bluuebunny/crossref_metadata_2025_split huggingface dataset:
Successful management of an unusual case of pediatric inflammatory myofibroblastic tumor: a case report and literature review
Authors: Amro Alhareth M. , Almassri Tabarak , Albandak Maram , Elqadi Mohammad , Bannoura Sami , Asafrah Anas A. , Abu Asbeh Yousef 
Published: December 2024

Introduction and importance:
Inflammatory myofibroblastic tumor (IMT) is a rare neoplastic condition that primarily affects children and young adults. This case report highlights the challenges in diagnosing and treating pediatric IMT, emphasizing the importance of tailored interventions.

Case presentation:
An 8-year-old boy presented with respiratory symptoms and was diagnosed with an IMT located in the left main bronchus. Imaging studies revealed a soft tissue mass and lymph node enlargement. Bronchoscopy and biopsy confirmed the diagnosis. The patient underwent bronchoscopic debulking procedures followed by lobectomy and bronchoplasty due to persistent disease.

Clinical discussion:
IMTs pose diagnostic challenges due to their varied clinical presentation and similarities with other neoplasms. A multidisciplinary approach involving pathologists, radiologists, and surgeons is crucial for accurate diagnosis and optimal treatment planning. The pathogenesis of IMTs is not fully understood, but theories suggest an inflammatory response or involvement of the ALK gene. IMTs can affect various organs, each with distinct symptoms. Imaging modalities lack specificity, emphasizing the importance of histopathological examination.

Conclusion:
IMTs require individualized treatment approaches based on the location and extent of the tumor. Long-term follow-up is essential for monitoring recurrence and metastasis. Further research is needed to enhance our understanding of IMT biology and develop targeted therapies to improve patient outcomes. This case report underscores the importance of tailored interventions in pediatric IMT cases and highlights the challenges in diagnosis and treatment.
The health effects of poor air quality
Authors: Bingham Karilee W. 
Published: December 2024

Abstract:
Smoke, particularly from wildfires and other combustion sources, is a significant contributor to air pollution, comprising a complex mixture of particulate matter and gaseous pollutants. Prolonged exposure to smoke can exacerbate respiratory diseases, such as asthma and chronic obstructive pulmonary disease, leading to increased ED visits and hospitalizations. This article examines the significant health risks associated with air pollution, particularly chronic diseases and acute respiratory conditions, and discusses the emergency treatment of acute respiratory distress from exposure.
Enhancing primary healthcare in under-resourced communities with mobile health clinics
Authors: David Marjory , Charles Marie Lourdes 
Published: December 2024

Abstract:
Mobile health clinics (MHCs) have the potential to enhance primary care in low-resource communities. This article describes an initiative spearheaded by public health nurses that utilized MHCs to provide affordable, equitable, and culturally appropriate primary healthcare services to a rural community in Haiti.
Nurse stress relief
Authors: Noel Stacy A. , Sarik Danielle Altares , Collins Michelle 
Published: December 2024

Abstract

Purpose:
To investigate and assess the effects of Healing Touch (HT) level-one education and training and the 21-day practice of the self-chakra connection technique on the perceived stress levels of nurses at a large healthcare system located in the Mid-Atlantic US region.

Methods:
This study used a mixed-methods design to collect quantitative and qualitative data via pre- and post-intervention surveys with Cohen's Perceived Stress Scale and post-open-ended questions. Data were analyzed using descriptive and correlational statistics.

Results:
In this pilot study of 58 nurses who participated in HT classes, 34 nurses completed the presurvey and 22 completed both pre- and post-surveys. Results revealed a 3.8-point mean decrease in perceived stress scores, with participants reporting improved stress management, increased confidence, and better work preparedness. However, statistical significance was not achieved due to low post-survey completion rates.

