Initial Success Research Articles

Assessment of Anti-oxidative, Anti-inflammatory, and Anti-cancer Activity of Magnesium Oxide Doped Chitosan/Polyvinyl Alcohol With Catharanthus roseus: An In Vitro Study.

Background Recent biomedical research has emphasized the potential of biocomposite materials for medicinal purposes. This work investigates the combination of magnesium oxide (MgO)-doped chitosan and polyvinyl alcohol (PVA) with extracts from Catharanthus roseus, a medicinal plant renowned for its abundant alkaloid content and therapeutic advantages. The antioxidant, anti-inflammatory, and anti-cancer characteristics of this unique biocomposite material are being studied better to understand its prospective uses in biomedicine. Aim The goal of this study is to investigate the in vitro oxidative, anti-inflammatory, and anti-cancer properties of a biocomposite made of MgO-doped chitosan and PVA, combined with an extract from C. roseus. Materials and methods The biocomposite was made by blending chitosan and PVA in equal proportions and adding MgO nanoparticles to C. roseus extract. The surface morphology was analysed using scanning electron microscopy (SEM). The antioxidant activity was measured using the H2O2 test, the anti-inflammatory activity was identified using the egg albumin assay, and the anti-cancer activity was analyzed using the MTT assay on MCF-7 breast cancer cell lines. In addition, cell morphology investigations were performed to evaluate any alterations after treatment. Results The SEM investigation showed clearly defined and sleek nanoparticles. The biocomposite demonstrated notable antioxidant activity, with inhibition percentages escalating in proportion to the concentration. The anti-inflammatory assays demonstrated inhibition percentages comparable to diclofenac, reaching approximately 90% at the maximum concentration. The MTT experiment revealed that the viability of MCF-7 cells decreased in a manner that was dependent on the dose administered. The IC-50 value, which represents the concentration required to inhibit 50% of cell viability, was determined to be 60 µg/mL. The morphological examinations demonstrated cytotoxic effects, such as cell shrinkage and membrane blebbing, which indicate the successful initiation of apoptosis. Conclusion The biocomposite of chitosan/PVA doped with MgO, combined with C. roseus extract, has shown significant antioxidant, anti-inflammatory, and anti-cancer characteristics. These findings indicate that it has the potential to be used in therapy, particularly for treating illnesses related to oxidative stress, inflammatory disorders, and cancer. Future research should focus on improving formulation and delivery systems for therapeutic applications, with the support of in vivostudies and clinical trials.

Therapeutic Potential of Molsidomine-Loaded Liquid Crystal Nanoparticles for the Treatment and Management of Niacin-Induced Varicose Veins: In Vitro and In Vivo Studies.

Varicose vein therapy has historically relied significantly on invasive surgical procedures, which frequently resulted in poor compliance among patients. The tendency could stem from the past use of abrasive surgical procedures and a lack of documented drug-induced animal models. To address this challenge, we envisaged an innovative approach for animal model development that uses niacin-induced recurrent flushing. And to further treat the condition, we used liquid crystal nanoparticles (LCNPs) as carriers for the antiangiogenic, cardio protective, and anti-inflammatory drug molsidomine. After the successful initiation of reticular perforant varicose veins, the animals were administered and treated with molsidomine-loaded liquid crystal nanoparticles (MD-LCNPs) that were simultaneously synthesized via a straightforward homogenization method. The preparation of MD-LCNPs involved inducing the disruption of a cubic-phase gel of glyceryl monostearate (GMS) by Milli-Q water in the presence of a Tween-80. Characterization of MD-LCNPs encompassed an assessment of their physicochemical properties. Microscopic studies revealed monodispersity with an average size of 195 ± 55.94 nm. In vitro evaluations demonstrated commendable antioxidant potential, excellent swelling behavior, and sustained release behavior of MD-LCNPs. Furthermore, MD-LCNPs exhibited nontoxicity toward cells, with minimal generation of reactive oxygen species (ROS) or nitric oxide (NO). Histopathological and hematological analysis indicated the efficacy of MD-LCNPs in ameliorating niacin-induced varicose veins, the absence of detrimental and toxic effects on blood cells and visceral organs, and safety for intravenous administration. Following the administration of nanoparticles, the formulation demonstrated appropriate levels of prostaglandins (PGDs), vascular cell adhesion molecule-1 (VCAM-1), intercellular adhesion molecule-1 (ICAM-1), and vascular endothelial growth factor (VEGF). This substantiates the formulation's suitability for the treatment and management of varicose veins. In conclusion, our work shows an efficient method that induces varicose veins in rodents, and also a promising nanocarrier-based drug delivery approach using MD-LCNPs for effective and safe varicose vein therapy.

