bluuebunny/crossref_metadata_2025_split huggingface dataset:
The Use of Auditory Simulation in Undergraduate Nursing
Authors: Duprey Melissa D. , Silver-Dunker Kimberly , Whittaker Suzanne Landry 
Published: May 2021

Abstract
Auditory hallucination is common in schizophrenia, influencing emotional state and behavior. Most patients experience high levels of distress, paranoia, and depression. After participating in the “Hearing Voices” auditory simulation, which involved rotating through various workstations while listening to distressing voices, nursing students (n = 39) completed the Kiersma–Chen Empathy Scale. All were satisfied with the auditory simulation; 90 percent perceived the experience as beneficial to their role as a registered nurse. This innovative teaching strategy, utilizing simulation, provided an opportunity to experience auditory hallucinations, thereby increasing both understanding and empathy.
Exploring Nursing Students’ Motivation to Prepare for Class
Authors: Bernard R. Oscar , Rosales Marc , Zurcher Natasha 
Published: May 2021

Abstract
Although it has been proven that the classroom experience is enhanced when students come prepared to class, there is insufficient evidence on students’ perspectives about what motivates them to prepare for class. This qualitative phenomenology study included records review from 130 accelerated second-degree undergraduate nursing students and a focus group and interviews to discover what motivates students to prepare for class. The data analysis revealed five prominent themes: knowing what to study, deep learning, accountability, getting into the textbook, and content engagement. The study validated several interventions that successfully motivate students to prepare for class.
How One Healthcare Organization Is Creating a True System
Authors: Daily Aimee 
Published: May 2021

SUMMARY
Founded in 1897 as a 12-bed hospital and training school in Springfield, Illinois, Memorial Health System (MHS) today serves communities throughout central Illinois with five affiliated hospitals, ambulatory care services, and behavioral health programs. The system includes Memorial Medical Center in Springfield, Abraham Lincoln Memorial Hospital in Lincoln, Taylorville Memorial Hospital in Taylorville, Passavant Area Hospital in Jacksonville, Decatur Memorial Hospital in Decatur, and the Memorial Physician Services, Memorial Home Services, and Memorial Behavioral Health network across central Illinois. The evolution of MHS from a system in name only—lacking full integration of organizational functions—to its current status as an optimized health system has been marked by challenges, from the initial doubts of employees and the community to the upheaval caused by the COVID-19 pandemic. Systemness requires visionary and sure-handed leadership to identify and realize economies of scale, share best practices for operational improvements, and reduce unwanted variation to improve quality of care. As the MHS story illustrates, that all starts, grows, and endures with strategic planning.
Variability in the criteria for a difficult intubation alert in the age of videolaryngoscopy: a scenario-based, multidisciplinary, multi-institutional provider survey
Authors: Allyn John W. , Curry Craig S. , Hubbs P. Robert , Hicks Anne , Craig Wendy , Muns Emily , Susser Philip , Richard Janelle M. , Atkins Joshua H. 
Published: May 2021

Introduction:
Our goal was to characterize further variability in how providers both define a difficult intubation and apply a difficult tracheal intubation alert.

Materiala and Methods:
We developed a survey describing 26 different intubation scenarios encompassing a range of clinical complexity and equipment. Scenarios included multiple factors hypothesized to impact a provider’s definition of a difficult intubation and the threshold for a difficult intubation alert. Provider responses were then assessed for variability and agreement.
The survey was distributed at 2 academic medical centers, 1 in Portland, ME (1 teaching hospital, 600 beds) and 1 in Philadelphia, PA (2 teaching hospitals, 1180 total beds). Electronic surveys were sent to anesthesia and emergency medicine providers (total N=617). Providers were asked to grade the difficulty of the scenario presented and whether they would activate the difficult intubation alert in the electronic health record. Responses were pooled and summarized as a frequency (%) and analyzed by provider type and institution.

Results:
Providers lacked agreement about scenarios that were very difficult or when an alert should be used. This variability was similar among provider types and institutions. Providers assessed scenarios as being more difficult and were more likely to apply an alert when videolaryngoscopy was not available.

