Evaluation of subretinally delivered Cas9 ribonucleoproteins in murine and porcine animal models highlights key considerations for therapeutic translation of genetic medicines.

Genetic medicines, including CRISPR/Cas technologies, extend tremendous promise for addressing unmet medical need in inherited retinal disorders and other indications; however, there remain challenges for the development of therapeutics. Herein, we evaluate genome editing by engineered Cas9 ribonucleoproteins (eRNP) in vivo via subretinal administration using mouse and pig animal models. Subretinal administration of adenine base editor and double strand break-inducing Cas9 nuclease eRNPs mediate genome editing in both species.

Can an Algorithm Tell How Spiritual You Are? Using Generative Pretrained Transformers for Sophisticated Forms of Text Analysis.

Objective: Text analysis is a form of psychological assessment that involves converting qualitative information (text) into quantitative data. We tested whether automated text analysis using Generative Pre-trained Transformers (GPTs) can match the "gold standard" of manual text analysis, even when assessing a highly nuanced construct like spirituality.

Method: In Study 1, N = 2199 US undergraduates wrote about their goals (N = 6597 texts) and completed self-reports of spirituality and theoretically related constructs (religiousness and mental health).

Pediatric Triage Accuracy in Pediatric and General Emergency Departments.

Background And Objectives: Accurate triage at the time of emergency department (ED) presentation is critical for timely acuity assessment and anticipating resource requirements. Commonly, triage is conducted using the Emergency Severity Index (ESI); however, the accuracy of this approach for children in general EDs is uncertain. The purpose of this study was to quantify pediatric triage accuracy in a national sample of ED visits and evaluate whether presentation to a pediatric vs general ED is associated with mistriage.

Developing methods to identify resilience and improve communication about diagnosis in pediatric primary care.

Communication underlies every stage of the diagnostic process. The Dialog Study aims to characterize the pediatric diagnostic journey, focusing on communication as a source of resilience, in order to ultimately develop and test the efficacy of a structured patient-centered communication intervention in improving outpatient diagnostic safety. In this manuscript, we will describe protocols, data collection instruments, methods, analytic approaches, and theoretical frameworks to be used in to characterize the patient journey in the Dialog Study.

Predictors of Transition Outcomes in Cystic Fibrosis: Analysis of National Patient Registry and CF RISE (Responsibility. Independence. Self-care. Education) Data.

Objective: To identify predictors of change in lung function and body weight during health care transition in cystic fibrosis (CF).

Methods: We conducted a retrospective cohort study using data from the CF Foundation Patient Registry and the web-based transition program CF RISE (Responsibility. Independence.

Attachment to God, Contingent Self-Worth, and Mental Health Outcomes in U.S. Collegiate Athletes.

Scholars and practitioners have recently devoted increased attention to the psychological well-being of student-athletes. However, sparse research has examined the role of religion/spirituality in well-being in athletic populations. In a sample of U.

Reducing Pediatric Unplanned Extubation Across Multiple ICUs Using Quality Improvement.

Objectives: Unplanned extubation (UE) in pediatric patients can result in significant harm or mortality. In our institution, efforts to reduce UE in the ICU were siloed and learnings were not shared. Our goal was to implement shared initiatives across ICUs in a pediatric institution using quality improvement methodology, with the global aim of reducing serious harm caused by UEs.

Home Environment Influence on Adolescent Health Literacy.

Adolescent health disparities are influenced by individuals' health literacy. To date, the only known household factors to influence adolescent health literacy (AHL) are social capital factors of parental health literacy, parent education, and household income. Therefore, the purpose of this study was to expand the understanding of household factors that influence AHL for future interventions.

Clinical Evaluation of the Torq Zero Delay Centrifuge System for Decentralized Blood Collection and Stabilization.

Blood sample collection and rapid separation-critical preanalytical steps in clinical chemistry-can be challenging in decentralized collection settings. To address this gap, the Torq™ zero delay centrifuge system includes a lightweight, hand-portable centrifuge (ZDrive™) and a disc-shaped blood collection device (ZDisc™) enabling immediate sample centrifugation at the point of collection. Here, we report results from clinical validation studies comparing performance of the Torq System with a conventional plasma separation tube (PST).

The Generalizability of a Medication Administration Discrepancy Detection System: Quantitative Comparative Analysis.

Background: As a result of the overwhelming proportion of medication errors occurring each year, there has been an increased focus on developing medication error prevention strategies. Recent advances in electronic health record (EHR) technologies allow institutions the opportunity to identify medication administration error events in real time through computerized algorithms. MED.

