bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses Lived Experiences, Burdens and Coping Strategies During COVID-19 Pandemic
Authors: Jarrad Reem Ahmad , ALdasoqi Khadeejeh Yousef Abdul Aziz , ALnatsheh Malak Tareq Talib 
Published: June 2024

This is a qualitative phenomenological study that was designed to navigate through nurses’ lived experiences, burdens, and coping strategies while working with COVID-19 patients. The sample included 20 nurses who had worked with COVID-19 patients for more than or equal to 6 months. The interviews were conducted between October 1, 2021, and April 15, 2022. At that time, the third COVID wave had elapsed, and we were peaking on a fourth pandemic wave, so included participants had lived through a minimum of 2 to 3 peaks. Six themes emerged, which were: nurses coping with COVID-19 crisis, professional relationship burden, personal burden, environmental burden, physical symptom burden, and emotional burden of the crisis. Nurses’ lived experiences during the pandemic were deep, intense, and moderately to highly affecting their ways of thinking, feeling, and behaving. That experience opened nurses’ eyes on countless number of challenges that require special attention, care, and preparation on many levels. The minimal preparatory levels are personal, departmental, organizational, and strategic.
A novel objective evaluation method, shear wave elastography, in the treatment of atrophic vaginitis by nonablative intravaginal Er:YAG laser, a randomized-sham controlled pilot study
Authors: Bayraktar Elif , Erel C.Tamer , Akturk Hayedeh , Erkan Ipek Betul Ozcivit , Hamid Rauf , Alper Ebru , Adaletli Ibrahim , Urfalioglu Mert 
Published: June 2024

Abstract

Objective
The aim of the study was to investigate the effectiveness of intravaginal Er:YAG laser for treating atrophic vaginitis in postmenopausal women utilizing shear wave elastography.

Methods
In this prospective randomized sham-controlled double-blind pilot study, 20 participants were included (laser group [n = 12] / sham-control group [n = 8]). A nonablative (Smooth mode) Er:YAG laser with a wavelength of 2,940 nm was used. Objective evaluation of laser treatment efficacy was conducted using a special ultrasonic technique: shear wave elastography. Ultrasonic velocity measurements were taken from the anterior and posterior vaginal walls. Mean elasticity (Emean) was expressed in kilopascals (kPa). Additional outcome parameters were vaginal pH, Vaginal Health Index (VHI), Female Sexual Function Index (FSFI), and visual analog scale (VAS) scores for dyspareunia.

Results
Baseline clinical characteristics, vaginal pH, VHI, VAS and FSFI scores, and Emean values were comparable between the laser and sham-control groups. Statistically significant differences were observed in the final Emean values of the anterior vaginal wall (13.1 ± 6.3 vs 20.0 ± 3.3 kPA, P = 0.01) and posterior vaginal wall (12.7 ± 10.3 vs 19.4 ± 6.9 kPA, P = 0.04) between the laser and sham-control group. Despite comparable baseline Emean values, significant differences in vaginal wall stiffness posttreatment indicated a notable increase in tissue elasticity following laser treatment. Statistically significant differences were also observed in final vaginal pH values, VHI, VAS scores, and FSFI score improvement in favor of laser treatment.

Conclusions
Shear wave elastography may be considered as a reliable and objective technique for evaluating the efficacy of Er:YAG laser treatment in women with atrophic vaginitis. However, additional studies with larger sample sizes are necessary to establish conclusive evidence.
Comparison of low-energy FLACS and conventional cataract surgery: meta-analysis and systematic review
Authors: Yeh Cyuan-Yi , Fang Hwa-Shin , Ou You-Ci , Cheng Cheng-Kuo , Wu Tzu-En 
Published: June 2024

Topic:
To systematically compare the effectiveness of conventional phacoemulsification surgery (CPS) and low-energy femtosecond laser–assisted cataract surgery (FLACS) in patients with cataract.

Clinical Relevance:
Cataract surgery is a common procedure, and comparing different techniques such as CPS and low-energy FLACS is crucial for optimizing patient outcomes.

