Successful Outcome Research Articles

Обратная связь как инструмент эффективного управления проектами: значимость, методы использования и практические примеры

This article analyzes the importance of feedback in Agile projects, emphasizing its role in improving management processes and motivating personnel. Methods of collecting feedback, such as surveys, meetings, and project data analysis, are discussed. Special attention is paid to practical aspects of giving and receiving feedback, including strategies for effective communication among project participants. Principles of transparency, openness, and respect are discussed in the context of the Agile approach, along with recommendations for developing authentic leadership and building trusting relationships within teams. The influence of feedback on the process of continuous improvement and project refinement is explored. Overall, the article provides an overview of modern methods and practices of using feedback in Agile projects and recommendations for their application to achieve suc-cessful outcomes.

Improved outcomes and cost savings for patients with bleeding disorders: a quality improvement project

BackgroundProviding optimal care for patients with bleeding disorders according to national standards remains a challenge at designated Hemophilia Treatment Centers (HTCs). Improved care may reduce bleeds and costs. ObjectivesTo improve care and demonstrate cost-savings by 1) reducing preventable hospitalizations and ER visits (PHER) for bleeding, 2) increasing use of prophylaxis in severe hemophilia, 3) improving patient-HTC communication and primary care engagement. MethodsProspective quality improvement project using the DMAIC (Define, Measure, Analyze, Improve, Control) methodology to implement uniform guideline-based bleeding disorder care at a rural HTC (N=88). Intervention used a standardized physician checklist, improved communication, and reserved physician time for urgent management. Outcomes were determined by retrospective chart review, urgent management was tracked prospectively. Results and conclusionsIntervention significantly reduced PHER by 85.4%. Use of prophylaxis in patients with severe hemophilia increased from 58.8% to 100%, attainment of a primary care physician and electronic portal enrollment met outcomes for intervention success. HTC clinic visit attendance was low at 55.2%. The majority of patients (71.6%) had at least one outpatient urgent episode (mean 0.72 episode per year), and 93% had non-urgent management (mean 9.3 episodes per year) occurring outside of a clinic visit. Hospital PHER factor cost in the group was reduced by 94.5%, from $11,800 to $640 per patient per year—a cost savings of $982,088 yearly.

Sensor-Based Discovery of Search and Palpation Modes in the Clinical Breast Examination.

Successful implementation of precision education systems requires widespread adoption and seamless integration of new technologies with unique data streams that facilitate real-time performance feedback. This paper explores the use of sensor technology to quantify hands-on clinical skills. The goal is to shorten the learning curve through objective and actionable feedback. A sensor-enabled clinical breast examination (CBE) simulator was used to capture force and video data from practicing clinicians (N = 152). Force-by-time markers from the sensor data and a machine learning algorithm were used to parse physicians' CBE performance into periods of search and palpation and then these were used to investigate distinguishing characteristics of successful versus unsuccessful attempts to identify masses in CBEs. Mastery performance from successful physicians showed stable levels of speed and force across the entire CBE and a 15% increase in force when in palpation mode compared with search mode. Unsuccessful physicians failed to search with sufficient force to detect deep masses ( F [5,146] = 4.24, P = .001). While similar proportions of male and female physicians reached the highest performance level, males used more force as noted by higher palpation to search force ratios ( t [63] = 2.52, P = .014). Sensor technology can serve as a useful pathway to assess hands-on clinical skills and provide data-driven feedback. When using a sensor-enabled simulator, the authors found specific haptic approaches that were associated with successful CBE outcomes. Given this study's findings, continued exploration of sensor technology in support of precision education for hands-on clinical skills is warranted.

Genitourinary Fistula: 5 Years' Experience of Five Referral Centers in Iran.

