bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Neuman Systems Model-Based Forensic Nursing Course
Authors: McDowell Betsy M. 
Published: February 2025

ABSTRACT
Because nursing theory is integral to effective nursing practice, education, and research, today's faculty are expected to weave nursing theory throughout the nursing curricula at both advanced and entry academic levels. However, incorporating nursing theory across all courses may be unfamiliar for many faculty. In this article, a senior-year elective course in forensic nursing included in a prelicensure baccalaureate curriculum with a Neuman Systems Model focus is presented. Suggested forensic nursing metaparadigm concepts, a possible schedule of topics and activities, and samples of Neuman Systems Model-based assignments are provided. This example could easily be adapted to other nursing theories and/or to other courses across the curriculum. Also emphasized is the importance of nurses providing trauma-informed care for all clients and reinforces the value of accurate evidence collection techniques and documentation. Finally, this course offers students a view of forensic nursing as a viable career choice.
Performance of Government-Financed Cervical Cancer Screening in Hunan, China and Optimization of Triage Strategies
Authors: Liao Zexi , Zou Kehan , Lei Ming , Wu Yinglan , Yang Wenqing , Zhang Yu 
Published: February 2025

Objectives
Cervical cancer is a preventable and manageable public health concern. This study aimed to evaluate the performance of a government-financed cervical cancer screening program and to discuss optimal primary screening approach and triage strategies for large-scale population screening.

Methods
This population-based study was conducted from 2015 to 2020 and included 6,373,279 eligible women. The performance of the cervical cancer screening program in Hunan Province was evaluated by comparing cancer incidence and mortality rates. The screening powers of primary human papillomavirus (HPV) testing and cytology were compared by calculating positive outcomes and cervical intraepithelial neoplasia 2 or worse (CIN2+) detection rates. Triage strategies for individuals positive for HPV-16/18 after primary HPV testing were discussed by comparing the CIN2+ detection rates and associated costs.

Results
The cervical cancer screening program has contributed to lower cancer mortality rates in Hunan Province. The HPV testing showed a higher CIN2+ detection rate than cytology as the primary screening approach (0.604% vs. 0.324%). For individuals positive for HPV-16/18, reflex cytology demonstrated a higher CIN2+ detection rate than direct colposcopy (51.11% vs 41.25%), although it was more expensive. For individuals with high-risk HPV types other than HPV-16/18, direct colposcopy exhibited a similar CIN2+ detection power as reflex cytology, but cost less.

Conclusions
The cervical cancer screening program should be expanded because the benefits outweigh the costs. Statistical data indicate that HPV testing is a cost-effective preliminary screening approach for large-scale population screening.
Clinician Characteristics Associated With Adoption of Updated National Colposcopy Guidelines
Authors: Fuzzell Lindsay , Brownstein Naomi C. , Fontenot Holly B. , Lake Paige , Michel Alexandra , Perkins Rebecca B. , Vadaparampil Susan T. 
Published: February 2025

Objective
To evaluate adherence to the 2019 ASCCP risk-based management consensus guidelines for management of patients following colpscopic cervical biopsy among US colposcopists.

Methods
To elucidate factors associated with utilization of the 2019 guidelines for patients undergoing colposcopic cervical biopsy, we cross-sectionally surveyed physicians and advanced practice professionals who perform colposcopy. Clinicians responded to clinical vignettes describing scenarios for which management recommendations differed between 2019 and prior management guidelines. Vignette 1 involved deferral of repeat colposcopy for patients with a low-risk biopsy, HPV, and cytology results. Vignette 2 involved deferral of excisional treatment on a patient with repeated low-grade biopsy results. Binomial logistic regression models determined factors associated with utilization of 2019 guidelines.

Results
A total of 670 colposcopists participated from across the United States. For Vignettes 1 and 2, guideline-adherent responses were given by 30.5% and 66.1% of participants, respectively. Colpsocopists practicing in community health centers were more likely to perform guideline-concordant care for Vignettes 1 and 2. Hispanic compared to non-Hispanic colposcopists and Internal or Family medicine compared to OB-GYN colposcopists are less likely to perform guideline-concordant care in Vignette 2. Irrespective of their chosen response, most believed they were guideline-adherent.

