bluuebunny/crossref_metadata_2025_split huggingface dataset:
Palonosetron in pediatric patients: A single-center, retrospective evaluation of policy and clinical practice guideline discordance
Authors: Ames Meredith , Patel Priya , Dupuis L Lee , Koo Alicia 
Published: March 2024

Introduction Clinical practice guidelines (CPGs) recommending palonosetron for the prevention and management of chemotherapy-induced nausea and vomiting (CINV) were adapted for use at our institution. Palonosetron was restricted for use in patients experiencing breakthrough CINV and receiving highly emetogenic chemotherapy (HEC) or undergoing stem cell transplant conditioning and in patients with refractory CINV receiving HEC. Given the significant cost of palonosetron, we aimed to determine the proportion of chemotherapy blocks where palonosetron use was discordant with the institutional policy or source CPG. Methods A retrospective review of the health records of patients who received palonosetron between 1 July 2019 and 30 June 2020 was undertaken. Details of palonosetron use, antiemetic regimen and the date and time of each vomit during the acute and delayed phases were collected for each chemotherapy block where palonosetron was given. Discordance with the institutional policy and the source CPG was determined by assessing the indication for palonosetron and the dose. In the subset of chemotherapy blocks where information regarding vomiting episodes was available, the extent of acute phase chemotherapy-induced vomiting (CIV) control was reported. Results Four hundred thirty-eight chemotherapy blocks, representing 122 patients (mean age 9 years), receiving 595 palonosetron doses were included. Palonosetron use was discordant with institutional policy during most (72%; 314/438) of the chemotherapy blocks analyzed. However, palonosetron use was concordant with the source CPG during most chemotherapy blocks (74%; 326/438). Complete CIV control during the acute phase was observed in 66% (195/295) of chemotherapy blocks where palonosetron was given, irrespective of concomitant antiemetics administered. Conclusion The majority of palonosetron use at our institution was discordant with institutional policy, but concordant with the source CPG. Our institutional policy has since been updated to be more aligned with the source CPG.
Ultrasound cyclo plasty in advanced glaucoma: Intermediate-term success, predictors for failure and complications
Authors: Almobarak Faisal A. , Alrubean Ahmed , Alsarhani Waleed K. , Aljenaidel Abdullah 
Published: March 2024

Purpose To report the intermediate-term success rate of ultrasound cyclo plasty (UCP), predictors for failure and complications in advanced glaucoma. Methods This study included patients with advanced glaucoma who underwent UCP. The main outcome measures were intraocular pressure (IOP), the number of antiglaucoma medications, and the presence of complications. Success was defined as an IOP reduction ≥30% and IOP between 6 mmHg and 18 mmHg with no vision-threatening complications. Cox proportional hazard regression analysis was performed to identify possible predictors for failure. Results We included 65 eyes of 58 patients in the study. The mean IOP and number of antiglaucoma medications decreased significantly from 27.60 ± 5.5 mmHg and 3.40 ± 0.9 at baseline to 17.80 ± 8.0 mmHg (35.51% reduction) and 2.43 ± 1.3 at 12 months and 17.10 ± 8.2 mmHg (38.04% reduction) and 2.41 ± 1.5 at 24 months, respectively ( p < 0.01 for both). The success rates were 66.2% (43/65) and 72.4% (21/29), while the failure rates were 33.8% (22/65) and 27.6% (8/29) at 12 and 24 months postoperatively, respectively. The cumulative probabilities of overall success were 67.7 ± 5.8% and 33.8 ± 5.9% at 12 and 24 months, respectively. High baseline IOP and history of old glaucoma surgery were associated with a higher risk for failure (Hazard ratio = 1.10 and 5.82, p = 0.03 and p < 0.01, respectively). The most common complications were anterior chamber reaction (18.5%) and cataract development/progression (15.4%). Two eyes (3.1%) developed phthisis bulbi. Conclusions Although UCP is effective in lowering IOP in eyes with advanced glaucoma, the intermediate-term success rates were moderate.
Slow coagulation versus micropulse transscleral cyclophotocoagulation for refractory childhood glaucoma
Authors: Seixas Regina Cele Silveira , Russ Heloisa Helena Abil , Maestrini Heloisa Andrade , Balbino Marcos , Fernandes Thatiana Almeida Pereira , Lima Núbia Vanessa dos Anjos , Lopes Nara Lídia Vieira , Neto Taurino dos Santos Rodrigues 
Published: March 2024