Brain Mappers of Tomorrow: An international multilingual initiative for neuroscience dissemination

The initiative “Brain Mappers of Tomorrow” coordinated by the Organization for Human Brain Mapping (OHBM) Diversity and Inclusivity Committee (DIC) aims to make neuroscience accessible to children worldwide, particularly those from historically underrepresented backgrounds. Over the past several years, this successful initiative has grown and evolved, offering live reviews of scientific papers tailored for children in multiple languages. These live review events have seen exponential growth, engaging over 1,000 children in 2023 alone. Through partnerships and innovative strategies, the initiative has successfully reached diverse audiences, fostering curiosity and critical thinking in young minds. Although some challenges remain, including recruiting scientists and participants from underprivileged communities, ongoing efforts strive to overcome these barriers. The success of “Brain Mappers of Tomorrow” demonstrates the potential for similar initiatives across scientific disciplines, emphasizing the importance of diversity and inclusivity in science education and outreach. Such efforts can foster positive impacts at multiple levels, from individuals (children and presenters) to global society. This editorial highlights the benefits and challenges of such initiatives, shares experiences and resources to assist other scientific communities in launching similar endeavors, and discusses future directions.

Uncovering student profiles. An explainable cluster analysis approach to PISA 2022

Educational data mining (EDM) applied to the wealth of data generated from international large-scale assessments (ILSAs) shows potential for identifying successful educational initiatives. Despite limited research on clustering methods in ILSAs, leveraging these methods to uncover student profiles can help decision-making in designing tailored programs. This study aims to identify and characterize 15-year-old student profiles using PISA 2022 data and reveal insights into the relationship between these profiles and factors such as ICT availability and use, gender, academic performance, and educational expectations. We analyzed PISA 2022 Spanish student data (n = 30,800) with a selection of 74 contextual variables, applying an end-to-end explainable cluster analysis methodology that integrates different machine learning (ML) and explainable artificial intelligence (XAI) techniques. This methodology covered data pre-processing, dimensionality reduction, clustering, and classification to ensure data quality and result explainability. We obtained 16 derived variables, 7 student clusters, and an optimal XGBoost classifier with a global accuracy of 0.8643. Using local and global SHAP values, we interpreted clusters, finding that socio-economic status and ICT availability and use at home are the most important factors differentiating student profiles. Our findings suggest the need to emphasize (i) proper ICT accessibility and use, as well as student support networks to improve academic performance, (ii) gender-specific well-being programs, and (iii) the encouragement of educational expectations tailored to students’ gender and their exposure to higher education. These results pave the way for personalized academic policies and programs through ML-based tools for uncovering student profiles.

Uncovering the coronavirus outbreak: present understanding and future research paths.

The review discusses the pathophysiological mechanisms of SARS-CoV-2, the modes of transmission, and the long-term health consequences of COVID-19, emphasizing the importance of research and successful public health initiatives. COVID-19 taxonomy, pathophysiology, symptomatology, and epidemiological importance are the key objects of this research paper. This review explains how COVID-19 affects different systems of the body, including respiratory, cardiovascular, and reproductive systems of the human body. It describes the modes of entry of the virus into the cell; more precisely, ACE2 and TMPRSS2 in viral entry. In addition, the present study analyzes the situation of COVID-19 in India regarding vaccine development and the transmission rate related to socioeconomic factors. The manifestation of COVID-19 presents a lot of symptoms and post-acute problems, issues which are seriously impacting mental health and physical health as well. The present review summarizes current research into pathogenicity and the mode of virus transmission, together with immunological responses. Coupled with strong vaccination programs, public health initiatives should hold the key to fighting this pandemic. Long-term effects and the development of treatment methods will need further study, as ambiguities on COVID-19 remain. Multidisciplinary collaboration across healthcare sectors in this respect is of paramount importance for the prevention of further spread and protection of public health.

