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Background Laboratory parameters and the associated clinical outcomes have been an area of focus in COVID-19 research globally. Purpose We performed a scoping review to synthesize laboratory values described in the literature and their associations with mortality and disease severity. Methods We identified all primary studies involving laboratory values with clinical outcomes as a primary endpoint by performing data searches in various systematic review databases until 10th August, 2020. Two reviewers independently reviewed all abstracts (13,568 articles) and full text (1126 articles) data. A total of 529 studies involving 165,020 patients from 28 different countries were included. Investigation of the number of studies and patients from a geographical perspective showed that the majority of published literature from January–March 2020 to April–June 2020 was from Asia, though there was a temporal shift in published studies to Europe and the Americas. For each laboratory value, the proportion of studies that noted a statistically significant (p

Background Nutritional deficiencies are seen in patients with food allergy. Low vitamin D levels have been found in patients with atopic conditions. Eosinophilic esophagitis (EoE) is a chronic immune antigen-mediated disease found to be highly associated in patients with atopic disease and treated with dietary elimination with recommendations to utilize a dietician to prevent nutritional deficiencies. Nonetheless, the relationship between EoE and vitamin deficiency remains unclear. We aimed to systematically review the evidence to support a possible association between vitamin deficiency and eosinophilic esophagitis. Methods Electronic searches were performed with keywords relating to EoE and vitamins among pediatric patients in MEDLINE, EMBASE, and The Cochrane Library. Summary estimates were calculated. Citations were reviewed against pre-defined criteria. (Inclusion: human subjects, aged 0-18, with eosinophilic esophagitis. Exclusion: adults over 18 years, non-English papers). Results The search yielded 1707 studies. Five of these studies with a total of 137 pediatric patients were included in the systematic review. Outcome measures were assessed at different points in EoE treatment across studies. The single common outcome measure across all included studies was vitamin D. Reported prevalence of low vitamin D varied in these studies (0%-52%). Vitamin D levels of children with EoE both pre- and post-intervention were low. Conclusions There is limited published literature on vitamin deficiencies associated with EoE both pre- and post-intervention. The limited data on vitamin D suggest that insufficiency or deficiency may be present in these patients, but it remains unclear whether deficiency is caused by diet. More prospective, well-defined studies, in addition to routine reporting on dietary intake and nutritional status, are needed to make any conclusions or recommendations for screening.

Rational and Objective Evaluate predictors of Emergency Department (ED) utilization by adult patients receiving hemodialysis (HD) and interventions to reduce ED utilization by HD patients. Study Design We searched Ovid MEDLINE, Ovid EMBASE, and The Cochrane Library for randomized controlled trials and observational studies up until April 2020. Selection Criteria for Studies We included studies that investigated predictors of ED utilization and/or interventions to reduce ED utilization in HD patients. Data Extraction We extracted data regarding study design, study population, and results regarding ED utilization from 38 studies using Excel software. Analytical Approach We performed narrative synthesis to group articles that investigated similar themes. Results 1060 titles and abstracts were screened, of which 98 were selected for full-text review. 38 studies met inclusion criteria and underwent data extraction. Quality was high according to the Downs and Black tool, with 11 rated as good, 22 as fair, and 5 as poor. 34 studies described predictors of ED utilization, while 4 studies investigated interventions where ED utilization was studied. Our narrative synthesis produced 8 concept subgroups in the core concepts of access to care, comorbidity burden, and new healthcare models. Poor access to care and high comorbidity burden are associated with increased ED use. No ED-based interventions designed to reduce ED utilization were identified, but recent changes in healthcare systems like the formation of ESRD Seamless Care Organizations (ESCOs) and greater involvement of palliative care services are associated with improved outcomes. Limitations Clinical heterogeneity and variability in the included studies precluded a meta-analysis. Conclusions HD patients' high ED use is multifactorial. Further research is required to understand and predict ED utilization in this vulnerable population, which will facilitate the development of interventions to reduce avoidable ED use.