Methods:
The PubMed, Web of Science, MEDLINE, EMBASE, and Cochrane library databases were searched for clinical trials. Outcomes of procedure time, effective phacoemulsification time, balanced salt solution usage, cumulative dissipated energy, mean change of corrected distance visual acuity, endothelial cells reduction, central corneal thickness (CCT), and aqueous cytokine level were evaluated. The effect measures were weighted mean differences with 95% CI. The protocol was registered at the Prospective Register for Systematic Reviews (registration number CRD42023420173).

Results:
11 studies were included in this meta-analysis, of which 1680 eyes were analyzed (637 eyes in the low-energy FLACS group and 1043 eyes in the CPS group). Low-energy FLACS demonstrated significantly fewer reductions in endothelial cell count at 6 months (P < .001) compared with CPS. It also exhibited a shorter effective phacoemulsification time (P < .001) and less balanced salt solution usage (P < .001). However, there were no differences in cumulative dissipated energy, corrected distance visual acuity, CCT changes, or aqueous cytokine levels between the 2 groups.

Conclusions:
Both low-energy FLACS and CPS are effective in treating cataracts, but low-energy FLACS may offer advantages such as reduced phacoemulsification time and less endothelial cell loss.
The impact of carbohydrate restriction-induced elevations in low-density lipoprotein cholesterol on progression of coronary atherosclerosis: the ketogenic diet trial study design
Authors: Javier Denise Alison R. , Manubolu Venkat S. , Norwitz Nicholas G. , Kinninger April , Aldana-Bitar Jairo , Ghanem Ahmed , Ahmad Khadije , Vicuna Will D. , Hamidi Hossein , Bagheri Marziyeh , Elsayed Tasneem , Villanueva Bea , Ichikawa Keishi , Flores Ferdinand , Hamal Sajad , Feldman David , Budoff Matthew J. 
Published: June 2024

Background
Despite innovations in pharmacotherapy to lower lipoprotein cholesterol and apolipoprotein B, risk factors for atherosclerotic cardiovascular disease (ASCVD), ASCVD persists as the leading global cause of mortality. Elevations in low-density lipoprotein cholesterol (LDL-C) are a well-known risk factor and have been a main target in the treatment of ASCVD. The latest research suggests that ketogenic diets are effective at improving most non-LDL-C/apolipoprotein B cardiometabolic risk factors. However, ketogenic diets can induce large increases in LDL-C to >190 mg/dl in some individuals. Interestingly, these individuals are often otherwise lean and healthy. The influence of increased levels of LDL-C resulting from a carbohydrate-restricted ketogenic diet on the progression of atherosclerosis in otherwise metabolically healthy individuals is poorly understood. This observational study aims to assess and describe the progression of coronary atherosclerosis in this population within 12 months.

Methods
Hundred relatively lean individuals who adopted ketogenic diets and subsequently exhibited hypercholesterolemia with LDL-C to >190 mg/dl, in association with otherwise good metabolic health markers, were enrolled and observed over a period of 12 months. Participants underwent serial coronary computed tomography angiography scans to assess the progression of coronary atherosclerosis in a year.

Results
Data analysis shall begin following the conclusion of the trial with results to follow.

Conclusion
Ketogenic diets have generated debate and raised concerns within the medical community, especially in the subset exhibiting immense elevations in LDL-C, who interestingly are lean and healthy. The relationship between elevated LDL-C and ASCVD progression in this population will provide better insight into the effects of diet-induced hypercholesterolemia.
Influence of Preterm Birth and Environmental Context on Academic Performance and Neurodevelopmental Outcomes
Authors: Kelly Michelle M. , Brace Margaret 
Published: June 2024

Background
Preterm birth affects 10% of all births annually in the United States. Outcomes of people born preterm are challenging to predict because of multiple influences, including gestational age, birth weight, and social and environmental contexts, that contribute to an individual’s growth and developmental trajectory. The influence of toxic stress is underrepresented in the literature assessing preterm birth outcomes.

Objectives
The current analyses use the eco-bio-developmental model of poverty and preterm birth as a framework to model the pathways among toxic stress, preterm birth, and neurodevelopmental outcomes. Poverty and toxic stress were hypothesized to increase the risk for impaired neurodevelopmental and academic outcomes—both directly and indirectly.

