bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical Interventions and Hemodynamic Monitoring in the Setting of Left Ventricular Systolic Heart Failure in Children: Insights From a Physiologic Simulator
Authors: Loomba Rohit S. , Savorgnan Fabio , Acosta Sebastian , Elhoff Justin J. , Farias Juan S. , Villarreal Enrique G. , Flores Saul 
Published: September 2024

Background:
In pediatric critical care, vasoactive/inotropic support is widely used in patients with heart failure, but it remains controversial because the influence of multiple medications and the interplay between their inotropic and vasoactive effects on a given patient are hard to predict. Robust evidence supporting their use and quantifying their effects in this group of patients is scarce.

Study Question:
The aim of this study was to characterize the effect of vasoactive medications on various cardiovascular parameters in pediatric patient with decreased ejection fraction.

Study Design:
Clinical-data based physiologic simulator study.

Measure and Outcomes:
We used a physics-based computer simulator for quantifying the response of cardiovascular parameters to the administration of various types of vasoactive/inotropic medications in pediatric patients with decreased ejection fraction. The simulator allowed us to study the impact of increasing medication dosage and the simultaneous administration of some vasoactive agents. Correlation and linear regression analyses yielded the quantified effects on the vasoactive/inotropic support.

Results:
Cardiac output and systemic venous saturation significantly increased with the administration of dobutamine and milrinone in isolation, and combination of milrinone with dobutamine, dopamine, or epinephrine. Both parameters decreased with the administration of epinephrine and norepinephrine in isolation. No significant change in these hemodynamic parameters was observed with the administration of dopamine in isolation.

Conclusions:
Milrinone and dobutamine were the only vasoactive medications that, when used in isolation, improved systemic oxygen delivery. Milrinone in combination with dobutamine, dopamine, or epinephrine also increased systemic oxygen delivery. The induced increment on afterload can negatively affect systemic oxygen delivery.
Alterations in serum levels of calcium, vitamin D, phosphorus, and parathyroid hormone in patients with clinically confirmed familial hypercholesterolemia: a cross-sectional study
Authors: Heshmat-Ghahdarijani Kiyan , Vaseghi Golnaz , Hajian Shabnam , Taheri Marzieh , Haghjooy-Javanmard Shaghayegh , Sarrafzadegan Nizal , Habibi Danial , Babak Anahita , Rabiee Rad Mehrdad 
Published: September 2024

Background:
Familial hypercholesterolemia (FH), an autosomal dominant disease, is associated with an increased risk of premature cardiovascular disease (CVD). This study aimed to examine the variations in serum levels of calcium, vitamin D, phosphorus, and parathyroid hormone (PTH) among FH patients, as these factors have been associated with an increased susceptibility to CVD.

Materials and methods:
In this cross-sectional study, the authors used data from Isfahan FH registry. The Dutch Lipid Clinic Network (DLCN) criteria was used for diagnoses of FH patients. Control group included participants with hyperlipidemia and were unlikely FH according to DLCN criteria. All biochemical parameters were measured using standard methods.

Results:
A total of 131 patients (mean age, 53.1 ± 12.2; male, 51.4%) were included in the analysis. Patients with FH had lower serum vitamin D levels compared with control groups in the unadjusted model (P= 0.028). The relationship between serum vitamin D and FH was not significant after adjustment for traditional risk factor (P= 0.184). No significant association was observed between FH and serum calcium (P= 0.886), phosphorus (P= 0.463), and PTH (P= 0.849). Besides, there was no significant association between LDL-C or total cholesterol and serum minerals in FH patients.