Conclusion:
Nurses who received HT training and practiced the self-chakra connection technique as part of their self-care reported decreased perceived stress levels, supporting the use of HT as a potentially effective approach to stress reduction among nurses.
Essential guide to epidural analgesia for nurses
Authors: Sawhney Monakshi , Martinez-Rivera Emily 
Published: December 2024

Abstract:
Epidural analgesia is an effective way to manage pain for labor and delivery, surgery, trauma, cancer, and neuropathic pain. It involves the administration of local anesthetics and/or opioids into the epidural space. To ensure its efficacy and safety, nurses must understand the basic anatomy and pharmacology of epidural analgesia, considerations when monitoring patients, and identify its adverse reactions.
Embracing practice innovation
Authors: Makic Mary Beth Flynn , Dailey-Vail Jennifer , Armstrong Gail , Rosenthal Laura 
Published: December 2024

Abstract:
This article explores the synergistic relationship between evidence-based practice (EBP) and quality improvement (QI) methods in nursing, highlighting their potential to enhance patient outcomes and foster practice change. By identifying clinical gaps and employing a structured approach to integrate EBP and QI, nurses can effectively implement best practices tailored to evolving healthcare needs. Ultimately, this article provides a comprehensive framework for nurses to leverage EBP and QI collaboratively, thereby advancing nursing practice and improving patient care.
Family Presence at the PICU Bedside and Pediatric Patient Delirium: Retrospective Analysis of a Single-Center Cohort, 2014–2017
Authors: Smith Mallory B. , Killien Elizabeth Y. , Watson R. Scott , Dervan Leslie A. 
Published: December 2024

Objectives:
To examine the association between family presence at the PICU bedside and daily positive delirium screening scores.

Design:
Retrospective cohort study.

Setting:
Tertiary children’s hospital PICU.

Subjects:
Children younger than 18 years old with PICU length of stay greater than 36 hours enrolled in the Seattle Children’s Hospital Outcomes Assessment Program from 2014 to 2017.

Interventions:
None.

Measurements and Main Results:
In the dataset, delirium screening had been performed bid using the Cornell Assessment of Pediatric Delirium, with scores greater than or equal to 9 classified as positive. Family presence was documented every 2 hours. Among 224 patients, 55% (n = 124/224) had positive delirium screening on 44% (n = 408/930) of PICU days. Family presence at the bedside during PICU stay (< 90% compared with ≥ 90%) was associated with higher proportion of ever (as opposed to never) being screened positive for delirium (26/37 vs. 98/187; difference, 17.9% [95% CI, 0.4–32.1%]; p = 0.046). On univariate analysis, each additional decile of increasing family presence was associated with lower odds of positive delirium screening on the same day (odds ratio [OR], 0.87 [95% CI, 0.77–0.97]) and subsequent day (OR, 0.84 [95% CI, 0.75–0.94]). On multivariable analysis after adjustments, including baseline Pediatric Cerebral Performance Category (PCPC), higher family presence was associated with lower odds of subsequent-day positive delirium screening (OR, 0.89 [95% CI, 0.81–0.98]). Among patients with PCPC less than or equal to 2, each additional decile of increasing family presence was independently associated with lower odds of both same-day (OR, 0.90 [95% CI, 0.81–0.99]) and subsequent-day (OR, 0.85 [95% CI, 0.76–0.95]) positive delirium screening.

Conclusions:
In our 2014–2017 retrospective cohort, greater family presence was associated with lower odds of delirium in PICU patients. Family presence is a modifiable factor that may mitigate the burden of pediatric delirium, and future studies should explore barriers and facilitators of family presence in the PICU.
Challenges and Supports for Implementing Health Equity During National Accreditation Among Small Local Health Departments in the United States
Authors: Crenshaw Andrew N. , Allen Peg , Fifolt Matthew , Lang Britt , Belflower Thomas Amy , Erwin Paul C. , Brownson Ross C. 
Published: December 2024

Objective:
This article focuses on supports and challenges to health equity that small local health departments (LHDs) experienced while working toward national reaccreditation or Pathways Recognition with the Public Health Accreditation Board’s Standards & Measures Version 2022 (PHAB S&M v2022).

Design:
The study team conducted 22 qualitative interview sessions with members of health department leadership teams.

Setting:
In the spring of 2024, participants from 4 small LHDs in the western and midwestern regions of the United States participated in individual remote interview sessions.

Participants:
Participants were members of leadership teams in LHDs with population jurisdictions less than 50 000.

