bluuebunny/crossref_metadata_2025_split huggingface dataset:
Building Interprofessional Collaborative Practices Through a Support Program for Patients With Type 2 Diabetes in Primary Care
Authors: Bawab Noura , Moullin Joanna , Jotterand Sébastien , Rossier Christophe , Schneider Marie-Paule , Perraudin Clémence 
Published: March 2023

Introduction:
The building of interprofessional collaborative practices throughout the implementation process of a patient support program (Siscare) in primary care for patients with type 2 diabetes was assessed. Siscare included regular patient–pharmacist motivational-based interviews; medication adherence, patient-reported, and clinical outcomes monitoring; and physician–pharmacist interactions.

Method:
This investigation was a prospective, multicenter, observational, mixed-methods cohort study. Interprofessionality was operationalized through four progressive levels of interrelationship practices between the health care professionals. The target number of patients per pharmacy was 10 among 20 pharmacies.

Results:
The project started with the recognition of Siscare by stakeholders, the creation of an interprofessional steering committee, and the adoption of Siscare by 41 pharmacies among 47 pharmacies in April 2016. Nineteen pharmacies presented Siscare at 43 meetings attended by 115 physicians. Twenty-seven pharmacies included 212 patients; however, no physician prescribed Siscare. Collaboration primarily occurred through the unidirectional transmission of information from the pharmacist to the physician (level 1: 70% of pharmacists transmitted interview reports to physicians), bidirectional exchange of information sometimes occurred (level 2: 42% received physician responses), and concerted measures of treatment objectives took place occasionally (level 3). Twenty-nine of 33 physicians surveyed were in favor of this collaboration.

Discussion:
Despite multiple implementation strategies, physician resistance and lack of motivation to participate exists, but Siscare was well received by pharmacists, patients, and physicians. Barriers to collaborative practice (financial and IT) need to be further explored. Interprofessional collaboration is a clear need to improve type 2 diabetes adherence and outcomes.
Are We Ever Going Back? Exploring the Views of Health Professionals on Postpandemic Continuing Professional Development Modalities
Authors: Cassidy Dara , Edwards Gareth , Bruen Catherine , Kelly Helen , Arnett Richard , Illing Jan 
Published: March 2023

Introduction:
The COVID-19 pandemic has profoundly altered the ways in which health care professionals engage with continuing professional development (CPD), but the extent to which these changes are permanent remains unknown at present. This mixed-methods research aims to capture the perspectives of health professionals on their preferences for CPD formats, including the conditions that inform preferences for in-person and online CPD events and the optimum length and type of online and in-person events.

Methods:
A survey was used to gain a high-level perspective on health professionals' engagement with CPD, areas of interest, and capabilities and preferences in relation to online formats. A total of 340 health care professionals across 21 countries responded to the survey. Follow-up semistructured interviews were conducted with 16 respondents to gain deeper insights into their perspectives.

Results:
Key themes include CPD activity before and during COVID, social and networking aspects, access versus engagement, cost, and time and timing.

Discussion:

Recommendations regarding the design of both in-person and online events are included. Beyond merely moving in-person events online, innovative design approaches should be adopted to capitalize on the affordances of digital technologies and enhance engagement.
Differences in Physician Performance and Self-rated Confidence on High- and Low-Stakes Knowledge Assessments in Board Certification
Authors: Price David W. , Wang Ting , O'Neill Thomas R. , Bazemore Andrew , Newton Warren P. 
Published: March 2023

Introduction:
Evidence links assessment to optimal learning, affirming that physicians are more likely to study, learn, and practice skills when some form of consequence (“stakes”) may result from an assessment. We lack evidence, however, on how physicians' confidence in their knowledge relates to performance on assessments, and whether this varies based on the stakes of the assessment.

Methods:
Our retrospective repeated-measures design compared differences in patterns of physician answer accuracy and answer confidence among physicians participating in both a high-stakes and a low-stakes longitudinal assessment of the American Board of Family Medicine.

Results:
After 1 and 2 years, participants were more often correct but less confident in their accuracy on a higher-stakes longitudinal knowledge assessment compared with a lower-stakes assessment. There were no differences in question difficulty between the two platforms. Variation existed between platforms in time spent answering questions, use of resources to answer questions, and perceived question relevance to practice.

