authors: Krause Trudy Millard , Greenberg Raymond , Ghosh Lopita , Wozny Joseph S. , Hansen Regina M. , Schaefer Caroline 
Published: April 2023

Abstract
Objective
To create and validate a methodology to assign a severity level to an episode of COVID-19 for retrospective analysis in claims data.

Data Source
Secondary data obtained by license agreement from Optum provided claims records nationally for 19,761,754 persons, of which, 692,094 persons had COVID-19 in 2020.

Study Design
The World Health Organization (WHO) COVID-19 Progression Scale was used as a model to identify endpoints as measures of episode severity within claims data. Endpoints used included symptoms, respiratory status, progression to levels of treatment and mortality.

Data Collection/Extraction methods
The strategy for identification of cases relied upon the February 2020 guidance from the Centers for Disease Control and Prevention (CDC).

Principal Findings
A total of 709,846 persons (3.6%) met the criteria for one of the nine severity levels based on diagnosis codes with 692,094 having confirmatory diagnoses. The rates for each level varied considerably by age groups, with the older age groups reaching higher severity levels at a higher rate. Mean and median costs increased as severity level increased. Statistical validation of the severity scales revealed that the rates for each level varied considerably by age group, with the older ages reaching higher severity levels (p < 0.001). Other demographic factors such as race and ethnicity, geographic region, and comorbidity count had statistically significant associations with severity level of COVID-19.

Conclusion
A standardized severity scale for use with claims data will allow researchers to evaluate episodes so that analyses can be conducted on the processes of intervention, effectiveness, efficiencies, costs and outcomes related to COVID-19.
Molecular mimicry and cancer vaccine development
Authors: Tagliamonte Maria , Cavalluzzo Beatrice , Mauriello Angela , Ragone Concetta , Buonaguro Franco M. , Tornesello Maria Lina , Buonaguro Luigi 
Published: April 2023

AbstractBackgroundThe development of cancer immunotherapeutic strategies relies on the identification and validation of optimal target tumor antigens, which should be tumor-specific as well as able to elicit a swift and potent anti-tumor immune response. The vast majority of such strategies are based on tumor associated antigens (TAAs) which are shared wild type cellular self-epitopes highly expressed on tumor cells. Indeed, TAAs can be used to develop off-the-shelf cancer vaccines appropriate to all patients affected by the same malignancy. However, given that they may be also presented by HLAs on the surface of non-malignant cells, they may be possibly affected by immunological tolerance or elicit autoimmune responses.Main bodyIn order to overcome such limitations, analogue peptides with improved antigenicity and immunogenicity able to elicit a cross-reactive T cell response are needed. To this aim, non-self-antigens derived from microorganisms (MoAs) may be of great benefit.
The anesthesia workforce in Canada: a methodology to identify physician anesthesia providers using health administrative data
Authors: Simkin Sarah , Orser Beverley A. , Wilson C. Ruth , Bourgeault Ivy Lynn 
Published: April 2023

Abstract
Background
Safe and timely anesthesia services are an integral component of modern health care systems. There are, however, increasing concerns about the availability of anesthesia services in Canada. Thus, a comprehensive approach to assess the capacity of the anesthesia workforce to provide service is a critical need. Data regarding the anesthesia services provided by specialists and family physicians are available through the Canadian Institute for Health Information (CIHI) but collating the data across delivery jurisdictions has proven challenging. As a result, information related to the activity of physician anesthesia providers is routinely excluded from annual physician workforce reports. Our goal was to develop a novel approach to identifying and characterizing the anesthesia workforce on a pan-Canadian scale.

Methods
The study was approved by the University of Ottawa Office of Research Ethics and Integrity. We developed a methodology to identify physicians who provided anesthesia services in Canada between 1996 and 2018 using data elements from the CIHI National Physician Database. We iteratively consulted with expert advisors and compared the results with Scott’s Medical Database, the Canadian Medical Association (CMA) Masterfile, and the College of Family Physicians of Canada membership database.

Results
The methodology identified providers of anesthesia services using data elements from the CIHI National Physician Database, including categories of the National Grouping System, specialty designations, activity levels and participation thresholds. Physicians who provided anesthesia services only sporadically and medical residents-in-training were excluded. This methodology produced estimates of anesthesia providers that aligned with other sources. The process we followed was sequential, transparent, and intuitive, and was strengthened by collaboration and iterative consultation with experts and stakeholders.

Conclusions
Using physician activity patterns, this novel methodology allows stakeholders to identify which physician provide anesthesia services in Canada. It is an essential step in developing a pan-Canadian anesthesia workforce strategy that can be used to examine patterns and trends related to the workforce and support evidence-informed workforce decision-making. It also establishes a foundation for assessing the effectiveness of a variety of interventions aimed at optimizing physician anesthesia services in Canada.
Snack consumption patterns and their associations with risk of incident metabolic syndrome: Tehran lipid and glucose study
Authors: Gaeini Zahra , Malmir Hanieh , Mirmiran Parvin , Feizy Zahra , Azizi Fereidoun 
Published: April 2023

Abstract
Aim
Few studies considered the association between snack patterns and metabolic abnormalities. Here we aimed to characterize the major snack patterns among Iranian adults and determine their association with the risk of metabolic syndrome (MetS).