Social technology and people's mental health: informal work in an urban context

This article presents the experience of implementing the Health Promotion Extension Project through Social and Mental Health Education through Applied Technology, that is, Plant Biotechnology applied as a resource for Eco-Socio-Environmental Technology products. Aimed at members of indigenous peoples and ethnic groups in Rio de Janeiro, users of the Environmental Health, Parasitology and Bioethics Project (SAPB-LIPAT/FF/UFRJ), the project was carried out in an intersectoral partnership with the Laboratory for Studies on Aging Processes (PROVE/IPUB/UFRJ) and the Amazon Biobusiness Center (CBA), in a multi, inter and transdisciplinary approach. The article discusses the importance of social actors in the operationalization of public policy guidelines, with a focus on the promotion and defense of human rights, especially with regard to the right to work. The participation of the Sateré-Mawé and Tukano indigenous people was highlighted, demonstrating the leading role of these groups in solving local problems, which strengthened their cultures, worldviews and self-direction, demystifying attitudinal barriers. The present study was initiated through anamnesis in ethnopsychiatry (whose approach includes cultural anthropology). This study included the participation of these individuals from indigenous peoples and other peoples in an urban context in Rio de Janeiro, demonstrating how the anamnesis of unique ethnographic narratives favored investment in local study and work with elements of their cultures, reinforcing social ties and civic contribution. The project also explored procedures in plant biotechnology, specifically the ecophysiology of Euterpe oleraceae (Açaí) seeds, to analyze the desired biological effects of plant extracts of ethnic origin (Euphorbia tirucalli, Bixa orellana, Punica granatum and Tagetes erecta). Only E. tirucalli exerted antifungal action on the seeds used for informal work (crafts). In this way, equity of access and mental health were promoted through listening, but also through the resolution of concrete local problems, in a simple and viable way, maintaining the participation and autonomy of the participants through informal work. However, the expansion of this small and successful initiative depends on the engagement of a greater number of professionals, teachers and public managers committed to promoting dignity through work for these populations.

Abstract A069: Development of an AAV-mediated GEM model to investigate the impact of age on pancreatic tumorigenesis

Abstract Much of our understanding of PDAC initiation comes from Genetically Engineered Mouse (GEM) models where a pancreas-specific Cre (such as Pdx- or p48-Cre) drives expression of specific mutations. While these GEM models generally recapitulate the key histopathological features of human PDAC, they have limitations when it comes to studying the impact of age on PDAC initiation since the Cre drivers induce recombination at the embryonic stage. This is an important consideration since in humans the disease manifests later in life, with the median age at diagnosis being 70 years old. Here, we describe the development of an intrapancreatic injection model using adeno-associated virus (AAV) to study how age influences PDAC initiation and the dynamics of tumor progression. This new viral transduction-based mouse model employs AAV-Cre to induce expression of an oncogenic KRasG12D allele together with a Trp53R172H tumor suppressor mutation within the pancreata of mice at different ages. Our approach utilizes mice with the genotype LSL-KrasG12D; LSL-Trp53R172H that are injected with different AAV-Cre directly into the parenchyma of the pancreas. In our initial studies, we used rAAV vectors expressing Cre recombinase and EGFP (AAV-Cre-EGFP) into young mice (10-14 weeks old) and older mice (32 weeks old) and analyzed EGFP expression using IVIS imaging and immunohistochemistry (IHC) at various timepoints post-injection. To evaluate tumor initiation, we assessed the extent of PanIN lesion formation using H&E staining. Our preliminary findings indicate that AAV-Cre-EGFP effectively transduces cells in vivo and triggers tumor development in the pancreas. To account for potential immunogenicity of the fluorescent protein, we then used rAAV vectors lacking EGFP expression. As controls, we administered identical rAAV vectors to wild-type cohorts matched for age and sex, along with mock injections. Transduction efficiency within the pancreas was determined by evaluating Cre and p53 expression levels, given that the R172H mutation stabilizes the protein. Notably, we found that EGFP is not necessary for either successful transduction or tumor initiation. We are currently evaluating PDAC initiation using a wide spectrum of ages, but our preliminary data using this model suggest that increased age may impact tumor progression, and that this effect may be sex-specific. Our novel AAV-Cre injection model holds promise for investigating age-related aspects of PDAC initiation, and in the future, such approaches could be leveraged to investigate how age impacts the effectiveness of different therapeutic modalities. Citation Format: Karen XD Duong-Polk, Madelaine Neff, Cosimo Commisso. Development of an AAV-mediated GEM model to investigate the impact of age on pancreatic tumorigenesis [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Advances in Pancreatic Cancer Research; 2024 Sep 15-18; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(17 Suppl_2):Abstract nr A069.