Conclusions
Many colposcopists may not realize their current management strategies are inconsistent with 2019 guidelines. Tailored education initiatives could address knowledge gaps, maximize patient benefits, and minimize harms.
Effects of Insertion Depth and Modiolar Proximity on Cochlear Implant Speech Recognition Outcomes With a Precurved Electrode Array
Authors: Canfarotta Michael W. , Dillon Margaret T. , Thompson Nicholas J. , Selleck A. Morgan , Dedmon Matthew M. , Brown Kevin D. 
Published: February 2025

Objectives
To examine the relationship between angular insertion depth (AID), modiolar proximity, and speech recognition outcomes for cochlear implant (CI) recipients of a precurved electrode array.

Study Design
Retrospective review.

Setting
Tertiary academic referral center.

Patients
Thirty-five adult CI recipients (n = 40 ears) of precurved electrode arrays listening with a CI-alone device.

Interventions
Cochlear implantation with postoperative computed tomography.

Main Outcome Measures
Consonant-nucleus-consonant (CNC) word recognition at 6 months post-activation.

Results
A multivariate regression model demonstrated that both deeper apical AID and closer modiolar proximity in the basal turn were independently associated with better CNC word scores at 6 months (F
2,37 = 7.264, p = 0.002). A deeper basal insertion depth was positively correlated with apical AID (r = 0.754, p < 0.001) but negatively correlated with modiolar proximity in the basal turn (r = −0.766, p < 0.001).

Conclusions
These data suggest that both apical cochlear coverage and modiolar proximity independently confer speech recognition benefit with a precurved array. However, these benefits are mutually exclusive for current precurved array designs as a deeper basal insertion depth results in greater apical coverage but lateralization of electrodes away from the modiolus in the basal turn. Future work is needed to elucidate mechanisms behind these findings that may motivate electrode array design modifications to further optimize outcomes for CI users.
Otologic Symptoms Following Teprotumumab Administration in Patients with Thyroid Eye Disease
Authors: Epperson Madison V. , Hughes Sara , Valenzuela Carla V. , Stucken Emily Z. 
Published: February 2025

Objective
Comprehensively characterize subjective otologic adverse events following teprotumumab administration with standardized patient reported outcome metrics. Understand the impact on patients’ quality of life and perception of the medication.

Study Design
Retrospective case series.

Setting
Tertiary referral center.

Patients
Thirty-two adults with thyroid eye disease treated with teprotumumab from 2020 to 2023.

Main Outcome Measures
Subjective hearing loss, tinnitus, dizziness (Dizziness Handicap Inventory), patulous eustachian tube (Eustachian Tube Dysfunction Questionnaire-7, Patulous Eustachian Tube Handicap Inventory-10), effect of hearing loss on quality of life, and decisional regret.

Results
Half reported hearing loss (n = 16, 50%) while receiving teprotumumab. Onset was gradual in 75% of patients with onset at the sixth [IQR 5–7] infusion. It was nonfluctuating (93.8%), bilateral (100%), and did not return to baseline (93.8%). Of those reporting hearing loss, 37.5% reported dizziness and 87.5% reported tinnitus; 87.5% felt it affected quality of life, and 33.3% would opt to not receive the medication again. The median DHI score was 9 [0–35] in those with hearing loss compared to 0 [0–5] in those without hearing loss (p = 0.02, Wilcoxon rank sum). Based on the ETDQ-7, 37.5% of patients experienced eustachian tube dysfunction; 15.6% experienced symptoms of a patulous eustachian tube with a median PHI-10 score of 15 [3–24], indicating a mild handicap.

Conclusions
Many patients experience subjective hearing loss following teprotumumab administration, typically gradual in onset, nonfluctuating, bilateral, persistent, and significantly affecting quality of life. Patients may also experience comorbid vertigo and symptoms of eustachian tube dysfunction or patulous eustachian tube with variable severity.
Epidemiology, clinic, therapeutic, and outcome of pelvic organ prolapse: a retrospective single-center cohort study
Authors: Amadou Issa Abdou , Soumana Diaouga Hamidou , Lankonde Salifou Zelika , Abdoul-Wahab Mahamadou Moumouni , Oumara Maina , Oumarou Garba Souleymane , Harouna Salifou Jamila , Abdoulaye Maman Bachir , Nouhou Hassan , Nayama Madi 
Published: February 2025

Introduction:
Pelvic organ prolapse (POP) is a major public health problem. This study aims to determine the incidence, sociodemographic profile of patients, the management and outcomes of POP in a maternity hospital with limited resources in Niger.