Purpose To compare the safety and efficacy of micropulse laser (MP-TSCP) and slow coagulation transscleral cyclophotocoagulation (TSCP) with a diode laser for reducing intraocular pressure (IOP) in patients with refractory childhood glaucoma (CG). Methods Patients with CG and at least 12 months of medical chart data were included. Data on preoperative and postoperative outcomes were analyzed. The primary outcomes were an IOP of 6–21 mmHg and/or ≥ 20% reduction in the baseline value. Results A total of 17 eyes were included. The preoperative mean IOP was 28 mmHg in the MP-TSCP and 29.9 mmHg in the TSCP. The mean IOP decreased significantly to 17.26 ± 3.27 mmHg in the MP-TSCP and 14.68 ± 5.79 mmHg TSCP at the last medical record. Three anti-glaucoma meds were administered to the eyes preoperatively in both groups. A mean of 1.02 eye drops was administered to the MP-TSCP and 2.06 to the TSCP. The number of medications decreased by 2.38 ± 1.55 in the MP-TSCP and 0.82 ± 1.68 in the TSCP. The median preoperative visual acuity (logMAR) was 1.51 ± 1.06 in the MP-TSCP and 1.87 ± 0.74 in the TSCP. The variation in mean visual acuity (logMAR) was −0.027 ± 0.05 in the MP-TSCP and −0.40 ± 0.58 in the TSCP. The most frequent complication was corneal decompensation (one - MP-TSCP and two - TSCP). Conclusion Both techniques were effective and relatively safe for reducing IOP. These techniques appear to extend the indications of cyclophotocoagulation in CG eyes and improve the functional prognosis.
Improving Medical Student Knowledge and Reducing Stigmatizing Attitudes Toward Treating Patients With Opioid Use Disorder
Authors: Chung Dana H. , Slat Stephanie , Rao Aditi , Thomas Jennifer , Kehne Adrianne , Macleod Colin , Madden Erin F. , Lagisetty Pooja 
Published: March 2024

Objectives: Stigma and lack of knowledge are barriers to clinicians when caring for individuals with opioid use disorder (OUD). In 2018, only about 15 out of 180 American medical schools had comprehensive addiction programs. The AAMC reports that institutions are increasingly incorporating competencies to address the OUD and opioid epidemic. There have been few evaluated curriculums focused on reducing stigmatizing attitudes. This study evaluated whether a 4-hour case-based curriculum focused on improving stigmatizing attitudes toward patients with OUD could reduce medical student perceptions around viewing addiction as a punitive condition and other substitution-based misconceptions around opioid agonist-based medication. Methods: Medical students completed a 4-hour curricular workshop which included learning objectives focusing on barriers to healthcare/stigmatizing attitudes, effective behavioral therapy options, and appropriate use of opioid medications. We measured changes in knowledge and attitudes using validated scales on stigma. Non-parametric repeated measure tests determined statistically significant differences between pre and post assessments between OUD related perceptions and a control condition (diabetes). Results: Of 135 eligible participants, 99 (76%) students completed both pre- and post-surveys. Mean scores across knowledge questions improved (60%-81%, P < .001) and stigmatizing attitudes regarding perceived violence of people with OUD decreased (2.04-1.82, P = .016). There was significant improvement in mean scores for OUD-related opinions including desire to work with and effectively treat patients with OUD (3.58-3.88, P < .001) while no significant concurrent change was observed in mean opinion scores of a non-OUD comparator, diabetes (3.88-3.97, P = .201). Conclusions: Results indicate that the workshop was associated with measurable changes in knowledge and attitudinal forms of OUD stigma. With recent policy changes eliminating the X-waiver, healthcare institutions are eager to design curriculum around OUD management and treatment. This study provides a blueprint for an effective curriculum that improves clinician knowledge and reduces stigmatizing attitudes.
Incidence of ADHD medication use among Finnish children and adolescents in 2008–2019: a need for practice changes?
Authors: Kolari Terhi A. , Vuori Miika , RÄttÖ Hanna , Varimo Eveliina A. , Aronen Eeva T. , Saastamoinen Leena K. , Ruokoniemi PÄivi T. 
Published: March 2024

