BACKGROUND & AIMS: :The Grassi test for completeness of vagotomy is a useful adjunct to vagotomy that aids the surgeon in severing all the vagal innervation of the acid-producing portion of the stomach. The Congo Red stick allows the surgeon to perform the Grassi test with a significant reduction in the amount of equipment and personnel required by either pH electrode or liquid Congo Red methods.

背景与目标： : 迷走神经切断术完整性的Grassi测试是迷走神经切断术的有用辅助手段，可帮助外科医生切断胃酸产生部分的所有迷走神经。刚果红棒允许外科医生进行Grassi测试，大大减少了pH电极或液态刚果红方法所需的设备和人员数量。

BACKGROUND & AIMS: PURPOSE:To evaluate the role of a complete transurethral resection of bladder tumors (c-TURBT) on oncological outcomes after radical cystectomy (RC) and its relationship with adverse pathological features. METHODS:We retrospectively analyzed data of 727 patients treated with RC and bilateral pelvic lymph node dissection at three tertiary referral centers. Possible c-TURBT was reported by the treating surgeon. Multivariable Cox regression analyses were used to assess the relationship of c-TURBT and survival outcomes after surgery in 1:1 propensity score-matched cohort adjusted for age and gender. Moreover, multivariable logistic regression (MVA) was built to predict the relationship between c-TURBT and pT3-T4 stages at RC, lymph node invasion (LNI) and positive soft tissue surgical margin (STSM). RESULTS:A total of 433 (60%) patients received a c-TURBT. 3.0% of patients with a c-TURBT achieved a pT0-pTa-pTis status vs. 2.0% of patients with incomplete TURBT. At multivariable Cox regression analyses, c-TURBT was not associated with survival outcomes. At MVA, incompleteness of TURBT was significantly associated with a pT3-T4 stage [odds ratio (OR) 8.04, 95% confidence interval (CI) 2.33-27.67, p = 0.001]. No significant association was found between c-TURBT, LNI and STSM. CONCLUSION:We found a low rate of achievement of pT0 stage at RC. An incomplete TURBT before RC represented a predictor of pT3-T4 stages, but no effect of a c-TURBT was shown on survival outcomes. Given the current inadequacy of clinical staging strategies with more than 50% of extravesical disease being under-staged, our results could improve patients selection for NAC, driving the decision-making in doubtful cases.

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BACKGROUND & AIMS: :Accurate data on West Nile virus (WNV) cases help guide public health education and control activities, and impact regional WNV blood product screening procedures. During an outbreak of WNV disease in Arizona, records from patients with meningitis or encephalitis were reviewed to determine the proportion tested for WNV. Of 60 patients identified with meningitis or encephalitis, 24 (40%) were tested for WNV. Only 12 (28%) of 43 patients aged <50 years were tested for WNV compared to 12 (71%) of 17 patients aged ≥50 years (P<0·01). Patients with clinical signs of weakness or paralysis, elevated CSF protein, admitted to an inpatient facility, or discharged to a rehabilitation facility were also more likely to have WNV testing performed. The lack of testing in younger age groups and in those with less severe disease probably resulted in substantial underestimates of WNV neuroinvasive disease burden.

背景与目标： : 关于西尼罗河病毒 (WNV) 病例的准确数据有助于指导公共卫生教育和控制活动，并影响区域WNV血液制品筛查程序。在亚利桑那州爆发WNV疾病期间，对脑膜炎或脑炎患者的记录进行了审查，以确定对WNV进行测试的比例。在确定患有脑膜炎或脑炎的60例患者中，对24例 (40% 例) 进行了WNV测试。43名年龄 <50岁的患者中只有12名 (28% 名) 接受了WNV测试，而17名年龄 ≥ 50岁的患者中只有12名 (71% 名) 接受了WNV测试 (P <0.01)。患有虚弱或瘫痪的临床症状，CSF蛋白升高，住院治疗或出院至康复治疗的患者也更有可能进行WNV测试。在较年轻的年龄段和疾病较轻的人群中缺乏测试可能导致严重低估了WNV神经浸润疾病的负担。

