bluuebunny/crossref_metadata_2025_split huggingface dataset:
Peripheral and central nervous system alterations in a rat model of inflammatory arthritis
Authors: Locke Samantha , Yousefpour Noosha , Mannarino Matthew , Xing Shuran , Yashmin Fatima , Bourassa Valerie , Ribeiro-da-Silva Alfredo 
Published: February 2020

Abstract
It is consistently reported that in inflammatory arthritis (IA), pain may continue despite well-controlled inflammation, most likely due to interactions between joint pathology and pain pathway alterations. Nervous system alterations have been described, but much remains to be understood about neuronal and central non-neuronal changes in IA. Using a rat model of IA induced by intra-articular complete Freund's adjuvant injection, this study includes a thorough characterization of joint pathology and objectives to identify peripheral innervation changes and alterations in the spinal dorsal horn (DH) that could alter DH excitatory balancing. Male and female rats displayed long-lasting pain-related behavior, but, in agreement with our previous studies, other pathological alterations emerged only at later times. Cartilage vascularization, thinning, and decreased proteoglycan content were not detectable in the ipsilateral cartilage until 4 weeks after complete Freund's adjuvant. Sympathetic and peptidergic nociceptive fibers invaded the ipsilateral cartilage alongside blood vessels, complex innervation changes were observed in the surrounding skin, and ipsilateral nerve growth factor protein expression was increased. In the DH, we examined innervation by peptidergic and nonpeptidergic nociceptors, inhibitory terminal density, the KCl cotransporter KCC2, microgliosis, and astrocytosis. Here, we detected the presence of microgliosis and, interestingly, an apparent loss of inhibitory terminals and decreased expression of KCC2. In conclusion, we found evidence of anatomical, inflammatory, and neuronal alterations in the peripheral and central nervous systems in a model of IA. Together, these suggest that there may be a shift in the balance between incoming and outgoing excitation, and modulatory inhibitory tone in the DH.
Evaluation of Fundamental Forensic Knowledge and Perceived Ability in Emergency Nurse Practitioner Education via Forensic Simulation
Authors: Drake Stacy A. , Godwin Kyler M. , Wolf Dwayne A. , Gallagher Martina 
Published: February 2020

Introduction
The need for trauma care and forensic services is among the top five reasons for seeking healthcare in the United States. Critical aspects of caring for a forensic patient include early recognition of the need for implementing forensic approaches to care: assessment, evidence collection and preservation, and forensic documentation. The intent of this study was to examine fundamental forensic knowledge and perceived ability of graduate-level emergency nurse practitioner students.

Methods
The study was designed to assess fundamental forensic knowledge of graduate-level emergency nurse practitioners using a pretest-and-posttest prospective design utilizing simulation.

Results
Students showed an increase in their knowledge of forensic nursing concepts from pretest to posttest (t(39) = 9.63, p < 0.001). In addition, there was an increase in students' perceived ability (confidence) to recognize the forensic aspects of patient care. Two unexpected findings were revealed during debriefing. Although the students were interested in gaining forensic knowledge, they felt it was more important to know when to refer a patient rather than to gain the requisite knowledge to perform forensic functions on their own. Furthermore, students developed an awareness of how their previous clinical experiences influenced their care.

Conclusion
Findings from this study will inform further development of graduate-level nursing education to include forensic and multidisciplinary simulation exercises.
Sexual Assault Victimization Among Children and Youth With Developmental Disabilities: Responding With Trauma-Informed Care
Authors: Reese Shannonlee , Deutsch Stephanie Anne 
Published: February 2020

ABSTRACT
Sexual assault victimization is a traumatic experience for children and youth, and care of survivors requires a trauma-informed approach. Children and youth with developmental disabilities are sexually victimized at higher rates than those without disabilities. Children with autism spectrum disorder (ASD), in particular, may be at an increased risk for both traumatic events and developing traumatic sequelae after sexual assault victimization. In this report, we present the case of a youth with ASD who sought acute sexual assault care, but whose care was compromised because of multiple systems failures, including gaps in communication regarding her unique needs, and inconsistent knowledge among multidisciplinary team members regarding necessary adaptations in the implementation of trauma-informed care for youth with ASD. Lessons learned, including proposed solutions to improve communication and education, and approaches to prevent unintended retraumatization are discussed.
Nursing Management of Gastrointestinal Adverse Events Associated With Delayed-Release Dimethyl Fumarate: A Global Delphi Approach
Authors: Campbell Trudy L. , Lefaux Béatrice Jenny , Mayer Lori Lee , Namey Marie , Riemer Gisela , Robles-Sanchez Miguel A. , White Sarah , Edwards Michael , Minor Charles 
Published: February 2020

