bluuebunny/crossref_metadata_2025_split huggingface dataset:
Outcome of Postchemotherapy Residual Disease in Extracranial Germ Cell Tumor in Children: Experience of a Tertiary Care Center
Authors: Shaukat Zunaira , Shaheen Najma , Abubakar Muhammad , Wali Rabia 
Published: September 2021

Objectives:
The aim was to review outcome with residual disease at the end of first line chemotherapy in patients with extracranial germ cell tumor (GCT) in our resource limited setting.

Methods:
A retrospective analysis of 196 patients with GCT recruited at Shaukat Khanum Memorial Cancer Hospital (SKMCH) from January 2008 to December 2016. Data fields included site, histopathology, stage, risk groups, baseline alpha fetoprotein, beta human chorionic gonadotropin levels, residuum after primary treatment, completeness of surgical excision and outcomes. Data analysis involved quantitative analysis, mean and median calculations, event free survival (EFS) and overall survival (OS) calculations using Kaplan-Meier curves.

Results:
In 196 included patients, M:F ratio was 1. There were 81 (41.3%) adolescents. Alpha fetoprotein was >10,000 IU/L in 56 (28.6%) patients. Sixty-two (31.6%) patients had extragonadal disease. Most patients (n=137, 69.9%) presented with advanced stage (III/IV). Seventy-six patients had postchemotherapy residual disease (n=59 [78%] with partial response (PR) and 17 [22%] with no response [NR]). Five-year OS was 83% and EFS was 67%. Five-year EFS of patients with complete remission after primary chemotherapy was 85% versus 70% in patients with PR and 6% in those with NR (P=0.001). OS in patients with complete remission, PR and NR was 94%, 87%, and 46%, respectively. All patients with NR progressed or relapsed and 8/17 died. Four patients with normalized tumor marker response were found to have active tumor on resection of postchemotherapy residuum.

Conclusion:
Patients with postchemotherapy residual disease in pediatric extracranial GCTs, fare better if their residuum is resected compared with those who do not undergo resection.
Oncology Nursing Telephone Triage Workshop
Authors: Ciccolini Kathryn , Spaulding Erin M. , Boyde Tiffini , Berizzi Donna , Hansen Bryan R. 
Published: September 2021

Background
Outpatient oncology nurses are responsible for symptom assessment/management and care coordination during telephone triage. Nursing telephone triage interventions can improve patient outcomes and clinical efficiency. Therefore, the lack of education and training in telephone triage can greatly impact patient care.

Objective
Using a prospective pretest/posttest design, we sought to determine if a telephone triage educational workshop would improve oncology nurses’ knowledge, confidence, and skill over 12 weeks.

Intervention/Methods
The educational intervention incorporated an online didactic lecture, group case scenario, and feedback on a virtual triage simulation. Evaluation was conducted before and after the intervention through an online, 13-item survey (knowledge and confidence) and simulation utilizing a 56-item checklist (skills).

Results
Thirteen oncology nurses were enrolled; 54% did not have telephone triage experience before this job. A total of 12 participants completed the workshop. From pretest to posttest, there was a median 1.0 out of 5.0 (interquartile range, 2.8) improvement in confidence (P = .008) and a 26.3% (interquartile range, 15.2) improvement in skills (P = .002). There was no difference in knowledge scores from pretest to posttest (P = .11).

Conclusions
This workshop was associated with an improvement in oncology nurse confidence and skill, using telephone triage models. It benefits an existing process within the outpatient center and it highlights a new educational strategy that may optimize nursing practice and improve patient care and experience.