Discussion:
This novel study of physician certification suggests that the accuracy of physician performance increases with higher stakes, even as self-reported confidence in their knowledge declines. It suggests that physicians may be more engaged in higher-stakes compared with lower-stakes assessments. With medical knowledge growing exponentially, these analyses provide an example of the complementary roles of higher- and lower-stakes knowledge assessment in supporting physician learning during continuing specialty board certification.
Is Academic Medicine Prepared to Teach About the Intersection of Childhood Experiences and Health? An Exploratory Survey of Faculty
Authors: Koo Angie , Irwin Jordyn , Sturgis Morgan , Schwartz Alan , Hasnain Memoona , Davis Elizabeth , Stillerman Audrey 
Published: March 2023

Introduction:Childhood experiences affect health across the lifespan. Evidence-based strategies targeting early-life stress are emerging. Nevertheless, faculty physicians' preparation to incorporate this science into practice has not been well studied. This study explores medical faculty knowledge and beliefs, timing and route of knowledge acquisition, perceived relevance and application of study topics, and characteristics associated with concept mastery.Methods:The authors developed and administered an exploratory survey to faculty from six departments at two medical schools. The team analyzed responses using quantitative and qualitative methods.Results:Eighty-one (8.8%) eligible faculty completed the survey. Of respondents, 53 (65.4%) achieved high knowledge, 34 (42.0%) high beliefs, and 42 (59.1%) high concept exposure question scores, but only 6 (7.4%) through a formal route. Although 78 (96.8%) respondents indicated that survey concepts are relevant, only 18 (22.2%) reported fully incorporating them in their work, and 48 (59.2%) identified the need for additional coaching. Respondents reporting full incorporation were significantly more likely to attain high concept exposure scores (17 respondents, 94.4%, versus 25 respondents, 39.7%,P< .001). Quantitative and qualitative analysis highlighted limited respondent awareness of trauma prevalence among health care workers, lack of familiarity with interventions, and time and resource challenges addressing childhood adversity.Discussion:Although survey respondents had some familiarity with study concepts and perceived their relevance, most are not fully applying them. Results suggest that exposure to study concepts is associated with full incorporation. Therefore, intentional faculty development is essential to prepare faculty to include this science in practice.
Effects of visual restoration on gait performance and kinematics of lower extremities in patients with age-related cataract
Authors: Ao Mingxin , Shi Huijuan , Li Xuemin , Huang Hongshi , Ao Yingfang , Wang Wei 
Published: March 2023

Abstract

Background:
Visual inputs are critical for locomotor navigation and sensorimotor integration in the elderly; however, the mechanism needs to be explored intensively. The present study assessed the gait pattern after cataract surgery to investigate the effects of visual restoration on locomotion.

Methods:
The prospective study recruited 32 patients (70.1 ± 5.2 years old) with bilateral age-related cataracts in the Department of Ophthalmology at Peking University Third Hospital from October 2016 to December 2019. The temporal-spatial gait parameters and kinematic parameters were measured by the Footscan system and inertial measurement units. Paired t-test was employed to compare data normally distributed and Wilcoxon rank-sum test for non-normally distributed.

Results:
After visual restoration, the walking speed increased by 9.3% (1.19 ± 0.40 m/s vs. 1.09 ± 0.34 m/s, P=0.008) and exhibited an efficient gait pattern with significant decrease in gait cycle (1.02 ± 0.08 s vs. 1.04 ± 0.07 s, P=0.012), stance time (0.66 ± 0.06 s vs. 0.68 ± 0.06 s, P=0.045), and single support time (0.36 ± 0.03 s vs. 0.37 ± 0.02 s, P=0.011). High amplitude of joint motion was detected in the sagittal plane in the left hip (37.6° ± 5.3° vs. 35.5° ± 6.2°, P=0.014), left thigh (38.0° ± 5.2° vs. 36.4° ± 5.8°, P=0.026), left shank (71.9° ± 5.7° vs. 70.1° ± 5.6°, P=0.031), and right knee (59.1° ± 4.8° vs. 56.4° ± 4.8°, P=0.001). The motor symmetry of thigh improved from 8.35 ± 5.30% to 6.30 ± 4.73% (P=0.042).