ABSTRACT

BACKGROUND: Gastrointestinal (GI) adverse events (AEs) are commonly encountered with delayed-release dimethyl fumarate (DMF), an approved treatment for relapsing multiple sclerosis (MS). METHODS: Two hundred thirty-nine MS nurses from 7 countries were asked to complete a 2-round Delphi survey developed by a 7-member steering committee. Questions pertained to approaches for mitigating DMF-associated GI AEs. RESULTS: Ninety-six percent of nurses followed the label recommendation for DMF dose titration in round 1, but 77% titrated the DMF dose more slowly than recommended in round 2. Although 86% of nurses advised persons with relapsing forms of MS (PWMS) to take DMF with food, patients were not routinely informed of appropriate types of food to take with DMF. Most nurses recommended both pharmacologic and nonpharmacologic symptomatic therapies for PWMS who experienced GI AEs on DMF. Pharmacologic and nonpharmacologic symptomatic therapies were regarded as equally effective at keeping PWMS on DMF. In round 2, 58% of nurses stated that less than 10% of PWMS who temporarily discontinued DMF went on to permanently discontinue treatment. Sixty-six percent of nurses stated that less than 10% of PWMS permanently discontinued DMF because of GI AEs in the first 6 months of treatment in round 1. Most nurses agreed that patient education on potential DMF-associated GI AEs contributes to adherence. CONCLUSION: This first real-world nurse-focused assessment of approaches to caring for PWMS with DMF-associated GI AEs suggests that, with implementation of slow dose titration, symptomatic therapies, and educational consultations, most PWMS can remain on DMF and, when necessary after temporary discontinuation, successfully restart DMF.
High-Risk Human Papillomavirus Identification in Precancerous Cervical Intraepithelial Lesions
Authors: Zheng Ruifang , Heller Debra S. 
Published: February 2020

Objective
This review aims to summarize the currently available human papillomavirus (HPV) testing methods for precancerous cervical intraepithelial lesions.

Materials and Methods
A literature search of PubMed using key words “high-risk HPV, precancerous cervical intraepithelial lesions, FDA-approved HPV tests, p16 IHC, Ki 67 IHC, fluorescent in situ hybridization for HPV, Pap smear, HPV vaccines, HPV tests using self-collected samples, and next-generation sequencing” was performed between January 1 and June 14, 2019. The package inserts of the Food and Drug Administration–approved HPV tests were obtained from the companies' Web sites.

Results
Multiple morphology-based, immunohistochemical staining and nucleic acid HPV tests were reviewed, including the material required, methodologies, result interpretations, as well as their advantages, limitations, and futures. The structure of HPV and its natural history of infection and transmission were touched on as well for a better understanding of these testing methods.

Conclusions
Human papillomavirus tests are a critical component for cervical cancer screening, and understanding of these tests helps test results interpretation and patients' triage.
What Genes Can Tell: A Closer Look at Vestibular Schwannoma
Authors: Aaron Ksenia A. , Manojlovic Zarko , Tu Nathan , Xu Yili , Jin Yuxin , Chang Sharon , Kwok Eric , Webb Michelle , Hurth Kyle , Friedman Rick A. 
Published: February 2020

Objective:
Comprehensive molecular profiling of radioresistant and cystic vestibular schwannoma (VS) subtypes.

Study Design:
Our study utilized whole-exome sequencing (WES), RNA-sequencing (RNAseq), and correlated clinical data from 12 samples (2 samples of solid sporadic subtype, 8 with cystic changes, and 2 previously irradiated).

Setting:
Academic medical center.

Patients:
Patients diagnosed with VS who required surgical treatment. Inclusion: Cystic and radioresistant tumors matched to age and tumor volume, with solid sporadic VS samples as control; Exclusion: NF-2 patients.