Genitourinary fistula is a devastating ailment that has an impact on women's physical health, mental health, emotional health, and financial security. The management of genitourinary fistula depends on the type, size, and duration of fistula formation. The purpose of this study is to report the features of genitourinary fistula in Iranian women and our experience in the management of fistula. Retrospective chart reviews of 283 patients were performed to determine the cause of the fistula, prior repairs, tissue interposition, and the success rate. The operation was considered successful if the patient did not have any urine leakage during the observation time. The mean (SD) age of women was 49.51 (19.39; range: 21-70) years, Of these, 137 (52.9%) had a history of previous genitourinary fistula surgery. The average fistula was 1.53 (0.041) cm in size. The median (interquartile range) operation lasted 70 (15) min. The success rate after fistula repair was 91.5%. The typical follow-up period lasted 13.26 (range: 1-88) months. Forty-three (15.2%) patients had a big fistula (>2.5cm) and 4 patients (1.4%) had a history of pelvic radiation therapy, among other reasons for failure. After a second repair, all patients' initial failures were resolved. There were no significant complications, as classified by Clavien-Dindo class 2 or greater. Additionally, there were no bowel, ureteral, or nerve injuries. Our patients with genitourinary fistula had a successful outcome following repair techniques, without any significant morbidity or mortality.

Ensuring timely completion and successful thesis outcomes: a case study of an online GIS master’s degree program

ABSTRACT Master of Science (M.S.) programs, including geography through geographic information science and technology (M.S. GIST), play a key part in training the science, technology, engineering, and math (STEM) workforce. A master’s thesis has been a traditional part of geography programs, and across all kinds of disciplines the value of a thesis is well-recognized. However, delivering master’s thesis supervision for large cohorts may result in lengthy completion times and poor completion rates. A growing literature focuses on master’s thesis supervision across a wide array of disciplines, but no study focuses on the master’s thesis for M.S. GIST programs. We offer a mixed-methods case study of a large, online M.S. GIST program showing how problems developed and were resolved over a 13-year period with program-wide structural reforms. Reform elements included increased attention to writing skills in admissions review, addition of writing instruction, earlier student engagement, staff engagement, faculty engagement, and development of thesis courses. Reforms shortened completion times and increased thesis completion rates while sustaining diversity and quality of thesis projects. Although this case study echoes many strategies found in the literature, it emphasizes that replication likely requires linking solutions together through structural reforms across a master’s degree program.

Sequential composite BIMA grafting for 3v-CAD: factors that predict successful outcome of the one-inflow and two-inflow revascularization techniques.

The effect of one-inflow and two-inflow coronary surgical revascularization techniques inclosing skeletonized double mammary artery (BIMA) as T-graft on outcome is studied. Early ad mid-term outcome of complete BIMA revascularization (C-T-BIMA) versus left-sided BIMA with right-sided aorto-coronary bypass (L-T-BIMA + R-CABG) is quantified and analyzed by multivariate logistic regression, Cox-regression, and Kaplan-Meier analysis in a series of 204 consecutive patients treated for triple-vessel coronary disease (3v-CAD). The L-T-BIMA + R-CABG technique (n = 104) enables higher number of total (4.02 ± 0.87 vs. 3.71 ± 0.69, p = 0.015) and right-sided (1.21 ± 0.43 vs. 1.02 ± 0.32, p = 0.001) coronary anastomoses, improves total bypass flow (125.88 ± 92.41 vs. 82.50 ± 49.26ml, p < 0.0001) and bypass flow/anastomosis (31.83 ± 23.9 vs.22.77 ± 14.23, p = 0.001), and enhances completeness of revascularization (84% vs.69%, p = 0.014) compared to C-T-BIMA strategy (n = 100), respectively. Although the incidence of MACCE was comparable in the two groups (8% vs.1.2%, p = 0.055), the progression of functional mitral regurgitation (FMR) was significantly lower after L-T-BIMA + R-CABG, then after C-T-BIMA (47% vs.64%, p = 0.017). The use of C-T-BIMA-technique (HR = 4.2, p = 0.01) and preoperative RCA occlusion (HR = 3.006, p = 0.023) predicted FMR progression, whereas L-T-Graft + R-CABG technique protected against it (X2 = 14.04, p < 0.0001) independent of the anatomic and clinical complexity (Syntax score I: HR = 16.2, p = 0.156, Syntax score II: HR = 1.901, p = 0.751), of early- (0.96% vs.2%, p = 0.617) and mid-term mortality (5.8% vs.4%, p = 0.748) when compared to C-T-BIMA, respectively. The two-inflow coronary revascularization by L-T-BIMA + R-CABG better protects against FMR progression without increasing MACCE and mortality. Older patients with RCA occlusion and reduced LV-EF benefit most from the two-inflow L-T-BIMA + R-CABG technique. Younger 3v-CAD patients with normal LV-EF can preferentially be managed with the one-inflow C-T-BIMA; however, long-term outcome remains to be revealed.