Conclusions:
The accelerated gait in response to visual restoration is characterized by decreased stance time and increased range of joint motion. Training programs for improving muscle strength of lower extremities might be helpful to facilitate the adaptation to these changes in gait.
Rising to “The Highest Morals”—The Rich History of Nursing Ethics
Authors: Fowler Marsha D. , Schoonover-Shoffner Kathy 
Published: March 2023

ABSTRACT:
Modern nursing is supported by a rich ethical tradition dating back to the mid-19th century. Moving illustrations of nursing practice and “the highest morals” (McIsaac, 1901) relay the distinguished history and distinctives of nursing ethics from the 1860s to the present day. Of note is that nursing ethics is relationally focused, virtue-based, preventative, and central to the identity of nursing. A brief history of how bioethics emerged in the mid-20th century and an overview of the development of nursing ethics unveils differences between the two ethical paradigms.
2000 Years of Clinical Trials
Authors: Zrelak Patricia Ann 
Published: March 2023

ABSTRACT:
Although the first documented clinical trial as described in the biblical book of Daniel dates to 606 BC, the prophet Daniel's nutrition study is contemporary in both approach and topic and could be considered the first comparative effectiveness research (CER) trial. This article summarizes the historical evolution of clinical trials and associated regulatory legislation. Ethical considerations foundational to nursing and evidence-based practice (EBP) in the 21st century are examined. Distinguishing features of CER, various study designs and checklists, and EBP are detailed. Biblical foundations for research and the Bible's relevance to modern research methods are discussed.
Persevering in Nursing with Godly Purpose
Authors: Biber Duke 
Published: March 2023

ABSTRACT:
COVID-19 impacted the psychological and spiritual wellness of healthcare providers, in addition to their physical health. Christian nurses must continue to look for reassurance of God's provision and control of circumstances as a means of coping through adversity in their work. Practical Scripture applications are provided to sustain nurses' resilience and encouragement.
The Presence of Implicit Gender Bias in Colon and Rectal Surgery Residency Letters of Recommendation
Authors: Al Jabri Ali , Bhat Hina , Abelson Jonathan S. , Breen Elizabeth M. , Kuhnen Angela H. , Stein Sharon L. , Steinhagen Emily , Saraidaridis Julia T. 
Published: March 2023

BACKGROUND:
Selection for colorectal surgery residency relies upon letters of recommendation for subjective assessment of candidates’ strengths and weaknesses. It is unclear if this process incorporates implicit gender bias.

OBJECTIVE:
To assess the presence of gender bias in letters of recommendation for colorectal surgery residency.

DESIGN:
Mixed methods assessment of the characteristics described within the blinded letters of the 2019 application cycle to a single academic residency.

SETTINGS:
Academic medical center.

PATIENTS/STUDY SUBJECTS:
Blinded letters from the 2019 colorectal surgery residency application cycle.

INTERVENTIONS:
Characteristics of the letters were determined using qualitative and quantitative measures.

MAIN OUTCOME MEASURES:
Association of gender with the presence of descriptors within the letters.

RESULTS:
There were 111 applicants, 409 letter writers, and 658 letters were analyzed. 43% of applicants were female. Female and male applicants had equal mean number of positive (5.4 vs. 5.8; p = 0.10) and negative (0.5 vs. 0.4; p = 0.07) attributes represented. Female applicants were more likely to be described as having poor academic skills (6.0 vs. 3.4%, p = 0.04) and possess negative leadership qualities (5.2% vs. 1.4%; p < 0.01) than male applicants. Male applicants were more likely to be described as being kind (36.6% vs. 28.3%; p = 0.03), curious (16.4% vs. 9.2%; p = 0.01), possessing positive academic skills (33.7% vs. 20.0%; p < 0.01), and positive teaching skills (23.5% vs. 17.0%; p = 0.04).

LIMITATIONS:
This study analyzed a single year of applications to an academic center and may not be generalizable.

CONCLUSION:
There are differences in the qualities used to describe female versus male applicants in colorectal surgery residency application letters of recommendation. Female applicants were more often described in negative academic terms and possessing negative leadership qualities. Males were more likely to be described as kind, curious, academically impressive, and possessing good teaching skills. The field may benefit from educational initiatives to reduce implicit gender bias in letters of recommendation.
Combined Endoscopic Robotic Surgery for Complex Colon Polyps
Authors: Broome Jacob M. , Coonan Erin E. , Jones Austin T. , Zelhart Matthew D. 
Published: March 2023

BACKGROUND:
Combined endoscopic robotic surgery is a surgical technique that modifies traditional endoscopic laparoscopic surgery with robotic assistance to aid in the removal of complex colonic polyps. This technique is previously described in the literature but lacks patient follow-up data.