Main Outcome Measure(s):
Common challenges relating to the health equity measures in the PHAB S&M v2022 included external influences on equity language; lack of small population data; and racially and ethnically homogeneous populations and staff. The main support was the national equity standards provided justification for pursuing equity work.

Results:
Strategies to overcome challenges associated with the equity measures included staff training, seeking alternative equity language, and examining socioeconomic inequities in addition to race and ethnicity. Internal workforce understanding of health equity was improved through department-wide training initiatives. When working under restrictive language requirements for state agencies, grants, and other funding sources, staff suggested using alternative phrases and keywords such as level playing field and equal access. When addressing racially and ethnically homogenous populations, staff pursued equity in terms of income and focused on those living with pre-existing conditions (ie, diabetes).

Conclusions:
Ensuring that LHDs can work toward health equity is crucial for reducing health inequities. While the equity focus of PHAB S&M v2022 proved challenging, for this selection of LHDs, participants affirmed that PHAB accreditation allowed them to solidify their equity work to better serve their communities.
Associations of Maternal Salivary Cortisol and Psychological Symptoms With Human Milk’s Microbiome Composition
Authors: Deflorin Nadia , Ehlert Ulrike , Amiel Castro Rita T. 
Published: December 2024

ABSTRACT

Objective
Human milk (HM) is considered the best source of infant nutrition with many benefits for the infant. However, pregnancy changes can lead to increased stress in some women, which might affect HM composition. Although studies have demonstrated a link between maternal psychopathology and child development, it remains unclear how maternal psychobiological changes can be intergenerationally transmitted. We aimed to investigate the associations of maternal stress, depressive symptoms, and anxiety symptoms with the HM microbiome; to analyze these parameters in relation to HM glucocorticoid concentrations; and to explore the influence of HM glucocorticoids on HM bacterial composition.

Methods
One hundred women completed psychological questionnaires (e.g., EPDS, STAI, GAS) at 34–36 weeks’ gestation and in the early postpartum period and provided saliva at 34–36 and 38 weeks’ gestation. HM samples were collected in the early postpartum. Microbiota were analyzed using 16S rRNA amplicon sequencing.

Results
Birth anxiety was negatively correlated with Alphaproteobacteria (τ = −0.20, FDR = 0.01), whereas in the postpartum period, anxiety symptoms were negatively correlated with different taxa. The sum of postpartum-related symptoms was linked to lower Propionibacteriales. Salivary cortisol AUCg at 34–36 weeks was negatively correlated with Stenotrophomonas (τ = −0.24, FDR = 0.05), whereas HM cortisol was positively correlated with Streptococcus mitis (τ = 0.26, FDR = 0.03) and Gemella haemolysans (τ = 0.24, FDR = 0.02). No associations emerged between psychobiological parameters and HM glucocorticoids.

Conclusions
Higher perinatal psychological symptoms and prenatal salivary cortisol AUCg were associated with lower relative abundances of different bacteria, whereas higher HM cortisol was linked to higher Gemella and Streptococcus. These findings suggest a negative association between high maternal psychobiological symptoms and relative abundances of the milk microbiota.
Psychosocial Problems at Preschool Age and Cardiometabolic Health Profile at Preadolescence
Authors: Ivanova Hristiyanna I. , de Rooij Susanne R. , Hutten Barbara A. , Vrijkotte Tanja G.M. 
Published: December 2024

Objective
Evidence suggests that children with psychosocial problems face a higher risk of cardiometabolic diseases in adulthood. However, this may already be evident prior to adulthood. In this study, the associations between psychosocial problems at preschool age and cardiometabolic outcomes 6 years later were investigated.

Methods
Data from 936 participants from the Amsterdam Born Children and their Development (ABCD) study was used. Psychosocial problems were assessed using the Strengths & Difficulties Questionnaire (SDQ) when the children were 5–6 years old, reported by both mothers and teachers. Cardiometabolic parameters, including body mass index, waist circumference, total cholesterol, triglycerides, high- and low-density lipoprotein cholesterol, fasting glucose, systolic and diastolic blood pressure, and carotid intima-media thickness were subsequently measured at ages 11–12 years. The associations between psychosocial problems and cardiometabolic outcomes were assessed using multivariable linear and logistic regression models.

