Quality Improvement Research Articles

Therapeutic efficacy and pharmacological mechanism of Bailing capsule on chronic obstructive pulmonary disease: a meta-analysis and network pharmacology

Context Bailing capsule, derived from Cordyceps sinensis (Berk.) Sacc. (Clavicipitaceae), has shown potential in the treatment of chronic obstructive pulmonary disease (COPD), a prevalent respiratory disorder. Objective This study elucidates the efficacy and mechanism of action of the use of Bailing capsules in the treatment of COPD using meta-analysis and network pharmacology. Materials and methods A meta-analysis of randomized controlled trials (RCTs) was performed. The treatment group received Bailing capsules alongside standard therapy, while the control group received standard therapy or in combination with other traditional Chinese medicines. Efficacy outcomes included lung function, exercise tolerance, acute exacerbation risk, and quality of life. Network pharmacology and molecular docking identified key targets of Bailing capsules. Results The meta-analysis of 27 RCTs showed significant improvements in the treatment group for forced expiratory volume in 1 s (FEV1), FEV1/FVC ratio, and the 6-min walk test (6MWT). Additionally, there was a marked reduction in acute COPD attacks and an improvement in quality of life. Meanwhile, network pharmacological analysis identified SRC, HIF1A, NFKB1, HDAC2, and PRKACA, as the potential core targets for Bailing capsules in the treatment of COPD. Discussion and conclusion Bailing capsules have shown promising results in the treatment of stable COPD. Future studies should focus on large-scale, multicenter RCTs to confirm the long-term benefits and safety of Bailing capsules.

Patient safety and quality improvement education in dermatology residency programs: a nationwide survey of program directors.

Patient Safety and Quality Improvement (PSQI) are key components of graduate medical training, as detailed by the Accreditation Council for Graduate Medical Education (ACGME), with specific requirements that residents participate in experiential learning in PSQI during residency training. This study aimed to analyze the breadth of available and required PSQI educational experiences across dermatology residency programs in the United States. The objective of this study was to characterize the scope of PSQI educational experiences across dermatology residency programs. We electronically surveyed program directors of all ACGME-accredited dermatology residency programs from September 2023 to March 2024. Responses to the survey were anonymously collected with Research Electronic Data Capture (REDCap). Of the 145 dermatology programs surveyed, 37 program directors responded (25.5%). 89.2% of programs reported requiring residents to participate in PSQI educational experiences, with the most common being participation in a resident-led QI project (70.3%), which was also the most commonly available experience (91.2%). The least common required experience was observed simulated patient safety events and analyses. 83.8% of programs reported formal mechanisms to assess residents' competency in QI. This study highlights variation in PSQI experiences within dermatology residency programs across the United States. More than 10% of surveyed programs reported no required QI experiences during residency training despite ACGME program requirements. Additional gaps include variation in assessment of resident PSQI competencies. This study provides insight on the current landscape of PSQI education across dermatology residency programs and identifies opportunities to strengthen dermatology programs' PSQI educational offerings.

Virtual practice facilitation as an implementation strategy for launching opioid safety committees for quality improvement in primary care: feasibility, acceptability, and intervention fidelity

BackgroundPractice facilitation (PF) is an evidence-based multicomponent in-person implementation strategy. COVID-19-related lockdowns caused many implementation initiatives to rapidly shift to virtual settings, but there is limited evidence on PF deployed exclusively using virtual meeting platforms. Our objective was to assess the feasibility and acceptability of virtual PF used in a primary care setting to implement interdisciplinary opioid safety committees (OSCs) to improve care for patients using opioid medicines for persistent pain and reduce high-dose opioid prescribing. We also describe alignment of virtual PF with the core functions of PF and fidelity of participating clinics to the OSC intervention.MethodsWe applied qualitative and quantitative methods to evaluate virtual PF used to implement a quality improvement project at Kaiser Permanente Washington, an integrated health system in Washington State. We established interdisciplinary OSCs in primary care clinics using virtual PF. OSCs were tasked with promoting opioid safety and high-quality pain care through population management and chart reviews. We used administrative data to calculate feasibility measures including attendance and retention. Acceptability data came from interviews with OSC members conducted by evaluators. Measures of fidelity to the OSC intervention were abstracted from meeting notes and administrative data. We used qualitative methods to assess the adherence of virtual PF to the core functions of PF.ResultsFacilitators carried out a comprehensive PF approach virtually and demonstrated adherence to the core functions of PF. We established OSCs in eight clinics and conducted an average of 17.5 virtual PF meetings over eight months of PF for each clinic. Average attendance was 75% and we had 84% retention. OSC members were highly satisfied with virtual PF. Facilitators effectively supported teams through implementation and technical challenges and OSC members gained skills through virtual PF. We implemented OSCs with high fidelity, suggesting virtual PF is an effective implementation strategy.ConclusionsWe found virtual PF is a feasible and acceptable implementation strategy for this intervention and identified strategies to support care teams through challenges. Our findings can help inform future implementation efforts, especially those hoping to engage geographically dispersed clinics or remote clinical staff.Trial registrationNot applicable.