STING activation reprograms the microenvironment to sensitize NF1-related malignant peripheral nerve sheath tumors for immunotherapy.

Neurofibromatosis Type 1 (NF1) is caused by mutations in the NF1 gene that encodes neurofibromin, a RAS GTPase-Activating Protein. Inactivating NF1 mutations cause hyperactivation of RAS-mediated signaling, resulting in development of multiple neoplasms, including Malignant Peripheral Nerve Sheath Tumors (MPNSTs). MPNSTs are an aggressive tumor and the main cause of mortality in NF1 patients. MPNSTs are difficult to resect and refractory to chemo- and radiotherapy, and no molecular therapies currently exist. Immune Checkpoint Blockade (ICB) is an approach to treat inoperable, undruggable cancers like MPNST, but successful outcomes require an immune cell-rich tumor microenvironment (TME). While MPNSTs are non-inflamed "cold" tumors, here, we turned MPNSTs into T cell-inflamed "hot" tumors by activating "stimulator of interferon genes" (STING) signaling. Mouse genetic and human xenograft MPNST models treated with STING agonist plus ICB exhibited growth delay via increased apoptotic cell death. This strategy offers a potential treatment regimen for MPNST.

Successful Clozapine Rechallenge After Clozapine-Induced Severe Anemia: A Case Report.

Clozapine, a second-generation antipsychotic (SGA), is considered the gold standard medication to treat patients with treatment-resistant schizophrenia (TRS). Despite its efficacy, clozapine is associated with adverse effects, notably neutropenia and agranulocytosis. Other hematological adverse effects are less common. Severe anemia is a rare adverse effect seldom reported in the literature and is typically associated with pure red cell aplasia (PRCA). Nevertheless, the benefits of clozapine in managing TRS make rechallenge a reasonable option. We present the case of a 35-year-old man with TRS, resistant to previous antipsychotics, who experienced severe anemia during clozapine treatment. An investigation for clozapine-induced anemia revealed PRCA on myelogram. After discontinuing clozapine, the patient's hemoglobin levels recovered. Subsequent treatments with olanzapine, zuclopenthixol, and aripiprazole proved ineffective, leading us to consider a clozapine rechallenge. The rechallenge, monitored for 58 days, resulted in improved psychiatric symptoms and stable hemoglobin levels. The patient remained stable during 6 months of follow-up, with no hematological changes. PRCA is a very rare adverse effect of clozapine. The cause of drug-induced PRCA is still unknown; for clozapine, there are no studies. Rechallenge after a severe and rare adverse effect is a complex decision. This case is the first to report a successful clozapine rechallenge following severe anemia without other blood dyscrasias, emphasizing the imperative need for close monitoring during the rechallenge process. Further study is warranted to understand the predictive factors for a successful outcome in clozapine rechallenges.

Pseudomonas aeruginosa ventricular assist device infections: findings from ineffective phage therapies in five cases.

