bluuebunny/crossref_metadata_2025_split huggingface dataset:
Atypical Molecular Features of Pediatric Tectal Glioma: A Single Institutional Series
Authors: Yakir Maayan Joy , Elster Jennifer D. , Paul Megan R. , Khanna Paritosh C. , Malicki Denise M. , Levy Michael L. , Crawford John Ross 
Published: February 2023

We present 4 children (diagnosed between 1 and 8 y, 3 females and 1 male) with molecularly distinct tectal gliomas (2 KRAS mutant, 1 EGFR mutant, 1 SRGAP3-RAF-1 fusion) that contributes to the growing literature of this uncommonly biopsied tumor. The patient with EGFR R222C mutation had a more severe course, earlier diagnosis, subsequent leptomeningeal metastatic disease, required more aggressive therapies, and died 9 years after diagnosis. Patients with KRAS mutations and SRGAP3-RAF-1 fusion had a more indolent course. Our series expands the molecular phenotype of tectal glioma with the potential for leptomeningeal dissemination. Future studies on establishing genotypic/phenotypic correlation from those who undergo biopsy are needed.
Physical, Leisure, and Daily Living Activities in Patients Before, During, and After Radiotherapy for Cancer
Authors: Efverman Anna 
Published: February 2023

Background
Avoiding inactivity and staying active during cancer therapy have great health effects.

Objective
The aims of this study were to describe level of daily, leisure, and physical activities before, during, and after radiotherapy and to investigate whether patients who had not restored activity level after radiotherapy differed from patients who had restored activity level regarding different characteristics.

Methods
In this descriptive longitudinal study, 196 patients undergoing pelvic-abdominal radiotherapy reported their activity level at baseline, weekly during radiotherapy, and at 1 month after radiotherapy.

Results
Patients decreased activity level during radiotherapy (P < .001 for all activities): physical activity (34% of patients decreased level), walking (26%), leisure activities (44%), social activities (15%), housework (34%), shopping (28%), and activities in general (28%). Almost half (47%) had not restored activity level after radiotherapy. Patients with colorectal cancer, older than 65 years, who had less education than university, and high capacity in overall daily activities at baseline were more likely than other patients not to restore activity level after radiotherapy. The patients not restoring their activity level after radiotherapy were more likely than others to experience anxious mood (P = .016), depressed mood (P = .003), and poor quality of life (P = .003) after radiotherapy.

Conclusion
Patients’ activity level decreased during radiotherapy, and almost half of patients did not restore activity level after radiotherapy.

Implications for Practice
Given that restored activity level after radiotherapy was less common in certain subgroups and that patients who restored activity level experienced better quality of life and less frequent anxious and depressed mood, cancer nursing professionals should consider supporting these subgroups of patients in performing activities.
“Their Bodies Just Give It Away”
Authors: Plummer Karin J. , McCarthy Maria C. , Newall Fiona H. , Manias Elizabeth 
Published: February 2023

Background
Children undergoing hematopoietic stem cell transplantation (HSCT) are vulnerable to pain.

Objective
This study aimed to examine how healthcare providers and parents assessed pain and what contextual factors influenced their pain assessment practices for children hospitalized after allogeneic HSCT therapy.

Methods
A qualitative case study was conducted in a tertiary level pediatric HSCT unit in 2 phases. Semistructured interviews with parents were conducted at 30 and 90 days after HSCT therapy. Healthcare providers participated in naturalistic observations of pain-related care provided to children during their hospitalization for HSCT therapy and a semistructured interview.

Results
The assessment of pain after transplantation by healthcare providers and parents was predominantly reliant on the observation of children for behaviors indicative of pain, rather than the application of validated pain assessment tools. Without formal measures of the pain experience, judgments regarding the severity of children’s pain were influenced by the context of high acuity of care posttransplantation and the emotional responses of healthcare providers and parents from bearing witness to children’s pain.

Conclusion
Pain assessments mostly reflected children’s ability to tolerate pain, rather than a genuine measurement of how significantly pain impacted the child.

