bluuebunny/crossref_metadata_2025_split huggingface dataset:
Effectiveness of a Novel Feeding Algorithm for Oral Feeding Transition of Infants Born Prematurely
Authors: Laborde Kelly , Gremillion Nanette , Harper Jeannie , Chapple Andrew G. , Deaton Ashley , Yates Allison , Spedale Steven , Sutton Elizabeth 
Published: September 2024

Background:
Feeding skill acquisition is commonly a limiting factor determining when an infant born prematurely can be discharged.

Purpose:
This study aimed to determine if the addition of a novel feeding progression algorithm (combination of objective data from a suck measurement device and slow flow/low variability nipples) to current neonatal intensive care unit (NICU) standards could decrease feeding-related length of stay (primary outcome). We hypothesized that by timing the initiation of oral feedings to coincide with adequate sensory-motor skill development, feeding-related length of stay may be decreased.

Methods:
This was a prospective intervention study, with a historical control cohort, of infants born less than 30 weeks’ gestational age without comorbidities affecting feeding skill acquisition at a Regional Level III-S NICU at a women and infant’s hospital in Louisiana. A novel feeding progression algorithm utilized objective assessment of sucking to determine progression in nipple flow rates with slow flow/low variability nipples (flow rates from 0 to 9 mL/min) for infants receiving intervention (n = 18). Thirty-six controls who did not receive the feeding progression algorithm were identified via electronic medical record retrospective chart review.

Results:
Eighteen completed the study. Compared to the control group, infants receiving feeding interventions had delayed sequencing initiation, extended time between initially off positive pressure ventilation and initiation of sequencing, and decreased feeding-related length of stay, with similar total length of stay.

Implications for Practice and Research:
This study adds to existing research supporting the effectiveness of novel feeding progression algorithms and interventions to support the health and outcomes of infants born prematurely. Future research should focus on implementation studies for feeding progression algorithm integration into standard NICU care.
The Association Between Vasopressin and Adverse Kidney Outcomes in Children and Young Adults Requiring Vasopressors on Continuous Renal Replacement Therapy
Authors: Hasson Denise C. , Gist Katja M. , Seo JangDong , Stenson Erin K. , Kessel Aaron , Haga Taiki , LaFever Sara , Santiago Maria Jose , Barhight Matthew , Selewski David , Ricci Zaccaria , Ollberding Nicholas J. , Stanski Natalja L. ,   on behalf of the Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK) Collaborative
Published: September 2024

OBJECTIVES:
Continuous renal replacement therapy (CRRT) and shock are both associated with high morbidity and mortality in the ICU. Adult data suggest renoprotective effects of vasopressin vs. catecholamines (norepinephrine and epinephrine). We aimed to determine whether vasopressin use during CRRT was associated with improved kidney outcomes in children and young adults.

DESIGN:
Secondary analysis of Worldwide Exploration of Renal Replacement Outcomes Collaborative in Kidney Disease (WE-ROCK), a multicenter, retrospective cohort study.

SETTING:
Neonatal, cardiac, PICUs at 34 centers internationally from January 1, 2015, to December 31, 2021.

PATIENTS/SUBJECTS:
Patients younger than 25 years receiving CRRT for acute kidney injury and/or fluid overload and requiring vasopressors. Patients receiving vasopressin were compared with patients receiving only norepinephrine/epinephrine. The impact of timing of vasopressin relative to CRRT start was assessed by categorizing patients as: early (on or before day 0), intermediate (days 1–2), and late (days 3–7).

INTERVENTIONS:
None.

MEASUREMENTS AND MAIN RESULTS:
Of 1016 patients, 665 (65%) required vasopressors in the first week of CRRT. Of 665, 248 (37%) received vasopressin, 473 (71%) experienced Major Adverse Kidney Events at 90 days (MAKE-90) (death, renal replacement therapy dependence, and/or > 125% increase in serum creatinine from baseline 90 days from CRRT initiation), and 195 (29%) liberated from CRRT on the first attempt within 28 days. Receipt of vasopressin was associated with higher odds of MAKE-90 (adjusted odds ratio [aOR], 1.80; 95% CI, 1.20–2.71; p = 0.005) but not liberation success. In the vasopressin group, intermediate/late initiation was associated with higher odds of MAKE-90 (aOR, 2.67; 95% CI, 1.17–6.11; p = 0.02) compared with early initiation.