The Physicochemical Properties and Structure of Mung Bean Starch Fermented by Lactobacillus plantarum

Understanding the relationship between gel formation and the hierarchical structure of mung bean starch fermented by Lactobacillus plantarum has potential value for its green modification and quality improvement. The variations in characteristics, including gelation characteristics, starch chain, and the molecular order degree of mung bean starch fermented by different L. plantarum, were compared. The results show that in the gelation process, starch began to disintegrate at 65 °C, indicating a critical temperature for structural changes. Compared with the control group, although the effects of different L. plantarum sources on mung bean starch varied, notable improvements were observed in water absorption across all groups of fermented starch, along with reduced free water-soluble substances and enhanced anti-expansion ability. This led to the easier formation of gels with higher viscosity, primarily attributed to decreased crystallinity, increased short-chain amylopectin tendency, an elevated amylose content, and enhanced short-range order when microorganisms acted on the crystallization zone. In conclusion, although L. plantarum came from different sources, its action mode on mung bean starch was similar, which could enhance the gel structure.

A 5-Year retrospective analysis of adverse events in dentistry at the Dental Hospital, Faculty of Dentistry, Chulalongkorn University

BackgroundPatient safety is a critical concern in dentistry. Adverse events (AEs) can harm patients, increase costs, and decrease satisfaction. Understanding AE types and frequencies is crucial for effective risk management and quality improvement. This study analyzes incident reports to identify preliminary incident patterns as a starting point for developing risk management strategies. However, under-reporting limits the ability to identify true incident patterns, highlighting the need for improved reporting systems and encouragement of incident reporting. Further research is underway to develop such a system and promote reporting to ensure sufficient data quality for effective risk management.MethodsA retrospective analysis of 1,618 incident reports from December 2018 to August 2023 was conducted. A validated classification system, developed from a 5-year retrospective analysis and approved by 14 experts, categorized patient safety incidents, aligning with Thailand’s Hospital Accreditation standards. Descriptive statistics summarized AE frequency and distribution.ResultsOf the reports, 752 were patient safety, 503 personnel safety, and 363 organizational safety incidents. Top patient safety incidents included medical record errors (176), accidental damage (66), post-operative complications (65), medical emergencies (64), and communication errors (53). Personnel safety incidents involved inappropriate working conditions (135) and work-related injuries with contact transmission risk (117). Organizational safety incidents mainly concerned policy and operational processes (131).ConclusionsThis study reveals the preliminary patterns of adverse events (AEs) in dental settings and underscores the limitations due to under-reporting, which affect the ability to fully understand true incident patterns. To effectively manage risks, there is a critical need for improving the existing incident reporting system and encouraging a culture of comprehensive reporting among dental professionals. Future efforts should focus on enhancing reporting systems to ensure high-quality data, enabling better identification of incident trends and supporting targeted risk management strategies to improve patient safety in dentistry.

