bluuebunny/crossref_metadata_2025_split huggingface dataset:
Be, V, and Cu in the halo star CS 31082-001 from near-UV spectroscopy
Authors: Ernandes H , Barbuy B , Friaça A , Hill V , Spite M , Spite F , Castilho B V , Evans C J 
Published: December 2021

ABSTRACT
The ‘First Stars’ programme revealed the metal-poor halo star CS 31082-001 to be r-process and actinide rich, including the first measurement of a uranium abundance for an old star. To better characterize and understand such rare objects, we present the first abundance estimates of three elements (Be, V, Cu) for CS 31082-001 from analysis of its near-ultraviolet spectrum. Beryllium is rarely measured in giant stars, and we confirm that its abundance in this star is low due to the rather cool effective temperature that causes destruction of both Be and Li in its atmosphere. Vanadium and copper are iron-peak elements that are starting to be used as chemical-tagging indicators to investigate the origin of stellar populations. We find V and Cu abundances for CS 31082-001 that are comparable to other metal-poor stars, and present new chemical evolution models to investigate our results. In the case of V, extra nucleosynthesis due to interaction of neutrinos with matter is included in the models to be able to reproduce the measured abundance. Given the availability of high-quality spectroscopy of CS 31082-001, we also explore other atomic lines in the near-ultraviolet as a template for future studies of metal-poor stars with the planned CUBES instrument in development for the Very Large Telescope.
Immortalization and functional screening of natively paired human T cell receptor repertoires
Authors: Fahad Ahmed S , Chung Cheng-Yu , Lopez Acevedo Sheila N , Boyle Nicoleen , Madan Bharat , Gutiérrez-González Matias F , Matus-Nicodemos Rodrigo , Laflin Amy D , Ladi Rukmini R , Zhou John , Wolfe Jacy , Llewellyn-Lacey Sian , Koup Richard A , Douek Daniel C , Balfour Jr Henry H , Price David A , DeKosky Brandon J 
Published: December 2021

Abstract
Functional analyses of the T cell receptor (TCR) landscape can reveal critical information about protection from disease and molecular responses to vaccines. However, it has proven difficult to combine advanced next-generation sequencing technologies with methods to decode the peptide-major histocompatibility complex (pMHC) specificity of individual TCRs. We developed a new high-throughput approach to enable repertoire-scale functional evaluations of natively paired TCRs. In particular, we leveraged the immortalized nature of physically linked TCRα:β amplicon libraries to analyze binding against multiple recombinant pMHCs on a repertoire scale, and to exemplify the utility of this approach, we also performed affinity-based functional mapping in conjunction with quantitative next-generation sequencing to track antigen-specific TCRs. These data successfully validated a new immortalization and screening platform to facilitate detailed molecular analyses of disease-relevant antigen interactions with human TCRs.
LOCAL DIAGNOSTIC REFERENCE LEVELS FOR PEDIATRIC RETROGRADE WEDGE PORTOGRAPHY INTERVENTIONAL PROCEDURES USING A DOSE MONITORING SOFTWARE AT A TRANSPLANTATION INSTITUTE
Authors: Gerasia R , Cannataci C , Gallo G S , Tafaro C , Maruzzelli L , Cortis K , Miraglia R 
Published: December 2021

Abstract
The aim of this work was to establish local diagnostic reference levels (DRLs) for retrograde wedge portography (RWP) performed on pediatric patients assessing the usefulness of radiation dose monitoring software in the establishing process. Between September 2016 and April 2020, 66 consecutive RWP were performed at a transplantation institute and were included in our study. Patients were divided in three groups according to age: n = 25 infants, n = 20 middle childhood and n = 21 early adolescence. The third quartile of both Air Kerma at the reference point (Ka,r) and air kerma-area product (PKA) were evaluated to establish local DRLs (lDRLs). In addition, to control high Ka,r levels during procedures, the software notified to operators if Ka,r exceeded the dose ‘alert’ threshold set at 2 Gy. lDRLs were established for all three groups using PKA and Ka,r: infant group: 5.6 Gy.cm 2 and 0.034 Gy; middle childhood: 6.4 Gy.cm2 and 0.018 Gy and early adolescence: 12.8 Gy.cm2 and 0.059 Gy. The dose threshold ‘alert’ was never encountered (alert quota: 0%). The dose monitoring system supports the feasibility of accurate and easier lDRLs’ establishment.
Application of the Nursing Process Using Moulage as a Problem-Based Approach to Teaching Dermatologic Content
Authors: Taylor Tracy , Kolcun Kaitlyn , Tornwall Joni 
Published: December 2021