Left ventricular assist devices (LVAD) are increasingly used for management of heart failure; infection remains a frequent complication. Phage therapy has been successful in a variety of antibiotic refractory infections and is of interest in treating LVAD infections. We performed a retrospective review of four patients that underwent five separate courses of intravenous (IV) phage therapy with concomitant antibiotic for treatment of endovascular Pseudomonas aeruginosa LVAD infection. We assessed phage susceptibility, bacterial strain sequencing, serum neutralization, biofilm activity, and shelf-life of phage preparations. Five treatments of one to four wild-type virulent phage(s) were administered for 14-51 days after informed consent and regulatory approval. There was no successful outcome. Breakthrough bacteremia occurred in four of five treatments. Two patients died from the underlying infection. We noted a variable decline in phage susceptibility following three of five treatments, four of four tested developed serum neutralization, and prophage presence was confirmed in isolates of two tested patients. Two phage preparations showed an initial titer drop. Phage biofilm activity was confirmed in two. Phage susceptibility alone was not predictive of clinical efficacy in P. aeruginosa endovascular LVAD infection. IV phage was associated with serum neutralization in most cases though lack of clinical effect may be multifactorial including presence of multiple bacterial isolates with varying phage susceptibility, presence of prophages, decline in phage titers, and possible lack of biofilm activity. Breakthrough bacteremia occurred frequently (while the organism remained susceptible to administered phage) and is an important safety consideration.

A 7-Year Retrospective Analysis of Hymenoplasty: Profiles From a Specialized Gynecological Cosmetic Surgery Practice.

Hymenoplasty, the surgical hymen reconstruction, is on the rise in Turkey, reflecting the enduring importance of virginity rooted in sociocultural and religious beliefs. Demographic factors shape women's decisions for this procedure. A seven-year retrospective analysis of 4259 patient records at a private clinic explores motivations and societal pressures, emphasizing the need for understanding and support amidst the cultural fixation on virginity. This investigation delves into multifaceted perceptions around virginity and hymenoplasty in Turkey, examining the impact of sociocultural and religious beliefs on women's decisions. It also explores demographic influences, offering insights into the societal and cultural backdrop of hymenoplasty. A retrospective analysis of 4259 patient records (2015-2022) at a private clinic was conducted, meticulously analyzing data for demographics and shared decision-making dynamics using statistical tools. In the examined cohort (83.3%), permanent hymenoplasty was prevalent among individuals aged 14-49, with 58.6% being engaged and seeking the procedure a week before marriage. Notably, 91.0% were accompanied by friends during consultations, and a minority disclosed childbirth history or forced intercourse experiences. An increasing trend in first-time and post-assault hymenoplasty procedures was observed in 2021. Geographically, the majority resided in Istanbul, representing all Turkish regions. Additional procedures like vaginoplasty were common, with mostly successful postprocedural outcomes and minor complications. This study highlights the enduring social importance of virginity in Turkey, emphasizing hymenoplasty as a coping strategy for psychological and societal challenges. It calls for comprehensive patient support and societal progress in respecting women's bodily autonomy, urging a shift away from the cultural fixation on virginity.

Characteristics, predictors and consequences of tuberculosis treatment interruption: A multicentre retrospective cohort study.