Conclusions:
Substantial variability was demonstrated in providers’ definition of a difficult intubation and the threshold to activate a difficult intubation alert. This variability is consistent with related findings by other groups and represents a latent patient safety threat. The availability alone of videolaryngoscopy influences a provider’s definition of a difficult intubation, resulting in the grading of a scenario as less difficult. The associated risks may be mitigated by the delineation of specific criteria for difficult intubation designation and alert activation at the hospital or health system level.
Psychiatry and the 21st Century
Authors: Becker Robert E. 
Published: May 2021

Abstract
After a long and torturous path, an elusive quest for structure and order may have misled the American Psychiatric Association to overexpand the scope of its Diagnostic and Statistical Manual (DSM) codification of mental disorders. The DSM and guidelines came to represent American psychiatry to the world. Although important for epidemiological and statistical research, in volume and complexity, the DSM challenges clinicians. The DSM effort at categorization must be reconceived to acknowledge modern biological realities. Molecular and other selective biological sciences no longer dominate biology as they did at the time of DSM’s initial conception. Today, a Darwinian-Hippocratic combined biology leads psychiatry to address individuals and populations irretrievably and uniquely interdependent with environments. Unfortunately, the DSM, as currently conceived, fails to support this emerging 21st century biological grounding for psychiatry.
A potential prokaryotic and microsporidian pathobiome that may cause shrimp white feces syndrome (WFS)
Authors: Prachumwat Anuphap , Munkongwongsiri Natthinee , Eamsaard Wiraya , Lertsiri Kanokwan , Flegel Timothy W. , Stentiford Grant D. , Sritunyalucksana Kallaya 
Published: May 2021

AbstractWhite feces syndrome (WFS) in shrimp cultivation ponds is characterized by the occurrence of shrimp with abnormal, white intestines (midguts) combined with large floating mats of white, shrimp fecal strings. The etiology for WFS is complex, similar to diarrhea in humans. EHP-WFS is a type of WFS characterized by massive quantities of spores from the microsporidian parasite Enterocytozoon hepatopenaei (EHP) together with mixed, unidentified bacteria in the shrimp hepatopancreas, midgut and fecal strings. However, WFS does not always develop in shrimp with severe EHP infections in controlled laboratory challenges. Further, in EHP-WFS outbreak ponds, some shrimp show white midguts (WG) while others in the same pond show grossly normal midguts (NG). We hypothesized that comparison of the microbial flora between WG and NG from the same EHP-WFS pond would reveal probable combinations of microbes significantly associated with EHP-WFS. To test this hypothesis, we selected a pond exhibiting a severe EHP-WFS outbreak in cultivated Penaeus vannamei and used a combination of microscopic and microbial profiling analyses to compare WG and NG samples. By histology, EHP plasmodia and spores were confirmed in the hepatopancreas (HP) and midgut of WG and NG shrimp, but pathological severity and spore quantity was higher in the WG shrimp. In addition, intestinal microbiomes in WG shrimp were less diverse and had higher abundance of bacteria from the genera Vibrio and Propionigenium. Propionigenium quantity in the HP of WG shrimp was significantly higher (P = 1.08e-5) than in NG shrimp (4,506 vs. 3 copies /100 ng DNA, respectively). These findings supported our hypothesis by revealing two candidate bacterial genera that should be tested in combination with EHP as a potential eukaryote-prokaryote pathobiome that causes EHP-WFS in P. vannamei.HighlightsWhite feces syndrome (WFS) shrimp often harbor the microsporidian Enterocytozoon hepatopenaei (EHP)The hepatopancreas (HP) and midgut of EHP-WFS shrimp had more EHP copies and spores than EHP-non.-WFS shrimpVibrio spp., Propionigenium sp. and EHP dominated in HP microbiomes of EHP-WFS shrimpPropionigenium copy numbers were uniquely high in the HP of EHP-WFS shrimpEHP-WFS shrimp also showed intestinal microbiomes of reduced diversity but more heterogeneity
Projecting the impact of nutrition policy to improve child stunting: A case study in Guatemala using the Lives Saved Tool
Authors: Tschida Scott , Cordon Ana , Asturias Gabriela , Mazariegos Mónica , Kroker-Lobos María F , Jackson Bianca , Rohloff Peter , Flood David 
Published: May 2021