Revitalising Rural and Township Youth Ministry in South Africa through Digital Innovation

This article explores the potential of digital innovation in revitalising rural and township youth ministry in South Africa, acknowledging the challenges churches face in engaging their youth in the evolving digital landscape. The study advocatesfor integrating digital platforms to complement physical interactions, emphasising the need for strategies resonating with digitally connected youth. Public theology is introduced as a paradigm encouraging the intertwining of faith with societal needs. Whilerecognising the promise of digital engagement, the article addresses unique challenges in rural areas, proposing solutions such as community access points and partnerships for inclusivity. The collaborative model envisions a hybrid approach, blending physical and virtual interactions through a game-like platform. The methodology involves a comprehensive literature review and cross-sectional analysis of successful digital engagement initiatives, informing a dynamic model. In conclusion, the article arguesthat embracing digital innovation and public theology can bridge traditional and techsavvy preferences, fostering a vibrant youth community with spiritual growth and meaningful societal impact.

Reducing Food Waste Through Choice Architecture: Insights From Denmark, the UK, and San Francisco

Food waste poses significant environmental, economic, and social challenges, with approximately 1.05 billion tonnes wasted globally in 2022, accounting for 19% of available consumable food. This paper explores the effectiveness of choice architecture in reducing food waste, highlighting successful initiatives in Denmark, the U.K., and San Francisco. Denmark’s “Stop Wasting Food” initiative achieved a 25% reduction in food waste through clear labeling and pricing strategies. The U.K.’s “Love Food Hate Waste” campaign reduced household food waste by 21% by providing practical tools and educational resources. San Francisco’s comprehensive waste management program, including mandatory composting and recycling laws, diverted 80% of waste from landfills. The paper suggests that governments and organizations can implement similar strategies, such as regulatory frameworks, public-private partnerships, and consumer education, to reduce food waste. It also identifies areas for further research, including the long-term sustainability of these interventions and their adaptability to different cultural and social contexts. These findings emphasize the importance of innovative approaches through choice architecture to reduce food waste for environmental sustainability and economic efficiency.

Practical pearls for management of cranial injury in the developing world.

Traumatic brain injury (TBI) remains a leading cause of morbidity and mortality, with approximately 69million individuals affected globally each year, particularly in low- and middle-income countries (LMICs) where neurosurgical resources are limited. The neurocognitive consequences of TBI range from life-threatening conditions to more subtle impairments such as cognitive deficits, impulsivity, and behavioral changes, significantly impacting patients' reintegration into society. LMICs bear about 70% of the global trauma burden, with causes of TBI differing from high-income countries (HICs). The lack of equitable neurosurgical care in LMICs exacerbates these challenges. Improving TBI care in LMICs requires targeted resource allocation, neurotrauma registries, increased education, and multidisciplinary approaches within trauma centers. Reports from successful neurotrauma initiatives in low-resource settings provide valuable insights into safe, adaptable strategies for managing TBI when "gold standard" protocols are unfeasible. This review discusses common TBI scenarios in LMICs, highlighting key epidemiological factors, diagnostic challenges, and surgical techniques applicable to resource-limited settings. Specific cases, including epidural hematoma, subdural hematoma, subarachnoid hemorrhage, and cerebrospinal fluid leaks, are explored to provide actionable insights for improving neurosurgical outcomes in LMICs.