Treatment interruption is associated with poor tuberculosis (TB) treatment outcomes and increased drug resistance. To address the issue, we aimed to investigate the characteristics, predictors and consequences of treatment interruption. We conducted a retrospective cohort study by retrieving 4 years (2018-2021) of TB patients' records at 10 public health clinics in Sarawak, Malaysia. Adult patients (≥18 years) with drug-susceptible TB were selected. Treatment interruption was defined as ≥2 weeks of cumulative interruption during treatment. The Chi-square test, Mann-Whitney U test, Kaplan-Meier and Cox proportional hazards regression were used to analyse the data, with p < 0.05 being considered statistically significant. Out of 2953 eligible patients, 475 (16.1%) experienced TB treatment interruption. Interruptions were most frequent during the intensive phase (46.9%, n = 223), with the greatest risk within the first 4 weeks of treatment. The median time to interruption was 2 weeks in the intensive phase and the cumulative interruption probability at the end of the intensive phase was 12.9%. Notably, treatment interruption occurred during both intensive and continuation phases for 144 patients (30.3%), while the remaining 108 (22.7%) experienced interruptions only during the continuation phase with a median time to interruption of 16 weeks. Three predictors were identified to increase the risk of treatment interruption: adverse drug reaction (aHR = 8.53, 95% Cl: 6.73-10.82), smoking (aHR = 2.67, 95% Cl: 2.03-3.53) and illicit drug use (aHR = 1.88, 95% Cl: 1.03-3.45). Conversely, underlying diabetes was associated with a reduced likelihood of treatment interruption (aHR = 0.72, 95% Cl: 0.58-0.90). Treatment interruption led to significant differences in treatment restarts (62.3% vs. 0.7%), changes in medications (47.8% vs. 4.9%), prolonged treatment duration (247 days [IQR = 105] vs. 194 days [IQR = 44.3]) and lower successful outcomes (86.5% vs. 99.9%). Understanding the temporal characteristics, predictors and negative consequences of treatment interruption can guide the development of time-relevant approaches to mitigate the problem.

Which factors are associated with a successful outcome following total hip arthroplasty in patients with early radiographic osteoarthritis?

It is unclear which factors are associated with a successful total hip arthroplasty (THA) in patients with early radiographic osteoarthritis (OA). 70 patients with early OA (Kellgren and Lawrence [KL] grades 0-2) who underwent THA were compared with 200 patients with advanced OA (KL grades 3-4). Outcomes were Oxford Hip Scores (OHS), EQ-5D and EQ-VAS scores; compared preoperatively with 1 year postoperatively. We investigated which clinical and radiographic (plain x-ray, CT, MRI) features predicted successful THA (postoperative OHS ⩾42). The early OA group were significantly younger (61 vs. 66 years; [p = 0.0035). There were no significant differences in BMI, ASA grade or gender. After adjusting for confounders, the advanced OA group had a significantly greater percentage of possible change (PoPC) in OHS (75.8% vs. 50.4%; p < 0.0001) and improvement in EQ-5D (0.151 vs. 0.002; p < 0.0001). There were no significant differences in complication, revision or readmission rates. In the early OA group, 16/70 (22.9%) patients had a 'successful' THA. Patients who had a 'successful' THA were significantly more likely to have subchondral cysts on CT/MRI (91.7% vs. 57.7%; p = 0.0362). The presence of cysts on CT/MRI was associated with a significantly greater PoPC in OHS (61.6% vs. 38.2%; p = 0.0353). The combination of cysts and joint space width <1 mm was associated with a PoPC of 68%. THA in patients with early OA (KL grades 0-2) on plain radiographs should be indicated with caution. We advocate preoperative cross-sectional imaging in these patients. In the absence of cysts on CT/MRI, a THA seems unlikely to provide a satisfactory outcome.

The Effects of Nasal Septal Deviation on Anterior Skull Base Parameters

Abstract Introduction Functional endoscopic sinus surgery and endoscopic skull base surgery are frequently performed surgeries today. Nasal septal deviation is a common finding and can affect the surgical area. Therefore, it is important to examine the effect of this deviation on other anatomical structures. Objectıve The aim of the present study was to determine whether there is a relationship between the degree of nasal septal deviation and anterior skull base structures using computed tomography (CT). Methods A total of 312 patients (aged 18 to 65 years old) whose paranasal sinus CT images were available were included in the study. Measurements were obtained on images retrieved from Picture Archiving and Communication System (PACS) and Horos image archive systems in the bone window in the coronal and axial plane. Results The mean age of 312 patients was 33.00 years old (standard deviation [SD] 11.22 years). The presence of septal deviation was not associated with changes in olfactory fossa (OF) depths, Keros degrees, and the angle between the lateral lamella and the cribriform lamella. However, OF depths and Keros degrees on the deviated side of the septum were found to change at a significant level (p &lt; 0.05). No significant association was observed between the degree of septal deviation and cribriform lamella-lateral lamella angle. Conclusion The study showed significantly increased OF depth and Keros degree on the deviated side of the nasal septum. Performing CT scans before endoscopic sinus surgery and endoscopic skull base surgery is important to increase the chances of a successful surgical outcome and to reduce complications.