Results
In model 1, adjusted for age, sex, and puberty status, and in model 2, for sociodemographic and biological predisposition factors, the combined mother-teacher score yielded a positive association with clustered cardiometabolic score (b = 0.05, 95% confidence interval = 0.03–0.10) 6 years later. Adjusting for lifestyle factors rendered this association nonsignificant. Significant associations between mother-reported SDQ scores and most cardiometabolic parameters, except for triglycerides, diminished after controlling for confounders. Children with higher total SDQ score (by mother) had 1.31 times higher odds of developing metabolic syndrome (95% confidence interval = 1.05–1.62).

Conclusion
This study established a small inverse association between mother-reported psychosocial problems at ages 5–6 years and cardiometabolic health profile at ages 11–12 years.
Health inequalities in respiratory tract infections – beyond COVID-19
Authors: Ulanova Marina 
Published: December 2024

Purpose of review
To discuss recent findings on the global burden of respiratory tract infections in underprivileged populations, highlighting the critical role of socioeconomic factors in the incidence and severity of these diseases, with a particular focus on health disparities affecting Indigenous communities.

Recent findings
Pulmonary tuberculosis and lower respiratory tract infections, particularly those caused by Streptococcus pneumoniae and respiratory syncytial virus (RSV), continue to disproportionally impact populations in low-income countries and Indigenous communities worldwide. Indigenous children <5 years old bear the highest global burden of RSV infection, reflecting persistent social inequalities between Indigenous and non-Indigenous populations. Repeated episodes of acute pneumonia during childhood significantly contribute to the high prevalence of chronic respiratory diseases among Indigenous populations. The widespread occurrence of bronchiectasis in these communities is closely linked to adverse socioeconomic conditions.

Summary
Significant disparities in the incidence and severity of lower respiratory tract infections between affluent and impoverished populations are driven by socioeconomic inequalities. Vaccinating vulnerable population groups with newly developed vaccines has the potential to prevent infections caused by pathogens such as S. pneumoniae and RSV. However, global access to these vaccines and monoclonal antibodies remains limited due to their high costs.
Role of intrauterine instillation of autologous platelet-rich plasma in prevention of intrauterine adhesions following surgical abortion: An interventional randomized controlled trial
Authors: Singh Akanksha , Jha Sangam , Das Bankim 
Published: December 2024

Objective:
The incidence of intrauterine adhesions (IUA) following surgical abortion is reportedly approximately 19%. It is associated with adverse reproductive outcomes. Therefore, there has been a search for preventive modalities that can facilitate endometrial regeneration and decrease the disease burden. This study aimed to estimate the incidence of IUAs after surgical abortion following intrauterine infusion of autologous platelet-rich plasma using the American fertility society (AFS) scoring system through hysteroscopy

Methods
A randomized controlled trial was conducted, and all women, aged 18-45 years, with a period of gestation (POG) <20 weeks who underwent surgical abortion were included in the study. The participants were randomized into two groups (33 in each); the intervention group received surgical abortion + PRP instillation and the control group underwent surgical abortion. All participants underwent follow-up hysteroscopy at 8 weeks to assess for the occurrence of IUA. The IUA was scored according to AFS scoring.

Results
The demographic and clinical characteristics of the study population were similar between the groups. The mean age was 28.09 ± 5.329 years and 26.94 ± 4.092 years in the intervention and control group, respectively. The mean adhesion score was significantly higher in the control group than in the intervention group (1.87 ± 2.71 vs. 0.43 ± 1.28; P=0.01). The overall incidence of IUAs was 29.3% and 10% (P=0.007) in the control and intervention group, respectively. Multivariate logistic regression analysis showed that POG >12 weeks (odds ratio [OR]=8.5), prior abortions >2 (OR=5.3), and prior suction-evacuation (OR=2.15) were significantly associated with the development of IUA. A predictive model was constructed using various risk factors with good sensitivity (79%) and specificity (88.2%) for identifying women at risk of developing IUA.