CONCLUSIONS:
Nearly two-thirds of children and young adults receiving CRRT required vasopressors, including over one-third who received vasopressin. Receipt of vasopressin was associated with more MAKE-90, although earlier initiation in those who received it appears beneficial. Prospective studies are needed to understand the appropriate timing, dose, and subpopulation for use of vasopressin.
The burden of pre-operative anaemia and postoperative outcomes in 15 166 surgical patients from a public hospital in Brazil
Authors: Mendanha Clarissa , Neto Paulo C.S. , Borges Rogério B. , Sirtoli Isabela , Pando Cleiton S. , Brandão Mariana , Weber Alexandre , Sekini Leo , Stefani Luciana Cadore 
Published: September 2024

BACKGROUND
Preoperative anaemia is associated with poor postoperative outcomes; however, few studies have reported its prevalence in developing countries and its association with significant postoperative outcomes.

OBJECTIVE
We aimed to identify the prevalence of anaemia and its association with postoperative outcomes in a major public hospital in Brazil.

DESIGN
Retrospective cohort study.

SETTING
Single-centre, 860-bed, quaternary university-affiliated teaching hospital in Southern Brazil.

PATIENTS
We included adult patients who had undergone surgery between 2015 and 2019. Main outcome measures: The main outcome was the in-hospital 30-day postoperative mortality. According to the World Health Organisation, we defined anaemia and its sub-classification (mild, moderate, and severe). We developed Poisson regression models to examine the association between preoperative anaemia and outcomes.

RESULTS
We included 15 166 patients, of whom 6387 (42.1%) were anaemic. After adjustment for confounding factors, patients with anaemia had an increased risk of in-hospital 30-day postoperative mortality (relative risk (RR) 1.69, 95% confidence interval (CI) 1.44 to 1.99, P < 0.001). Mild [relative risk (RR) 1.38, 95% CI 1.12 to 1.71, P = 0.003], moderate (RR 1.73, 95% CI 1.43 to 2.10, P < 0.001), and severe anaemia (RR 2.43, 95% CI 1.92 to 3.07, P < 0.001) were associated with the primary outcome. Anaemia increased the transfusion risk (RR 4.44, 95% CI 3.90 to 5.06, P < 0.001) and postoperative intensive care unit (ICU) admission (RR 1.09, 95% CI 1.04 to 1.16, P = 0.001).

CONCLUSIONS
Four out of 10 patients had anaemia. These patients had an increased risk of adverse postoperative outcomes. Comprehension of the magnitude and impact of anaemia is essential to establish interventions in low-resource scenarios to optimise the patient's journey.

STUDY REGISTRATION
Institutional Review Board Registration number 40522820000005327 (Brazilian CEP/CONEP System, available in https://plataformabrasil.saude.gov.br/).
Ocular Surface Squamous Neoplasia In Situ Secondary to Bruton Tyrosine Kinase Inhibitor Therapy
Authors: Bloomquist Ryan F. , Sakhalkar Monali V. , Fowler Teresa E. , Bloomquist Doan T. 
Published: September 2024

Abstract:
Bruton tyrosine kinase (BTK) inhibitors have become an important therapeutic option in treating B-cell malignancies including non-Hodgkin lymphoma and chronic lymphocytic leukemia. However, a noted morbidity associated with their use is the potential for the development of second primary malignancy related to immunomodulation. In this case, we report a second primary malignancy of ocular surface squamous neoplasia (OSSN) owing to BTK therapy. The OSSN was successfully treated and has been monitored without recurrence. To our knowledge, this is the first case of OSSN secondary to BTK therapy.
Hemophagocytic Lymphohistiocytosis Secondary to Anaplasmosis With Lyme Coinfection
Authors: Baum Alexandria , Argotsinger Jill , Taha Rami , Gavaghan Victoria 
Published: September 2024