Conclusion:
This study found no significant changes in serum calcium, vitamin D, phosphorus, and PTH in patients with FH.
Infiltration and Extravasation Risk with Midline Catheters: A Narrative Literature Review
Authors: Hadaway Lynn , Gorski Lisa A. 
Published: September 2024

Midline catheters have recently gained popularity in clinical use, with a common reason being the reduction of central venous catheter use and central line-associated bloodstream infections. At the same time, the number of nononcology vesicant medications has increased, and midline catheters are frequently being used for infusions of vesicant medications. The Infusion Nurses Society (INS) Vesicant Task Force identified midline catheter use as a possible risk factor for extravasation and concluded that a thorough literature review was necessary. This review highlights the variations in catheter terminology and tip locations, the frequency of infiltration and extravasation in published studies, and case reports of infiltration and extravasation from midline catheters. It also examines the many clinical issues requiring evidence-based decision-making for the most appropriate type of vascular access devices. After more than 30 years of clinical practice with midline catheters and what appears to be a significant number of studies, evidence is still insufficient to answer questions about infusion of vesicant and irritant medications through midline catheters. Given the absence of consensus on tip location, inadequate evidence of clinical outcomes, and importance of patient safety, the continuous infusion of vesicants, all parenteral nutrition formulas, and infusates with extremes in pH and osmolarity should be avoided through midline catheters.
The Impact of Frailty on the Toxic Reaction of Chemotherapy in Patients With Cervical Cancer
Authors: Wang Yanhong , Zhang Yaya , Liang Xueping , Liu Jin , Zhao Yanan , Su Qingling 
Published: September 2024

BackgroundLongitudinal research on the impact of frailty on chemotherapy toxicity in patients with cervical cancer is limited.ObjectivesTo explore the impact of frailty on chemotherapy toxicity in patients with cervical cancer.MethodsTwo hundred fifty-nine postoperative cervical cancer patients from a hospital located in Northwest China were enrolled between July 2020 and December 2021. Participating patients were followed up for 4 chemotherapy cycles after surgery. Frailty was measured using the Tilburg Frailty Indicator. Chemotherapy toxic reactions were evaluated using the Common Terminology Criteria for Adverse Events 4.0. Repeated-measures analysis of variance and Cox regression analysis were used to analyze the effect of frailty on chemotherapy toxicity.ResultsCox regression analysis showed that frailty could serve as an independent risk factor for total toxicity (hazard ratio [HR], 5.423; 95% confidence interval [CI], 3.260-9.023;P< .001), nausea (HR, 3.967; 95% CI, 2.446-6.433;P< .001), and vomiting (HR, 3.081; 95% CI, 1.921-4.942;P< .001). Repeated-measures analysis of variance showed that the white blood cell values of the frail group were lower than those of the nonfrail group (Fgroup effect= 4.172,P= .043), and the hemoglobin values of the frail group were lower than those of the nonfrail group (Fgroup effect= 6.589,P= .012).ConclusionsFrailty can increase the risk of total chemotherapy toxicity, nausea, and vomiting. Frailty can reduce the white blood cell and hemoglobin values of postoperative adjuvant chemotherapy cervical cancer patients.Implications for PracticeFindings may assist healthcare providers in taking effective measures to reduce the toxicity of chemotherapy.
Charting a Path From the Graduate QSEN Competencies to the New Essentials
Authors: Hays Deana , Hay Brittany , Tassell Barb , Zellefrow Cindy G. , Milner Kerry A. 
Published: September 2024

Background:
Graduate nursing programs were encouraged to map their curriculum to the Quality and Safety Education in Nursing (QSEN) graduate knowledge, skills, and attitudes (KSA) competency statements.

Purpose:
Evaluation of the alignment between the 2009 QSEN graduate KSA competency statements and the 2021 American Association of Colleges of Nursing (AACN) Essentials advanced-level (Level 2) subcompetencies is needed to support curricular transition to competency-based education and the Essentials.

Methods:
A team of 5 nursing education experts engaged in multiple rounds of review to seek consensus in determining alignment between the 2009 QSEN graduate KSA competency statements and the 2021 AACN advanced-level subcompetencies.

Results:
A QSEN-AACN graduate crosswalk tool was created, which reflects alignment of 34% of the 196 graduate QSEN KSA competency statements to the AACN Essentials subcompetencies at the advanced level. 36% of the graduate QSEN KSA competency statements were found to align with the AACN subcompetencies at the entry level.