Implications for Practice
This workshop contributes to existing evidence of telephone triage models and nursing education. The findings can guide future research, nursing orientation, and educational activities within the field of nursing and telehealth.
Relationship Between Anticipatory Grief and Communication Avoidance in Chinese Caregivers of Patients With Advanced Cancer
Authors: Yu Wenhua , Lu Qian , Lu Yuhan , Guo Renxiu , Hou Xiaoting , Yang Hong 
Published: September 2021

BackgroundAnticipatory grief (AG) and its relationship with communication avoidance in Chinese caregivers of patients with advanced cancer have not been previously examined. An association between AG and communication avoidance could provide important insights to Chinese caregivers worthwhile to be investigated.ObjectivesThe aims of this study were to evaluate AG and communication avoidance with patients among Chinese caregivers of patients with advanced cancer and to identify their relationship.MethodsA cross-sectional study was conducted with a convenience sample of caregivers of patients with advanced cancer practicing at an academic cancer hospital. The participants completed the Anticipatory Grief Scale (AGS) and the Caregivers’ Communication With Patients About Illness and Death scale.ResultsOf the 256 participants, the mean age was 49.10 (SD, 12.87) years, and 63.28% of participants were female. The mean AGS score was 88.05 (SD, 18.42). The AGS subscales in descending order of scores were feeling of loss, sadness, decreased ability to function at usual tasks, anxiety, anger, guilt, and irritability. The mean Caregivers’ Communication With Patients About Illness and Death score was 3.60 (SD, 1.13). In the multiple linear regression, AG severity was significantly, positively correlated with communication avoidance. Old age, low education level, religious belief, low income, and living with the patient, spouse, parents, and child implied severe AG.ConclusionsChinese caregivers of patients with advanced cancer reported a high AG and poor communication with patients about illness and death. Less communication was related to more severe AG.Implications for PracticeHealthcare professionals should pay attention to AG severity and communication of caregivers of patients with advanced cancer to explore the suitable clinical intervention.
Effect of Urea Cream on Hand-Foot Syndrome in Patients Receiving Chemotherapy
Authors: Lan Tzu-Chen , Tsou Po-Han , Tam Ka-Wai , Huang Tsai-Wei 
Published: September 2021

Background
Hand-foot syndrome (HFS) is a specific adverse effect of certain chemotherapy that may lead to dosage reduction or chemotherapy discontinuation in patients with cancer. Topical urea cream may reduce symptom severity in patients with HFS. However, these studies have not provided consonant results.

Objective
To determine the effectiveness of urea cream, we conducted a meta-analysis of clinical trials to evaluate the prevention and treatment of HFS.

Methods
PubMed, EMBASE, and Cochrane Library databases were searched for studies published before September 2020. The study registered at PROSPERO (CRD 42020203164). Incidence of HFS reported in studies at any grade and at second grade or greater was assessed within 3 to 12 weeks. Secondary outcomes were time to HFS, incidence of skin-related adverse events, chemotherapy dose reduction, and quality of life.

Results
Seven trials involving 1387 patients were reviewed. In the prophylactic subgroup, patients with urea cream intervention showed a significantly lower incidence of HFS at second grade or greater (risk ratio, 0.72; 95% confidence interval, 0.58-0.90) and a nonsignificant lower incidence of any-grade HFS (risk ratio, 0.79; 95% confidence interval, 0.58-1.08) than those not receiving urea cream intervention.

Conclusions
Urea cream has advantages to reduce the incidence of severe HFS.

Implications for Practice
Urea cream is a safe and viable topical prevention strategy that can reduce the incidence of high-grade HFS in patients undergoing chemotherapy. We recommend a routine treatment option before chemotherapy for the patients.
Mentoring and Support for Underrepresented Nursing Faculty
Authors: Mokel Melissa J. , Behnke Lyn M. , Gatewood Elizabeth , Mihaly Lisa K. , Newberry Emily B. , Lovence Keisha , Ro Kumhee , Bellflower Bobby B. , Tabi Marian , Kuster Andrea 
Published: September 2021

Background:
Nursing faculty members may need several mentors to succeed in scholarly productivity, career development, work-life balance, and socialization in the academy. Underrepresented (UR) faculty report additional challenges to success.

Purpose:
The aim of this study was to search the literature for best practices in mentoring UR faculty.

Methods:
An integrative review was conducted to identify best and evidence-based practices for mentoring UR faculty, including gender, sexual minority, race, ethnicity, and geographic remoteness (rural). Fifteen articles were rated on evidence and methodological quality.

Results:
Successful mentorship programs include honest communication, including all stakeholders in forming a mentoring program, goals and activities that come from the mentees, and guaranteed resources.