Abstract
Human granulocytic anaplasmosis and Lyme disease are tick-borne infections transmitted by the same vector, Ixodes scapularis, commonly isolated in areas within the Midwest region of the United States. Although typically associated with mild symptoms, both can progress to severe disease. Treatment of choice for a majority of tick-borne illness is doxycycline; however, options are limited in the setting of tetracycline allergy. Here, we present a complex case of human granulocytic anaplasmosis–induced hemophagocytic lymphohistiocytosis complicated by coinfection with Lyme encephalitis in a patient with a documented tetracycline allergy.
Decoding pain: uncovering the factors that affect the performance of neuroimaging-based pain models
Authors: Lee Dong Hee , Lee Sungwoo , Woo Choong-Wan 
Published: September 2024

Abstract
Neuroimaging-based pain biomarkers, when combined with machine learning techniques, have demonstrated potential in decoding pain intensity and diagnosing clinical pain conditions. However, a systematic evaluation of how different modeling options affect model performance remains unexplored. This study presents the results from a comprehensive literature survey and benchmark analysis. We conducted a survey of 57 previously published articles that included neuroimaging-based predictive modeling of pain, comparing classification and prediction performance based on the following modeling variables—the levels of data, spatial scales, idiographic vs population models, and sample sizes. The findings revealed a preference for population-level modeling with brain-wide features, aligning with the goal of clinical translation of neuroimaging biomarkers. However, a systematic evaluation of the influence of different modeling options was hindered by a limited number of independent test results. This prompted us to conduct benchmark analyses using a locally collected functional magnetic resonance imaging dataset (N = 124) involving an experimental thermal pain task. The results demonstrated that data levels, spatial scales, and sample sizes significantly impact model performance. Specifically, incorporating more pain-related brain regions, increasing sample sizes, and averaging less data during training and more data during testing improved performance. These findings offer useful guidance for developing neuroimaging-based biomarkers, underscoring the importance of strategic selection of modeling approaches to build better-performing neuroimaging pain biomarkers. However, the generalizability of these findings to clinical pain requires further investigation.
Therapist-led Microlearning Curriculum for Resident Mobility Education
Authors: Jain Bijal , Ansilio Laura , Baliki Marwan , Neal Jacqueline 
Published: September 2024

Background:Early mobility programs can mitigate or prevent functional decline in hospitalized patients. Studies have shown that insufficient staff mobility-related knowledge can hinder efficacy and sustainability of mobility initiatives. Integrating mobility education into residency training may help to bridge this knowledge gap. The purpose of this randomized pre-post survey study was to evaluate the impact of a standardized microlearning mobility curriculum embedded into daily interdisciplinary rounds on internal medicine residents’ self-reported beliefs, knowledge, and practices related to inpatient mobility.Methods:A mobility curriculum utilizing microlearning principles, consisting of 4 weekly 5-10-minute sessions, was developed and implemented at an academically-affiliated Veteran’s Hospital. Residents were randomly assigned by team numbers into an Education (intervention) group and a Control group. A questionnaire was developed and validated to assess the impact of the curriculum on learner perceptions, knowledge, and clinical practices. The survey was administered to the entire cohort of trainees at the beginning and end of their 4-week rotations, with results analyzed for differences between the groups.Outcomes:Both the Education and Control groups exhibited consistently positive attitudes towards inpatient mobility at baseline and after the study. The Education group reported higher confidence in mobility knowledge compared to the Control group post-intervention. Though reported mobility practices remained similar between groups, there was higher correlation between knowledge and practice responses in the Education group.Conclusion:As part of early mobility programmatic efforts, a microlearning curriculum embedded into interdisciplinary rounds can be effective in enhancing residents’ mobility-related knowledge and confidence.
mHealth Service Effects for Negative Emotions Among Parents of Preterm Infants: A Systematic Review and Meta-Analysis
Authors: He Kexin , Zhang Xin , Gou Jiayan , Wang Fei , Zou Liuni 
Published: September 2024

Purpose:
This review aims to ascertain the effects of mHealth on negative emotions among parents of preterm infants and analyze the current state of mHealth services in this context.

Background:
Caring for preterm infants often engenders negative emotions in parents, such as anxiety, depression, and stress. Mobile Health (mHealth) services offer potential benefits for preterm infant care. However, there are several uncertainties regarding the impact of mHealth services on parental emotions.