Abstract
Teaching dermatologic conditions can be challenging in lecture-style format. A class activity was implemented in a prelicensure nursing course to enhance learning of dermatologic conditions while emphasizing the nursing process, evidence-based treatments, transmission-based precautions, and teamwork. Students worked in teams to identify moulage-based dermatologic conditions and follow the nursing process to develop a plan of care. Students presented their findings to faculty and peers. Positive student feedback on the activity included enhanced teamwork, application of the nursing process, visual emphasis on content, and understanding of holistic care. This activity is an innovative alternative to traditional lecture format.
Beyond Traditional RN-BSN Programs
Authors: Prosser Regina , Gravens Kathleen A. 
Published: December 2021

Abstract
Seamless academic programs are essential to support key national recommendations to increase the number of baccalaureate-prepared nurses (BSN). Associate degree nursing programs graduate approximately 50 percent of the registered nurse workforce. Graduates need a quality RN-BSN in nursing pathway to advance their education. This article discusses a seamless dual admission program in northeast Ohio, a cost-effective partnership between one associate degree nursing program and one BSN program that reduced barriers for students and had positive student outcomes.
Utilizing an Online Communication Module With Baccalaureate Nursing Students to Teach Leadership in Team Meetings
Authors: Wittenberg Elaine , Johnson Renee R. , Tayyeb Ali R. 
Published: December 2021

Abstract
This article presents an online communication module for teaching nurse leadership in team meetings. Baccalaureate students (n = 64) participated in a one-hour online module as part of a leadership course. The module included a quantitative pre-post assessment and qualitative open-ended responses to video-based scenarios of team meetings. Student responses to scenarios revealed high levels of content mastery and ability to apply module content (range, 89 percent to 90 percent across two scenarios). The module was effective in increasing the knowledge, attitude, and behaviors of students and is effective for facilitating student understanding of nurse leadership in team meetings.
Social Presence and Satisfaction in Asynchronous Text-Based Communications in Online Nursing Education: A Comparison With Synchronous Video Communications
Authors: Grech Joseph 
Published: December 2021

Abstract
Asynchronous online nursing education has been associated with poor levels of student interaction. This study investigated perceived social presence, a construct used to understand online interactions, and satisfaction during asynchronous text-based communications with a sample of 33 first-year and second-year nursing students. Participants were also experiencing synchronous video communications for their online education. Although social presence in asynchronous text-based communications correlated positively with satisfaction, most students identified a higher degree of social presence and satisfaction with video communications. Consideration of social presence within online education using synchronous video communications is thus recommended.
Promoting System Thinking and Professionalism Through Simulated Hospital Experiences for Nursing and Clinical Laboratory Science Students
Authors: Stewart MaryAnne , McQuillen Elizabeth P. , Carter Erik V. 
Published: December 2021

Abstract
A simulation laboratory was developed for prelicensure nursing and undergraduate clinical laboratory science students using scripted patient cases with laboratory test results. The experience was guided by TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety). Participants (n = 66) completed the modified Interprofessional Professionalism Assessment pre- and postsimulation. Journal reflections provided qualitative data. All aspects of interprofessional professionalism increased after the simulation; the most significant gain was confidence in working with other health care professionals. Analysis of journal themes indicated the students perceived increased communication and collaboration skills concerning patient care and safety.
An Investigation of Program Factors Affecting Clinical Failure by Nursing Students
Authors: Potter Kara 
Published: December 2021

Abstract
Nursing student failure affects the number of nurses prepared to enter practice. Currently, there is a dearth of literature examining program factors that influence clinical failure. This survey of nursing directors used multiple linear regression to determine if the percentage of adjunct faculty, the number of simulation hours, and the number of clinical hours affect clinical failure rates. The results of the study showed a positive correlation between each of the independent variables and the percentage of student clinical failures.
An Innovative Experiential Approach to Learning About Quality Improvement Processes
Authors: Gaffney Mary K. 
Published: December 2021