Methodology:
This was an eight-year retrospective cohort study involving the analysis of medical records from patients who underwent management of POP between 1 January 2015 and 31 December 2022 in our department. The epidemiological data, treatment, and outcomes of POP were collated and subjected to analysis.

Results:
During the study period, 358 cases of POP were recorded out of a total of 12 536 patients treated in the department, representing a frequency of 2.8%. The mean age of the patients was 46.14 years (range: 17–90 years). The patients were identified as married (307 cases, 85.75%), unemployed (353 cases, 98.6%) and not attending school (332 cases, 92.74%). The largest number of cases were observed in large multiparous women (60.05%, 215 patients). The average parity was 6.5 children. The vast majority of patients (269 cases, 75.14%) lived in rural areas. The most frequent motif for consultation was the sensation of mass in the vagina (146 cases, 40.78%) and vulvar swelling (138 cases, 38.55%). The most frequent genital prolapses type was middle, made of the hysterocele essentially (150 cases, 41.90%). The stage III of genital prolapses was the most frequent in 76.51% (274 cases). All patients underwent surgical treatment (100%), and the vaginal access was most used in 57.55% (206 cases) of cases. Conservative treatment was performed in the majority of patients (197 cases, 55.02%). The intraoperative complications were vesical lesions (0.56%, two cases) and ureteral and vascular lesion (0.28%, one case).

Conclusion:
POP is a common occurrence in our region. Surgical treatment is the most practiced and hysterectomy by vaginal surgical approach is the most practiced.
Creation of a Novel Virtual Reality Simulation to Increase Nursing Skills in Management of Workplace Violence
Authors: Tobias Jane , DiDonato Stephen , Whitfield-Harris Lisa , Okupniak Carol , Santulli Gabrielle , Das Nimmy , Marino Marie 
Published: February 2025

OBJECTIVE
This article presents the design, development, and implementation of a novel and innovative virtual reality (VR) simulation aimed at increasing nursing skills in identifying, managing, and deescalating workplace violence (WPV) incidents and mitigating the effects after critical incidents.

BACKGROUND
The ANA reports that 1 in 4 nurses in the United States experience workplace assault annually, highlighting the novel role of VR simulations in educating and preparing nurses to recognize, address, and minimize the impact of WPV.

METHODS
A multidisciplinary team designed and implemented a VR simulation based on real WPV incidents reported by nurses in an urban health system, enlisting a film and video company's expertise to bring scenarios to life, addressing a critical gap.

CONCLUSIONS
This article discusses the collaborative creation of simulations using VR as a novel strategy for educating nurses on identification, management, and deescalation of incidents of WPV and mitigating the effects of WPV after critical incidents.
Focal Intense FDG Uptake of the Tongue Muscle Due to Repeated Tooth-Licking Mimicking Malignancy
Authors: Huo Yajing , Dong Aisheng , Han Yan 
Published: February 2025

Abstract
A 55-year-old woman underwent FDG PET/CT to detect possible multiple myeloma due to IgM κ paraproteinemia. FDG PET/CT showed a focal intense activity with SUVmax of 21.3 in her anterior tongue, suspicious for malignancy. MRI and physical examination of the tongue were normal. On further inquiry, the patient reported she had a habit of licking her anterior mandibular teeth and licked her teeth repeatedly before and after injection of FDG. Consequently, the tongue activity was interpreted as physiological tongue muscle activity due to repeated tooth-licking.
Multi-physics modeling for ion homeostasis in multi-compartment plant cells using an energy function
Authors: Mestdagh Guillaume , De Angeli Alexis , Godin Christophe 
Published: February 2025