Methods and study design:
Randomized controlled trial (RCT) and quasi-RCT were published in English and Chinese until 2023 and are available in the electronic databases of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Web of Science, Cumulative Index to Nursing and Allied Health Literature (CINHAHL), Chinese Biomedical Literature Database, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database were reviewed. Review Manager 5.4 was employed for random-effects meta-analysis.

Results:
Seven RCTs and 6 quasi-RCTs with high risks were included, most of them were based on small sample size and single-centered. Meta-analysis demonstrated that mHealth interventions mitigated negative emotions, including anxiety (standard mean difference [SMD] = −1.07; 95% confidence interval [CI], −1.47 to −0.66; P< 0.0001), depression (SMD = −1.94; 95% CI, −3.01 to −0.86; P< 0.0001), and stress (SMD = −1.24; 95% CI, −2.07 to −0.40; P< 0.0001), among parents of preterm infants.

Conclusions:
It is recommended to develop independent specialized software for mHealth, enhance theoretical underpinnings, and standardize practical protocols. Incorporating early recognition and screening of negative emotions within mHealth could offer comprehensive support for the mental health of parents with preterm infants.

Implications:
The mHealth-based interventions are needed to focus on the parents’ emotional needs and minimize the impacts associated with mental stress.
The Effect of Mother’s Voice and Father’s Voice Listened by Newborns During Heel Blood Collection on Pain Level and Physiological Parameters
Authors: Ünal Tuba , Konuk Sener Dilek 
Published: September 2024

Background:
The newborn can learn the voices of its mother and father during intrauterine life, and the reencounter with these familiar voices after birth has a relaxing and calming effect on the baby.

Purpose:
The purpose of this study was to determine the effect of mother’s voice and father’s voice that newborns listened to during the heel blood collection procedure on pain level and physiological parameters.

Methods:
The study was a randomized controlled trial. The study consisted of a total of 90 newborns as participants (mother voice group = 30, father voice group = 30, and control group = 30) at the Düzce Atatürk State Hospital Gynecology Service, Türkiye. Newborns randomly assigned to the intervention groups were made to listen to the mother’s voice/father’s voice during the heel prick procedure. The newborn in the control group received standard heel blood collection procedures.

Results:
When the pain level of newborns was examined, it was determined that the lowest Newborn Infant Pain Scale score was in the mother’s voice group (P < .05). When the physiological parameter results were evaluated, it was determined that the highest oxygen saturation value and the lowest heart rate were found in the mother’s voice group (P < .05).

Conclusion:
It was determined that the mother’s voice was the most effective method in relieving the pain that occurred during the heel prick procedure and in the positive course of physiological parameters in newborns. According to the results of the study, it is recommended to use the mother’s voice in order to reduce the pain caused by the heel prick attempt in newborns and to regulate their physiological parameters.
Adherence to patient blood management strategy in patients with gastrointestinal bleeding: a prospective nationwide multicenter study
Authors: Tejedor-Tejada Javier , Ballester María Pilar , Del Castillo-Corzo Francisco Jose , García-Mateo Sandra , Domper-Arnal María Jose , Parada-Vazquez Pablo , Saiz-Chumillas Rosa M. , Jiménez-Moreno Manuel Alfonso , Hontoria-Bautista Gadea , Bernad-Cabredo Belén , Gómez Concepción , Capilla María , Fernández-De La Varga Margarita , Ruiz-Belmonte Lara , Lapeña-Muñoz Berta , Calvo Iñiguez María , Fraile-González María , Flórez-Díez Pablo , Morales-Alvarado Víctor Jair , Delgado-Guillena Pedro G. , Cañamares-Orbis Pablo , Saez-González Esteban , García-Morales Natalia , Montoro Miguel , Murcia-Pomares Óscar 
Published: September 2024

Introduction
Patient blood management (PBM) adherence in clinical practice is unclear. This real-world practice study assessed the management of patients with gastrointestinal (GI) bleeding after the implementation of the PBM strategy.

Methods
This was a nationwide multicenter and prospective study involving consecutive adults with GI bleeding between March 2019 and March 2021. Patients were examined according to hemoglobin (Hb) level at admission (<7 g/dl, n = 93; 7–8 g/dl, n = 47; 8–9 g/dl, n = 61; and >9 g/dl, n = 249). Study outcomes measures were morbidity and mortality during hospitalization and at 3- and 6-month follow-up. Appropriate anemia or iron deficiency management was considered when adherence to PBM policy was higher than 75%.