ABSTRACTBackgroundChild stunting is a critical global health issue. Guatemala has one of the world’s highest levels of stunting despite sustained commitment to international nutrition policy best-practices endorsed by the Scaling Up Nutrition movement (SUN). Our objective was to use Guatemala as a case study by projecting the impact of a recently published national nutrition policy, the Great Crusade, that is consistent with SUN principles.MethodsWe used the Lives Saved Tool (LiST) to project the scaling-up of nutrition interventions proposed in the Great Crusade and recommended by SUN. Our outcomes were changes in stunting prevalence, number of stunting cases averted, and number of cases averted by intervention in children under five years of age from 2020-2030. We considered four scenarios: (1) intervention coverage continues based on historical trends, (2) coverage targets in the Great Crusade are achieved, (3) coverage targets in the Great Crusade are achieved with reduced fertility risk, and (4) coverage reaches an aspirational level.ResultsAll scenarios led to modest reductions in stunting prevalence. In 2024, stunting prevalence was estimated to change by -0.1% (95% CI 0.0% to -0.2%) if historical trends continue, -1.1% (95% CI -0.8% to -1.5%) in the Great Crusade scenario, and -2.2% (95% CI - 1.6% to -3.0%) in the aspirational scenario. In 2030, we projected a stunting prevalence of -0.4% (95% CI -0.2% to -0.8%) and -3.7% (95% CI -2.8% to -5.1%) in the historical trends and aspirational scenario, respectively. Complementary feeding, sanitation, and breastfeeding were the most impactful interventions across models.ConclusionsTargeted reductions in child stunting prevalence in Guatemala are unlikely to be achieved solely based on increases in intervention coverage. Our results show the limitations of current paradigms recommended by the international nutrition community. Policies and strategies are needed that address the broader structural drivers of stunting.
High-resolution within-sewer SARS-CoV-2 surveillance facilitates informed intervention
Authors: Reeves Katelyn , Liebig Jennifer , Feula Antonio , Saldi Tassa , Lasda Erika , Johnson William , Lilienfeld Jacob , Maggi Juniper , Pulley Kevin , Wilkerson Paul J. , Real Breanna , Zak Gordon , Davis Jack , Fink Morgan , Gonzalez Patrick , Hager Cole , Ozeroff Christopher , Tat Kimngan , Alkire Michaela , Butler Claire , Coe Elle , Darby Jessica , Freeman Nicholas , Heuer Heidi , Jones Jeffery R. , Karr Madeline , Key Sara , Maxwell Kiersten , Nelson Lauren , Saldana Emily , Shea Rachel , Salveson Lewis , Tomlinson Kate , Vargas-Barriga Jorge , Vigil Bailey , Brisson Gloria , Parker Roy , Leinwand Leslie A. , Bjorkman Kristen , Mansfeldt Cresten 
Published: May 2021

AbstractTo assist in the COVID-19 public health guidance on a college campus, daily composite wastewater samples were withdrawn at 20 manhole locations across the University of Colorado Boulder campus. Low-cost autosamplers were fabricated in-house to enable an economical approach to this distributed study. These sample stations operated from August 25th until November 23rd during the fall 2020 semester, with 1,512 samples collected. The concentration of SARS-CoV-2 in each sample was quantified through two comparative reverse transcription quantitative polymerase chain reactions (RT-qPCRs). These methods were distinct in the utilization of technical replicates and normalization to an endogenous control. (1) Higher temporal resolution compensates for supply chain or other constraints that prevent technical or biological replicates. (2) The endogenous control normalized data agreed with the raw concentration data, minimizing the utility of normalization. The raw wastewater concentration values reflected SARS-CoV-2 prevalence on campus as detected by clinical services. Overall, combining the low-cost composite sampler with a method that quantifies the SARS-CoV-2 signal within six hours enabled actionable and time-responsive data delivered to key stakeholders. With daily reporting of the findings, wastewater surveillance assisted in decision making during critical phases of the pandemic on campus, from detecting individual cases within populations ranging from 109 to 2,048 individuals to monitoring the success of on-campus interventions.SynopsisTracking SARS-CoV-2 in on-campus wastewater informs and monitors public health decisions and actions.TOC/Abstract Art
Possibility of SARS-CoV-2 infection in metastatic microenvironment of cancer
Authors: Hayashi Takuma , Konishi Ikuo 
Published: May 2021