Conclusions:
The 2009 QSEN graduate competencies are embedded within 2021 AACN Essentials at entry and advanced levels. However, a sizable shift toward entry level is noted, which represents an evolution in expectations for contemporary practice. This holds significance for graduate nursing faculty as they work to revise curriculum and assessments to meet new guidelines and standards for the profession.
Fostering Moral Resilience
Authors: Forte Kathy , Higgins Melinda , Pentz Rebecca D. 
Published: September 2024

Background:
Despite the high prevalence of moral distress in nursing, empirical evidence is lacking about the best educational approaches to foster moral resilience.

Purpose:
This study evaluates the effectiveness of an ethics simulation in a prelicensure program, 6 months into nursing practice.

Methods:
We used an exploratory design, including 2 instruments and open-ended questions. One instrument measured moral distress, the other measured moral resilience. Alumni who participated in the simulation were compared to alumni who received didactic teaching only.

Results:
Six months into practice, the quantitative data from this study did not show a statistical significance between those who received didactic training only and those who received a simulation, except for one element of the moral resilience scale (relational integrity), in which the control group had a higher score. Open-ended questions confirmed that alumni recognized the positive impact of the simulation in practice.

Conclusions:
Further study is needed to determine the best educational strategies for teaching ethics in prelicensure nursing programs, with a focus on improving retention and resilience in practice.
Using Quality Improvement to Expand and Align State Public Health Long-Term Follow-up Data Collection Across Newborn Screening Conditions
Authors: Bentler Kristi , Barber Lexie , Lintelmann Anna K. , Dierking Darcia M. , Meyer Abby C. , Comer Ashley , Hauser Jennifer 
Published: September 2024

Context:
Despite the undeniable success of newborn screening (NBS), numerous barriers exist regarding long-term follow-up (LTFU) of children with conditions included in NBS. Furthermore, there is a focus on condition-specific follow-up with no national guidelines for standard quality measures collected by state public health LTFU programs.

Program:
Minnesota Department of Health (MDH) Longitudinal Follow-up for NBS.

Implementation:
A state public health LTFU for NBS quality improvement (QI) project was carried out with collaboration between MDH project team members and a QI Steering Team who provided clinical, public health, education, caregiver, and community perspectives and expertise to MDH. Relevant measures were selected from existing data elements, and additional measures were developed based on exchange between MDH project team and the QI Steering Team. Potential data sources were explored and prioritized. Processes for querying existing data sources such as death records were refined, new sources such as electronic health records and paper/PDF health records were established, and data collection was piloted. The Minnesota Electronic Disease Surveillance System was modified, and an electronic data form was created to promote consistent data abstraction from sources. Throughout the project, progress was evaluated and shared. At project conclusion, MDH project team and the QI Steering Team reviewed project outcomes and approaches to evolve the project into ongoing surveillance.

Evaluation:
Five common public health LTFU measures were determined. Overall, 77% of attempted measures were successfully collected. Primary and secondary data sources were adopted. In addition, collected data resulted in 7% of cases that were closed to further public health LTFU, often related to a move out of state.

Discussion:
This project established the feasibility of state public health LTFU surveillance of outcomes and health care use by collecting a common data set applicable across NBS conditions.
Brief Report: Genital Microbiome, Inflammation, and Tenofovir Levels in Transgender Men and Cisgender Women Taking Oral PrEP
Authors: Hastie Elizabeth , Srivatsa Megha S. , Gianella Sara , Cottrell Mackenzie , Forsyth Kyra , Porrachia Magali , Burke Leah , Morris Sheldon , Rawlings Stephen A. , Karris Maile , Chaillon Antoine , Blumenthal Jill 
Published: September 2024

Background:
Little is known about the efficacy of preexposure prophylaxis (PrEP) or what biologic factors may influence HIV transmission in transgender men (TGM). In this study, we sought to explore the effect of testosterone on the vaginal microbiome, cervicovaginal fluid (CVF) tenofovir concentrations, and levels of CVF inflammatory markers in TGM on PrEP.

Methods:
Cervicovaginal fluid was collected from 13 TGM (7 using testosterone) and 32 cisgender women (CGW) on PrEP. The vaginal microbiome, CVF tenofovir concentrations, and CVF inflammatory markers were determined and compared.