Conclusions:
Underrepresented nursing faculty may benefit from formal mentoring programs, but more research is needed.
Thermoregulatory responses in persons with lower-limb amputation during upper-limb endurance exercise in a hot and humid environment
Authors: Fukuhara Kouki , Mikami Yukio , Hasegawa Hiroshi , Nakashima Daigo , Ikuta Yasunari , Tajima Fumihiro , Kimura Hiroaki , Adachi Nobuo 
Published: September 2021

Background:
Persons with an amputation may have an increased heat strain due to reduced surface area. However, there is limited evidence on the thermoregulatory responses in persons with lower-limb amputation (LLA). Although a previous study reported no difference in their rectal temperatures (Tres) in a hot environment, suggesting compensatory sweating of the intact limb, we examined the thermoregulatory responses of such persons in a hot and humid environment.

Objective:
To compare the thermoregulatory responses―through changes in Tre, sweat, and oxygen uptake (O2)―between persons with LLA and able-bodied (AB) individuals, in hot and humid environments.

Study design:
A nonrandomized control trial.

Methods:
Nine AB men (AB group) and nine persons with LLA group performed the arm ergometer exercise at 60% peak power output intensity for 60 min in a hot and humid environment, and they were tested before and after performing. The O2, Tre and skin temperature, and total body sweating, and local sweating during exercise were measured and compared between the groups.

Results:
The changes in O2 and Tre after the endurance exercise did not differ between the groups (ΔTre: AB group, 1.1°C ± 0.5°C; LLA group, 1.2°C ±0.3 °C; P = 0.65), whereas the amount of local sweating of the chest (group effect, P < 0.01 by two-way analysis of variance [group × time], the group effect size was medium, η2 = 0.10) and dehydration rate (AB group, 1.5% ± 0.5%; LLA group, 2.1% ± 0.5%; P = 0.03) were higher in the LLA than in the AB group.

Conclusions:
We compared the thermoregulatory responses of persons with LLA with those of AB individuals in hot and humid environments. Core body temperatures of persons with LLAs during endurance exercise were not different from those of AB men even in hot and humid environments. We found compensatory increases in the sweat rate of the chest and increased dehydration rate in persons with LLA. More sweat potentially means that athletes with LLA need to drink more fulids.
Site-Randomized Controlled Trial of a Combined Cognitive Behavioral Therapy and a Medication Management Algorithm for Treatment of Depression Among Youth Living With HIV in the United States
Authors: Brown Larry K. , Chernoff Miriam , Kennard Betsy D. , Emslie Graham J. , Lypen Kathryn , Buisson Sarah , Weinberg Adriana , Whiteley Laura B. , Traite Shirley , Krotje Chelsea , Harriff Lauren , Townley Ellen , Bunch Amber , Purswani Murli , Shaw Ray , Spector Stephen A. , Agwu Allison , Shapiro David E. ,   for the IMPAACT 2002 team
Published: September 2021

Background:
Depression is frequent among youth living with HIV (YLWH). Studies suggest that manualized treatment guided by symptom measurement is more efficacious than usual care.

Setting:
This study evaluated manualized, measurement-guided depression treatment among YLWH, aged 12–24 years at 13 US sites of the International Maternal Pediatric Adolescent AIDS Clinical Trials Network.

Methods:
Using restricted randomization, sites were assigned to either a 24-week, combination cognitive behavioral therapy and medication management algorithm (COMB-R) tailored for YLWH or to enhanced standard of care, which provided standard psychotherapy and medication management. Eligibility included diagnosis of nonpsychotic depression and current depressive symptoms. Arm comparisons used t tests on site-level means.

Results:
Thirteen sites enrolled 156 YLWH, with a median of 13 participants per site (range 2–16). At baseline, there were no significant differences between arms on demographic factors, severity of depression, or HIV status. The average site-level participant characteristics were as follows: mean age of 21 years, 45% male, 61% Black, and 53% acquired HIV through perinatal transmission. At week 24, youth at COMB-R sites, compared with enhanced standard of care sites, reported significantly fewer depressive symptoms on the Quick Inventory for Depression Symptomatology Self-Report (QIDS-SR score 6.7 vs. 10.6, P = 0.01) and a greater proportion in remission (QIDS-SR score ≤ 5; 47.9% vs. 17.0%, P = 0.01). The site mean HIV viral load and CD4 T-cell level were not significantly different between arms at week 24.