MICROSURGICAL REIMPLANTATION OUTCOMES FOR COMPLETE AND INCOMPLETE AMPUTATIONS OF DISTAL PHALANGES OF FINGERS.

The intricate endeavor of replanting the distal phalanx of the finger remains a persistent challenge. In the pursuit of addressing this concern, microsurgical replantation procedures have been systematically examined for distal phalanx injuries encircling the distal interphalangeal (DIP) joint, conducted at the Orthopaedic Hospital situated in Ho Chi Minh City. This investigation encompassed a cohort of 31 patients, comprising individuals with 17 instances of complete and 21 instances of incomplete amputations of the distal phalanges. The subjects' ages spanned a range from 3 to 56 years. The study divulged that eight fingers, involving four complete amputations and four incomplete amputations, did not achieve successful outcomes. In contrast, the remaining 30 fingers exhibited survival. A meticulous long-term follow-up of 17 fingers, extending over a period exceeding six months, unveiled commendable achievements encompassing satisfactory sensory recovery, cosmetic enhancement, and the resumption of pre-injury occupational activities by the patients. Vein anastomosis was revealed as a notably challenging aspect of the surgical procedures. In scenarios where conventional vein suturing was rendered unfeasible, the innovative recourse of one-way drainage emerged as a viable alternative. The endeavor to replant the distal phalanx of the finger engenders a substantial level of complexity, particularly in the realm of venous anastomosis. This research underscores the need for focused efforts to address and surmount the intricacies associated with this aspect of surgical intervention.

Design, Simulation, Building, and Testing of a Microcontroller-Based Automatic Drowsiness Detection, Vehicle Braking, and Alert System

Aims: The premier practical aspect of this research drive is to propose, build, simulate, and evaluate an Arduino-built automatic vehicle driver drowsiness detection and alert system.&#x0D; Study Design: The pivotal role of a reliable braking system in vehicular safety cannot be overstated, particularly considering the escalating frequency of traffic accidents, notably prevalent in Indonesia where human factors take center stage as the primary accident catalyst. An insightful poll underscores physical fatigue or drowsiness while driving as the foremost concern. Acknowledging the nuanced disparities between conventional air systems and electric systems, this research strategically directs its attention toward crafting a new system characteristic that mirrors the efficiency of the existing systems.&#x0D; Place and Period of Study: The research action engaged by the authors in a bunch of two students under the command of a professor as a part of one of his course capstone projects for the Bachelor of Science in Electrical and Electronic Engineering degree at the American International University Bangladesh (AIUB), Dhaka, Bangladesh. The authors performed their investigative tasks at AIUB from June 2023 to January 2024.&#x0D; Methodology: Recognizing the imperative to fortify vehicular safety, the integration of artificial intelligence emerges as a vital solution to assist drivers in ensuring the safety of individuals both within and outside the vehicle. This focused study, tailored specifically for Electric Vehicles (EVs), centers on the innovative application of object and distance identification methodologies to provide a comprehensive braking action indicator. Leveraging a minicomputer and a sophisticated neural network approach, images captured by a stereo camera undergo meticulous machine learning processes. This facilitates the precise categorization and measurement of distances between objects, with subsequent priority decisions determining the optimal degree of braking action. Employing an intelligent methodology, specifically fuzzy logic, the study demonstrates a successful outcome by constructing a curve while concurrently enhancing the dynamics of the pre-existing system. Moreover, a finely tuned Pulse Width Modulation (PWM) signal for braking, lasting 10 milliseconds, is intricately devised based on the study's discerning results.&#x0D; Results: The system is simulated in Proteus and tested in real time to check its functionality. The outcomes of the test showed that the system can produce the appropriate signals based on the detection of any kind of driver’s drowsiness and can stop the car.&#x0D; Conclusion: This comprehensive approach ensures the seamless replacement of components while concurrently elevating the overall performance of the braking system