Abstract
Baccalaureate nursing students receive education to develop quality and safety competencies. Approaches vary due to time constraints and availability of clinical sites. In this innovative, semester-long activity, student groups applied quality improvement resources from the Institute for Healthcare Improvement, addressing problems such as stethoscope hygiene practices and weekly screen time. Students’ evaluation of the experience indicated a growth in knowledge, skills, and positive attitudes toward quality improvement. Experiential nonclinical practices are an innovative and effective way to prepare baccalaureate students for participation in quality improvement activities.
Leveraging Innovation to Design a Psychiatric Mental Health Simulation for Undergraduate Nursing Students During the COVID-19 Global Pandemic
Authors: Hudgins Tracy , Camp-Spivey Logan , Lee Shirleatha 
Published: December 2021

Abstract
Undergraduate nursing students experience challenges integrating didactic knowledge into the clinical care of clients living with psychiatric mental illness. Simulation can be a successful teaching strategy to mitigate some of these challenges. The aim of this pilot simulation experience was to understand how academic technology and telehealth competencies could be leveraged to support the success of standardized patient simulations for nursing students during the COVID-19 pandemic. Data from debriefings found that students had greater confidence in their technical skills than their ability to manage their emotional responses to simulation scenarios.
Mothers' Decision Making Concerning Safe Sleep for Preterm Infants
Authors: Capper Beverly , Damato Elizabeth G. , Gutin-Barsman Sarah , Dowling Donna 
Published: December 2021

Background:
Parental decisions regarding infant sleep practices vary widely, resulting in a lack of adherence to the American Academy of Pediatrics safe sleep recommendations (SSR) and consequently an increased risk of sudden infant death syndrome (SIDS). Preterm infants are among those at a highest risk for SIDS, yet few studies focus on parental decision-making surrounding sleep practices for preterm infants.

Purpose:
The purpose of this study was to identify factors influencing decisions concerning infant sleep practices of mothers of preterm infants.

Methods:
This study used a mixed-methods design. Recruitment was through social media messaging by 2 parent support organizations. An online survey was used to assess factors influencing mothers' decisions regarding sleep practices for preterm infants.

Findings/Results:
Survey participants (n = 98) were from across the United States. Mothers of preterm infants (mean gestational age at birth = 29.42 weeks) most often reported positioning infants on their back to sleep (92.3%) and a low (15.4%) use of a pacifier at sleep time. Three themes emerged for the decisions made: adherence to SSR; nonadherence to SSR; and infant-guided decisions. Regardless of the decision, mothers indicated that anxiety over the infant's well-being resulted in a need for sleep practices that facilitated close monitoring of the infant.

Implications for Practice and Research:
The findings of this study indicate the need for understanding the underlying anxiety preventing mothers from adhering to SSR despite knowing them, along with tailoring infant sleep messaging and education to improve safety of sleep practices for preterm infants. Research is needed to examine decision making in more diverse populations.
Micro-preemie Parents' Perceptions of Trauma-Informed Developmental Neuroprotective Care and Nursing Support
Authors: Couper Jeannie 
Published: December 2021

Background:
Preterm birth is traumatic for both the infant and parents. Trauma-informed developmental neuroprotective care (TIDNC) may positively influence the outcomes for micro-preemie infants (infants born before 26 weeks' gestation) as well as support parents in crisis.

Purpose:
To explore how TIDNC influences micro-preemie parents' perceptions of nursing care and support.

Methods:
A descriptive cross-sectional study was conducted at a 56-bed level III neonatal intensive care unit (NICU). A convenience sample of micro-preemie parents (n = 16, 46%) completed the Nurse Parent Support Tool (NPST) questionnaire, which included 2 open-ended questions.

Results:
These parents scored high scores on the NPST (mean = 4.62 ± 0.24), indicating most parents felt support from the nursing staff and perceived individualized family-centered high-quality nursing care. Subscale scores were higher than all previous studies. Parents perceived high levels of support most of the time to almost always. Although 4 themes were closely associated with the subscales, the fifth theme, Praise has not been previously documented. Parents were grateful for nurses who provided compassionate care and support during one of the most difficult times of their lives.