Intervention(s):
WES using custom probes for copy number analysis. A modified version of the Agilent Human Whole Exome sequencing hybrid capture system was used to process samples. Recurrent variants were identified and compared between groups. Leukocyte-derived DNA was utilized as internal control to reduce false-positives.

Main Outcome Measure(s):
Analysis of genetic landscape of VS subtypes (naive solid VS, cystic VS, and previously irradiated VS) by performing deep next-generation sequencing.

Results:
WES data achieved a mean coverage of 202X and RNAseq generated an average of 74 million total reads. As a group, 25% of samples had 22q loss. Somatic analysis identified previously reported genes and multiple novel mutations across samples. Differential expression analysis of RNAseq data found significantly mutated genes such as COL6A3, CLMP, ART4, Lumican that were shared by both cystic VS and irradiated VS, but not seen in sporadic VS.

Conclusions:
Using WES we were able to demonstrate that cystic and irradiated samples are subtypes of VS with an increased mutation burden and a unique genetic fingerprint. We identified differences between the genomic and molecular profile of cystic VS and radioresistant VS. Our results help advance the understanding of the pathophysiology of these tumor subtypes and suggest possible molecular targets for novel treatment strategies.
Binaural Hearing Rehabilitation Improves Speech Perception, Quality of Life, Tinnitus Distress, and Psychological Comorbidities
Authors: Ketterer Manuel Christoph , Häussler Sophia-Marie , Hildenbrand Tanja , Speck Iva , Peus Dominik , Rosner Bastian , Knopke Steffen , Graebel Stefan , Olze Heidi 
Published: February 2020

Objectives:
To determine and compare the benefit of binaural hearing rehabilitation via cochlear implantation (CI) on speech perception, assessment of auditory abilities, tinnitus distress, health-related quality of life (HRQoL) and psychological comorbidities in patients suffering from asymmetric hearing loss (AHL) as well as bilaterally-deafened and sequentially bilaterally-implanted patients.

Methods:
53 patients were implanted between 2011 and 2016. 24 AHL patients were implanted unilaterally, using a hearing aid on the other side. 29 bilaterally-deafened patients were sequentially implanted bilaterally. Speech perception, subjective hearing quality, HRQoL, tinnitus distress, anxiety, depressiveness, perceived stress level and coping abilities were evaluated before implantation, as well as 6 and 24 months postoperatively.

Results:
Before CI, AHL and bilaterally-deaf patients showed significant differences regarding assessment of auditory abilities, speech discrimination, tinnitus distress and HRQoL. 24 months after CI both groups significantly improved in those scales. We could not find a significant difference between the groups after 2 years. Tinnitus distress significantly decreased 6 and 24 months postoperatively in both groups.

Conclusions:
This study demonstrates the long-term benefit of binaural hearing rehabilitation in AHL and bilaterally-deaf patients not only regarding speech perception but also HRQoL, tinnitus distress and subjective hearing quality. Bilaterally-deafened patients present lower scores preoperatively, but they did not differ from AHL patients 2 years after CI. Up to now, this is the first study evaluating the outcome of CI in AHL patients compared to bilaterally-implanted patients and demonstrating the benefit of binaural hearing rehabilitation in these specific groups.
Viral respiratory infections: a cause of community-acquired pneumonia or a predisposing factor?
Authors: Arnold Forest W. , Fuqua Joshua L. 
Published: February 2020

Purpose of review
A cause for community-acquired pneumonia (CAP) is only identified in ∼50% of cases. Nasopharyngeal PCR panels contain more viruses than previously. The problem then becomes determining the relevance of the organisms identified rather than figuring out which virus is present. This review addresses how to distinguish between viral CAP and bacterial CAP, how viral CAP predisposes to bacterial CAP and some novel antiviral treatment being conducted.

Recent findings
The pneumonia severity index has been studied in patients with viral CAP. There are new studies using biomarkers to help determine when antimicrobial treatment is needed in CAP patients, and there is still no consensus. Newer devices are being invented in an effort to separate upper from lower respiratory organisms to make test results more relevant. Several outcome studies in patients with viral CAP are reviewed.