Results:
The proportion of CVF Lactobacillus was significantly higher in CGW than in TGM (78% vs 24%, P < 0.001). Among TGM, the proportion of CVF Lactobacillus was lower, though not statistically significant, in those taking testosterone than in those not taking testosterone (14% vs 35%, P-value = 0.3). Interestingly, mean CVF tenofovir concentrations were the lowest in TGM on testosterone at 884 ng/mL compared with 3150 ng/mL in TGM not on testosterone and 1932 ng/mL in CGW; however, this difference was not statistically significant. There was no statistically significant difference in any of the genital inflammatory markers between groups and no correlation between inflammation and tenofovir levels.

Conclusions:
Our findings suggest a potential correlation between testosterone use, Lactobacillus dominance, and lower TFV concentrations in CVF, which may have implications on HIV acquisition from vaginal sex in TGMT. Future studies with larger sample sizes are needed to further investigate these relationships.
A Method of Tumescent Anesthesia Based on Facial and Cervical Nerve Block for Face and Neck Liposuction
Authors: Zhuang Jun , Chen Yi , Wang Cheng , Su Xueshang , Zheng Qiaoyuan , Zhang Ziming , Wei Qingqian , Liu Tun , Hu Jintian 
Published: September 2024

Objective:
Liposuction of the face and neck is a common treatment for fat deposition. If conventional methods are used for tumescent anesthesia, patients will experience pain, affecting their surgery experience. Using general anesthesia for liposuction of the face and neck can increase the cost to the patient and cause various adverse effects.

Methods:
The authors selected appropriate parts of the patient's neck, angle of the mandible, and face as needle entry points, and performed nerve block in different directions. Afterward, we performed facial liposuction on these patients and evaluated their level of pain.

Results:
This study included a total of 20 female participants who underwent facial liposuction after a nerve block. The Visual Analog Scale score of the 20 participants was 0.55 (±0.60). There were no significant adverse reactions during the treatment process, and all patients expressed satisfaction with this treatment.

Conclusions:
In this article, the authors present a method of tumescent anesthesia based on facial and cervical nerve block that significantly reduces the pain associated with facial and neck liposuction, eliminating the need for general anesthesia and enhancing the patient’s comfort during the procedure.
Clinical Characteristics and Underlying Pathophysiology in 4 Subtypes of Dysthyroid Optic Neuropathy Patients
Authors: Yoon EunGyu , Lee Hyunkyu , Baek Sehyun , Lee Hwa 
Published: September 2024

Objective:
To analyze different subtypes, clinical characteristics, and pathophysiologies of dysthyroid optic neuropathy (DON) based on orbital fat and extraocular muscle (EOM) volume increases on orbital CT images.

Methods:
The author retrospectively reviewed the medical records of 80 patients (152 eyes) who were diagnosed with DON and treated at Anam, Guro, or Ansan hospitals of the Korea University College of Medicine from February 2006 to December 2023. Clinical features, ophthalmic examination, demographic characteristics, thyroid status, and radiographic findings from computed tomography scans (prevalence of fat or muscle volume increases) were analyzed.

Results:
Four groups were designated based on EOM volume (MV) and orbital fat volume (FV). Group 1 had no increase in MV or FV (5.3%, 8 eyes), group 2 had increased FV only (8.66%, 13 eyes), group 3 had an increase in MV only (52.6%, 80 eyes), while group 4 had both MV and FV increase (33.6%, 51 eyes). Patients in group 1 were younger and had low diplopia scores than patients in the other groups. Decreases in visual acuity, color vision abnormalities, diplopia score, and apical crowding were less frequent in groups 1 and 2 than groups 3 and 4 (P=0.000). Patients in groups 3 and 4 had significantly more apical crowding and higher diplopia scores and CAS scores than patients in groups 1 and 2 (P=0.000 and 0.013, respectively). The number of patients who underwent decompression surgery was significantly higher in groups 3 and 4 than groups 1 and 2 (P=0.000).