Implications for Practice:
TIDNC encourages robust nurse–parent authentic caring relationships, which are foundational to the parents' perceptions of nursing care and support. These relationships, built on mutual trust, respect, and genuine listening, appear to foster an exceptionally high degree of support.

Implications for Research:
More research is needed to examine how unit culture, characteristics of nurses, parents, and infants as well as infant outcomes influence micro-preemie parents' perception of care and further explore the nature of support.
Femoral Lengthening in Children—A Comparison Between Magnetic Intramedullary Lengthening Nails and External Fixators
Authors: Hafez Mohamed , Nicolaou Nicolas , Offiah Amaka , Giles Stephen N. , Madan Sanjeev S. , Fernandes James A. 
Published: December 2021

Background:
Femoral lengthening can be achieved using external fixators or intramedullary lengthening nails. The purpose of this research was to compare the outcome of femoral lengthening in children using PRECICE magnetic lengthening nails with lengthening external fixators.

Methods:
Retrospective analysis of 50 children who had femoral lengthening. Group A included patients who had lengthening with external fixation, patients in Group B had lengthening with PRECICE intramedullary lengthening nails. Each group included 25 patients. The sample strictly included children aged between 11 and 17 years. Patients in each group were matched according to age and indication for lengthening whether congenital or acquired conditions. The outcomes focused on the ability to achieve target length, healing index, residual malalignment, length of hospitalization following the osteotomy surgery, and encountered complications.

Results:
Mean patient age was 14.7 years for each group. The length gain was 42±12 mm for Group A and 41.6±8 mm for Group B (P=0.84). Lengthening nails achieved the target length more accurately compared with external fixation (P=0.017). The healing index was significantly higher in group A with 53.2±19 days/cm compared with 40.2±14 days/cm in group B (P=0.03). Group A had significantly higher complications than group B (P<0.0001). There was no statistically significant difference in the final coronal malalignment between the 2 groups (P=0.2). The mean length of stay was 9.2±5.8 days for group A and 4.2±3.3 days for group B (P=0.0005).

Conclusion:
Magnetic lengthening nails are clinically effective for femoral lengthening in the pediatric population. Compared with external fixation, healing index and complications were more favorable with PRECICE nails. Further research is required to study the cost-effectiveness of this technique.

Level of Evidence:
Level IV—case series.
The Effect of L5-S1 Degenerative Disc Disease on Outcomes of L4-L5 Fusion
Authors: Conaway William , Karamian Brian A. , Mao Jennifer Z. , Kothari Parth , Canseco Jose A. , Bowles Daniel R. , DiMaria Stephen L. , Semenza Nicholas C. , Massood Alec J. , Gebeyehu Teleale F. , Kheir Nadim , Yen Winston W. , Woods Barrett I. , Lee Joseph K. , Rihn Jeffrey A. , Kaye I. David , Kepler Christopher K. , Hilibrand Alan S. , Vaccaro Alexander R. , Schroeder Gregory D. 
Published: December 2021

Study Design:
Retrospective cohort study.

Objective:
The aim was to investigate the clinical relevance of preoperative caudal adjacent segment degeneration (ASD) in patients undergoing isolated L4-5 fusion to determine a threshold of degeneration at which a primary L4-S1 fusion would be warranted.

Summary of Background Data:
Increased motion and biomechanical forces across the adjacent caudal segment in isolated L4-L5 fusion leads to concerns regarding the increased incidence of revision surgery because of the development of ASD.

Methods:
Patients who underwent isolated L4-L5 fusion between 2014 and 2019 were reviewed. Pfirrmann grading and the disc heights of the caudal level relative to the rostral level were used to quantify preoperative adjacent degenerative disc disease. To assess the influence of preoperative caudal degenerative disc disease, preoperative disc height ratios (DHRs) were compared for patients who reported minimal, moderate, and severe Oswestry disability index (ODI) sores on postoperative assessment. For each patient-reported outcome measure (PROM), adjacent DDD was compared for those who did and did not meet MCID. An area under curve analysis was used to identify a threshold of degeneration impacting outcomes from the preoperative DHR.