Transvaginal posterior levatorplasty and perineoplasty for female primary stress urinary incontinence: 12-month follow-up and technical presentation

ObjectiveTo investigate the feasibility of transvaginal posterior levatorplasty combined with perineoplasty (TPLP) for women with primary stress urinary incontinence and demonstrate the surgical technique with step-by-step procedures.MethodsA prospective, non-randomised study was conducted using technique of TPLP to treat female primary SUI from January 2019 to December 2021. Patient follow-up was performed at 3 and 12 months posteroperatively. A series of validated questionnaires were used to evaluate the improvement of symptom severity, sexual function and quality of life. In addition, 4-D ultrasonography was used to measure the anatomic changes of pelvic structures.ResultsA total of 47 patients were enrolled in this study with a mean age of 43.6 years. Mean operative time was 78.7 min. Median estimated intraoperative blood loss was 80.2 ml. Objective cure and subjective cure rates were 87.2% and 91.5%, respectively. Compared with baseline, scores of quality of life, symptom severity and sexual function improved after surgery. Meanwhile, mobility of the urethra and bladder neck and areas of levator hiatus were decreased after surgery. Mild coitus pain was reported in 15.4% (6/39) patients at the initial several times of intercourse after resuming sexual activity.ConclusionsThis study shows that transvaginal posterior levatorplasty combined with perineoplasty appears to be an effective surgical method for selected women with primary stress urinary incontinence.

The NAD+ precursor nicotinamide riboside protects against postovulatory aging in vitro.

Postovulatory aging (POA) of oocytes is clinically significant as it mirrors the degeneration observed in maternally aged oocytes, leading to substantial impairments in oocyte quality and the success rates of artificial reproductive technology (ART). The molecular alterations associated with POA, such as the degeneration of the first polar body, an increase in perivitelline space, reactive oxygen species (ROS) accumulation, energy depletion, and chromosomal and DNA damage, underscore the urgency of finding interventions to mitigate these effects. This study aims to identify whether nicotinamide riboside (NR) can prevent POA during the process of in vitro culture and raise the success rates of ART. Taking advantage of an in vitro postovulatory oocyte aging model, we examined the morphological integrity and NAD+ levels of ovulated mouse MII oocytes after 24h of culturing. Following in vitro fertilization, we assessed the embryonic developmental potential of oocytes affected by POA. Using immunofluorescence and confocal microscopy, we measured the levels of ROS, mitochondrial function, and γH2AX. We also evaluated spindle assembly and chromosome alignment. Additionally, we detected the distribution of cortical granules to assess the metabolic and quality changes in POA oocytes with the supplementation of NR. To further our analysis, quantitative real-time PCR was conducted to measure the mRNA expression levels of antioxidant enzymes Sod1 and Gpx1 in the oocytes. With 200μM NR supplementation during in vitro culture for 24h, the oocytes from POA demonstrated reduced signs of aging-related decline in oocyte quality, including reduced ROS accumulation, improved mitochondrial function, and corrected mis-localization of cortical granules. This improvement in oocyte quality is likely due to the inhibition of oxidative stress via the NAD+/SIRT1 signaling pathway, which also helped to restore normal spindle assembly and chromosome alignment, as well as reduce the elevated levels of γH2AX, thereby potentially enhancing the embryonic development potential. Current research provides evidence that NR is an efficient and safe natural component that prevents the process of POA and is thus a potential ideal antiaging drug for raising the success rates of ART in clinical practice.

D-Band 4.6 km 2 × 2 MIMO Photonic-Assisted Terahertz Wireless Communication Utilizing Iterative Pruning Deep Neural Network-Based Nonlinear Equalization

In this paper, we explore the enhancement of a 4.6 km dual-polarization 2 × 2 MIMO D-band photonic-assisted terahertz communication system using iterative pruning-based deep neural network (DNN) nonlinear equalization techniques. The system employs advanced digital signal processing (DSP) methods, including down-conversion, resampling, matched filtering, and various equalization algorithms to combat signal distortions. We demonstrate the effectiveness of DNN and iterative pruning techniques in significantly reducing bit error rates (BERs) across a range of symbol rates (10 Gbaud to 30 Gbaud) and polarization states (vertical and horizontal). Before pruning, at 10 GBaud transmission, the lowest BER was 0.0362, and at 30 GBaud transmission, the lowest BER was 0.1826, both of which did not meet the 20% soft-decision forward error correction (SD-FEC) threshold. After pruning, the BER at different transmission rates was reduced to below the hard decision forward error correction (HD-FEC) threshold, indicating a substantial improvement in signal quality. Additionally, the pruning process contributed to a decrease in network complexity, with a maximum reduction of 85.9% for 10 GBaud signals and 63.0% for 30 GBaud signals. These findings indicate the potential of DNN and pruning techniques to enhance the performance and efficiency of terahertz communication systems, providing valuable insights for future high-capacity, long-distance wireless networks.