AbstractPlant cells control their volume by regulating the osmotic potential of their cytoplasm and vacuole. Water is attracted into the cell as the result of a cascade of solute exchanges between the cell subcompartments and the cell surroundings, which are governed by chemical, electrostatic and mechanical forces. Due to this multi-physics aspect and to couplings between changes of volumes and chemical effects, modeling these exchanges remains a challenge that has only been partially adressed. In this paper, we introduce an energy-based approach to couple chemical, electrical and mechanical processes taking place between several subcompartments of a plant cell. The contributions of all physical effects are gathered in an energy function that allows us to derive the equations satisfied by each variable in a systematical way. This results in a modular, unified approach that can be interpreted analytically. We illustrate these properties on the modeling of ion and water transport in a guard cell during stoma opening. We represent the stoma opening process as a quasi-static evolution driven by hydrogen pumps in the plasma and vacuolar membranes, resulting in an interpretable model with few parameters. We perform numerical simulations to investigate the role of each hydrogen pump in this process. We show that this energy-based approach allows us to highlight a hierarchy between the forces involved in the system, that can be exploited to interpret the emergent properties of this complex multi-physics system.
Long-term restricted mean survival time survival of anterior large vessel occlusion strokes treated with endovascular thrombectomy
Authors: Wellington Daniel James , Diprose William , Campbell Douglas , Hong Jae Beom , Boyle Luke , Barber Peter Alan 
Published: February 2025

AbstractIntroductionEndovascular thrombectomy (EVT) has revolutionized the treatment of patients with large vessel occlusion (LVO) stroke. Three-month functional independence ranges between 33 and 60%, and mortality between 12 and 25%. Few studies have presented outcomes beyond five years and their reported odds or hazard ratios are difficult to apply clinically. Median survival is also challenging to interpret correctly. Restricted mean survival time (RMST) is a clinically intuitive metric that gives survival times up to specified cutoff points. We aimed to determine RMST at one, two and five years after EVT for anterior circulation stroke patients and evaluate survival impact of various risk factors.MethodsThis cohort study examined survival of patients treated with EVT for anterior circulation LVO stroke from 2011-2024 from the New Zealand national stroke database. Unadjusted RMST was determined for all age brackets. Cox regression adjusted survival curves were used to determine RMST and survival probabilities at one, two and five years for significant covariates.ResultsThere were 1457 anterior circulation LVO patients treated with EVT included for analysis (median follow-up 8.9 years [95% CI 7.57 – inf]). At five years, 415 (28%) patients had died. Patients aged 90 years or older had a RMST of 1.64 years, and a five-year survival probability of 33% compared with a 97% survival probability for those aged 15-39 years. Five-year RMST survival differences were; independent level of function versus dependent (0.77 years), low comorbidity versus high (0.71 years), mild-moderate NIHSS versus higher (0.49 years), smaller infarct cores versus large (0.48 years), and good reperfusion versus (0.67 years).DiscussionRMST provided clinically useful survival estimates and subgroup survival differences after EVT, especially in those of advanced age. RMST is easy to communicate, captures survival nuances, and can provide absolute differences that are not possible when outcomes are measured using median survival alone.
Spike-specific IgG4 generated post BNT162b2 mRNA vaccination is inhibitory when directly competing with functional IgG subclasses
Authors: Tam Jerry C. H. , Sibayan Abbie C. , Seow Jeffrey , Graham Carl , Kurshan Ashwini , Merrick Blair , Stanton Richard J. , Doores Katie J. 
Published: February 2025

AbstractThe rapid development of vaccines against SARS-CoV-2 during the COVID-19 pandemic proved vital in controlling viral spread and reducing mortality and morbidity. Both neutralising activity and effector function activity of Spike-specific antibodies have been shown to be important for their protective and therapeutic activity. However, several recent studies have reported that vaccination with mRNA based COVID-19 vaccines can lead to elevated levels of Spike-specific IgG4, an isotype which is often considered anti-inflammatory due to its reduced binding to Fcγ receptors on immune cells. Here we show that the level of Spike-specific IgG4 produced following BNT162b2 vaccination is impacted by the interval between and frequency of vaccines boosts, prior SARS-CoV-2 infection (hybrid immunity), breakthrough infection and bivalent vaccine boosters. Despite the increase in Spike-specific IgG4 between the 2ndand 3rdBNT162b2 vaccine dose, neutralisation, ADCD and ADCP activity all increased. Through expression of SARS-CoV-2 monoclonal antibodies cloned as IgG1, IgG2, IgG3 and IgG4, we demonstrated that whilst Spike-specific IgG4 had reduced effector function activity, including ADCC, ADCD and ADCP, IgG4 was only inhibitory when directly competing with functional IgG subclasses binding to an overlapping epitope. In the context of polyclonal plasma, ADCC and ADCD activity could not be depleted by addition of high concentrations of a Spike-specific IgG4 mAb cocktail suggesting the non-stimulatory effect of Spike-specific IgG4 may be hidden in more complex scenarios, such as polyclonal mixes in serum.
Evolution of cross-tolerance to metals in yeast
Authors: Bazzicalupo Anna L. , Kahn Penelope C. , Ao Eully , Campbell Joel , Otto Sarah P. 
Published: February 2025