OBJECTIVES/HYPOTHESIS This scoping review aims to provide a broad overview of the applications of artificial intelligence (AI) to office laryngoscopy to identify gaps in knowledge and guide future research. STUDY DESIGN Scoping Review. METHODS Searches for studies on AI and office laryngoscopy were conducted in five databases. Title and abstract and then full-text screening were performed. Primary research studies published in English of any date were included. Studies were summarized by: AI applications, targeted conditions, imaging modalities, author affiliations, and dataset characteristics. RESULTS Studies focused on vocal fold vibration analysis (43%), lesion recognition (24%), and vocal fold movement determination (19%). The most frequently automated tasks were recognition of vocal fold nodules (19%), polyp (14%), paralysis (11%), paresis (8%), and cyst (7%). Imaging modalities included high-speed laryngeal videos (45%), stroboscopy (29%), and narrow band imaging endoscopy (7%). The body of literature was primarily authored by science, technology, engineering, and math (STEM) specialists (76%) with only 30 studies (31%) involving co-authorship by STEM specialists and otolaryngologists. Datasets were mostly from single institution (84%) and most commonly originated from Germany (23%), USA (16%), Spain (9%), Italy (8%), and China (8%). Demographic information was only reported in 39 studies (40%), with age and sex being the most commonly reported, whereas race/ethnicity and gender were not reported in any studies. CONCLUSION More interdisciplinary collaboration between STEM and otolaryngology research teams improved demographic reporting especially of race and ethnicity to ensure broad representation, and larger and more geographically diverse datasets will be crucial to future research on AI in office laryngoscopy. LEVEL OF EVIDENCE N/A Laryngoscope, 2021.

Health science librarianship may interest nurses inclined toward research, technology, and education. This article discusses the role of health science librarians as part of the clinical team.

Context: Viscosupplementation is widely used for management of knee osteoarthritis. Many formulations of hyaluronic acid (HA) are available, ranging from a single injection to a series of up to 5 injections per treatment. Objective: To compare efficacy between single and multiple HA injection formulations. Data Sources: MEDLINE, EMBASE, Cochrane, Web of Science, Scopus databases were all searched. Study Selection: Full-text prospective randomized and nonrandomized controlled human trials, cohort studies, and cost-effectiveness evaluations in the English language comparing different injection regimens of viscosupplementation were included. Study Design: Systematic review. Level of Evidence: Level 1. Data Extraction: Data were collected using the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. Four databases were searched by a librarian and the principal investigator, identifying 6196 articles for screening. Results: Eleven studies met the inclusion criteria. Of the studies comparing single- with multiple-injection formulations of HA for treatment of knee osteoarthritis, there was no consistent difference in patient-reported outcomes. Furthermore, 5-injection formulations do not appear to be superior to 3-injection formulations. Conclusion: There are limited head-to-head trials comparing viscosupplementation formulations that differ based on number of injections, and in particular, there is a paucity of trials evaluating single-injection formulations. Based on the currently available data, there appears to be similar efficacy with the possibility for greater cost-effectiveness and less patient inconvenience with single-injection formulations.

Although a growing number of studies suggest interactions between Schistosoma parasites and viral infections, the effects of schistosome infections on the host response to viruses have not been evaluated comprehensively. In this systematic review, we investigated how schistosomes impact incidence, virulence, and prevention of viral infections in humans and animals. We also evaluated immune effects of schistosomes in those coinfected with viruses. We screened 4,730 studies and included 103. Schistosomes may increase susceptibility to some viruses, including HIV and Kaposi’s sarcoma-associated herpesvirus, and virulence of hepatitis B and C viruses. In contrast, schistosome infection may be protective in chronic HIV, Human T-cell Lymphotropic Virus-Type 1, and respiratory viruses, though further research is needed. Schistosome infections were consistently reported to impair immune responses to hepatitis B and possibly measles vaccines. Understanding the interplay between schistosomes and viruses has ramifications for anti-viral vaccination strategies and global control of viral infections., Author summary Many studies have described the effects of parasitic Schistosoma worm infections on the way that humans and animals respond to a variety of viral infections. Our goal was to evaluate, in a systematic manner, how having a schistosome parasitic infection affects a host’s susceptibility to viral infections, the clinical disease course of viral infections, and prevention of viral infections by vaccines. We also assessed the effects of schistosome infection on the host immune response to viruses. We screened 4,730 studies for potential relevance and included 103 of them in this review. Overall, our analysis showed that schistosome infection impairs the host response to many viruses. This includes increasing host susceptibility to HIV and possibly Kaposi’s sarcoma-associated herpesvirus, worsening the severity of clinical disease in hepatitis B and C infections, and decreasing immune responses to vaccines for hepatitis B and possibly measles. The studies that we analyzed also suggested that schistosome infection may protect the host against poor clinical outcomes from some viral infections including Human T-cell Lymphotropic Virus-Type 1, respiratory viruses, and chronic HIV. We discuss how these findings might be interpreted, and the additional research needed, in order to improve anti-viral vaccination strategies and control of viral infections globally.