WTDUN: Wavelet Tree-Structured Sampling and Deep Unfolding Network for Image Compressed Sensing

Deep unfolding networks have gained increasing attention in the field of compressed sensing (CS) owing to their theoretical interpretability and superior reconstruction performance. However, most existing deep unfolding methods often face the following issues: 1) they learn directly from single-channel images, leading to a simple feature representation that does not fully capture complex features; and 2) they treat various image components uniformly, ignoring the characteristics of different components. To address these issues, we propose a novel wavelet-domain deep unfolding framework named WTDUN, which operates directly on the multi-scale wavelet subbands. Our method utilizes the intrinsic sparsity and multi-scale structure of wavelet coefficients to achieve a tree-structured sampling and reconstruction, effectively capturing and highlighting the most important features within images. Specifically, the design of tree-structured reconstruction aims to capture the inter-dependencies among the multi-scale subbands, enabling the identification of both fine and coarse features, which can lead to a marked improvement in reconstruction quality. Furthermore, a wavelet domain adaptive sampling method is proposed to greatly improve the sampling capability, which is realized by assigning measurements to each wavelet subband based on its importance. Unlike pure deep learning methods that treat all components uniformly, our method introduces a targeted focus on important subbands, considering their energy and sparsity. This targeted strategy lets us capture key information more efficiently while discarding less important information, resulting in a more effective and detailed reconstruction. Extensive experimental results on various datasets validate the superior performance of our proposed method.

Predicting the long-term course: Shunt surgery results in idiopathic normal pressure hydrocephalus-a comprehensive study.

Idiopathic normal pressure hydrocephalus is a neurological disorder primarily affecting the elderly. Shunt surgery is the gold standard treatment, yet long-term outcome remains poorly investigated, especially concerning neuropsychological performance, motor skills and quality of life. This study aimed to evaluate the long-term effects of shunting in iNPH patients up to three years post-surgery. A cohort of 30 patients with iNPH who underwent shunt placement between January 2020 and February 2021 was followed up for three years. A standardized test battery assessed neuropsychological performance, quality of life, and motor skills. The patients were tested before and one, two and three years after surgery. Motor skills, particularly lower body function, significantly improved post-surgery and remained improved even after three years. Upper body motor skills exhibited mixed results, with improvement in manual dexterity but not in finger tapping tests. Neuropsychological assessments revealed sustained improvement in certain aspects up to three years post-surgery, while a various degree of deterioration was observed in others. Quality of life, as measured by the Rankin Scale as well as Stein and Langfitt Grading, showed initial improvement post-surgery but declined over time. iNPH patients demonstrate sustained improvements in motor skills, neuropsychological function and quality of life after shunt surgery. In long-term, motor skill and certain neuropsychological aspects remained improved, quality of life and some other neurocognitive aspects declined progressively over the follow up period.These findings underscore the importance of long-term follow-up and highlight the need for further research to better understand iNPH.

A Biotechnical System for Increasing the Effectiveness of the Pre-Sowing Pulsed Laser Irradiation of Seeds to Increase Sunflower Yield

In this study, we investigated the use of the pre-sowing electrophysical stimulation of seeds, particularly focusing on optimizing technological regimes for enhancing seed quality. The aim of this study was to improve sunflower seed germination utilizing laser optical radiation. The methods explored involved the pre-sowing stimulation of oilseeds and analyzing the key mechanisms affecting germination. Through our experimental research, we sought to identify the most effective laser irradiation parameters, ensuring the maximum seed quality improvement with minimal energy use. Using seeds of the first reproduction, we employed artificial aging to simulate a reduced seed quality and determined optimal irradiation regimes. Standard methods were followed to assess seed quality before and after irradiation, with 6–7 days of further exposure. Seed germination was carried out under controlled light and temperature conditions using the “on paper” method with paper napkins. A full factorial experiment was performed and key parameters for laser irradiation were determined, confirming that the pre-sowing laser pulse treatment significantly improved seed quality. In this research, we developed a biotechnical system for processing seeds and propose a method to adjust irradiation parameters based on the initial seed quality. The system effectively enhanced germination and crop yield, offering a reliable solution for improving sunflower seed productivity through laser treatment.