Functional and Radiological Outcomes of All-Posterior Surgical Correction of Dystrophic Curves in Patients with Neurofibromatosis Type 1.

A retrospective cohort study. To determine outcomes following all-posterior surgery using computed tomography navigation, hybrid stabilization, and multiple anchor point techniques in patients with neurofibromatosis type 1 (NF-1) and dystrophic scoliosis. Previous studies favored antero-posterior fusion as the most reliable method; however, approaching the spine anteriorly was fraught with significant complications. With the advent of computer assisted navigation and multiple anchor point method, posterior only approach is reporting successful outcomes. This study included patients who underwent all-posterior surgical deformity correction for dystrophic NF-1 curves. Coronal and sagittal Cobbs angles, apical rotation, and the presence of dystrophic features were evaluated before surgery. Postoperatively, sagittal, coronal, and axial correction, implant position, and implant densities were evaluated. The decline in curve correction and implant-related complications were evaluated at follow-up. Clinical outcomes were evaluated using the Scoliosis Research Society-22 revised index. This study involved 50 patients with a mean age of 13.6 years and a mean follow-up duration of 5.52 years. With a mean coronal flexibility of 18.7%, the mean apical vertebral rotation (AVR), preoperative coronal Cobb angle, and sagittal kyphosis were 27.4°, 64.01°, and 47.70°, respectively. The postoperative mean coronal Cobb angle was 30.17° (p <0.05), and the sagittal kyphosis angle was 25.4° (p <0.05). The average AVR correction rate was 41.3%. The correction remained significant at the final mean follow-up, with a coronal Cobb angle of 34.14° and sagittal kyphosis of 25.02° (p <0.05). The average implant density was 1.41, with 46% of patients having a high implant density (HID). The HID had a markedly higher mean curve correction (29.30° vs. 38.05°, p <0.05) and a lower mean loss of correction (5.7° vs. 3.8°, p <0.05). Utilizing computer-assisted navigation, hybrid instrumentation, and multiple anchor point technique and attaining high implant densities, this study demonstrates successful outcomes following posterior-only surgical correction of dystrophic scoliosis in patients with NF-1.

Patient experience of partnership: What is the relative value of interpersonal skill?

AbstractMedical literature seems not to have a consistent definition of interpersonal skills, but there is a consensus on the value of emotional intelligence, empathy and effective communication. This editorial reflects on both empirical data and personal experience to consider the relative value of interpersonal versus technical skills in the patient experience of partnership in healthcare. It explores the question of whether technical or interpersonal skills are more valuable in medical care. On highlighting the different attitudes towards technical and interpersonal skills among patients in different medical specialities, this editorial suggests that the contemporary focus on interpersonal skills is driven by a recognition that patient experience encompasses more than just successful outcomes. The quality of a patient's remaining life and their sense of respect, care and dignity are also important. It concludes with the emphasis that both technical and interpersonal skills are crucial in patient care and that a holistic understanding of patient experience can enhance medical education and practice.

Machine learning-assisted prediction of trabeculectomy outcomes among patients of juvenile glaucoma by using 5-year follow-up data.