Knowledge, Attitude, and Practice of Health Care Professionals Toward Breastfeeding

Successful initiation and continuation of breastfeeding is proportionate to the attitude and knowledge of health care professionals toward breastfeeding; therefore, we conducted a study in Alkhoms district hospital, aimed to evaluate knowledge, attitude and practices of health care professionals toward breastfeeding. A well-structured questionnaire was designed to test their knowledge on Breastfeeding process, and their ability to deal with different problems and questions that may face during their practice. A total of 155 health care providers participates in this study [72 nurses, 25 midwives, and 58 junior doctors], all of them filled the questionnaire completely and each separately. The study has shown clearly deficiencies of health care providers in some aspects of their knowledge on and their abilities to deal with practical problems that may facing the lactating mother.

Valorisation and sensory evaluation of natural colorants for a sustainable food supply

The study explored the potential of several typical Tunisian food plants as sources of natural colorings, focusing on sustainability and ecology. Five common fruits and vegetables were studied: spinach, beetroot, red cabbage, carrot, and turmeric. Their deep pigments, affected by pH, were examined. Red cabbage was found to be the richest in condensed tannins, while turmeric contained the highest levels of anthocyanins. These natural colorings were then incorporated into the formulation of two bakery products, one sweet and the other savory, to give an attractive appearance and stimulate the appetite, as the food industry commonly does with synthetic colorings. Additionally, orange and lemon peels were upcycled by extracting essential oils for analysis. The primary findings indicate that these essential oils are complicated blends of many substances, with monoterpenes and sesquiterpenes being the most prevalent. The last part of this project required using gluten-free flour to make two food products (zouza and ravioli dough), substituting fructose for sucrose, and adding other colorings that had been produced and tested. We also improved the flavor by adding essential oils. Sensory research with sixty unsuspecting panelists revealed that our items were well-liked by all. The result of a very successful initiative is the packaging for these goods and the market research that went into it.

Addressing disaster-related internal displacement through participatory initiatives

One of the most severe consequences of disasters on people's lives is displacement. When their homes or places of habitual residence are too badly damaged, and their support networks or socioeconomic resources do not allow them to repair and stay in disaster-affected areas, they are forced to leave their homes temporarily or forever. In disaster risk reduction practice, it is therefore essential to take displacement in consideration and incorporate measures to prevent it, or mitigate it as much as possible.The Internal Displacement Monitoring Centre (IDMC), which has been recognized by the United Nations as a key provider of data on internal displacement at the global level, started documenting promising and successful initiatives that have managed to do so in various countries and disaster contexts. One of the main takeaways from this research is that participatory approaches that involve affected communities tend to be much more impactful and sustainable than others.From drought-affected communities in sub-Saharan Africa to urban settlements repeatedly ravaged by Monsoon floods in Asia, this brief practitioner article presents selected case studies to show how participation can contribute to overcoming some of the most frequent challenges of prevention and response to disaster displacement around the world.

Community-based natural resource management in Roatan: Strengths and challenges.

This study explored the transformative journey of community-based natural resource management (CBNRM) in the Bay Islands National Marine Park, Honduras, revealing the interplay of cooperation, funding, and communication in fostering successful conservation initiatives. Using a mixed-method approach, we investigated the historical and legislative process and enabling conditions that led to the transition to CBNRM, based on Gruber's 12 key principles. In regards to the present CBNRM system, we looked at its strengths, its challenges, and whether its functioning is seen as satisfying by local resource-users. Findings showed that key CBNRM principles-including an enabling environment, conflict resolution, research-based decision-making, public trust, and monitoring-fostered the transition. Furthermore, satisfaction with reef management and perceived patrol effectiveness, which are pivotal aspects in CBNRM, exceeded 70% in Roatan. Challenges such as strengthening local institutions and enhancing compliance were identified. Nonetheless, co-managers are actively working to resolve these challenges by focusing on enforcement, diverse funding acquisition mechanisms and community participation. The study underscores the pivotal role of local NGOs and collaborative committees in facilitating successful CBNRM. By providing evidence-based insights, we highlight the efficacy of multilevel, co-management models in resource management and emphasize the value of adaptable strategies. These findings contribute to a deeper understanding of CBNRM dynamics in Latin America and the Caribbean, which may ultimately foster successful conservation initiatives in the Global South.