THE INFLUENCE OF SERVICE QUALITY, PRICE PERCEPTION, AND PRODUCT QUALITY FROM PT KERETA API INDONESIA (PERSERO) ON CUSTOMER SATISFACTION AT PT BUKIT ASAM, TBK

This study examines the factors influencing customer satisfaction of PT Bukit Asam, Tbk regarding the services and products provided by PT Kereta Api Indonesia (Persero) for coal transportation. Customer satisfaction is analyzed based on three key factors: service quality, price perception, and product quality, specifically in transporting coal from the Tanjung Enim Mining Unit to Tarahan Port and Kertapati Pier, which accounted for 32,423,156 tons transported in 2023. The research findings indicate that all three factors—service quality, price perception, and product quality—have a positive and significant effect on customer satisfaction. The contribution of this research is twofold: it provides insights into the direct impact of these factors on corporate customer satisfaction and offers practical recommendations for PT Kereta Api Indonesia (Persero) to enhance its service performance, thereby improving its competitiveness in Indonesia's transportation and logistics sector. Future research could focus on additional factors, such as technological innovation and environmental sustainability, and investigate their influence on customer satisfaction across different industries or regions, offering broader insights into service quality improvement in the logistics industry.

Bilateral value chain reshaping through regional trade agreements deepening: Evidence from belt and road countries

This paper investigates the impact of Regional Trade Agreements (RTAs) on the reshaping of value chains from both domestic and regional perspectives by using national-level data from the Belt and Road countries. The findings indicate that the depth of RTAs among Belt and Road countries can not only enhance regional integration characterized by regional value chain inter-connections and promote the value chain upgrading of trading partners in the regional production system, but also facilitates the construction of domestic value chains, thus forming a new pattern of bilateral value chain reshaping. The conclusions still hold after addressing the potential endogeneity and robustness concerns. Mechanism test results show that the effects of productivity enhancement and institutional quality improvement are important channels for RTAs-deepening to promote value chain reshaping. Heterogeneity test results indicate that ‘WTO-X’ provisions of RTAs are more conducive to promoting value chain reshaping, and the promoting effect of RTAs-deepening on value chain reshaping is more significant for the manufacturing industry. These findings have important policy implications to further expand high-level opening-up, deepen RTAs provisions and actively participate in global governance.

ANALYSIS OF PERIODIC SELF-ASSESSMENTS WITHIN THE SCOPE OF HEALTH QUALITY STANDARDS IN TERMS OF MATERIAL MANAGEMENT AS A PREVENTIVE ACTIVITY: A RETROSPECTIVE STUDY IN A UNIVERSITY HOSPITAL

This study aims to investigate the effects of periodic self-assessments on materials management within the framework of quality management in healthcare. The retrospective study, conducted in a university hospital, evaluates the effectiveness of quality improvement initiatives and compliance with health standards, while examining in detail the effects of these processes on materials management. It also investigates how self-assessment processes improve healthcare service delivery and contribute to materials management processes. Problems identified through Fishbone and Pareto analysis are examined, prioritised and solutions are developed. The findings obtained aim to improve material management processes and increase quality standards in health. The main purpose of the research is to examine the effects of periodic self-assessments on materials management in order to improve the quality of healthcare services. The findings emphasise the importance of maintaining quality standards in health services and systematic handling of periodic self-assessments. Problems identified by Fishbone and Pareto analysis are analysed by root cause analysis and solutions are developed. This approach aims to contribute to the development of materials management processes and to the improvement of quality standards in healthcare. The results of the research are an important guide for practitioners, managers and policy makers in the fields of quality management and materials management in health services.

Multi-stage ecological pond and reservoir system to enhance river water quality: demonstration study on Periurban River

ABSTRACT Pollution of urban rivers not only destroys the river ecology but also adversely affects the health of residents and urban landscape. In this regard, we selected a certain river in Wuhan for research. In this paper, we utilize the modified bypass multi-stage ecological pond reservoir system, set up the front parthenogenetic pond, aeration and oxygenation pond, ecological purification pond and other processes, supplemented with aeration–bacteriophage coupling, filler-type ecological floating island and other technologies to improve the water quality of the river. Results show that 4 months after the operation of the system, the rate of enhancement in water transparency reached 550%, and with a dissolved oxygen (DO) uplift rate of 322%, in addition, this system achieved 77.98, 77.78 and 74.41% removal of the ammonia nitrogen (NH3-N), total phosphorus (TP), chemical oxygen demand (COD) respectively, and the effluent water quality meets the target water quality standard. The process not only has a good pollutant removal effect, low cost and other characteristics but also can enhance the river landscape and improve biodiversity. It can provide a reference for similar river pollution water quality improvement.