Conclusion
PRP instillation after surgical abortion reduced the primary incidence of IUA.
Diversity in crisis: The impact of race and ethnicity on failure to rescue among geriatric trauma patients over the years
Authors: Huang Raymond , Hejazi Omar , Khurshid Muhammad Haris , Nelson Adam , Stewart Collin , Anand Tanya , Matthews Marc R. , Okosun Stanley E. , Magnotti Louis J. , Joseph Bellal 
Published: December 2024

BACKGROUND
Failure to rescue (FTR) is an indicator of the quality of care provided by trauma centers. The aim of this study was to examine the trends of FTR incidence in geriatric trauma patients over the years and to determine whether race, ethnicity, and sex impact the FTR incidence.

METHODS
This is a retrospective analysis of the American College of Surgeons Trauma Quality Improvement Program database over 4 years (2017–2020). All geriatric (≥60 years) trauma patients were included. Patients who died within 24 hours of admission or whose length of stay was ≤1 day were excluded. Trend analysis was performed. Patients were stratified based on race, ethnicity, and sex, and multivariable regression analyses were performed.

RESULTS
Over the course of 4 years, 1,105,651 geriatric patients were identified, of whom 30,984 (2.8%) developed major complications and 10,684 (34.5% of those with complications) had FTR. The mean (SD) age was 75 (9) years, 46% were male, 86% were White, and 6% were Hispanic. The median (interquartile range) Injury Severity Score was 9 (4–10) with no change over the years (p = 0.364) and 96.8% sustained a blunt injury. Over the 4 years, the rate of FTR increased from 0.55% in 2017 to 1.04% in 2020 (p < 0.001). An analysis of trends in FTR patients revealed no significant difference in the proportion of males and females over the years (p = 0.482). However, there was a notable increase in the proportion of Black and Hispanic patients in comparison with White (p < 0.001) and non-Hispanic patients (p = 0.023), respectively. The odds of developing FTR have been increasing over the years, with Black race and Hispanic ethnicity identified as the independent risk factors for FTR.

CONCLUSION
The risk-adjusted odds of developing FTR have been increasing over the years, with one in every three patients who developed complications not surviving to discharge. Our findings demonstrate that racial and ethnic factors significantly impact the incidence of FTR.

LEVEL OF EVIDENCE
Therapeutic/Care Management; Level III
<xhtml:span xmlns:xhtml="http://www.w3.org/1999/xhtml" xml:lang="en">Investigating the presence of hypervirulent carbapenemase-producing Klebsiella&#160; pneumoniae, through three phenotypic tests, in the Maltese islands
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Authors: Fenech Kamel El Din Jasmine , Haider Julie , Zahra Graziella , Moore John 
Published: December 2024

Hypervirulence and multi-drug resistance are two separate qualities of Klebsiella pneumoniae that have posed a public health threat in separate strains for decades now. The convergence of these two phenotypes into singular strains of Klebsiella pneumoniae have created a super bug, causing both severe infections in the young and healthy and having limited antibiotic treatment available against them. These strains were first discovered in Asia in 2013 but are now emerging all around the globe. In this study, hypervirulence was assessed in 493 known carabapenemase-producing Klebsiella pneumoniae strains isolated and cryopreserved between 2019 and 2021 from various specimen types from health institutions around the Maltese islands. Three phenotypic tests were used, namely, the string test for hypermucoviscosity, lateral flow assays for the identification of K1 and K2 capsular serotypes, and quantification of siderophore production. Since the latter test was the one that was known to be the most significant for the detection of hypervirulence, and none of the strains surpassed the set limit of a concentration of 30µg/ml, none of the 493 assayed strains were deemed hypervirulent. Hypermucoviscous, K1 and K2 capsular serotype belonging strains were found, though, so much so that a statistically significant relationship was found between hypermucoviscosity and capsular serotype. Other statistical tests carried out exploring the relationship between hypermucoviscosity and siderophore concentration and hypermucoviscosity and type of carabapenemase gene were not found to be statistically significant. According to this
research, hypervirulent carabapenemase-producing Klebsiella pneumoniae strains have not yet arrived in the Maltese archipelago.