Clinical Medical Librarians at Weill Cornell Medicine (WCM), Samuel J. Wood Library provide unique health literacy services for patients, families, and caregivers on the Phyllis and David Komansky Center for Children’s Health pediatric floors of New York-Presbyterian Hospital (NYPH) by conducting twice weekly patient rounds and bringing consumer health information and services to bedsides. Although in its infancy, the Pediatric Consumer Librarian Service (PCLS) generates statements of appreciation from patients and parents, enthusiasm among stakeholders, and reports of increased job satisfaction by librarians. We report on experiences, methods, feedback from users, and plans for the future.

Objective: The goal of this scoping review was to collect data on patient- and family-centered care (PFCC) programs and initiatives that have included the direct involvement of librarians and information professionals to determine how librarians are involved in PFCC and highlight opportunities for librarians to support PFCC programs.Methods: Systematic literature searches were conducted in seven scholarly databases in the information, medical, and social sciences. Studies were included if they (1) described initiatives presented explicitly as PFCC programs and (2) involved an information professional or librarian in the PFCC initiative or program. Based on the definition of PFCC provided by the Institute for Patient- and Family-Centered Care, the authors developed a custom code sheet to organize data elements into PFCC categories or initiatives and outcomes. Other extracted data elements included how the information professional became involved in the program and a narrative description of the initiatives or programs.Results: All included studies (n=12) identified patient education or information-sharing as an integral component of their PFCC initiatives. Librarians were noted to contribute to shared decision-making through direct patient consultation, provision of health literacy education, and information delivery to both provider and patient with the goal of fostering collaborative communication.Conclusions: The synthesis of available evidence to date suggests that librarians and information professionals should focus on patient education and information-sharing to support both patients or caregivers and clinical staff. The burgeoning efforts in participatory care and inclusion of patients in the decision-making process pose a unique opportunity for librarians and information professionals to offer more personalized information services.

Fredrick E. Batten defined the pathology of subacute combined degeneration and made seminal observations about myasthenia gravis, poliomyelitis, and infantile neuronal lipofuscinosis.Fredrick Eusta...

Background: Anatomical subjects depicted in Eduard Pernkopf’s richly illustrated Topographische Anatomie des Menschen may be victims of the Nazi regime. Special collections librarians in the history of medicine can use this primary resource to initiate dialogs about ethics with medical students.Case Presentation: Reported here is the authors’ use of Pernkopf’s Atlas in an interactive medical humanities seminar designed for third-year medical students. Topical articles, illustrations, and interviews introduced students to Pernkopf, his Atlas, and the surrounding controversies. We aimed to illustrate how this controversial historical publication can successfully foster student discussion and ethical reflection.Conclusions: Pernkopf’s Atlas and our mix of contextual resources facilitated thoughtful discussions about history and ethics amongst the group. Anonymous course evaluations showed student interest in the subject matter, relevance to their studies, and appreciation of our special collection’s space and contents.

This article examines the inspiration, construction, and meaning of the Bellevue Classification System (BCS), created during the 1930s for use in the Bellevue School of Nursing Library. Nursing instructor Ann Doyle, with assistance from librarian Mary Casamajor, designed the BCS after consulting with library leaders and examining leading contemporary classification systems, including the Dewey Decimal Classification and Library of Congress, Ballard, and National Health Library classification systems. A close textual reading of the classes, subclasses, and subdivisions of these classification systems against those of the resulting BCS, reveals Doyle's belief that the BCS was created not only to organize the literature, but also to promote the burgeoning intellectualism and professionalism of early twentieth-century American nursing.

A look at dolls in nursing care in the 20th century. Editor's note: Looking Back features the work of scholars using primary-source visual and textual documents. The column seeks interesting historical photographs accompanied by brief essays that speak to each photograph's context and implications for contemporary nursing. See AJN's author guidelines at http://ajn.edmgr.com.