Specialty-Based Ambulatory Quality Improvement Program: A Specialty-Specific Ambulatory Metric Project.

Healthcare is increasingly being delivered in the outpatient setting, but robust quality improvement programs and performance metrics are lacking in ambulatory care, particularly specialty-based ambulatory care. To promote quality improvement in ambulatory care, we developed an infrastructure to create specialty-specific quality measures and dashboards that could be used to display providers' performance across relevant measures to individual providers and institutional leaders. The products of this program include a governance and infrastructure for specialty-specific ambulatory quality metrics as well as two distinct dashboards for data display. One dashboard is provider-facing, displaying provider's performance on specialty-specific measures as compared to institutional standards. The second dashboard is a leadership dashboard that provides overall and provider-level information on performance across measures. The Specialty-based Ambulatory Quality program reflects a systematic, institutionally-supported quality improvement framework that can be applied across diverse ambulatory specialties. As next steps, we plan to evaluate the program's impact on provider performance across measures and expand this program to other specialties practicing in the outpatient setting.

Using motivational interviewing to improve sleep quality among patients with hypertension attending a tertiary hospital in southern Nigeria: a randomized controlled trial

IntroductionRestorative sleep is essential for the maintenance of overall health and for the prevention of chronic diseases, including hypertension. The aim of this study was to determine the effect of motivational interviewing (MI) on sleep quality in patients with hypertension.MethodsThe study was a randomised controlled trial (PACTR202301917477205) of 250 adult patients aged 18 to 65 years (125 in each group) with hypertension presenting to the Family Medicine Clinics of Irrua Specialist Teaching Hospital, Irrua, Nigeria from April to December 2023. Patients were selected through systematic random sampling and randomised into intervention and control group with the intervention group having monthly sessions of motivational interviewing in addition to standard care for hypertension and the control group having standard care only. Data were analysed with Stata with level of significance set at p < 0.05.ResultsThe participants had a mean age of 51.5 ± 10.0 years, were mostly females 156 (62.4%), married 135 (54.0%), and Christians 134 (53.6%). There was no significant difference in the sleep pattern of both the intervention and control groups (χ2 = 1.111 and p = 0.292) at baseline. Post-intervention with MI, there was a significant improvement in sleep quality (p = 0.002) and a corresponding improvement in blood pressure control (p < 0.001) of patients in the intervention group compared to controls.ConclusionThe use of motivational interviewing led to a significant improvement in sleep quality and a corresponding improvement in blood pressure control. Motivational interviewing should be employed by physicians and other health workers during sleep prescription counselling.

Matching-Adjusted Indirect Comparison of Risankizumab Versus Deucravacitinib in Patients with Moderate-to-Severe Plaque Psoriasis.

Despite advancements in the treatment of psoriasis (PsO), there are few head-to-head studies assessing comparative effectiveness of the newest therapies approved to treat PsO. Our objective was to assess the comparative clinical effectiveness of risankizumab and deucravacitinib in patients with moderate-to-severe PsO. This placebo-anchored matching-adjusted indirect comparison (MAIC) analysis utilized data from UltIMMa-1/2 risankizumab and POETYK PSO-1/2 deucravacitinib trials. Individual patient data from UltiMMA-1/2 were weighted via propensity score to match POETYK PSO-1/2 published summary data. Rate differences between risankizumab and deucravacitinib were assessed for Psoriasis Area and Severity Index (PASI) 75/90/100, the Static Physician Global Assessment (sPGA = 0 or 0/1), and the Dermatology Life Quality Index (DLQI) 0/1. At 16weeks, risankizumab-treated patients demonstrated statistically significantly higher rates of skin clearance and greater improvement in quality of life (QoL) compared to those treated with deucravacitinib. Across all outcomes, risankizumab demonstrated a lower number needed to treat compared to deucravacitinib. Limitations are potential bias due to unobserved/unmeasurable differences and limited generalizability of the results. This indirect comparison demonstrates that risankizumab has higher rates of skin clearance and greater improvements in QoL than deucravacitinib. This study will help inform healthcare providers in their treatment and management strategy of PsO.