Aims: This study examined the incidence of attention-deficit/hyperactivity disorder medication among children and adolescents by sex and age group in Finland during 2008–2019. Methods: The data on children and adolescents aged 6–18 years receiving reimbursement for any attention-deficit/hyperactivity disorder medication was collected from the nationwide register on reimbursed purchases. The incidence was calculated as a ratio of the number of new users and the number of age and sex-matched population at risk. Negative binomial models were used to calculate rate ratios (RRs). Results: In 2019, the incidence of attention-deficit/hyperactivity disorder medication was 13.4 per 1000 boys and 4.8 per 1000 girls. Among boys, the incidence became 3.7 times greater during the observed years (RR 95% confidence interval (CI) 2.0, 6.5, P<0.0001), whereas in girls it was 7.6 times greater (RR 95% CI 2.1, 27.4, P=0.0019). The boys had 2.8 times the incidence rate compared with the girls (RR 95% CI 2.2, 3.6, P<0.0001). The increase was associated with age only among boys ( P=0.0001). The highest incidence rate 23.4 per 1000 individuals (95% CI 22.5, 24.4) was found in 2019 among 6–8-year-old boys. Conclusions: The incidence of attention-deficit/hyperactivity disorder medication use among children and adolescents increased significantly in Finland during the study period. Incidence was higher among boys, but the increase was greater among girls. The most common group to start attention-deficit/hyperactivity disorder medication was 6–8-year-old boys. These findings warrant critical evaluation of the diagnostic and treatment policies currently available in Finland for the treatment of attention-deficit/hyperactivity disorder and related symptoms.
Artificial Intelligence in nursing: trustworthy or reliable?
Authors: Higgins Oliver , Chalup Stephan K , Wilson Rhonda L 
Published: March 2024

Background: Trustworthiness in Artificial Intelligence (AI) innovation is a priority for governments, researchers and clinicians; however, clinicians have highlighted trust and confidence as barriers to their acceptance of AI within a clinical application. While there is a call to design and develop AI that is considered trustworthy, AI still lacks the emotional capability to facilitate the reciprocal nature of trust. Aim: This paper aims to highlight and discuss the enigma of seeking or expecting trust attributes from a machine and, secondly, reframe the interpretation of trustworthiness for AI through evaluating its reliability and validity as consistent with the use of other clinical instruments. Results: AI interventions should be described in terms of competence, reliability and validity as expected of other clinical tools where quality and safety are a priority. Nurses should be presented with treatment recommendations that describe the validity and confidence of prediction with the final decision for care made by nurses. Future research should be framed to better understand how AI is used to deliver care. Finally, there is a responsibility for developers and researchers to influence the conversation about AI and its power towards improving outcomes. Conclusion: The sole focus on demonstrating trust rather than the business-as-usual requirement for reliability and validity attributes during implementation phases may result in negative experiences for nurses and clinical users. Implications for practice: This research will have significant implications for the way in which future nursing is practised. As AI-based systems become a part of routine practice, nurses will be faced with an increasing number of interventions that require complex trust systems to operate. For any AI researchers and developers, understanding the complexity of trust and creditability in the use of AI in nursing will be crucial for successful implementation. This research will contribute and assist in understanding nurses’ role in this change.
Post-stroke cognitive impairment remains highly prevalent and disabling despite state-of-the-art stroke treatment
Authors: Gallucci Laura , Sperber Christoph , Guggisberg Adrian G , Kaller Christoph P , Heldner Mirjam R , Monsch Andreas U , Hakim Arsany , Silimon Norbert , Fischer Urs , Arnold Marcel , Umarova Roza M 
Published: March 2024