Conclusion:
Extraocular muscle enlargement occurred in 86% of DON patients and compression of the optic nerve due to enlargement of EOMs at the orbital apex is the main cause of DON. Optic nerve stretch and vascular insufficiency due to increased orbital pressure are other potential mechanisms underlying DON in groups without an increase in FV or MV. Although decreased visual acuity, color vision abnormalities, and diplopia were less frequent in these groups, greater attention should be paid to the timely diagnosis of DON.
A Patient With Exposed Costal Cartilage After Microtia Surgery Successfully Treated With Perifascial Areolar Tissue Grafting
Authors: Kasai Shogo , Kuba Ryogo , Asato Reiko 
Published: September 2024

Postoperative costal cartilage exposure is a troublesome complication following costal cartilage grafting for microtia. The authors report a case of attempted recovery using perifascial areolar tissue (PAT) transplantation that achieved favorable results. The patient was a 13-year-old boy, who developed a 27 × 11 mm2 skin ulcer with a 6 × 3.5 mm2 area of exposed cartilage at the helix 1 month after ear ablation surgery. PAT harvested from above the trapezius muscle was grafted onto the ulcer. The wound was closed 14 days later using a split-thickness skin graft from the head. PAT transplants can be harvested from anywhere in the body, are minimally invasive, and are highly flexible. This case demonstrates that, although factors such as the extent and location of cartilage exposure must be considered, PAT transplants are an option for microtia salvage surgery.
The Peripheral Reduction With Keyhole Tongue Reduction Technique for Macroglossia in Beckwith-Wiedemann Syndrome
Authors: Romeo Dominic J. , Massenburg Benjamin B. , Wilson Alexander T. , George Andrew , Akarapimand Patrick , Lenz Theodor , Wu Meagan , Ng Jinggang J. , Kalish Jennifer M. , Taylor Jesse A. 
Published: September 2024

Objective:
Patients with Beckwith-Wiedemann syndrome commonly have macroglossia, which can negatively affect dentoskeletal development, breathing, speaking, and eating. Tongue reduction surgery can improve symptoms, but there is no standardized surgical approach.

Methods:
A video and observational commentary highlighting the effectiveness of a tongue reduction technique for BWS were presented.

Results:
The peripheral resection with a keyhole approach safely reduced tongue volume, maintained the lateral neurovascular pedicles, optimized intraoperative visualization, and limited bleeding.

Conclusions:
The peripheral resection with a keyhole tongue reduction surgical technique is effective for treating symptomatic macroglossia in BWS.
Characterization of Baseline Lung Allograft Dysfunction in Single Lung Transplant Recipients
Authors: Gerckens Michael , Mümmler Carlo , Richard Alexander , Strodel Johannes , Mertsch Pontus , Milger Katrin , Veit Tobias , Gade Nils , Yildirim Ali Önder , Schneider Christian , Kauke Teresa , Michel Sebastian , Irlbeck Michael , Behr Jürgen , Kneidinger Nikolaus 
Published: September 2024

Background.
Baseline lung allograft dysfunction (BLAD) is characterized by the failure to achieve normal baseline lung function after double lung transplantation (DLTX) and is associated with a high risk of mortality. In single lung transplant (SLTX) recipients, however, cutoff values and associated factors have not been explored. Here, we aimed to define BLAD in SLTX recipients, investigate its impact on allograft survival, and identify potential risk factors for BLAD in SLTX recipients.

Methods.
We performed a retrospective, single-center analysis of the LTX cohort of LMU Munich between 2010 and 2018. In accordance with DLTX cutoffs, BLAD in SLTX recipients was defined as failure to achieve percentage of forced expiratory volume in 1 s and percentage of forced vital capacity of >60% on 2 consecutive tests >3 wk apart. Survival analysis and regression analysis for potential predictors of BLAD were performed.

Results.
In a cohort of 141 SLTX recipients, 43% of patients met BLAD criteria. SLTX recipients with BLAD demonstrated impaired survival. Native lung hyperinflation was associated with BLAD in obstructive disease, whereas donor/recipient lung size mismatch was associated with BLAD in both obstructive and restrictive underlying diseases. Pulmonary function testing at 3 mo after lung transplantation predicted normal baseline lung function in SLTX recipients with obstructive lung disease.

Conclusions.
BLAD in SLTX recipients is as relevant as in DLTX recipients and should generally be considered in the follow-up of LTX recipients. Risk factors for BLAD differed between underlying obstructive and restrictive lung disease. A better understanding of associated factors may help in the development of preventive strategies.