Summary
In addition to clinical correlation, using biomarkers can be useful to distinguish viral from bacterial CAP. Outcomes in patients with a co-infection are generally worse as a viral infection may predispose someone to a bacterial pneumonia. Influenza CAP treatment may be initially accompanied with antimicrobials until a patient's diagnosis is clear (∼48–72 h). Future research is being conducted for antiviral treatment more than for influenza.
Less invasive surfactant administration: best practices and unanswered questions
Authors: Herting Egbert , Härtel Christoph , Göpel Wolfgang 
Published: February 2020

Purpose of review
The purpose of this review is to describe current concepts in the field of Less Invasive Surfactant Administration (LISA). The use of continuous positive airway pressure (CPAP) has become standard for the treatment of premature infants with respiratory problems throughout the world. However, if CPAP fails, technologies like LISA are needed that can combine surfactant delivery and spontaneous breathing with the support of noninvasive modes of ventilation.

Recent findings
LISA with thin catheters has been in use in Germany for more than 15 years. In the last 5 years, there was substantial interest in this method around the world. Randomized studies and recent metaanalyses indicate that the LISA technique helps to avoid mechanical ventilation especially in emerging respiratory distress syndrome (RDS). LISA is also associated with improved outcomes of preterm infants, specifically in the prevention of bronchopulmonary dysplasia (BPD) and intracranial hemorrhage (ICH). By now, a variety of different LISA catheters, devices and techniques have been described. However, most of the technologies are still connected with the unpleasant experience of laryngoscopy for the affected infants, so that the search for even less invasive techniques, for example, surfactant application by nebulization, goes on.

Summary
Maintenance of spontaneous breathing with support by the LISA technique holds big promise in the care of preterm infants. Patient comfort and lower complication rates are strong arguments to further investigate and promote the LISA approach. Open questions include exact indications for different patient groups, the usefulness of devices/catheters that have recently been built for the LISA technique and -- perhaps most urgently -- the issue of analgesia/sedation during the procedure. Studies on long-term outcome after LISA are under way.
Update on penicillin allergy delabeling
Authors: Shaker Marcus , McWilliams Samuel , Greenhawt Matthew 
Published: February 2020

Purpose of review
To review phenotyping and risk classification of penicillin allergy and provide an update on penicillin allergy delabeling strategies for primary care.

Recent findings
Beta-lactams are considered the treatment of choice for a wide range of bacterial pathogens; however, many patients receive second-line agents due to being labeled as having an allergy to penicillin. This approach can lead to antibiotic resistance and inferior health outcomes. While 10% of the population is labeled as penicillin allergic, penicillin anaphylaxis occurs in less than 1% of patients. For patients with delayed benign skin rashes (e.g., urticaria or maculopapular exanthem >1 h after administration) attributable to beta-lactam administration occurring more than 12 months ago, direct oral challenge (rechallenge with antibiotic in the clinical setting) can be a safe and effective strategy, with immediate reactions occurring in less than 5% of such low-risk patients and delayed reactions appearing infrequently. In patients with penicillin-associated immediate urticaria, other IgE-mediated features, or anaphylaxis, further allergy evaluation and penicillin skin testing is warranted. Any severe idiosyncratic cutaneous adverse reaction is rare, but can be dangerous so prompt removal of the inciting agent is required.

Summary
Penicillin allergy delabeling is a high-value service that can be effectively delivered through a multidisciplinary collaborative approach.
Autism: considerations for transitions of care into adulthood
Authors: Enner Stephanie , Ahmad Samiya , Morse Anne M. , Kothare Sanjeev V. 
Published: February 2020

Purpose of reviewThe steady rise in number of youth diagnosed with autism spectrum disorder (ASD) has led to the need to examine transition of care considerations specific to ASD. Improved understanding and guidance addressing these needs will allow pediatric and adult providers to work together to optimize social, medical, and occupational outcomes for these patients.Recent findingsHealth-care transition is a delicate time when children with ASD outgrow the services of pediatric programs and enter a fragmented healthcare system that is unfamiliar, insufficiently knowledgeable, and underfunded for their needs.SummaryIncreasing autism prevalence and an aging population with autism lend urgency to improve outcomes in children transitioning to adult-care. Research reveals poor consequences in social support, education, vocational training and employment, housing, and healthcare. Specific considerations to address these issues and ensure successful transition from pediatric to adult care are needed.
Vitamin D Deficiency and Sleep Quality in Minority Pregnant Women
Authors: Woo Jennifer , Penckofer Susan , Giurgescu Carmen , Yeatts Paul E. 
Published: February 2020

Abstract

Purpose:
To examine if vitamin D deficiency was associated with poor sleep quality in a sample of African American and Hispanic pregnant women. We also examined if race moderates the relationship between serum 25(OH)D levels and sleep quality among participants in this sample.