The Role of Technology in Enhancing Work-Study Integration for Chinese Students

The rapid integration of technology into education and the workforce demands innovative approaches in order to the gap between classroom learning and real-world experience. This review paper analyses the growing role of technology in enhancing work-study integration for Chinese students, specifically focusing on virtual internships, online learning platforms, and AI-powered assessments. In the context of higher education, the integration of work and study is one of the key components, as a result of which the students not only study theoretical materials but also receive practical knowledge and first-hand experience. The Chinese students’ perception of technology is of paramount importance because apart from merely creating an integrated relationship between work and study, the latest technological advancements enable an individual to pursue new ways of learning, cooperation, and sharpening particular abilities. This paper reveals the complex nature of technology-related integration between work and in-school study for Chinese learners and contributes to the wider holistic view of education. The analysis of the existing research and successful initiatives coupled with how these technologies facilitate workplace learning, and develop essential skills is core to improving overall work-study experiences for Chinese students.

GeoTraductores: A Collaborative Initiative Democratizing Science Communication in Latin America

AbstractGeoTraductores is an collaborative initiative between Eos, Planeteando, andGeoLatinas that aims to provide Spanish‐speaking communities access to current scientific findings. This goal is accomplished by translating science articles originally published in English on AGU's Eos.org, within their Science News magazine, into Spanish. This cross‐organizational initiative has translated, edited, and published over 150 articles, breaking the language barrier for Spanish‐speaking communities. Our experience since 2020 has allowed us to tailor an efficient co‐production model, which starts with (a) the selection of articles of interest to translate, followed by (b) the translation, reviewing, and editing process by volunteers, and (c) the publication and social media dissemination of the translated article. The tangible impact of GeoTraductores is evident in the substantial surge of visitor traffic to the Eos website between 2020 and 2023, particularly from Latin American countries. Notably, increases exceeding 85% were observed in Colombia, Mexico, and Panama, with 20% or greater growth in Chile, Brazil, Costa Rica, Peru, and Ecuador, confirming the initiative's success in meeting a genuine need. This impact extends globally, with Spain experiencing a 40% increase in visitors. Our co‐production model is possible thanks to the contribution of around 40 GeoTraductores, mainly women (85%), who are native Spanish speakers or bilingual (Spanish and English speaking). These early‐career scientists, through their volunteer work, enhance their bilingual communication skills while breaking down language barriers in science communication. The Eos‐Planeteando‐GeoLatinas co‐production model fosters science democratization for Latin America while promoting diversity, equity, and inclusion in Earth Sciences, one translation at a time.

Integrating Real Estate Investment Environment Indicators with Sustainable Urban Development: An Evaluation Framework for Egyptian new cities

Abstract The decision-making process in real estate investment is strongly linked with economic development and the real estate market, exerting a significant influence on the construction industry. In Egypt, decision-makers often prioritize responding to investment pressures to attract investors and establish projects, neglecting the alignment of investments with the principles of sustainable urban development. This study aims to identify the indicators of real estate investment environment according to the sustainable urban development, enhancing the decision-making process in the urban development of new Egyptian cities. Additionally, the research seeks to show best practices and successful global initiatives that effectively integrate real estate investment environment with sustainable urban development, emphasizing on innovative strategies and policies. The study will conclude indicators that harmonize economic progress with spatial, environmental, and social sustainability to enhance decision-making processes in urban development by adopting a more holistic and inclusive approach.

