bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development and implementation of sexual and gender minority curriculum for advanced practice nursing: A feasibility study
Authors: Tsusaki Rebecca , Mullassery Daisy , Ramaswamy Padmavathy 
Published: January 2024

AbstractAimTo explore the feasibility of development and implementation of an educational intervention addressing sexual and gender minority healthcare issues; examine recruitment processes and instrument appropriateness.DesignNon‐randomized feasibility study.MethodsThe educational intervention was developed and implemented in family nurse practitioner courses with data collection from August through December 2022. Clinical preparedness, attitudinal awareness and basic knowledge were measured using the lesbian, gay, bisexual and transgender Development of Clinical Skills Scale.ResultsDevelopment and implementation of the intervention was feasible but will require amendment before progressing to the pilot study. Clinical preparedness and basic knowledge increased post‐intervention, but attitudinal awareness did not improve. Recruitment did not achieve the desired sample size. Instrument internal consistency reliability was confirmed.ConclusionFeasibility was established but will require amendment prior to the pilot study.Implications for the Profession and/or Patient CareTo prepare nurses and nurse practitioners to care for sexual and gender minority patients.ImpactThis study addressed the feasibility of developing and implementing a sexual and gender minority healthcare education using an e‐Learning platform. Findings confirm that the intervention was feasible but will require amendment. The intervention increased knowledge and clinical preparedness in caring for this population, but recruitment was challenging. This research will impact nurses, nurse practitioners and nurse educators.Reporting MethodThe authors adhered to the relevant EQUATOR guidelines. The Consolidated Standards of Reporting Trials guideline extension for reporting randomized and feasibility guidelines were used.Public ContributionSexual and gender minority community members contributed to the intervention development.What Does this Paper Contribute to the Wider Global Clinical Community?

The feasibility of using interactive e‐learning educational resources to provide sexual and gender minority healthcare curriculum.
Evidence to support the use of the Lesbian, Gay, Bisexual, and Transgender Development of Clinical Skills Scale to measure learning outcomes.

Trial RegistrationThis study was not prospectively registered because it was an educational intervention involving graduate student nurses and did not assess clinical outcomes of patients.
The evolution of nutritional care in children and young people with acute lymphoblastic leukaemia: a narrative review
Authors: Lovell Amy L. , Gardiner Breeana , Henry Louise , Bate Jessica M. , Brougham Mark F. H. , Iniesta Raquel Revuelta 
Published: January 2024

AbstractBackgroundAcute lymphoblastic leukaemia (ALL) is the most common paediatric malignancy in the world. Advances in treatment protocols have resulted in survival rates of >80% in most high‐income countries (HIC); however, children and young people (CYP) with ALL continue to face significant nutrition‐related challenges during treatment.MethodsThis narrative review outlines the changing landscape of treatment and survivorship for CYP with ALL and the advances in nutrition knowledge that call for changes to clinical nutrition practice.ResultsThe incidence of ALL has remained stable in HIC; however, there have been significant advances in survival over the past 30 years. Overweight and obesity are increasingly prevalent in CYP with ALL at diagnosis, during treatment and in survivorship. Coupled with poor diet quality, high‐energy and saturated fat intakes, altered eating behaviours and inactivity, this necessitates the need for a shift in nutrition intervention. Undernutrition remains a concern for CYP with high‐risk treatment protocols where oral or enteral nutrition support remains a cornerstone of maintaining nutrition status.ConclusionsWith improved treatment protocols and high survival rates, a shift to focusing on diet quality, prevention of excessive weight gain and obesity during treatment and survivorship is necessary.
Melatonin suppression by light involves different retinal photoreceptors in young and older adults
Authors: Najjar Raymond P. , Prayag Abhishek S. , Gronfier Claude 
Published: January 2024