BACKGROUND & AIMS: PURPOSE:This article explores the current structure of NANDA-I nursing diagnoses (ND) labels. METHODS:Critical analysis of the ND labels, as categorized in the NANDA-I terminology. FINDINGS:Most of the 244 ND labels are composed of terms from the focus and judgment axes. CONCLUSIONS:The specificity of the human responses toward health and life transitions may not be totally represented in the two most common axes, as categorized within taxonomy II. IMPLICATIONS FOR NURSING PRACTICE:Improvements in NANDA-I diagnosis labels would contribute to an advanced terminology and to increased specificity and accuracy of the diagnostic process that is needed in clinical practice. Completeness of the ND labels would reflect clinical reasoning preciseness and help students and nurses in delivering more personalized, safe, and effective patient-centered care. OBJETIVO:Este artigo explora os títulos dos diagnósticos de enfermagem da NANDA-I. MÉTODOS: Análise crítica dos títulos dos diagnósticos de enfermagem da NANDA-I. RESULTADOS:A maioria dos 244 diagnósticos de enfermagem classificados são compostos essencialmente por termos referentes ao foco e ao julgamento. CONCLUSÕES: A especificidade das respostas às transições de saúde e vida pode não estar totalmente representada nos dois eixos mais comuns, como apresentado na taxonomia II. IMPLICAÇÕES PARA A PRÁTICA: Melhorias nos diagnósticos da NANDA-I em relação ao seu aspeto multiaxial contribuiriam no desenvolvimento da sua terminologia e poderiam melhorar a especificidade e acurácia do processo diagnóstico que é necessário à prática clínica. Complementar os títulos dos diagnósticos de enfermagem poderia refletir a acurácia do raciocínio clínico e ajudar os estudantes e enfermeiros em prestarem cuidados centrados no paciente mais personalizados, seguros e eficazes.

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BACKGROUND & AIMS: BACKGROUND:Completeness of ascertainment is a very important aspect of cancer registration. There is no recent published estimate for childhood cancer in Britain. METHODS:We estimated completeness of ascertainment by the National Registry of Childhood Tumours for cancer diagnosed under age 15 years in residents of Britain during 2003-04. Stratified two-source capture-recapture was applied to notifications from general cancer registries (CRs) and specialist clinicians. Variation in notification patterns was assessed by logistic regression. Results were verified by cross-checking with Hospital Episode Statistics for leukaemia patients from England born in 1998 and diagnosed before 2005. RESULTS:CRs notified 92-96% of registrations, and specialist clinicians 93%. Notification patterns varied slightly according to registry region, age at diagnosis, diagnostic group, socioeconomic status, and whether the patient had died. Irrespective of stratification by these factors, the overall completeness estimate was 99-100% (assuming independence of sources). Estimated completeness was at least 99% within all subgroups, except for one region (Thames 98-99%) and two small diagnostic groups (germ-cell and gonadal cancer 98-99%, melanoma and non-skin cancer 97-98%). INTERPRETATION:The independence assumption cannot be fully justified, as both sources used records from treatment centres. With this caveat, ascertainment of recently diagnosed childhood cancer in Britain appears to be virtually complete.

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BACKGROUND & AIMS: BACKGROUND:Estimates of completeness of death registration are crucial to produce estimates of life tables and population projections and to estimate the burden of disease. They are an important step in assessing the quality of data. In the case of subnational data analysis in Brazil, it is important to consider spatial and temporal variation in the quality of mortality data. There are two main sources of data quality evaluation in Brazil, but there are few comparative studies and how they evolve over time. The aim of the paper is to compare and discuss alternative estimates of completeness of death registration, adult mortality (45q15) and life expectancy estimates produced by the National Statistics Office (IBGE), Institute for Health Metrics and Evaluation (IHME), and estimates presented in Queiroz et al. (2017) and Schmertmann and Gonzaga (2018), for 1980 and 2010. METHODS:We provide a descriptive and comparative analysis of aforementioned estimates from four (4) sources of estimates at subnational level (26 states and one Federal District) in Brazil from two different points in time. RESULTS:We found significant differences in estimates that affect both levels and trends of completeness of adult mortality in Brazil and states. IHME and Queiroz et al. (2017) estimates converge by 2010, but there are large differences when compared to estimates from the National Statistics Office (IBGE). Larger differences are observed for less developed states. We have showed that the quality of mortality data in Brazil has improved steadily overtime, but with large regional variations. However, we have observed that IBGE estimates show the lowest levels of completeness for the Northern of the country compared to other estimates. Choice of methods and approaches might lead to very unexpected results. CONCLUSION:We produced a detailed comparative analysis of estimates of completeness of death registration from different sources and discuss the main results and possible explanations for these differences. We have also showed that new improved methods are still needed to study adult mortality in less developed countries and at a subnational level. More comparative studies are important in order to improve quality of estimates in Brazil.