Conclusions:
A manualized, measurement-guided psychotherapy and medication management algorithm tailored for YLWH significantly reduced depressive symptoms compared with standard care at HIV clinics.
The many functions of vocal learning
Authors: Carouso-Peck Samantha , Goldstein Michael H. , Fitch W. Tecumseh 
Published: September 2021

The capacity to learn novel vocalizations has evolved convergently in a wide range of species. Courtship songs of male birds or whales are often treated as prototypical examples, implying a sexually selected context for the evolution of this ability. However, functions of learned vocalizations in different species are far more diverse than courtship, spanning a range of socio-positive contexts from individual identification, social cohesion, or advertising pair bonds, as well as agonistic contexts such as territorial defence, deceptive alarm calling or luring prey. Here, we survey the diverse usages and proposed functions of learned novel signals, to build a framework for considering the evolution of vocal learning capacities that extends beyond sexual selection. For each function that can be identified for learned signals, we provide examples of species using unlearned signals to accomplish the same goals. We use such comparisons to generate hypotheses concerning when vocal learning is adaptive, given a particular suite of socio-ecological traits. Finally, we identify areas of uncertainty where improved understanding would allow us to better test these hypotheses. Considering the broad range of potential functions of vocal learning will yield a richer appreciation of its evolution than a narrow focus on a few prototypical species.This article is part of the theme issue ‘Vocal learning in animals and humans’.
The multi-dimensional nature of vocal learning
Authors: Vernes Sonja C. , Kriengwatana Buddhamas Pralle , Beeck Veronika C. , Fischer Julia , Tyack Peter L. , ten Cate Carel , Janik Vincent M. 
Published: September 2021

How learning affects vocalizations is a key question in the study of animal communication and human language. Parallel efforts in birds and humans have taught us much about how vocal learning works on a behavioural and neurobiological level. Subsequent efforts have revealed a variety of cases among mammals in which experience also has a major influence on vocal repertoires. Janik and Slater (Anim. Behav.60, 1–11. (doi:10.1006/anbe.2000.1410)) introduced the distinction between vocal usage and production learning, providing a general framework to categorize how different types of learning influence vocalizations. This idea was built on by Petkov and Jarvis (Front. Evol. Neurosci.4, 12. (doi:10.3389/fnevo.2012.00012)) to emphasize a more continuous distribution between limited and more complex vocal production learners. Yet, with more studies providing empirical data, the limits of the initial frameworks become apparent. We build on these frameworks to refine the categorization of vocal learning in light of advances made since their publication and widespread agreement that vocal learning is not a binary trait. We propose a novel classification system, based on the definitions by Janik and Slater, that deconstructs vocal learning into key dimensions to aid in understanding the mechanisms involved in this complex behaviour. We consider how vocalizations can change without learning, and a usage learning framework that considers context specificity and timing. We identify dimensions of vocal production learning, including the copying of auditory models (convergence/divergence on model sounds, accuracy of copying), the degree of change (type and breadth of learning) and timing (when learning takes place, the length of time it takes and how long it is retained). We consider grey areas of classification and current mechanistic understanding of these behaviours. Our framework identifies research needs and will help to inform neurobiological and evolutionary studies endeavouring to uncover the multi-dimensional nature of vocal learning.This article is part of the theme issue ‘Vocal learning in animals and humans’.
A researcher's guide to the comparative assessment of vocal production learning
Authors: Lattenkamp Ella Z. , Hörpel Stephen G. , Mengede Janine , Firzlaff Uwe 
Published: September 2021