AbstractAge‐related sleep and circadian rhythm disturbances may be due to altered nonvisual photoreception. Here, we investigated the temporal dynamics of light‐induced melatonin suppression in young and older individuals. In a within‐subject design study, young and older participants were exposed for 60 min (0030‐0130 at night) to nine narrow‐band lights (range: 420−620 nm). Plasma melatonin suppression was calculated at 15, 30, 45, and 60 min time intervals. Individual spectral sensitivity of melatonin suppression and photoreceptor contribution were predicted for each interval and age group. In young participants, melanopsin solely drove melatonin suppression at all time intervals, with a peak sensitivity at 485.3 nm established only after 15 min of light exposure. Conversely, in older participants, spectral light‐driven melatonin suppression was best explained by a more complex model combining melanopsin, S‐cone, and M‐cone functions, with a stable peak (~500 nm) at 30, 45, and 60 min of light exposure. Aging is associated with a distinct photoreceptor contribution to melatonin suppression by light. While in young adults melanopsin‐only photoreception is a reliable predictor of melatonin suppression, in older individuals this process is jointly driven by melanopsin, S‐cone, and M‐cone functions. These findings offer new prospects for customizing light therapy for older individuals.
Prevalence of subclinical infectious agents in a blood donor population tested on every donation
Authors: Correia B. , Magalhães A. , Rocha L. , Cardoso I. , Ferreira R. R. F. , Mesa‐Sanchez I. 
Published: January 2024

ObjectivesThis study aimed to assess the prevalence of blood‐borne infectious agents in healthy, client‐owned dogs from a blood donor population in Portugal and Spain, and to address the importance of a screening protocol on every donation.Materials and MethodsClient‐owned healthy dogs were tested before each donation on a veterinary blood bank. Blood samples from new potential donors, and from regular donors, were tested by real‐time polymerase chain reaction for Leishmania species, Ehrlichia species, Brucella species, Babesia species and Anaplasma species Serological tests were also performed for Leishmania species, Ehrlichia species and Dirofilaria immitis. All donors were tested for every infectious agent in each donation.ResultsThe study found that out of a total of 8036 donors and 35,120 samples tested, 3.9% of blood donors tested positive for at least one of the agents, with the most prevalent being Anaplasma species (2.1%). Serological tests also revealed positive results in 14.0% of donors, with the highest percentage for Leishmania species (7.7%). Moreover, the study found that 28.2% of positive results were from dogs with negative results in donations performed 3 to 12 months before, and 18.0% of positive results were recent infections.Clinical SignificanceThese findings indicate a high prevalence of infectious agents in seemingly healthy, selected dogs eligible to become blood donors in the Iberian Peninsula, highlighting the importance of regular testing on every donation. This study emphasises the importance of a regular screening protocol for every donation instead of annual testing, as is commonly performed in veterinary medicine.
Estimating vigilance from the pre‐work shift sleep using an under‐mattress sleep sensor
Authors: Manners Jack , Kemps Eva , Guyett Alisha , Stuart Nicole , Lechat Bastien , Catcheside Peter , Scott Hannah 
Published: January 2024

SummaryPredicting vigilance impairment in high‐risk shift work occupations is critical to help to reduce workplace errors and accidents. Current methods rely on multi‐night, often manually entered, sleep data. This study developed a machine learning model for predicting vigilance errors based on a single prior sleep period, derived from an under‐mattress sensor. Twenty‐four healthy volunteers (mean [SD] age = 27.6 [9.5] years, 12 male) attended the laboratory on two separate occasions, 1 month apart, to compare wake performance and sleep under two different lighting conditions. Each condition occurred over an 8 day protocol comprising a baseline sleep opportunity from 10 p.m. to 7 a.m., a 27 h wake period, then daytime sleep opportunities from 10 a.m. to 7 p.m. on days 3–7. From 12 a.m. to 8 a.m. on each of days 4–7, participants completed simulated night shifts that included six 10 min psychomotor vigilance task (PVT) trials per shift. Sleep was assessed using an under‐mattress sensor. Using extra‐trees machine learning models, PVT performance (reaction times <500 ms, reaction, and lapses) during each night shift was predicted based on the preceding daytime sleep. The final extra‐trees model demonstrated moderate accuracy for predicting PVT performance, with standard errors (RMSE) of 19.9 ms (reaction time, 359 [41.6]ms), 0.42 reactions/s (reaction speed, 2.5 [0.6] reactions/s), and 7.2 (lapses, 10.5 [12.3]). The model also correctly classified 84% of trials containing ≥5 lapses (Matthews correlation coefficient = 0.59, F1 = 0.83). Model performance is comparable to current fatigue prediction models that rely upon self‐report or manually entered data. This efficient approach may help to manage fatigue and safety in non‐standard work schedules.
Realities of comfort and discomfort in the heritage language classroom: Looking to transformative positive psychology for juggling a double‐edged sword
Authors: Driver Meagan 
Published: January 2024