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BACKGROUND & AIMS: AIMS:ST-segment recovery (STR) is a strong mechanistic correlate of infarct size (IS) and outcome in ST-segment elevation myocardial infarction (STEMI). Characterizing measures of speed, amplitude, and completeness of STR may extend the use of this noninvasive biomarker. METHODS AND RESULTS:Core laboratory continuous 24-h 12-lead Holter ECG monitoring, IS by single-photon emission computed tomography (SPECT), and 30-day mortality of 2 clinical trials of primary percutaneous coronary intervention in STEMI were combined. Multiple ST measures (STR at last contrast injection (LC) measured from peak value; 30, 60, 90, 120, and 240min, residual deviation; time to steady ST recovery; and the 3-h area under the time trend curve [ST-AUC] from LC) were univariably correlated with IS and predictive of mortality. After multivariable adjustment for ST-parameters and GRACE risk factors, STR at 240min remained an additive predictor of mortality. Early STR, residual deviation, and ST-AUC remained associated with IS. CONCLUSIONS:Multiple parameters that quantify the speed, amplitude, and completeness of STR predict mortality and correlate with IS.

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BACKGROUND & AIMS: :Vaccinating premature and low birthweight (LBW) infants according to chronological age has been found safe and effective. Although these infants are susceptible to infections, vaccinations are often delayed. We estimated vaccination coverage (VC) in preterm and LBW infants compared to term infants in a cohort study (2016 Israel birth cohort, n = 181,543) using the National Immunization Registry. Vaccinations included Hepatitis B, Diphtheria-Tetanus-acellular Pertussis-IPV-Haemophilus influenzae B, Oral Polio Bivalent, Rotavirus, Pneumococcal Conjugate, Measles-Mumps-Rubella-Varicella and Hepatitis A. Inclusion criteria: (1) born in Israel; (2) having a unique identifier (allowing data matching); and (3) surviving to 24 months. VC at 24 months and timeliness of vaccine doses were evaluated according to infants' birthweight (BW) and gestational age (GA). Preterm infants (GA < 37 weeks) comprised 7.0% (n = 12,264); LBW infants (BW< 2500 g) were 7.7% (n = 13,950); BW was 1500-2499 g in 6.8%, 1000-1499 g in 0.6% and below 1000 g in 0.3%. Compared to normal birthweight (NBW) infants (BW≥2500 g), LBW infants showed delayed initiation of vaccinations. Odds ratio (OR) for delay: DTaP-IPV-Hib 1 OR = 1.26 [95%CI 1.19-1.33]; Rota 1, OR = 1.22 [95%CI 1.16-1.29]. Vaccination delay rates were higher among smaller new-borns (below 1000 g). At 24 months there was no significant difference regarding vaccination status. This national cohort VC analysis focused on preterm/LBW infants. Vaccinating preterm and LBW infants according to the recommended schedule induces protection against life-threatening infectious diseases. Vaccination initiation among LBW infants showed considerable delay. Health practitioners and parents should cooperate to improve timely vaccination initiation.