OBJECTIVE:
This study aimed to evaluate the safety and outcomes of combined endoscopic robotic surgery.

DESIGN:
A retrospective review of a prospective database.

SETTING:
East Jefferson General Hospital, Metairie Louisiana

PATIENTS:
The ninety-three consecutive patients who underwent combined endoscopic robotic surgery by a single colorectal surgeon from March 2018 to October 2021.

MAIN OUTCOME MEASURES:
Operative time, intraoperative complication, 30-day postoperative complication, hospital length of stay, and follow-up pathology report results.

RESULTS:
Combined endoscopic robotic surgery was completed in 88 of 93 (95%). Among the 88 participants who completed combined endoscopic robotic surgery, the average age was 66 years (standard deviation = 10), body mass index was 28.8 (standard deviation = 6), and history of previous abdominal surgeries was 1 (standard deviation = 1). Median operative time and polyp size were 72 minutes (range 31-184 minutes) and 40 millimeters (range 5-180 millimeters), respectively. The most common polyp locations were the cecum, ascending, and transverse colon (31%, 28%, 25%). Pathology mainly demonstrated tubular adenoma (76%). Data on 40 patients that underwent follow-up colonoscopy was available. The average follow-up time was 7 months (range 3-22 months). One patient (2.5%) had resection site polyp recurrence.

LIMITATIONS:
Limitations for our study include a lack of randomization and follow-up rate to assess for recurrence. The low compliance rate may be due to patient reluctance to get a colonoscopy or procedure cancelations/difficulty scheduling due to changing COVID-19.

CONCLUSION:
Compared to literature-reported statistics for its laparoscopic counterpart, combined endoscopic robotic surgery was associated with decreased operation times and resection site polyp recurrence.
The Learning Curve for Advanced Endoscopy for Colorectal Lesions: A Surgeon’s Experience at a High-Volume Center
Authors: Giugliano Danica N. , Feinberg Adina E. , Sapci Ipek , Ozgur Ilker , Valente Michael A. , Steele Scott R. , Gorgun Emre 
Published: March 2023

BACKGROUND:
Advanced endoscopy can be utilized for complete removal of large colorectal polyps. To date, few surgeons perform advanced endoscopy, and it is unknown how many procedures are needed to reach proficiency.

AIM:
To determine the learning curve for colorectal advanced endoscopy.

DESIGN:
Retrospective.

SETTING:
Tertiary referral center.

PATIENTS:
We queried a prospectively maintained institutional database of advanced endoscopy performed by a high-volume colorectal surgeon between 2011 and 2018.

MAIN OUTCOME MEASURES:
Advanced endoscopy characteristics were compared for 6 chronological intervals. Primary endpoints were the rates of complications and polyp recurrence. Secondary endpoint was the change in polyp removal rate (mm/hour) over time. Proficiency was defined as achieving low complication and polyp recurrence rates, high en-bloc resection rate, and an efficient removal rate, equivalent to the median polyp size per hour.

RESULTS:
Total of 207 patients underwent advanced endoscopy for a single colorectal polyp. Median polyp size was 30 (4-70) mm, 61.5% were located in right colon, and 8.8% were malignant. Mean procedure time was 77 (range, 16-320) minutes. Immediate colon resection occurred in 25 patients due to suspicion of cancer or concern for perforation and were excluded from learning curve analysis. The remaining 182 advanced endoscopy procedures were divided into intervals of 30 procedures. Median removal rate was highest in the last interval and in the endoscopy suite. A removal rate of 30 mm/hour was achieved after performing 100 cases. Complication rate (bleeding or return to OR) was 12.1% and was similar across intervals. Readmission rate was 11.5%, and 6.6% of 6-month follow-up colonoscopies showed polyp recurrence at the resection site.

LIMITATIONS:
Retrospective design, single surgeon.

CONCLUSION:
The learning curve for achieving proficiency with advanced endoscopy in the colon and rectum requires a minimum of 100 cases with a low complication rate, low polyp recurrence rate, high en-bloc resection rate, and a polyp removal rate of 30mm/hr.
Predictive model for early urosepsis prediction by using systemic inflammatory response syndrome after percutaneous nephrolithotomy
Authors: Jakjaroenrit Nattawit , Tanthanuch Monthira , Bejrananda Tanan 
Published: March 2023

Abstract

Objectives
The aims of the study are to analyze the potential risk factors associated with systemic inflammatory response syndrome after percutaneous nephrolithotomy for renal stones and to establish a predictive model to prevent postoperative early urosepsis postoperative with percutaneous nephrolithotomy and develop a novel nomogram.