AbstractAs emotions research in the field of second language acquisition continues to evolve, it is equally important to explore the impact of social–emotional variables that are specifically relevant to heritage language (HL) contexts. Anchoring on foundations in critical heritage language education (HLE), this study examines the discomforts of the HL classroom from a diverse heritage speaker (HS) perspective. Additionally, comforts that support the HL classroom as a safe space for emotional security and well‐being for HSs across HLs are explored. Examining the HL classroom from the perspective of HL practices and knowledge systems, this study ultimately aims to: (a) outline the emotional complexity of HL pedagogical spaces, and (b) provide concrete and meaningful recommendations for supporting HS well‐being and HL development from a transformative positive psychology lens. Data for the current qualitative study were provided through two separate methodologies. First, 64 HSs of Spanish responded to a qualitative questionnaire probing the emotional reactions and memories instigated by authentic HL classroom reading material on sensitive topics of racism, bilingualism, and immigration. The themes identified in written narrative data through an inductive thematic approach were then used as a foundation for semistructured interviews with language learners (n = 6) and educators (n = 8) from eight different HL backgrounds. Findings revealed feelings of comfort and discomfort, and even trauma and healing, in HLE spaces rooted in (a) language learning experiences, (b) social memories of (dis)comfort, and (c) intergenerational histories. Together, the data suggest how the HL classroom can act both as a trigger of social injustice, linguistic insecurity, and family conflict and, at the same time, as a space instigating affective reactions associated with social rebellion, linguistic confidence, intergenerational healing, and emotional refuge. Specific pedagogical recommendations are made to equip educators with a concrete toolkit for the HL classroom.
Clinical characteristics, bacterial coinfections and outcomes in COVID‐19‐associated pulmonary aspergillosis in a third‐level Mexican hospital during the COVID‐19 pre‐vaccination era
Authors: Hernández‐Silva Graciela , Corzo‐León Dora E. , Becerril‐Vargas Eduardo , Peralta‐Prado Amy Bethel , Odalis Rodríguez‐Ganes , Morales‐Villarreal Fernando , Ríos‐Ayala Martin Armando , Alonso Tortoriello‐Garza , Agustín Fernández‐López David , Ramón Avilez‐Félix , Hugo Ahumada‐Topete Víctor 
Published: January 2024

AbstractBackgroundDamage due to respiratory viruses increases the risk of bacterial and fungal coinfections and superinfections. High rates of invasive aspergillosis are seen in severe influenza and COVID‐19. This report describes CAPA cases diagnosed during the first wave in the biggest reference centre for severe COVID‐19 in Mexico.ObjectivesTo describe the clinical, microbiological and radiological characteristics of patients with invasive pulmonary aspergillosis associated with critical COVID‐19, as well as to describe the variables associated with mortality.MethodsThis retrospective study identified CAPA cases among individuals with COVID‐19 and ARDS, hospitalised from 1 March 2020 to 31 March 2021. CAPA was defined according to ECMM/ISHAM consensus criteria. Prevalence was estimated. Clinical and microbiological characteristics including bacterial superinfections, antifungal susceptibility testing and outcomes were documented.ResultsPossible CAPA was diagnosed in 86 patients among 2080 individuals with severe COVID‐19, representing 4.13% prevalence. All CAPA cases had a positive respiratory culture for Aspergillus species. Aspergillus fumigatus was the most frequent isolate (64%, n = 55/86). Seven isolates (9%, n = 7/80) were resistant to amphotericin B (A. fumigatus n = 5/55, 9%; A. niger, n = 2/7, 28%), two A. fumigatus isolates were resistant to itraconazole (3.6%, n = 2/55). Tracheal galactomannan values ranged between 1.2 and 4.05, while serum galactomannan was positive only in 11% (n = 3/26). Bacterial coinfection were documented in 46% (n = 40/86). Gram negatives were the most frequent cause (77%, n = 31/40 isolates), from which 13% (n = 4/31) were reported as multidrug‐resistant bacteria. Mortality rate was 60% and worse prognosis was seen in older persons, high tracheal galactomannan index and high HbA1c level.ConclusionsOne in 10 individuals with CAPA carry a resistant Aspergillus isolate and/or will be affected by a MDR bacteria. High mortality rates are seen in this population.
MHO or MUO? White adipose tissue remodeling
Authors: Zhao Jing Yi , Zhou Li Juan , Ma Kai Le , Hao Rui , Li Min 
Published: January 2024