Methods
The analytic sample of 55,873 children aged 6–17 years was derived from the National Survey of Children’s Health 2020–2021. Structural equation models with combined measurement and path models for each dependent variable were constructed using latent toxic stress variables. The structural path equations included direct paths from the latent measure of prenatal toxic stress, preterm birth status, and the latent measure of childhood toxic stress to the neurodevelopmental outcome, as well as an indirect, mediated path from prenatal toxic stress through preterm birth status to the outcome.

Results
Across models, higher levels of prenatal toxic stress were significantly associated with preterm birth and lower birth weight ranges. Preterm low birth weight status was associated with a greater likelihood of neurodevelopmental impairment, repeating a grade, and special education plans. The predicted probabilities of neurodevelopmental impairment, repeating grades, and special education plans are significantly higher with above-average levels of exposure to prenatal and childhood toxic stress.

Discussion
There is a need for prospective studies that assess predictors and outcomes of preterm birth that are stratified by gestational age and consider the timing, chronicity, and influence of toxic stress and environmental exposures. There is an imperative for public health programs and policies designed to support families, caregivers, and children to address the individual and structural social determinants of health that contribute to toxic stress, thereby increasing preterm birth rates and negatively affecting the outcomes of children born preterm.
Scoping review: Mobility aids for people with sight loss across the ICF domains of functions, activities, and participation
Authors: Knights Holly M. , Benham Alex E. , Durrans Rachael M. , Burton Kim 
Published: June 2024

SIGNIFICANCE
There is little literature linking mobility aids for people with sight loss to the functions, activities, and participation domains of the International Classification of Functioning, Disability and Health (ICF). Future studies on this relationship should be funded and pursued to better understand ways to maximize the benefit of mobility aids.

PURPOSE
The ICF domains of functions, activities, and participation are potentially health-supporting aspects of daily living that may be impeded for people with sight loss. Although mobility aids facilitate safely navigating obstacles to optimize independence, it is not clear if they have any effect on functions, activities, or participation. This review explores the current literature to establish the associations between mobility aids and ICF domains.

METHODS
An established scoping review methodological framework was used to systematically search, select, and synthesize the existing literature.

RESULTS
Of 116 unique retrieved articles, three observational studies were eligible for inclusion with a total of 124 participants. A small experimental study found that blind adults had slower Timed Up and Go times than sighted and better performance with a long cane than without. One observational study found that physical activity was strongly related to level of visual acuity but with no independent impact of mobility aids. A single mixed-methods study explored travel frequency for blind people with assistance dogs and considered constraints to participation.

CONCLUSIONS
Despite the included studies involving some aspect of mobility aid use by people with sight loss, to date, no study has focused exclusively on mobility aid intervention for people with sight loss within the physical function, physical activity, and participation domains of the ICF. There is no reliable evidence on the associations between mobility aids and physical function, physical activity, and participation. This is an important knowledge gap for determining the most suitable aids, as well as their use, to best facilitate health-supporting activities.
Quality Improvement Initiative Enhances Outpatient Pediatric Pulmonology Follow-up for Premature Infants with Bronchopulmonary Dysplasia
Authors: Brumer Eliaz , Godse Sanjiv , Chandrasekar Leela , Kockar Kizilirmak Tuba , Blythe Eleanor , Gozzo Yeisid , Peterec Steven , Kandil Sarah , Grossman Matthew , Chen Laura , Weiss Pnina , Sheares Beverley 
Published: June 2024

Introduction:
Bronchopulmonary dysplasia (BPD) is a chronic lung disorder affecting many premature infants. Infants with BPD have higher hospital readmission rates due to respiratory-related morbidity. We aimed to increase the rates of outpatient pulmonary follow-up and attendance of premature babies with moderate and severe BPD to above 85% within 6 months.

Methods:
We conducted a quality improvement project at Yale New Haven Children’s Hospital. Key interventions included developing a BPD clinical pathway integrated into the electronic medical record to assist providers in correctly classifying BPD severity, assigning the appropriate International Classification of Diseases, 10th Revision code (P27.1), and providing standardized treatment options. The outcome measures included correct diagnosis and classification of BPD, the percentage of patients with BPD scheduled for pediatric pulmonology appointments within 45 days, and the percentage attending those appointments.