背景与目标： : 已发现根据年龄对早产和低出生体重 (LBW) 婴儿进行疫苗接种是安全有效的。尽管这些婴儿容易感染，但疫苗接种往往会延迟。在一项队列研究 (2016以色列出生队列，n = 181,543) 中，我们使用国家预防接种登记处估算了早产和LBW婴儿与足月婴儿的疫苗接种覆盖率 (VC)。疫苗接种包括乙型肝炎，白喉-破伤风-无细胞百日咳-IPV-流感嗜血杆菌B，口服脊髓灰质炎二价，轮状病毒，肺炎球菌结合物，麻疹-腮腺炎-风疹-水痘和甲型肝炎。纳入标准 :( 1) 出生于以色列; (2) 具有唯一标识符 (允许数据匹配); (3) 存活到24个月。根据婴儿的出生体重 (BW) 和胎龄 (GA) 评估24个月时的VC和疫苗剂量的及时性。早产儿 (GA <37周) 包括7.0% (n = 12,264); 低出生体重儿 (BW< 2500g) 为7.7% (n = 13,950); 6.8% 体重1500-2499g，0.6% 1000-1499g，0.3% 低于1000g。与正常出生体重 (NBW) 婴儿 (bw ≥ 2500g) 相比，LBW婴儿显示延迟开始接种疫苗。延迟的优势比 (OR): DTaP-ipv-hib 1 OR = 1.26 [95% CI 1.19-1.33]; Rota 1，OR = 1.22 [95% CI 1.16-1.29]。较小的新生婴儿 (低于1000g) 的疫苗接种延迟率较高。在24个月时，疫苗接种状况没有显着差异。这项国家队列VC分析的重点是早产/LBW婴儿。根据推荐的时间表为早产儿和LBW婴儿接种疫苗可预防威胁生命的传染病。LBW婴儿的疫苗接种开始显示出相当大的延迟。卫生从业人员和父母应合作，以改善及时的疫苗接种。

BACKGROUND & AIMS: :Following the publication of this article [1], the authors reported a typesetting error in Table 1 that caused the columns of the table to be ordered incorrectly, and a typographical error in a sentence in the Conclusions section.

背景与目标： : 在本文发表 [1] 之后，作者报告了表1中的排版错误，导致表的列顺序错误，并且在结论部分的句子中出现了印刷错误。

BACKGROUND & AIMS: :Notifiable disease surveillance systems provide essential data for infectious disease prevention and control programs at the local, state, and national levels. Given that reporting completeness is known to vary considerably, this review identifies methods that can reliably enhance completeness of reporting. These surveillance-related activities include initiating active surveillance when appropriate; implementing automated, electronic laboratory-based reporting; strengthening ties with clinicians and other key partners in notifiable disease reporting; and increasing the use of laboratory diagnostic tests in identifying new cases. Despite ample data in support of these strategies, notifiable disease surveillance continues to receive insufficient attention and resources. Recent attention to public health preparedness provides an opportunity to strengthen notifiable disease surveillance and enhance completeness of reporting.

背景与目标： : 法定疾病监测系统为地方，州和国家各级的传染病预防和控制计划提供必要的数据。鉴于已知报告完整性差异很大，因此本次审查确定了可以可靠地增强报告完整性的方法。这些与监测有关的活动包括在适当时启动主动监测; 实施基于实验室的自动化电子报告; 加强与临床医生和其他关键伙伴在法定疾病报告方面的联系; 以及在识别新病例时更多地使用实验室诊断测试。尽管有足够的数据支持这些战略，但应报告的疾病监测仍然没有得到足够的关注和资源。最近对公共卫生准备的关注为加强应报告的疾病监测和报告的完整性提供了机会。

BACKGROUND & AIMS: BACKGROUND:The purpose of this study was to investigate the completeness of TNM (Tumor, Node, Metastasis) staging of melanoma in the Danish Cancer Registry (DCR). METHODS:We identified 8762 patients with a first primary diagnosis of melanoma from the DCR between 2004 and 2009. We obtained information on level of comorbidity, defined according to the Charlson Comorbidity Index, through the Danish National Patient Register. We computed the completeness of TNM staging overall and by each stage component. Analyses were stratified by gender, age, year of diagnosis, and level of comorbidity. We designed an algorithm that categorized melanoma stage as localized, regional, distant, or unknown. Owing to knowledge on clinical coding practice, we allowed for categorization of tumors with certain missing stage components. RESULTS:The overall completeness of the TNM staging was 78.4% (95% confidence interval [CI] 77.5-79.3). Completeness varied little by gender and year of diagnosis. However, completeness decreased from 83.5% (95% CI 81.7-85.3) in patients aged 0-39 years to 68.7% (95% CI 65.7-71.6%) in patients 80 years or older, and from 80.3% (95% CI 79.4-81.3) among patients with a low level of comorbidity to 67.4% (95% CI 63.1-71.4) among patients with a high level of comorbidity. Using the algorithm, 87.3% of cases could be assigned to one of the defined stage categories. CONCLUSION:The overall completeness of the TNM registration for melanoma was fairly high but varied with age and level of comorbidity. Thus, data on TNM stage should be used with caution in epidemiological and other research.