AbstractOrganisms often face multiple selective pressures simultaneously (e.g., mine tailings with multiple heavy metal contaminants), yet we know little about when adaptation to one stressor provides cross-tolerance or cross-intolerance to other stressors. To explore the potential for cross-tolerance, we first adaptedSaccharomyces cerevisiaeto high concentrations of six single metals in a short-term evolutionary rescue experiment. We then measured the cross-tolerance of each metal-adapted line in the other five metals. We generated and tested three predictors for the degree of cross-tolerance, based on the similarity between pairs of metal environments in (1) their physiochemical properties, (2) the overlap in genes known to impact tolerance to both metals, and (3) their co-occurrence in the environment. None of these predictors explained significant variation in cross-tolerance. Instead, we observed that adapted lines in one metal were frequently cross-tolerant to certain metals (manganese and nickel) and intolerant to others (cobalt and zinc). Furthermore, cross-tolerance between pairs of metals was not reciprocal, with mutations accumulating in one metal (e.g., copper) providing adaptation to another metal (e.g., manganese), but notvice versa. Evolved lines also differed in their degree of specialization, with lines evolved in manganese or copper more specialized to that metal, but lines evolved in cobalt or zinc more generally tolerant. To determine the genetic basis of these metal adaptations, we sequenced the genomes of 109 metal-adapted yeast lines. The SNP mutation spectrum was significantly different in cadmium, cobalt, and manganese than expected in a mutation accumulation experiment inS. cerevisiae. In addition, two lines were highly mutated, bearing defects in DNA repair genes (both in manganese). Thirteen genes exhibited parallel adaptation to different metals; three of these genes generated broad cross-tolerance. Several mutations were found in vacuolar transporter genes, suggesting an important role for vacuolar proteins in adapting to metal stress. Our results with these metal-adapted lines indicate that cross-tolerance is challenging to predict, depending on the combined stressors experienced and the nature of the mutations involved.
Neurod2/6 transcription factors control basal progenitor differentiation and sequential production of neocortical cell subtypes
Authors: Yan Kuo , Newman Andrew G , Tutukova Svetlana , Gavrish Maria , Bormuth Ingo , Bormuth Olga , Tarabykin Victor 
Published: February 2025

AbstractNeurod2 and Neurod6 (Neurod2/6) are key transcription factors that promote neuronal differentiation, however, their role in the developing neocortex is not fully understood. Both genes have similar expression patterns during development as well as binding motifs. In order to investigate their role in cortical neurogenesis, we generated a mouse model deficient for both Neurod2/6. Here we demonstrate that differentiation of Tbr2-positive (Tbr2+) basal progenitors (BPs), but not Pax6+ apical progenitors, was severely defected, resulting in ectopically expanded BPs in perinatal Neurod2/6 deficient brains. The sequential fate specification of cortical neurons was also impaired in the absence of Neurod2/6. Ectopic Tbr2+ BPs expressed multiple proliferation markers and were able to self-renew. Olig2+ glial precursors were consequently over-produced in Neurod2/6 deficient brains. Restoration of Neurod2/6 in the double deficient brains downregulated Tbr2 expression, and exhibited substantial rescue effects on defected laminar subtype specification and excessive gliogenesis. Our work indicates that Neurod2/6 regulate BP differentiation and sequential production of cortical cell subtypes via inhibiting Tbr2-dependent genetic program.