Results:
There were 226 patients in our study, including 85 in the baseline period. Correct diagnosis of BPD increased from 49% to 95%, the percentage of scheduled appointments increased from 71.9% to 100%, and the percentage of appointments attended increased from 55.6% to 87.1%.

Conclusions:
Our quality improvement initiative improved the accuracy of diagnosis, severity classification, and outpatient pulmonary follow-up of children with moderate and severe BPD.
Measuring the Interprofessional Health of the Pediatric Cardiovascular Operating Room Work Environment
Authors: Thornton Jason M. , Connor Jean A. , Dwyer Patricia A. , Porter Courtney L. , Hartwell Lauren P. , DiPasquale Zachary , Chiloyan Araz , Hickey Patricia A. 
Published: June 2024

Introduction:
Pediatric cardiac surgery is complex and has significant risk, requiring interprofessional teamwork for optimal outcomes. Unhealthy work environments have been linked to poor patient outcomes, staff dissatisfaction, and intention to leave. We describe the interprofessional health of pediatric cardiovascular operating room (CVOR) work environments in the United States and the establishment of a healthy work environment (HWE) benchmark score.

Methods:
Utilizing the American Association of Critical Care Nurses Healthy Work Environments Assessment Tool (HWEAT), interprofessional staff from 11 pediatric CVORs were surveyed. Responses were aggregated, summarized, and stratified by role to examine differences. The following phase used an e-Delphi approach to obtain expert consensus on a benchmark target.

Results:
Across 11 centers, 179 (60%) completed surveys were reviewed. The interprofessional mean HWEAT score was 3.55 (2.65–4.34). Mean scores for each standard were within the “good” range. Participants reported the highest scores for effective decision-making, with a mean of 3.69 (3.00–4.20). Meaningful recognition scored lowest, mean 3.26 (2.33–4.07). When stratified, surgeons reported higher overall HWE scores (M = 3.79, SD = 0.13) than nurses (M = 3.41, SD = 0.19; P = 0.02, two-tailed). The proposed benchmark was 3.50.

Conclusions:
This is the first time the American Association of Critical Care Nurses HWEAT has been used to describe the interprofessional health of work environments in pediatric CVORs in the United States. The targeted benchmark can support pediatric CVOR improvement strategies. Creating and sustaining an HWE is an interprofessional opportunity to support high-quality patient outcomes and clinical excellence.
68Ga-PSMA Versus 18F-FDG PET/CT in the Evaluation of Epithelioid Hemangioendothelioma
Authors: Şenses Veysi , Kaplan İhsan , Kaya Fulya , Ibiloğlu İbrahim , Can Canan 
Published: June 2024

Abstract
A 32-year-old man with epithelioid hemangioendothelioma was imaged with 68Ga-PSMA PET/CT to evaluate the potential of 177Lu-PSMA radionuclide therapy after progression findings were observed on follow-up 18F-FDG PET/CT imaging. Liver lesions showed low FDG SUVmax. The lesion-to-background ratio (TBR) was calculated as 5.1/2.9 on 18F-FDG PET/CT imaging. However, 68Ga-PSMA PET/CT showed moderate PSMA SUVmax. TBR was calculated as 4.5/1.1. In conclusion, in this case report, we demonstrated that 68Ga-PSMA with moderate TBR in epithelioid hemangioendothelioma may be promising for 177Lu-PSMA radionuclide therapy.
18F-FDG Brain PET/MRI in Granulomatous Primary Angiitis of the Central Nervous System
Authors: Sagnelli Matthew , Alkabie Samir , Franceschi Ana M. 
Published: June 2024

Abstract
An 18-year-old man presented with encephalopathy, headache, tremor, and left hemiparesis. 18F-FDG brain PET/MRI revealed pronounced hypometabolism in the right cerebral hemisphere corresponding to extensive T2/FLAIR signal abnormality, with accompanying miliary enhancement and microhemorrhages in this region. The differential diagnosis favored an autoimmune or inflammatory origin, rather than an infectious or neoplastic etiology. Brain biopsy demonstrated nonnecrotizing granulomatous inflammation affecting the vessel walls, without evidence of glial neoplasm, lymphoma, or infection. Treatment with corticosteroids was subsequently initiated, with favorable clinical response.
Unifying the Research Landscape of Desiccation Tolerance to Identify Trends, Gaps, and Opportunities
Authors: Lotreck Serena G. , Ghassemi Mohammad , VanBuren Robert T. 
Published: June 2024