AbstractAccording to a report from the World Health Organization, the mortality and severity rates among patients with cancer infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are significantly higher than those of individuals infected with SARS-CoV-2 without complications. Common and cancer-specific risk factors may be involved in the mortality and severity rates of coronavirus disease 2019 (COVID-19). Various factors have been determined to contribute to the aggravation of COVID-19 in patients with cancer. However, on the basis of current research, the factors involved in the aggravation of COVID-19 in patients with cancer have not been fully investigated. In the general course of treatment for patients with cancer, the detection of the formation of metastases in other organs is common. Therefore, the present study investigates the association between lung metastatic lesion formation and SARS-CoV-2 infectivity. On the basis of the results obtained, in the pulmonary micrometastatic niche of patients with ovarian cancer, alveolar epithelial stem-like cells adjacent to the ovarian cancer were observed. Moreover, it was revealed that angiotensin-converting enzyme 2, a host-side receptor for SARS-CoV-2, was expressed in alveolar epithelial stem-like cells adjacent to the ovarian cancer in the pulmonary micrometastatic niche. Furthermore, it was also observed that the SARS-CoV-2 spike glycoprotein receptor-binding domain binds to alveolar epithelial stem-like cells. In other words, it was suggested that patients with cancer and pulmonary micrometastases may be more susceptible to SARS-CoV-2. The prevention of de novo niche formation in metastatic disease may be a new strategy for the clinical treatment of COVID-19 for patients with cancer.
Disentangling network topology and pathogen spread
Authors: Pérez-Ortiz María , Manescu Petru , Caccioli Fabio , Fernández-Reyes Delmiro , Nachev Parashkev , Shawe-Taylor John 
Published: May 2021

AbstractHow do we best constrain social interactions to prevent the transmission of communicable respiratory diseases? Indiscriminate suppression, the currently accepted answer, is both unsustainable long term and implausibly presupposes all interactions to carry equal weight. Transmission within a social network is determined by the topology of its graphical structure, of which the number of interactions is only one aspect. Here we deploy large-scale numerical simulations to quantify the impact on pathogen transmission of a set of topological features covering the parameter space of realistic possibility. We first test through a series of stochastic simulations the differences in the spread of disease on several classes of network geometry (including highly skewed networks and small world). We then aim to characterise the spread based on the characteristics of the network topology using regression analysis, highlighting some of the network metrics that influence the spread the most. For this, we build a dataset composed of more than 9000 social networks and 30 topological network metrics. We find that pathogen spread is optimally reduced by limiting specific kinds of social contact – unfamiliar and long range – rather than their global number. Our results compel a revaluation of social interventions in communicable diseases, and the optimal approach to crafting them.
The Maldistribution of Pediatric Providers as a Potential Driver of Reduced Educational Outcomes
Authors: Boyle Jessica C. , Domingue Benjamin W. 
Published: May 2021

AbstractObjectiveDespite evidence of a strong bidirectional connection between educational achievement and health, few studies have examined the link between these intertwining forces on a national level. This study takes advantage of a new population-level dataset to explicitly link child health access to academic outcomes in nearly every U.S. school district.MethodsNational data were used to construct and link district-level measures of child health access to district-level measures of third-grade achievement. Specifically, location data for over 256,000 practicing pediatricians and family physicians were linked to achievement data from 12,296 school districts. We include district-level rates of uninsured children as an additional measure of child health access.ResultsFirst, physician supply is unequally distributed across districts and their student populations. Second, districts that had higher physician supply tended to have higher test scores. This relationship is most pronounced for districts with relatively few pediatricians and family physicians. While the rate of uninsured children is largely correlated with community socioeconomic status, physician supply appears to operate independently of this measure.ConclusionEarly childhood health and wellbeing are linked to cognitive performance and achievement in school. We provide evidence to illustrate an aspect of this relationship: children with less access to healthcare providers also do less well in school. The specific patterning of this finding suggests a need to reconsider how availability and access to pediatricians and family physicians is currently configured. Future research should examine whether a redistribution of the existing physician workforce could result in a net academic benefit for students.
SARS-CoV-2 convergent evolution as a guide to explore adaptive advantage
Authors: Zahradník Jiří , Nunvar Jaroslav , Schreiber Gideon 
Published: May 2021