Vocal production learning (VPL) is the capacity to learn to produce new vocalizations, which is a rare ability in the animal kingdom and thus far has only been identified in a handful of mammalian taxa and three groups of birds. Over the last few decades, approaches to the demonstration of VPL have varied among taxa, sound production systems and functions. These discrepancies strongly impede direct comparisons between studies. In the light of the growing number of experimental studies reporting VPL, the need for comparability is becoming more and more pressing. The comparative evaluation of VPL across studies would be facilitated by unified and generalized reporting standards, which would allow a better positioning of species on any proposed VPL continuum. In this paper, we specifically highlight five factors influencing the comparability of VPL assessments: (i) comparison to an acoustic baseline, (ii) comprehensive reporting of acoustic parameters, (iii) extended reporting of training conditions and durations, (iv) investigating VPL function via behavioural, perception-based experiments and (v) validation of findings on a neuronal level. These guidelines emphasize the importance of comparability between studies in order to unify the field of vocal learning.
This article is part of the theme issue ‘Vocal learning in animals and humans’.
Evolving the capacity for socially guided vocal learning in songbirds: a preliminary study
Authors: Carouso-Peck Samantha , Goldstein Michael H. 
Published: September 2021

Socially guided vocal learning, the ability to use contingent reactions from social partners to guide immature vocalizations to more mature forms, is thought to be a rare ability known to be used only by humans, marmosets and two unrelated songbird species (brown-headed cowbirds and zebra finches). However, this learning strategy has never been investigated in the vast majority of species that are known to modify their vocalizations over development. We propose a novel, preliminary evolutionary modelling approach that uses ecological, reproductive and developmental traits to predict which species may incorporate social influences as part of their vocal learning system. We demonstrate our model using data from 28 passerines. We found three highly predictive traits: temporal overlap between sensory (memorization) and sensorimotor (practice) phases of song learning, song used for mate attraction, and social gregariousness outside the breeding season. Species with these traits were distributed throughout the clade, suggesting that a trait-based approach may yield new insights into the evolution of learning strategies that cannot be gleaned from phylogenetic relatedness alone. Our model suggests several previously uninvestigated and unexpected species as likely socially guided vocal learners and offers new insight into the evolution and development of vocal learning.
This article is part of the theme issue ‘Vocal learning in animals and humans’.
The role of vocal learning in call acquisition of wild grey seal pups
Authors: Stansbury Amanda L. , Janik Vincent M. 
Published: September 2021

Pinnipeds have been identified as one of the best available models for the study of vocal learning. Experimental evidence for their learning skills is demonstrated with advanced copying skills, particularly in formant structure when copying human speech sounds and melodies. By contrast, almost no data are available on how learning skills are used in their own communication systems. We investigated the impact of playing modified seal sounds in a breeding colony of grey seals (Halichoerus grypus) to study how acoustic input influenced vocal development of eight pups. Sequences of two or three seal pup calls were edited so that the average peak frequency between calls in a sequence changed up or down. We found that seals copied the specific stimuli played to them and that copies became more accurate over time. The differential response of different groups showed that vocal production learning was used to achieve conformity, suggesting that geographical variation in seal calls can be caused by horizontal cultural transmission. While learning of pup calls appears to have few benefits, we suggest that it also affects the development of the adult repertoire, which may facilitate social interactions such as mate choice.This article is part of the theme issue ‘Vocal learning in animals and humans’.
Protophones, the precursors to speech, dominate the human infant vocal landscape
Authors: Oller D. Kimbrough , Ramsay Gordon , Bene Edina , Long Helen L. , Griebel Ulrike 
Published: September 2021

Human infant vocalization is viewed as a critical foundation for vocal learning and language. All apes share distress sounds (shrieks and cries) and laughter. Another vocal type, speech-like sounds, common in human infants, is rare but not absent in other apes. These three vocal types form a basis for especially informative cross-species comparisons. To make such comparisons possible we need empirical research documenting the frequency of occurrence of all three. The present work provides a comprehensive portrayal of these three vocal types in the human infant from longitudinal research in various circumstances of recording. Recently, the predominant vocalizations of the human infant have been shown to be speech-like sounds, or ‘protophones’, including both canonical and non-canonical babbling. The research shows that protophones outnumber cries by a factor of at least five based on data from random-sampling of all-day recordings across the first year. The present work expands on the prior reports, showing the protophones vastly outnumber both cry and laughter in both all-day and laboratory recordings in various circumstances. The data provide new evidence of the predominance of protophones in the infant vocal landscape and illuminate their role in human vocal learning and the origin of language.This article is part of the theme issue ‘Vocal learning in animals and humans’.