Methods
This study was conducted on 1713 MetS-free adults who participated in the third phase of the Tehran Lipid and Glucose Study (TLGS). At baseline, dietary intake of snack was assessed using a validated 168-items food frequency questionnaire, and snack patterns were obtained by principal component analysis (PCA). Adjusted Hazard Ratios (HRs) and 95% confidence intervals (CIs) were calculated for the association of incident MetS with the extracted snack patterns.

Results
PCA identified five major snack patterns, defined as “healthy pattern”, “low-fructose pattern”, “high-trans pattern”, “high-caffeine pattern” and “high-fructose pattern”. Participants in the highest tertile of the “high-caffeine pattern” had lower risk of MetS (HR = 0.80, 95% CI = 0.65–0.99, P for trend = 0.032). Other snack patterns have not shown any significant association with MetS incidence.

Conclusions
Our findings suggest that consuming a snack pattern with high loads of caffeine, defined as “High-caffeine pattern” in the present study, could reduce the risk of MetS in healthy adults. Further prospective studies are needed to more fully determine the association between snack patterns and MetS incidence.
Open versus closed reduction internal fixation for lateral condyle humeral fractures in children: a systematic review and meta-analysis
Authors: Zhu Suyue , Zheng Yan , Jiang Yazhou , Yin Hanjun , Zhu Dongsheng 
Published: April 2023

Abstract
Objective
The objective of this meta-analysis was to illustrate the clinical outcomes and safety of two different management options for Song stage 2–4 lateral condyle humeral fractures in children.

Method
In January 2023, a systematic computer-based search was conducted. Data were retrieved for patients with two different management options for lateral condyle humeral fractures in children. The primary endpoints were clinical outcomes based on infection, avascular necrosis, and nonunion. After testing for publication bias and heterogeneity between studies, the data was aggregated for stochastic effect models when necessary.

Results
Eight clinical studies with 742 patients were eventually included in the meta-analysis. There was no significant difference between the closed reduction and percutaneous pinning, and open reduction and internal fixation in terms of the clinical outcomes based on infection, avascular necrosis, and nonunion (P > 0.05).

Conclusions
Closed reduction and percutaneous pinning, as well as open reduction and internal fixation of lateral condyle humeral fractures in children, resulted in similar structural stability and functional outcomes. More high-quality randomized controlled trials are needed to determine this conclusion.
Identification of complex and cryptic chromosomal rearrangements by optical genome mapping
Authors: Shi Shanshan , Huang Peizhi , Yan Ruiling , Li Ruiman 
Published: April 2023

Abstract
Background
Optical genome mapping (OGM) has developed into a highly promising method for detecting structural variants (SVs) in human genomes. Complex chromosomal rearrangements (CCRs) and cryptic translocations are rare events that are considered difficult to detect by routine cytogenetic methods. In this study, OGM was applied to delineate the precise chromosomal rearrangements in three cases with uncertain or unconfirmed CCRs detected by conventional karyotyping and one case with a cryptic translocation suggested by fetal chromosomal microarray analysis (CMA).

Results
In the three cases with CCRs, OGM not only confirmed or revised the original karyotyping results but also refined the precise chromosomal structures. In the case with a suspected translocation not detected by karyotyping, OGM efficiently identified the cryptic translocation and defined the genomic breakpoints with relatively high accuracy.

Conclusions
Our study confirmed OGM as a robust alternative approach to karyotyping for the detection of chromosomal structural rearrangements, including CCRs and cryptic translocations.
Multiple PIK3CA mutation clonality correlates with outcomes in taselisib + fulvestrant-treated ER+/HER2–, PIK3CA-mutated breast cancers
Authors: Hutchinson Katherine E. , Chen Jessica W. , Savage Heidi M. , Stout Thomas J. , Schimmoller Frauke , Cortés Javier , Dent Susan , Harbeck Nadia , Jacot William , Krop Ian , Trabucco Sally E. , Sivakumar Smruthy , Sokol Ethan S. , Wilson Timothy R. 
Published: April 2023

Abstract
Background
Mutations in the p110α catalytic subunit of phosphatidylinositol 3-kinase (PI3K), encoded by the PIK3CA gene, cause dysregulation of the PI3K pathway in 35–40% of patients with HR+/HER2– breast cancer. Preclinically, cancer cells harboring double or multiple PIK3CA mutations (mut) elicit hyperactivation of the PI3K pathway leading to enhanced sensitivity to p110α inhibitors.

Methods
To understand the role of multiple PIK3CAmut in predicting response to p110α inhibition, we estimated the clonality of multiple PIK3CAmut in circulating tumor DNA (ctDNA) from patients with HR+/HER2– metastatic breast cancer enrolled to a prospectively registered clinical trial of fulvestrant ± taselisib, and analyzed the subgroups against co-altered genes, pathways, and outcomes.

Results
ctDNA samples with clonal multiple PIK3CAmut had fewer co-alterations in receptor tyrosine kinase (RTK) or non-PIK3CA PI3K pathway genes compared to samples with subclonal multiple PIK3CAmut indicating a strong reliance on the PI3K pathway. This was validated in an independent cohort of breast cancer tumor specimens that underwent comprehensive genomic profiling. Furthermore, patients whose ctDNA harbored clonal multiple PIK3CAmut exhibited a significantly higher response rate and longer progression-free survival vs subclonal multiple PIK3CAmut.

Conclusions
Our study establishes clonal multiple PIK3CAmut as an important molecular determinant of response to p110α inhibition and provides rationale for further clinical investigation of p110α inhibitors alone or with rationally-selected therapies in breast cancer and potentially other solid tumor types.