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BACKGROUND & AIMS: OBJECTIVE:The aim of this study was to investigate the completeness and legibility of prescriptions dispensed in community pharmacies located in Sana'a, Yemen. MATERIALS AND METHODS:A cross-sectional study was conducted at 23 randomly selected community pharmacies throughout the capital city of Sana'a, Yemen, from May 2015 to January 2016. A total of 2,178 prescriptions were analyzed for the essential elements of a complete prescription using a validated checklist. RESULTS:Of the 2,178 prescriptions, 19 (0.87%) were considered to be of good quality. The remaining 2,159 (99.12%) were considered as being of very poor quality. Writing errors relating to patients and prescribed medications were the most common errors. CONCLUSION:In this study, the quality of prescription writing was found to be very poor. Hence, continuous professional development programs are recommended to improve the quality of prescription writing among physicians. Future studies in other cities and investigation of the impact of continuous educational programs on the quality of prescription writing are strongly recommended.

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BACKGROUND & AIMS: BACKGROUND:Studies of the accuracy and completeness of handwritten anesthesia records demonstrate deficiencies in documentation, suggesting that the quality of anesthesia records can be improved. METHODS:We reviewed all electronic anesthesia records generated during a 1-month period at our institution to ascertain completion rates for six clinical documentation elements: allergies, IV access, electrocardiogram rhythm, ease of mask ventilation, laryngoscopic grade of view, and insertion depth of the endotracheal tube. RESULTS:Of 2838 records, 64% had the necessary free text remark in the allergy element. The free text required to complete endotracheal tube depth documentation appeared in 538 of 918 cases in which the patient was tracheally intubated (59%). Free text documentation of the electrocardiogram rhythm diagnosis appeared at least once in 86% of records. Documentation of mask ventilation characteristics was entered by touch screen from a pick list and was expected in 781 records but appeared in 664 records (85%). Laryngoscopic grade of view documentation was also selected by touch screen and expected in 883 records but present in 811 cases (92%). Any notation of IV access appeared in 84% of records. CONCLUSIONS:We found that electronic clinical anesthesia documentation was often incomplete. Dependence on free text remarks and the record keeping system's inability to automatically present entries in logical sequences consistent with workflow were associated with incomplete data entry. Our results suggest that the user interface for data entry, and the logic that an electronic system uses for preventing omissions and inconsistencies, merit further study and development in order to facilitate clinically useful documentation.

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BACKGROUND & AIMS: BACKGROUND:Achieving adequate response rates is an ongoing challenge for longitudinal studies. The World Trade Center Health Registry is a longitudinal health study that periodically surveys a cohort of ~71,000 people exposed to the 9/11 terrorist attacks in New York City. Since Wave 1, the Registry has conducted three follow-up surveys (Waves 2-4) every 3-4 years and utilized various strategies to increase survey participation. A promised monetary incentive was offered for the first time to survey non-respondents in the recent Wave 4 survey, conducted 13-14 years after 9/11. METHODS:We evaluated the effectiveness of a monetary incentive in improving the response rate five months after survey launch, and assessed whether or not response completeness was compromised due to incentive use. The study compared the likelihood of returning a survey for those who received an incentive offer to those who did not, using logistic regression models. Among those who returned surveys, we also examined whether those receiving an incentive notification had higher rate of response completeness than those who did not, using negative binomial regression models and logistic regression models. RESULTS:We found that a $10 monetary incentive offer was effective in increasing Wave 4 response rates. Specifically, the $10 incentive offer was useful in encouraging initially reluctant participants to respond to the survey. The likelihood of returning a survey increased by 30% for those who received an incentive offer (AOR = 1.3, 95% CI: 1.1, 1.4), and the incentive increased the number of returned surveys by 18%. Moreover, our results did not reveal any significant differences on response completeness between those who received an incentive offer and those who did not. CONCLUSIONS:In the face of the growing challenge of maintaining a high response rate for the World Trade Center Health Registry follow-up surveys, this study showed the value of offering a monetary incentive as an additional refusal conversion strategy. Our findings also suggest that an incentive offer could be particularly useful near the end of data collection period when an immediate boost in response rate is needed.

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