SummaryIn this review, we delve into the intricate relationship between white adipose tissue (WAT) remodeling and metabolic aspects in obesity, with a specific focus on individuals with metabolically healthy obesity (MHO) and metabolically unhealthy obesity (MUO). WAT is a highly heterogeneous, plastic, and dynamically secreting endocrine and immune organ. WAT remodeling plays a crucial role in metabolic health, involving expansion mode, microenvironment, phenotype, and distribution. In individuals with MHO, WAT remodeling is beneficial, reducing ectopic fat deposition and insulin resistance (IR) through mechanisms like increased adipocyte hyperplasia, anti‐inflammatory microenvironment, appropriate extracellular matrix (ECM) remodeling, appropriate vascularization, enhanced WAT browning, and subcutaneous adipose tissue (SWAT) deposition. Conversely, for those with MUO, WAT remodeling leads to ectopic fat deposition and IR, causing metabolic dysregulation. This process involves adipocyte hypertrophy, disrupted vascularization, heightened pro‐inflammatory microenvironment, enhanced brown adipose tissue (BAT) whitening, and accumulation of visceral adipose tissue (VWAT) deposition. The review underscores the pivotal importance of intervening in WAT remodeling to hinder the transition from MHO to MUO. This insight is valuable for tailoring personalized and effective management strategies for patients with obesity in clinical practice.
Inverse ratio ventilation versus conventional ratio ventilation during one lung ventilation in neonatal open repair of esophageal atresia/tracheoesophageal fistula: A randomized clinical trial
Authors: Youssef Azza M. , El‐Ozairy Hala S. , El‐Hennawy Ahmed M. , Amer Akram M. 
Published: January 2024

AbstractBackgroundMaintaining oxygenation during neonatal open repair of esophageal atresia/tracheoesophageal fistula is difficult. Inverse ratio ventilation can be used during one lung ventilation to improve the oxygenation and lung mechanics.ObjectiveThe aim of this study was to describe the impact of two different ventilatory strategies (inverse ratio ventilation vs. conventional ratio ventilation) during one lung ventilation in neonatal open repair of esophageal atresia/tracheoesophageal fistula on the incidence of oxygen desaturation episodes.MethodsWe enrolled 40 term neonates undergoing open right thoracotomy for esophageal atresia/tracheoesophageal fistula repair and randomly assigned into two groups based on inspiratory to expiratory ratio of mechanical ventilation parameters (2:1 in inverse ratio ventilation “IRV” and 1:2 in conventional ratio ventilation “CRV”). The incidence of desaturation episodes that required stopping the procedure and reinflation of the lung were recorded as the primary outcome while hemodynamic parameters, incidence of complications, and length of surgical procedure were recorded as the secondary outcomes.ResultsThere was a trend toward a reduction in the incidence of severe desaturations (requiring stopping of surgery) with the use of inverse ratio ventilation (15% in IRV vs. 35% in CRV, RR [95% CI] 0.429 [0.129–1.426]). Incidence of all desaturations (including those requiring only an increase in ventilatory support or inspired oxygen saturation) was also reduced (40% in IRV vs. 75% in CRV, RR [95% CI] 0.533 [0.295–0.965]). This in turn affected the length of surgical procedure being significantly shorter in inverse ratio ventilation group (mean difference −16.3, 95% CI −31.64 to −0.958). The intraoperative fraction of inspired oxygen required to maintain adequate oxygen saturation was significantly lower in the inverse ratio ventilation group than in the conventional ratio ventilation group (mean difference −0.22, 95% CI −0.33 to −0.098), with no significant difference in hemodynamic stability or complications apart from higher blood loss in inverse ratio group.ConclusionThere may be a role for inverse ratio ventilation with appropriate positive end‐expiratory pressure to reduce the incidence of hypoxemia during open repair of esophageal atresia/tracheoesophageal fistula in neonates, further studies are required to establish the safety and efficacy of this technique.
Comparison of preformed microcuff and preformed uncuffed endotracheal tubes in pediatric cleft palate surgery—A randomized controlled trial
Authors: Kamaladevi Rithu Krishna , Mishra Sandeep Kumar , Rudingwa Priya , Mohapatra Devi Prasad , Badhe Ashok Shankar , Senthilnathan Muthapillai 
Published: January 2024