Results
A total of 450 patients (57.6% men, median age: 74 years, interquartile range: 63–82) were included. Overall, 55.1% and 59.3% of patients received transfusion and iron supplementation, respectively. The rates of appropriate transfusion and iron supplementation adherence were 90.9% (range: 86.9–93.5%, P = 0.109) and 81.8% (range: 78.5–85.1%, P = 0.041), depending on Hb level, respectively. No associations were observed between adherence to the PBM strategy and length of stay (P = 0.263) or risk of further bleeding (P = 0.742). Patients who were transfused [hazard ratio (HR): 0.79, 95% confidence interval (CI): 0.27–0.85] and iron supplemented (HR: 0.91, 95% CI: 0.38–1.41), however, appropriately achieved a lower risk of death. Age (HR: 1.12, 95% CI: 1.12–1.25) and further bleeding (HR: 39.08, 95% CI: 4.01–181.24) were poor prognostic factors. No serious adverse events were reported.

Conclusions
In this nationwide study, there is a high level of adherence and safety of PBM for the treatment of GI bleeding. Adherence to the PBM strategy improved outcomes in patients with GI bleeding.
Nursing Students’ Perception of the Clinical Learning Environment
Authors: Nasirudeen A.M.A. , Song Xiao , Sng Brandon , Pan Donghong 
Published: September 2024

Background:
The clinical learning environment (CLE) plays a vital role in students’ learning in clinical settings. However, to our knowledge, no longitudinal cohort studies have been published on how CLE influences nursing students’ learning during clinical placements.

Purpose:
This study investigated a cohort of nursing students’ perceptions of CLE during their first and third-year clinical placements.

Methods:
The clinical learning environment inventory (CLEI) questionnaire was used in this study. In 2021, a convenience sample of 450 first-year nursing students was invited to complete the CLEI questionnaire. In 2023, the same cohort of students in their third year of study were invited to complete the questionnaire.

Results:
Personalization, satisfaction, and task orientation had higher mean scores than the other CLEI subscales. The lowest mean scores were found for the teaching innovation and individualization subscales. Multiple regression and bivariate correlation analyses revealed task orientation as the strongest predictor of student satisfaction with the CLE.

Conclusions:
Nursing students in Singapore have a moderately positive satisfaction with their CLE. Clinical instructors should design innovative lesson plans to improve the student experience and learning in the CLE.
Adverse Events in Patients Transitioning From the Emergency Department to the Inpatient Setting
Authors: Tsilimingras Dennis , Schnipper Jeffrey , Zhang Liying , Levy Phillip , Korzeniewski Steven , Paxton James 
Published: September 2024

Objectives
The objective of this study was to determine the incidence and types of adverse events (AEs), including preventable and ameliorable AEs, in patients transitioning from the emergency department (ED) to the inpatient setting. A second objective was to examine the risk factors for patients with AEs.

Methods
This was a prospective cohort study of patients at risk for AEs in 2 urban academic hospitals from August 2020 to January 2022. Eighty-one eligible patients who were being admitted to any internal medicine or hospitalist service were recruited from the ED of these hospitals by a trained nurse. The nurse conducted a structured interview during admission and referred possible AEs for adjudication. Two blinded trained physicians using a previously established methodology adjudicated AEs.

Results
Over 22% of 81 patients experienced AEs from the ED to the inpatient setting. The most common AEs were adverse drug events (42%), followed by management (38%), and diagnostic errors (21%). Of these AEs, 75% were considered preventable. Patients who stayed in the ED longer were more likely to experience an AE (adjusted odds ratio = 1.99, 95% confidence interval = 1.19–3.32, P = 0.01).

Conclusions
AEs were common for patients transitioning from the ED to the inpatient setting. Further research is needed to understand the underlying causes of AEs that occur when patients transition from the ED to the inpatient setting. Understanding the contribution of factors such as length of stay in the ED will significantly help efforts to develop targeted interventions to improve this crucial transition of care.