AbstractDesiccation tolerance, or the ability to survive extreme dehydration, has evolved recurrently across the tree of life. While our understanding of the mechanisms underlying desiccation tolerance continues to expand, the compartmentalization of findings by study system impedes progress. Here, we analyzed 5,963 papers related to desiccation and examined model systems, research topics, citation networks, and disciplinary siloing over time. Our results show significant siloing, with plant science dominating the field, and relatively isolated clustering of plants, animal, microbial, and fungal literature. Topic modeling identified 46 distinct research topics, highlighting both commonalities and divergences across the knowledge of desiccation tolerance in different systems. We observed a rich diversity of model desiccation tolerant species within the community, contrasting the single species model for most biology research areas. To address citation gaps, we developed a rule-based algorithm to recommend new invitees to a niche conference, DesWorks, enhancing the integration of diverse research areas. The algorithm, which considers co-citation, co-authorship, research topics, and geographic data, successfully identified candidates with novel expertise that was unrepresented in previous conferences. Our findings underscore the importance of interdisciplinary collaboration in advancing desiccation tolerance research and provide a framework for using bibliometric tools to foster scientific integration.
A library-on-library screen reveals the breadth expansion landscape of a broadly neutralizing betacoronavirus antibody
Authors: Ornelas Marya Y. , Ouyang Wenhao O. , Wu Nicholas C. 
Published: June 2024

ABSTRACTBroadly neutralizing antibodies (bnAbs) typically evolve cross-reactivity breadth through acquiring somatic hypermutations. While evolution of breadth requires improvement of binding to multiple antigenic variants, most experimental evolution platforms select against only one antigenic variant at a time. In this study, a yeast display library-on-library approach was applied to delineate the affinity maturation of a betacoronavirus bnAb, S2P6, against 27 spike stem helix peptides in a single experiment. Our results revealed that the binding affinity landscape of S2P6 varies among different stem helix peptides. However, somatic hypermutations that confer general improvement in binding affinity across different stem helix peptides could also be identified. We further showed that a key somatic hypermutation for breadth expansion involves long-range interaction. Overall, our work not only provides a proof-of-concept for using a library-on-library approach to analyze the evolution of antibody breadth, but also has important implications for the development of broadly protective vaccines.
Leading causes of death among adult solid organ transplant recipients in the United States, 1999–2019
Authors: Volesky-Avellaneda Karena D , Wang Jeanny H , Pfeiffer Ruth M , Castenson David , Israni Ajay K , Miller Jonathan M , Musgrove Donnie , Shiels Meredith S , Snyder Jon J , Yu Kelly J , Engels Eric A 
Published: June 2024

ABSTRACTUnderlying medical conditions, graft failure, and immunosuppression place solid organ transplant recipients (“recipients) at heighten risk of death. We report the underlying causes of death among adult US recipients and compare their mortality to the US general population. We obtained causes of death by linking a sample of deaths from the US organ transplant registry to the National Death Index and weighted the linked deaths to represent all deaths among recipients aged ≥18 years during 1999–2019. To compare mortality to the US general population, we calculated standardized mortality ratios (SMRs). Among 496,467 recipients, 153,491 deaths occurred, of which 99,373 were NDI-linked. Leading causes of death were heart disease (16.9% of deaths), graft failure (14.9%), and cancer (14.4%). Compared to the US general population, recipients had 4.02 times the risk of death, and mortality was elevated for all 16 causes analyzed (e.g., 3.32-fold for heart disease and 2.08-fold for cancer) except dementia/Alzheimer’s disease. During 2015–2019, overall mortality was elevated 3.08-fold, with lung recipients experiencing the highest elevation (SMR=7.91), followed by heart (3.20), liver (2.86), and kidney (2.81) recipients. Although mortality improved over time, US recipients continue to face substantially elevated mortality, both overall and for common causes of death.