Study Design and Methods:
Using a cross-sectional design, a sample of 115 African American and Hispanic pregnant women were enrolled from a federally qualified health center in the Midwest. Women completed questionnaires and had blood drawn for serum 25(OH)D levels between 24- and 32 weeks gestation. The questionnaires included demographic characteristics, the Pittsburgh Sleep Quality Index, and dietary vitamin D and calcium intake.

Results:
The overall regression model indicated that the predictors explained 17% of variance in sleep quality (F
(5, 103) = 4.10, p = .002, R
2 = 0.17). Serum 25(OH)D levels were significant predictors of sleep quality after controlling for covariates (i.e., race, maternal age, prepregnancy body mass index, gestational age at data collection). Race did not moderate the association between serum 25(OH)D levels and sleep quality among women in this sample.

Clinical Implications:
Pregnant women should be screened for vitamin D deficiency. Women who have vitamin D deficiency should be provided vitamin D supplementation. Vitamin D supplementation may be a simple solution to enhance sleep quality at this critical time in a woman's life.
Impact of Single Sign-on Adoption in an Assessment Triage Unit
Authors: James Neely , Marwaha Shruti , Brough Stacie , John Thomas T. 
Published: February 2020

BACKGROUND
Clinician time is a valuable and costly resource. In an age where computer and clinical application usage is increasing, the need for providers to remember multiple usernames and passwords is increasingly inefficient. Further complexity is added to clinical workflows if clinicians must log into smart devices frequently without a simple solution for access and data security.

OBJECTIVE
The purpose of this study was to measure the average time required and time savings when taking vital sign measurements using the Single Sign-On (SSO) (badge scan and go) on the electronic medical record–connected vital sign monitors versus using 2-factor authentication (entry of username and password). In addition, user satisfaction, system usability, workflow preference, and efficacy of the deployment of Network Connectivity Engine, that is, the host middleware for SSO, were evaluated through surveys.

METHODS
A preimplementation and postimplementation study was performed in the unit piloting the initiative before hospital-wide deployment. Clinician usability and workflow preference surveys were conducted postimplementation.

RESULTS
Analysis showed significance in time savings by adopting SSO.

CONCLUSION
SSO had a positive impact on staff efficiency and was the preferred method versus the 2-factor log-in.
Clinical Nurse Specialists on the Night Shift
Authors: Fischer-Cartlidge Erica , Arenas Elizabeth , Ogbuagu Linda , Remondini Carla , Murphy Jane 
Published: February 2020

Background
Night-shift nurses care for complex and acutely ill patients but are frequently more junior compared with day shift. They often have less access to support resources such as educators and clinical nurse specialists (CNSs). This article describes the addition of night CNS positions, their roles, and associated outcomes.

Intervention
The night CNSs were implemented to perform a highly flexible set of activities including proactive rounding on high-risk patients and medications; code/rapid response support; education; nursing practice/policy reinforcement; providing psychosocial support to nurses, patients, and families; and responding to consults. To capture work effort at night and truly define the role of the night CNS, a shared consultation log was created.

Outcomes
Between October 2017 to April 2019, 6053 CNS encounters were captured in 24 different categories. The top 5 reasons for consultation included policy/procedure education or change, education/in-service, nursing practice review/reinforcement, medication/blood administration, and clinical assist. Five hundred sixty-nine rapid response/codes have been responded to. There was also a 17% increase in event reporting on the night shift. Outcomes have continued to support additional budgeted positions for the nights and weekends.

Implications
Night CNS expertise and knowledge are vital to offsetting novice nurse deficits in advanced assessment, which is paramount to patient outcomes. They provide support with on-the-spot education and empower individual development. Organizations should strongly consider implementation of this role or, if that is not possible, consider flexible scheduling into evening hours to support night staff.