AbstractBackground and AimsAirway management in children with oral cleft surgery carries unique challenges, concerning the proximity of the surgical site and the tracheal tube. We hypothesized that using a Microcuff oral RAE tube would reduce tube exchange and migration rate. We aimed to compare the performance of Microsoft and uncuffed oral performed tracheal tubes in children undergoing cleft palate surgeries regarding the rate of tracheal tube exchange, endobronchial intubation, and ventilatory parameters.MethodsOne hundred children scheduled for cleft palate surgery were randomized into two groups. In the uncuffed group (n = 50), the tracheal tube was selected using the Modified Coles formula, and in the Microcuff (n = 50) group, the manufacturer's recommendations were followed. Intraoperatively, we compared the primary outcome of tube exchange using the chi‐square test. The leak pressure and ventilatory parameters after head extension and mouth gag application were measured in both groups.ResultsThe tracheal tube exchange rate was significantly lower in the Microcuff group (0/50) than in uncuffed (19/50) preformed tubes (0 vs. 38% respectively; p <.001). The uncuffed and Microcuff tracheal tube were comparable concerning ventilation parameters and leak pressure of finally placed tubes (17.78 ± 3.95 vs. 19.26 ± 3.81 cm H2O respectively, with a mean difference (95% CI) of −1.48 (−0.01–2.98); p‐value =0.059. Cuff pressure did not vary significantly during the initial hour, and the incidence of postoperative airway morbidity between uncuffed and Microcuff tube was comparable, 5/50 (10%) versus 7/50 (14%) with risk ratio (95% CI) of 0.71(0.24–2.1), p value .49.ConclusionMicrocuff oral preformed tubes performed better than uncuffed tubes regarding tube exchange during cleft palate surgery.
Spinal cord stimulation for the symptomatic treatment of rigidity and painful spasm in a case of stiff person syndrome
Authors: Patel Janus , Deschler Emily , Galang Enrique 
Published: January 2024

AbstractBackgroundStiff person syndrome (SPS) is a rare neuroimmunological disorder characterized by rigidity and painful spasm primarily affecting the truncal and paraspinal musculature due to autoimmune‐mediated neuronal hyperexcitability. Spinal cord stimulation (SCS) is an approved therapy for managing painful neuropathic conditions, including diabetic peripheral neuropathy and refractory angina pectoris. We describe the novel use of SCS for the treatment of spasm and rigidity in a 49‐year‐old man with seropositive stiff person syndrome (SPS). The patient was treated with intravenous immunoglobulin (IVIG) and oral medications over a 13‐month period with minimal improvement, prompting consideration of SCS. To our knowledge, this is the first report of the successful use of SCS in SPS with the demonstration of multifaceted clinical improvement.MethodsFollowing a successful temporary SCS trial, permanent implantation was performed. Spasm/stiffness (Distribution of Stiffness Index; Heightened Sensitivity Scale; Penn Spasm Frequency Scale, PSFS), disability (Oswestry Disability Index, ODI; Pain Disability Index, PDI), depression (Patient Health Questionnaire‐9, PHQ‐9), sleep (Pittsburgh Sleep Quality Index, PSQI), fatigue (Fatigue Severity Scale, FSS), pain (Numerical Pain Rating Scale, NPRS), quality of life (EuroQoL 5 Dimension 5 Level, EQ‐5D‐5L), and medication usage were assessed at baseline, 6‐month, and 10‐month postimplantation.ResultsODI, PHQ‐9, FSS, NPRS, PSQI, and EQ‐5D‐5L scores showed a notable change from baseline and surpassed the defined minimal clinically important difference (MCID) at 6‐month and 10‐month follow‐up. Oral medication dosages were reduced.ConclusionsThe novel use of SCS therapy in seropositive SPS resulted in functional improvement and attenuation of symptoms. We present possible mechanisms by which SCS may produce clinical response in patients with SPS and aim to demonstrate proof‐of‐concept for a future comprehensive pilot study evaluating SCS‐mediated response in SPS.