To develop machine learning (ML) models, using pre and intraoperative surgical parameters, for predicting trabeculectomy outcomes in the eyes of patients with juvenile-onset primary open-angle glaucoma (JOAG) undergoing primary surgery. The study included 207 JOAG patients from a single center who met the following criteria: diagnosed between 10 and 40 years of age, with an IOP of >22 mmHg in the eyes on two or more occasions, open angle on gonioscopy in both eyes, with glaucomatous optic neuropathy, and requiring a trabeculectomy for IOP control. Only the patients with a minimum 5-year follow-up after surgery were included in the study. A successful surgical outcome was defined as IOP ≤18 mmHg (criterion A) or 50% reduction in IOP from baseline (criterion B) 5 years after trabeculectomy. Feature selection techniques were used to select the most important contributory parameters, and tenfold cross-validation was used to evaluate model performance. The ML models were evaluated, compared, and prioritized based on their accuracy, sensitivity, specificity, Matthew correlation coefficient (MCC) index, and mean area under the receiver operating characteristic curve (AUROC). The prioritized models were further optimized by tuning the hyperparameters, and feature contributions were evaluated. In addition, an unbiased relationship analysis among the parameters was performed for clinical utility. Age at diagnosis, preoperative baseline IOP, duration of preoperative medical treatment, Tenon's thickness, scleral fistulation technique, and intraoperative mitomycin C (MMC) use, were identified as the main contributing parameters for developing efficient models. The three models developed for a consensus-based outcome to predict trabeculectomy success showed an accuracy of >86%, sensitivity of >90%, and specificity of >74%, using tenfold cross-validation. The use of intraoperative MMC and a punch for scleral fistulation compared to the traditional excision with scissors were significantly associated with long-term success of trabeculectomy. Optimizing surgical parameters by using these ML models might reduce surgical failures associated with trabeculectomy and provide more realistic expectations regarding surgical outcomes in young patients.

Healthcare Branding and Reputation Management Strategies for Organizational Success

This study searches into the critical aspect of branding and reputation management within the dynamic view of the healthcare industry. This research aims to provide actionable insights for healthcare organizations to navigate the complexities of building and maintaining a strong brand identity by comprehensively analyzing the multifaceted aspects of healthcare branding, including its foundational principles, strategies, challenges, and opportunities. The research problem centers on identifying gaps and challenges in current healthcare branding and reputation management practices, recognizing the pressing need for systematic examination within evolving patient expectations, competitive pressures, and regulatory environments. This study offers a nuanced understanding of these critical areas through a structured exploration of healthcare branding’s fundamental significance, strategies employed for reputation management, and identifying existing challenges and opportunities. Drawing upon Brand Equity Theory, which underscores the value of a brand beyond solid assets, the study explains the role of brand equity in shaping patient perceptions, organizational success, and overall health outcomes within the healthcare context. Furthermore, the research outlines future avenues for investigation, including the impact of emerging technologies, longitudinal assessments of branding initiatives, data-driven insights, ethical considerations, and collaborative co-creation strategies. This study aims to advance knowledge and practice in healthcare branding and reputation management by addressing these areas and empowering healthcare organizations to enhance patient experiences, organizational performance, and public health outcomes in an ever-evolving healthcare view.

Efficacy of surgical staple line reinforcement in Glissonean stapling: A single-center pilot study.

Vascular staplers are routinely used in laparoscopic liver resection, which has become a standard procedure in advanced medical facilities. Although previous reports have outlined the benefits of staple line reinforcement (SLR), its application in Glissonean pedicle transection during hepatic resection remains poorly studied. This study investigated surgical SLR as a tool to enhance staple line strength and improve perioperative hemostasis. Here, 10 patients who underwent laparoscopic liver resection using the Tri-StapleTM2.0 Reinforced Reload were included. Patient characteristics, surgical details, and outcomes were assessed. The results demonstrated successful outcomes with no complications related to bile leakage or injuries during staple insertion. Overall, our findings suggest that SLR can be safely utilized in Glissonean pedicle transection during laparoscopic liver resections. Further studies are required to comprehensively evaluate its benefits compared with conventional surgical staplers.