Background: State-of-the-art stroke treatment significantly reduces lesion size and stroke severity, but it remains unclear whether these therapeutic advances have diminished the burden of post-stroke cognitive impairment (PSCI). Aims: In a cohort of patients receiving modern state-of-the-art stroke care including endovascular therapy, we assessed the frequency of PSCI and the pattern of domain-specific cognitive deficits, identified risk factors for PSCI, and determined the impact of acute PSCI on stroke outcome. Methods: In this prospective monocentric cohort study, we examined patients with first-ever anterior circulation ischemic stroke without pre-stroke cognitive decline, using a comprehensive neuropsychological assessment ⩽10 days after symptom onset. Normative data were stratified by demographic variables. We defined PSCI as at least moderate (<1.5 standard deviation) deficits in ⩾2 cognitive domains. Multivariable regression analysis was applied to define risk factors for PSCI. Results: We analyzed 329 non-aphasic patients admitted from December 2020 to July 2023 (67.2 ± 14.4 years old, 41.3% female, 13.1 ± 2.7 years of education). Although most patients had mild stroke (median National Institutes of Health Stroke Scale (NIHSS) 24 h = 1.00 (0.00; 3.00); 87.5% with NIHSS ⩽ 5), 69.3% of them presented with PSCI 2.7 ± 2.0 days post-stroke. The most severely and often affected cognitive domains were verbal learning, episodic memory, executive functions, selective attention, and constructive abilities (39.1%–51.2% of patients), whereas spatial neglect was less frequent (18.5%). The risk of PSCI was reduced with more years of education (odds ratio (OR) = 0.47, 95% confidence interval (CI) = 0.23–0.99) and right hemisphere lesions (OR = 0.47, 95% CI = 0.26-0.84), and increased with stroke severity (NIHSS 24 h, OR = 4.19, 95% CI = 2.72-6.45), presence of hyperlipidemia (OR = 1.93, 95% CI = 1.01–3.68), but was not influenced by age. After adjusting for stroke severity and depressive symptoms, acute PSCI was associated with poor functional outcome (modified Rankin Scale > 2, F = 13.695, p < 0.001) and worse global cognition (Montreal Cognitive Assessment (MoCA) score, F = 20.069, p < 0.001) at 3 months post-stroke. Conclusion: Despite modern stroke therapy and many strokes having mild severity, PSCI in the acute stroke phase remains frequent and associated with worse outcome. The most prevalent were learning and memory deficits. Cognitive reserve operationalized as years of education independently protects post-stroke cognition.
Adjuvant and neoadjuvant chemotherapy for MSI early gastric cancer: a systematic review and meta-analysis
Authors: Petrelli Fausto , Antista Maria , Marra Francesca , Cribiu’ Fulvia Milena , Rampulla Valentina , Pietrantonio Filippo , Dottorini Lorenzo , Ghidini Michele , Luciani Andrea , Zaniboni Alberto , Tomasello Gianluca 
Published: March 2024

Background: Perioperative chemotherapy (CT) is an established therapeutic approach for patients diagnosed with stage IB–III gastric cancer (GC). Objectives: This study aimed to investigate the efficacy of this approach in individuals with GC exhibiting high microsatellite instability (MSI-H). Design: A systematic review was conducted, including studies that provided data on (neo)adjuvant CT outcomes in patients with MSI-H GC. Methods: Systematic searches were conducted in PubMed, Cochrane Central of Controlled Trials, and Embase databases. Data were aggregated using hazard ratios (HRs) to compare overall survival between CT and surgery. Results: Data analysis from 23 studies, including 22,011 patients, revealed that the prevalence of MSI-H is 9.8%. Administration of adjuvant or perioperative CT did not significantly reduce the risk of death or relapse in patients with MSI-H GC (HR = 0.8, 95% CI 0.54–1.16; p = 0.24 and HR = 0.84, 95% CI 0.59–1.18; p = 0.31, respectively). Conclusion: Chemotherapy did not benefit patients diagnosed with MSI-H nonmetastatic GC but rather will be integrated with immune checkpoint inhibitors in the near future.
Performance of ChatGPT on the National Korean Occupational Therapy Licensing Examination
Authors: Lee Si-An , Heo Seoyoon , Park Jin-Hyuck 
Published: March 2024

Background ChatGPT is an artificial intelligence-based large language model (LLM). ChatGPT has been widely applied in medicine, but its application in occupational therapy has been lacking. Objective This study examined the accuracy of ChatGPT on the National Korean Occupational Therapy Licensing Examination (NKOTLE) and investigated its potential for application in the field of occupational therapy. Methods ChatGPT 3.5 was used during the five years of the NKOTLE with Korean prompts. Multiple choice questions were entered manually by three dependent encoders, and scored according to the number of correct answers. Results During the most recent five years, ChatGPT did not achieve a passing score of 60% accuracy and exhibited interrater agreement of 0.6 or higher. Conclusion ChatGPT could not pass the NKOTLE but demonstrated a high level of agreement between raters. Even though the potential of ChatGPT to pass the NKOTLE is currently inadequate, it performed very close to the passing level even with only Korean prompts.
Efficacy of dalfampridine in neuromyelitis optica spectrum disorder: A pilot study
Authors: de Seze Jérôme , Clerc Christine , Béreau Matthieu , Bourre Bertrand , Zephir Hélène , Collongues Nicolas , Kremer Laurent , Vermersch Patrick , Bigaut Kevin 
Published: March 2024