Health Literacy of Adolescents.

Purpose: The purpose of this study is to describe influencing factors of adolescent health literacy.

Methods: This study is a descriptive, correlational, cross-sectional study. Based on an a priori power analysis and utilizing convenience sampling, 105 adolescents completed the Newest Vital Sign (NVS) health literacy instrument via the Qualtrics online platform.

Integrating and Evaluating the Data Quality and Utility of Smart Pump Information in Detecting Medication Administration Errors: Evaluation Study.

Background: At present, electronic health records (EHRs) are the central focus of clinical informatics given their role as the primary source of clinical data. Despite their granularity, the EHR data heavily rely on manual input and are prone to human errors. Many other sources of data exist in the clinical setting, including digital medical devices such as smart infusion pumps.

Human-Based Errors Involving Smart Infusion Pumps: A Catalog of Error Types and Prevention Strategies.

Over 4000 preventable injuries due to medication errors occur each year in any given hospital. Smart pumps have been widely introduced as one means to prevent these errors. Although smart pumps have been implemented to prevent errors, they fail to prevent specific types of errors in the medication administration process and may introduce new errors themselves.

Assessment of an Unplanned Extubation Bundle to Reduce Unplanned Extubations in Critically Ill Neonates, Infants, and Children.

Importance: Unplanned extubations (UEs) in children contribute to significant morbidity and mortality, with an arbitrary benchmark target of less than 1 UE per 100 ventilator days. However, there have been no multicenter initiatives to reduce these events.

Objective: To determine if a multicenter quality improvement initiative targeting all intubated neonatal and pediatric patients is associated with a reduction in UEs and morbidity associated with UE events.

Smart pumps improve medication safety but increase alert burden in neonatal care.

Background: Smart pumps have been widely adopted but there is limited evidence to understand and support their use in pediatric populations. Our objective was to assess whether smart pumps are effective at reducing medication errors in the neonatal population and determine whether they are a source of alert burden and alert fatigue in an intensive care environment.

Methods: Using smart pump records, over 370,000 infusion starts for continuously infused medications used in neonates and infants hospitalized in a level IV NICU from 2014 to 2016 were evaluated.

Data Challenges With Real-Time Safety Event Detection And Clinical Decision Support.

Background: The continued digitization and maturation of health care information technology has made access to real-time data easier and feasible for more health care organizations. With this increased availability, the promise of using data to algorithmically detect health care-related events in real-time has become more of a reality. However, as more researchers and clinicians utilize real-time data delivery capabilities, it has become apparent that simply gaining access to the data is not a panacea, and some unique data challenges have emerged to the forefront in the process.

Clinical feasibility of a wearable, conformable sensor patch to monitor motor symptoms in Parkinson's disease.

Introduction: Clinical assessment of motor symptoms in Parkinson's disease (PD) is subjective and may not reflect patient real-world experience. This two-part pilot study evaluated the accuracy of the NIMBLE wearable biosensor patch (containing an accelerometer and electromyography sensor) to record body movements in clinic and home environments versus clinical measurement of motor symptoms.

Methods: Patients (Hoehn & Yahr 2-3) had motor symptom fluctuations and were on a stable levodopa dose.

Patterns in the long-term viability of North American zoo populations.

Recent concerns about the viability of zoo populations have motivated studies on the historic and current status of animal populations in North American and European zoos. However, these evaluations may not accurately reflect the populations' long-term viability in the decades to come. Here, we assessed the projected future status of North American zoo populations by conducting standardized population viability analyses (PVAs) for 137 cooperative breeding programs.

Foxc2 is required for proper cardiac neural crest cell migration, outflow tract septation, and ventricle expansion.

Background: Proper development of the great vessels of the heart and septation of the cardiac outflow tract requires cardiac neural crest cells. These cells give rise to the parasympathetic cardiac ganglia, the smooth muscle layer of the great vessels, some cardiomyocytes, and the conotruncal cushions and aorticopulmonary septum of the outflow tract. Ablation of cardiac neural crest cells results in defective patterning of each of these structures.

Designing and evaluating an automated system for real-time medication administration error detection in a neonatal intensive care unit.

Background: Timely identification of medication administration errors (MAEs) promises great benefits for mitigating medication errors and associated harm. Despite previous efforts utilizing computerized methods to monitor medication errors, sustaining effective and accurate detection of MAEs remains challenging. In this study, we developed a real-time MAE detection system and evaluated its performance prior to system integration into institutional workflows.