AbstractMuch can be learned from 1.2 million sequences of SARS-CoV-2 generated during the last 15 months. Out of the overwhelming number of mutations sampled so far, only few rose to prominence in the viral population. Many of these emerged recently and independently in multiple lineages. Such a textbook example of convergent evolution at the molecular level is not only curiosity but a guide to uncover the basis for adaptive advantage behind these events. Focusing on the extent of the convergent evolution in the spike (S) protein, our report confirms that the most concerning SARS-CoV-2 lineages carry the heaviest burden of convergent S-protein mutations, suggesting their fundamental adaptive advantage. The great majority (21/25) of S-protein sites under convergent evolution tightly cluster in three functional domains; N-terminal domain, receptor-binding domain, and Furin cleavage site. We further show that among the S-protein receptor-binding motif mutations, ACE2 affinity-improving substitutions are favored. While the probed mutation space in the S protein covered all amino-acids reachable by single nucleotide changes, substitutions requiring two nucleotide changes or epistatic mutations of multiple-residues have only recently started to emerge. Unfortunately, despite their convergent emergence and physical association, most of these adaptive mutations and their combinations remain understudied. We aim to promote research of current variants which are currently understudied but may become important in the future.
Plitidepsin has a positive therapeutic index in adult patients with COVID-19 requiring hospitalization
Authors: Varona José F. , Landete Pedro , Lopez-Martin Jose A. , Estrada Vicente , Paredes Roger , Guisado-Vasco Pablo , de Orueta Lucía Fernández , Torralba Miguel , Fortún Jesús , Vates Roberto , Barberán José , Clotet Bonaventura , Ancochea Julio , Carnevali Daniel , Cabello Noemí , Porras Lourdes , Gijón Paloma , Monereo Alfonso , Abad Daniel , Zúñiga Sonia , Sola Isabel , Rodon Jordi , Izquierdo-Useros Nuria , Fudio Salvador , Pontes María José , Rivas Beatriz de , Girón de Velasco Patricia , Sopesén Belén , Nieto Antonio , Gómez Javier , Avilés Pablo , Lubomirov Rubin , White Kris M. , Rosales Romel , Yildiz Soner , Reuschl Ann-Kathrin , Thorne Lucy G. , Jolly Clare , Towers Greg J. , Zuliani-Alvarez Lorena , Bouhaddou Mehdi , Obernier Kirsten , Enjuanes Luis , Fernández-Sousa Jose M. ,   Plitidepsin – COVID - 19 Study Group, Krogan Nevan J. , Jimeno José M. , García-Sastre Adolfo 
Published: May 2021

AbstractPlitidepsin is a marine-derived cyclic-peptide that inhibits SARS-CoV-2 replication at low nanomolar concentrations by the targeting of host protein eEF1A (eukaryotic translation-elongation-factor-1A). We evaluated a model of intervention with plitidepsin in hospitalized COVID-19 adult patients where three doses were assessed (1.5, 2 and 2.5 mg/day for 3 days, as a 90-minute intravenous infusion) in 45 patients (15 per dose-cohort). Treatment was well tolerated, with only two Grade 3 treatment-related adverse events observed (hypersensitivity and diarrhea). The discharge rates by Days 8 and 15 were 56.8% and 81.8%, respectively, with data sustaining dose-effect. A mean 4.2 log10 viral load reduction was attained by Day 15. Improvement in inflammation markers was also noted in a seemingly dose-dependent manner. These results suggest that plitidepsin impacts the outcome of patients with COVID-19.One-Sentence SummaryPlitidepsin, an inhibitor of SARS-Cov-2 in vitro, is safe and positively influences the outcome of patients hospitalized with COVID-19.
Use of traditional medicine in treatment of migraine during coronavirus disease 2019 (COVID-19) pandemic: an online survey
Authors: Ismail Ismail Ibrahim , Al-Hashel Jasem Y. 
Published: May 2021

AbstractSince the declaration of coronavirus disease 2019 (COVID-19) pandemic, patients with migraine were specifically vulnerable to worsening of their headaches. Traditional medicine (TM) has been used to treat headache disorders for centuries, especially during times of a healthcare emergencies, similar to the current pandemic. We aimed to assess the use of TM in treatment of migraine amid COVID-19 pandemic in Kuwait, using an online, self-administered questionnaire. A total of 1018 patients completed the survey. TM was used by 39.9% respondents. The greatest users of TM were those with older age (p =0.04), and longer disease duration (p =0.005). TM users were found to be more compliant to treatments than non-TM users (p<0.02). However, they reported significantly less communication with their physicians (p <0.001) during the pandemic. This study showed higher rates of TM use, as a way of self-treatment, among patients with migraine during COVID-19 pandemic. Neurologists should prepare their patients with “rescue” strategies for headache management, and new means of communication, to face these “new normal” challenges.