Pretesting of Printed Information, Education and Communication Materials among Diabetic Patients who are (30 to 80) Years Old in South Kolkata, at Ward no 144, West Bengal

Background: In India, the (IEC) Information, Education &amp; Communication strategy is designed to enhance public awareness and disseminate crucial information about the various benefits offered under the different schemes and programs initiated by the Ministry. This strategy plays a pivotal role in guiding citizens on effectively accessing these benefits, ensuring that the intended population is well-informed and empowered to take advantage of the available resources. A brief study was conducted to pretest the IEC material related to Diabetes Mellitus in a specific ward in Kolkata, West Bengal, India. Following this, we will evaluate and analyse the IEC material.  Methods: A locality‐based cross‐sectional mix method study was conducted in south Kolkata ward no 144, West Bengal from 10/05/2024 to 31/05/2024.A predesigned pretested semi‐structured questionnaire was used to collect quantitative and qualitative variables. Data were collected through personal face-to-face interviews using Epi‐Collect 5 and analysed using EXCEL and SPSS.  Result: Out of 20 study participants, Cent per cent(20) of study participants voted that the IEC material is attractive. The brochure is interesting enough to attract and hold the attention of the target audience, participants like it. several messages attract the most attention. 95%(19)clearly understand, almost comprehensible. Cent per cent(20) of participants accepted that IEC material is not offensive/inappropriate for the individuals or community. The brochure is perceived by individuals in the target audience. They feel that the brochure is made for themselves or made for those who are suffering from diabetic mellitus. Cent per cent(20) of the IEC material is relevant. Cent per cent(20) target audience opined that call to action regarding pretesting IEC material. The target audience is those suffering from diabetic mellitus and complications. Cent per cent(20) of the brochure can convince the study participants to undertake the desired behaviour.25%(5) target audience opined that brochures regarding diabetic mellitus should be improved.  Conclusion: In this short study, we discovered that the use of (Brochure)IEC materials was affected by a variety of factors. Therefore, essential to focus on these IEC materials and strive for enhancements in their quality. Improving the quality of brochures can lead to better comprehension and engagement among the target audience. By addressing the many specific qualitative variables that influence their effectiveness, we can ensure that these materials serve their intended purpose more effectively. This will not only facilitate better communication but also promote a deeper understanding of the information being conveyed. This brochure(IEC) material could be implemented after the improvement of quality in Kolkata 144 no ward, West Bengal.

Automated Extraction of Stroke Severity From Unstructured Electronic Health Records Using Natural Language Processing.

Multicenter electronic health records can support quality improvement and comparative effectiveness research in stroke. However, limitations of electronic health record-based research include challenges in abstracting key clinical variables, including stroke severity, along with missing data. We developed a natural language processing model that reads electronic health record notes to directly extract the National Institutes of Health Stroke Scale score when documented and predict the score from clinical documentation when missing. The study included notes from patients with acute stroke (aged ≥18 years) admitted to Massachusetts General Hospital (2015-2022). The Massachusetts General Hospital data were divided into training/holdout test (70%/30%) sets. We developed a 2-stage model to predict the admission National Institutes of Health Stroke Scale, obtained from the GWTG (Get With The Guidelines) stroke registry. We trained a model with the least absolute shrinkage and selection operator. For test notes with documented National Institutes of Health Stroke Scale, scores were extracted using regular expressions (stage 1); when not documented, least absolute shrinkage and selection operator was used for prediction (stage 2). The 2-stage model was tested on the holdout test set and validated in the Medical Information Mart for Intensive Care (2001-2012) version 1.4, using root mean squared error and Spearman correlation. We included 4163 patients (Massachusetts General Hospital, 3876; Medical Information Mart for Intensive Care, 287); average age, 69 (SD, 15) years; 53% men, and 72% White individuals. The model achieved a root mean squared error of 2.89 (95% CI, 2.62-3.19) and Spearman correlation of 0.92 (95% CI, 0.91-0.93) in the Massachusetts General Hospital test set, and 2.20 (95% CI, 1.69-2.66) and 0.96 (95% CI, 0.94-0.97) in the MIMIC validation set, respectively. The automatic natural language processing-based model can enable large-scale stroke severity phenotyping from the electronic health record and support real-world quality improvement and comparative effectiveness studies in stroke.