Objective To assess the efficacy of dalfampridine in patients with neuromyelitis optica spectrum disorder. Methods We included 15 consecutive patients, who were started on a treatment of dalfampridine 10 mg twice daily for 2 weeks. Efficacy assessment was based on walking ability improvement using Timed-25-Foot Walk and 12-item Multiple Sclerosis Walking Scale tests. Results The mean Timed-25-Foot Walk score was reduced from 14.8 (±2.4) to 11.3 (±1.9) seconds ( p = 0.01). The mean score on the 12-item Multiple Sclerosis Walking Scale was reduced from 41.2 (±3.5) to 31.4 (±3.2) ( p = 0.004). Conclusion Dalfampridine seems to be useful for symptomatic treatment of walking impairment in neuromyelitis optica spectrum disorder.
Digital Equity and School Leadership in a Post-Digital World
Authors: Liu (刘艳) Katrina , Tschinkel Rebecca , Miller Richard 
Published: March 2024

Purpose This study analyzes digital equity realities in U.S. K-12 schools and the role that school leadership plays in digital equity. Design/Approach/Methods Based on Selwyn’s conception of technology as three interlocking elements (access, educational practices, and social context), we applied the ideals of equity and social justice to each of the three elements to conceptualize a framework of digital equity, situating school practice in the larger social, cultural, and political context of the United States. Guided by this framework, we conducted a systematic literature review of the current state of digital equity and school leadership in K-12 schools. Findings The findings demonstrate that U.S. K-12 schools face digital inequity issues, including inequitable access to technology, exclusionary and punitive educational practices using technology, and an unjust social context for technology in schools. These findings indicate that school leadership plays an important role in digital inequity. Originality/Value Based on these findings, we present a framework to assist K-12 leaders in enhancing digital equity, including addressing educational inequities and creating an inclusive social context for the school, ensuring equitable accessibility to technology in schools, and supporting teachers in developing meaningful and equitable practices using technology to address the opportunity gaps encountered by marginalized learners.
Higher Vocational Nursing Students’ Clinical Core Competence in China: A Cross-Sectional Study
Authors: Wang Siping , Huang Shanshan , Yan Lulu 
Published: March 2024

Introduction Understanding the clinical core competence of nursing students in higher vocational colleges is crucial for adjusting the nursing core curriculum and training of nursing professionals. However, little is known about the level of clinical core competence of higher vocational nursing students in China. Objective To investigate nursing students’ clinical core competence in the school of nursing and health at a vocational and technical college in Guangdong, China. Methods The Core Competency Scale for Registered Nurses in China was used to evaluate the clinical core competence of higher vocational nursing students from February to March 2022. Data were analyzed by descriptive statistics, Mann-Whitney U test and Kruskal–Wallis test. Results A total of 1,120 nursing students were investigated, 1,069 were valid questionnaires, and the response rate was 95.4%. The total score of core competence score of higher vocational nursing students was 176.55 ± 43.95, only 43.3% of students obtained an overall score more than 178, and 47.7% of students scored between 116 and 178 scores. The lowest score was on critical thinking and scientific research (2.72 ± 0.77) following by clinical nursing (2.85 ± 0.80), which had differences in gender, category of students, and years of study. There were differences in the total average score of core competence in terms of gender and category of students. Leadership and interpersonal relationships differ significantly by gender, while professional development, teaching, and coaching differ significantly by category of student. Conclusions The findings revealed the core competence of higher vocational nursing students is at a medium level. Moreover, critical thinking and scientific research, and clinical nursing ability are significantly insufficient.
Online Mindset Training for Prelicensure Nursing Students: A Randomized Longitudinal Study
Authors: Lewis Lisa S. , Williams Cheryl A. , Dawson Stephanie 
Published: March 2024

Introduction Research suggests students with a growth mindset are more successful. Utilizing Dweck's growth mindset model, the study explored the benefits of mindset training within nursing education. Objective To determine the impact of an online mindset training intervention on first-semester prelicensure nursing students’ mindset beliefs and learning and studying strategies. Methods This study employed a randomized longitudinal design, conducted entirely online. Sixty-eight participants completed all phases of the study. Data were collected using the Williams Inventory of Learning Strategies tool before and after participants viewed an online training. Results Findings indicate that online mindset training positively influenced student learning, reducing fear of failure and increasing willingness to remediate. Conclusion These results highlight the promising impact of an online learning approach in fostering a growth mindset among nursing students; suggesting the potential for integrating mindset training into the nursing curriculum to enhance student success, with recommendations for further research in larger-scale studies.