Methods
Patients who had undergone percutaneous nephrolithotomy between June 2012 and December 2019 were enrolled and classified into two groups according to their systemic inflammatory response status. Univariable and multivariable logistic regression analyses were performed to identify the predictive factors associated with systemic inflammatory response syndrome after percutaneous nephrolithotomy. The nomograms were developed by using the significant factors, and the discriminative ability was assessed using receiver operating characteristic curve analyses.

Results
Two hundred sixty two patients with renal stones treated with percutaneous nephrolithotomy were enrolled, and systemic inflammatory response syndrome occurred in 117 patients (44%) after percutaneous nephrolithotomy. Multivariable logistic regression analysis revealed that the three factors independently related to systemic inflammatory response syndrome: renal stone size ≥3 cm, positive preoperative urine white blood cells, and positive preoperative urine culture. According to the results, the logistic regression analyses of significant factors were used to develop the nomogram. Developed nomogram prediction model displayed favorable fitting in the Hosmer-Lemeshow test (P = 0.938). Internal validation of the nomogram showed that the area under the receiver operating characteristic curve was 0.702.

Conclusions
Positive preoperative urine white blood cells, positive urine culture, and renal stone size ≥3 cm are the most significant predictors. The novel nomogram helps identify high-risk individuals and facilitates the early detection of systemic inflammatory response syndrome after percutaneous nephrolithotomy.
Comparison of Wound Healing Effect of Skin Micrograft Impregnated into Two Kinds of Artificial Dermis in a Murine Wound Model
Authors: Li Yuanjiaozi , Sakamoto Michiharu , Sawaragi Eiichi , Nakano Takashi , Katayama Yasuhiro , Yamanaka Hiroki , Tsuge Itaru , Morimoto Naoki 
Published: March 2023

Background:A micrograft (MG) suspension produced by the Rigenera protocol has been used to stimulate tissue regeneration. Recently, a combination therapy of an artificial dermis and skin MG has been used to promote angiogenesis and granulation tissue formation in the artificial dermis. There are no reports comparing the differences in MG impregnation efficiency between different artificial dermis products. Therefore, we compared the impregnation of skin MG in Pelnac Gplus and Integra.Methods:Skin MG was prepared from the skin of C57BL/6JJcl mice using Rigeneracons and administered onto Pelnac Gplus and Integra sheets. The amount of MG suspension impregnated in Pelnac Gplus and Integra was evaluated. Pelnac Gplus and Integra sheets combined with MG were applied to murine defects, and wound area, neoepithelium length, granulation tissue formation, and newly formed capillaries were compared with the control groups on days 7 and 14.Results:The weight percentage of the MG absorbed by Pelnac Gplus and Integra was 88.8% ± 3.5% and 28.2% ± 7.0%, respectively (P< 0.05). In the in vivo experiment, the area of newly formed granulation tissue and both the number and area of newly formed capillaries in the PelnacG + MG group were significantly larger than those in the control group at 14 days after implantation (P< 0.05).Conclusions:Skin MG was successfully impregnated into Pelnac Gplus by simple administration but not into Integra. Administration of skin MG into the Pelnac Gplus promoted granulation formation and angiogenesis. Pelnac Gplus was more suitable than Integra in the combination therapy.
Pronator Quadratus: A Preferable Recipient for Targeted Muscle Reinnervation of Neuromas in the Hand
Authors: Felder John M. , Saoud Karim 
Published: March 2023

Summary:
Targeted muscle reinnervation (TMR) has emerged as a useful solution to the problem of painful neuromas and is increasingly being applied in many clinical circumstances. Relatively little has been written about TMR for painful neuromas of the hand, and what has been written describes use of the intrinsic muscles as recipients for the nerve transfer. Except in cases of amputation, intrinsic muscle sacrifice carries morbidity. Furthermore, TMR to intrinsic muscles will place the nerve coaptation in areas subject to pressure with loading of the palm. For these reasons, the pronator quadratus may be a preferable target muscle when performing TMR for painful neuromas of the hand. In this report, we describe the rationale for its use and demonstrate the surgical technique and outcomes with case examples.