Results:
A total of 123 patients were studied with an average follow-up of 2.11 years. All patients demonstrated a significant improvement in all PROMs after surgery. When categorizing patients based on the severity of postoperative ODI scores, there were no preoperative differences in the L5-S1 Pfirrmann grading or DHRs. There was a significant association between greater preoperative anterior DHR and an increased number patients who met MCID for visual analog scale back. There were no radiographic differences in preoperative L5-S1 Pfirrmann grade or DHR for ODI, visual analog scale leg, MCS-12, or PCS-12. area under curve analysis was not able to identify a preoperative DHR threshold that reflected worse MCID for any PROM.

Conclusion:
No preoperative radiographic indicators of caudal ASD were predictive of worse clinical outcomes after isolated L4-5 fusion.

Level of Evidence:
Level III.
Diagnostic value of aldosterone to renin ratio calculated by plasma renin activity or plasma renin concentration in primary aldosteronism: a meta-analysis
Authors: Liu Zhenjie , Deng Xiaohong , Luo Li , Li Shaopeng , Li Man , Deng Qinqin , Zhong Weiguo , Luo Qiang 
Published: December 2021

Abstract

Background:
Since the diagnostic value of aldosterone to renin ratio (ARR) calculated by plasma renin concentration (PRC) or plasma renin activity (PRA) is still inconclusive, we conducted a meta-analysis by systematically reviewing relevant literature to explore the difference in the diagnostic efficacy of ARR calculated by PRC or PRA, so as to provide guidance for clinical diagnosis.

Methods:
We searched PubMed, Embase, and Cochrane Library from the establishment of the database to March 2021. We included studies that report the true positive, false positive, true negative, and false negative values for the diagnosis of primary aldosteronism, and we excluded duplicate publications, research without full text, incomplete information, or inability to conduct data extraction, animal experiments, reviews, and systematic reviews. STATA 15.1 was used to analyze the data.

Results:
The pooled results showed that ARR (plasma aldosterone concentration [PAC]/PRC) had a sensitivity of 0.82 (95% confidence interval [CI]: 0.78–0.86), a specificity of 0.94 (95% CI: 0.92–0.95), a positive-likelihood ratio (LR) of 12.77 (95% CI: 7.04–23.73), a negative LR of 0.11 (95% CI: 0.07–0.17), and symmetric area under the curve (SAUC) of 0.982, respectively. Furthermore, the diagnostic odds ratio (DOR) of ARR (PAC/PRC) was 180.21. Additionally, the pooled results showed that ARR (PAC/PRA) had a sensitivity of 0.91 (95% CI: 0.86–0.95), a specificity of 0.91 (95% CI: 0.90–0.93), a positive LR of 7.30 (95% CI: 2.99–17.99), a negative LR of 0.10 (95% CI: 0.04–0.26), and SAUC of 0.976, respectively. The DOR of ARR (PAC/PRA) was 155.52. Additionally, we conducted a subgroup analysis for the different thresholds (<35 or ≥35) of PAC/PRC. The results showed that the DOR of the cut-off ≥35 groups was higher than the cut-off <35 groups (DOR = 340.15, 95% CI: 38.32–3019.66; DOR = 116.40, 95% CI = 23.28–581.92).

Conclusions:
The research results suggest that the determination of ARR (PAC/PRC) and ARR (PAC/PRA) was all effective screening tools for PA. The diagnostic accuracy and diagnostic value of ARR (PAC/PRC) are higher than ARR (PAC/PRA). In addition, within a certain range, the higher the threshold, the better the diagnostic value.
Indeterminant Cell Histiocytosis in a Patient With Hemophagocytic Lymphohistiocytosis
Authors: Berman Hannah S. , Uzzell Jamar , Smart Chandra 
Published: December 2021

Abstract:
Indeterminant cell histiocytosis is a rare disorder, which often presents as a benign, papular eruption without age or sex predilection. It is diagnosed based on histologic findings that are similar to those seen in Langerhans cell histiocytosis without the characteristic Birbeck granules. Hemophagocytic lymphohistiocytosis is a potentially life-threatening disease of immune overactivation that may present with severe symptoms and multiorgan involvement. It can develop because of a primary genetic mutation or secondary to a trigger. Despite their widely different clinical manifestations, both diseases originate from the monocyte-macrophage cell lineage. In this article, we describe the unique case of a 2-year-old patient presenting with both of these histiocytic pathologies.