Strategic leadership and organisational change in distance and e-learning contexts

The rapid expansion of e-learning, accelerated by the COVID-19 pandemic, has reshaped the educational landscape, necessitating strategic leadership and organisational change. This study examines the pivotal role of strategic leadership in navigating the complexities of digital learning environments and driving successful e-learning initiatives. A comprehensive literature review and data analysis were conducted, utilising sources from the US, West African countries, China and other Asian and European nations. The findings highlight the importance of digital competence, visionary leadership and effective change management strategies in implementing e-learning. Challenges such as technology access disparities, digital fluency and integrating interactive learning tools were identified. The emergence of e-leadership, emphasising adaptability and fostering positive digital learning environments, was also noted. Strategic leadership and organisational change are critical in successfully adopting and managing distance and e-learning. Therefore, policy makers should prioritise addressing technology access gaps, enhancing digital literacy and supporting educators and students. Visionary leadership must be cultivated to steer educational institutions through the evolving demands of the 21st century. The study needs longitudinal data on the long-term impact of e-learning on student outcomes to deal with its limitations and thoroughly examine the financial implications of transitioning to e-learning for educational institutions.

From Policy to Practice: Assessing the State Innovation Models Initiative's Early Success in Incorporating Social Determinants of Health in ASCVD Hospitalizations in the United States.

The study examines effects of the CMS State Innovation Models(SIM) on capturing social risk factors in adults hospitalized with Atherosclerotic Cardiovascular Disease (ASCVD). Using a difference-in-differences(DID) approach with propensity score weights, the study compared documentation of secondary diagnosis of SDOH/social factors using ICD-9 V codes ("SDOH codes") in adults hospitalized with ASCVD as a primary diagnosis (N= 1,485,354). Data were gathered from January 1, 2010, to September 30, 2015, covering the period before and after the SIM implementation in October 2013. From January 2010 to September 2015, SDOH codes were infrequently utilized among adults with ASCVD(0.55%, 95% CI: 0.43%-0.67%). SDOH codes with ASCVD increased from pre- to post-period in SIM states(0.56% to 0.93%) and comparison states (0.46% to 0.56%). SIM implementation was associated with greater improvement in SDOH codes utilization (adjusted OR 1.30, 95%CI: 1.18-1.43) during ASCVD hospitalizations. The odds of SDOH codes utilization were 86% higher in ED admissions(AOR 1.86, 95%CI: 1.76-1.97) than in routine admissions with ASCVD. Findings were similar when limiting population to older adults(>=65 years) enrolled in Medicare(AOR 1.50, 95%CI 1.31-1.71), whereas not significant for Medicaid beneficiaries. The study points to challenges for healthcare providers in documenting SDOH in adults with ASCVD.

Decreasing Invasive Urinary Tract Infection Screening in a Pediatric Emergency Department to Improve Quality of Care.

Obtaining urine samples in younger children undergoing urinary tract infection (UTI) screening can be challenging in busy emergency departments (EDs), and sterile techniques, like catheterization, are invasive, traumatizing, and time consuming to complete. Noninvasive techniques have been shown to reduce catheterization rates but are variably implemented. Our aim was to implement a standardized urine bag UTI screening approach in febrile children aged 6 to 24 months to decrease the number of unnecessary catheterizations by 50% without impacting ED length of stay (LOS) or return visits (RVs). After forming an interprofessional study team and engaging key stakeholders, a multipronged intervention strategy was developed using the Model for Improvement. A urine bag screening pathway was created and implemented using Plan, Do, Study Act (PDSA) cycles for children aged 6 to 24 months being evaluated for UTIs. A urine bag sample with point-of-care (POC) urinalysis (UA) was integrated as a screening approach. The outcome measure was the rate of ED urine catheterizations, and balancing measures included ED LOS and RVs. Statistical process control methods were used for analysis. During the 3-year study period from January 2019 to June 2022, the ED catheterization rate successfully decreased from a baseline of 73.3% to 37.7% and was sustained for approximately 2 years. Unnecessary urine cultures requiring microbiology processing decreased from 79.8% to 40.7%. The ED LOS initially decreased; however, it increased by 17 minutes during the last 8 months of the study. There was no change in RVs. A urine bag screening pathway was successfully implemented to decrease unnecessary, invasive catheterizations for UTI screening in children with only a slight increase in ED LOS. In addition to the urine bag pathway, an ED nursing champion, strategic alignment, and broad provider engagement were all instrumental in the initiative's success.