Implication for Practice
This study has emphasized how the assessment of pain for children hospitalized during HSCT therapy is limited by the complexity of the clinical environment. It is recommended that validated methods of assessing pain by healthcare providers and parents be implemented into clinical practice to ensure children’s pain is visible.
Survivorship Experiences of Chinese Hematopoietic Stem Cell Transplantation Survivors
Authors: Ruan Jiayin , Qian Ying , Zhuang Yiyu 
Published: February 2023

BackgroundThe number of global hematopoietic stem cell transplantation (HSCT) survivors is increasing rapidly. Survivors encounter many challenges, but studies regarding survivorship experiences in China are scarce.ObjectivesThis study aimed to explore the survivorship experiences of Chinese patients with hematological cancers after HSCT and to describe the impact of HSCT on the survivors’ lives.MethodsDescriptive qualitative research was used. Purposive sampling was used to recruit HSCT survivors who were treated in a teaching hospital in Zhejiang Province from June 2021 to June 2022. Audio-recorded semistructured interviews were conducted, transcribed verbatim, and analyzed via conventional content analysis.ResultsFifteen HSCT survivors aged 18 to 59 years participated in this study. Four themes and 11 subthemes emerged: (1) transplant being harder than you thought (body function impaired, forced to modify diet, disturbed by survivorship uncertainty), (2) difficulty blending into circles (limited activity space, suffering from discrimination), (3) adjusting value judgment (health being a top priority, contributing to family as much as possible, feeling worthless), and (4) still being the lucky one (recovered better than others, genuine relationships acquired, self-improvement achieved).ConclusionThis study offers insight into subjective survivorship experiences of patients with hematological cancers post-HSCT within a Chinese sociocultural context and presents changed perceptions of HSCT, life alterations, adjusted value judgments, and positive self-evaluation since treatment.Implications for PracticeNurses can provide person-centered survivorship care based on the understanding of survivorship experiences of Chinese HSCT survivors. Intervention programs and informational materials should be developed to address difficulties encountered by Chinese HSCT survivors.
Use of Theory in Quality Innovations
Authors: Cronn Susan , Trevino Colleen , Jansen Kay 
Published: February 2023

Background:
Inconsistent and nonstandardized patient handoffs can increase the risk of adverse events. Using change theory may promote adoption of effective handoff processes.

Local Problem:
A Midwest emergency department (ED) had no standardized practice for shift change handoffs. Previous handoff quality improvement efforts had been unsuccessful.

Methods:
A pre/postintervention pilot project design was used. Nurses' compliance with the new handoff protocol was evaluated.

Interventions:
Using Diffusion of Innovation (DOI) theory, an evidence-based shift change protocol was designed and implemented, which included a comprehensive handoff tool specific to the ED.

Results:
Four elements in the new shift change process saw statistically significant improvements after implementation, including discussion of the patient's illness severity (P = .001), synthesis of the patient's care (P < .001), completing a bedside safety checklist (P < .001), and providing a formal transition-of-care process (P < .001).

Conclusions:
Using DOI theory may improve the adoption of new shift change practices.
Use of the Modified Early Warning Score by Medical-Surgical Nurses to Initiate the Rapid Response Team
Authors: Miles Iman , Anderson Maighdlin , Ren Dianxu , Coker Tamara , Fennimore Laura 
Published: February 2023

Background:
Cardiac arrests are often preceded by several hours of physiological deterioration that may go undetected.

Local Problem:
Cardiac arrests frequently occurred on medical-surgical units without prior rapid response team intervention.

Methods:
A pre/postintervention design was used to evaluate a protocol to guide the use of the Modified Early Warning Score (MEWS) by medical-surgical nurses to escalate the care of deteriorating adult patients.

Interventions:
Following staff education, the MEWS protocol was implemented across 8 medical-surgical units.

Results:
There was a significant increase in patients experiencing a rapid response prior to a cardiac arrest after implementing the MEWS protocol (P < .0001).

Conclusion:
Implementing a consistent review of MEWS values allows medical-surgical nurses to initiate assistance from a rapid response team that may prevent an inpatient cardiac arrest.
OB HUB
Authors: Lowery Deb , De Leon Betsy , Krening Cynthia , Dempsey Amy , Dwork Peter , Brou Lina , Tynes John , Thompson Lisa 
Published: February 2023

Abstract

Objective:
The purpose of this project was to implement a remote fetal surveillance unit with increased vigilance and timelier responses to electronic fetal monitor tracings to improve neonatal outcomes and increase safety.

Methods:
A pilot project, OB HUB, facilitated implementation of a centralized remote fetal surveillance unit including artificial intelligence software and nurse experts dedicated to fetal monitoring interpretation. A telemetry room was established. Notification parameters were created to promote consistent communication between OB HUB nurses and bedside nurses. Outcomes for term neonates included body cooling, arterial cord pH less than 7.0, Apgar scores less than 7 at 5 minutes, emergency cesarean births, and cesarean births. Surveys were used to evaluate team perceptions of fetal safety.

Results:
There were 2,407 births 6 months pre OB HUB implementation and 2,582 births during the 6-month trial, for a total sample of 4,989 births included in the analysis. Six births (0.25%) resulted in cooling prior to implementation and 2 (0.08%) cooling events occurred during the trial; these differences were not significant (p = .10). There were no significant differences between groups for neonatal outcomes. Average level of safety perceived by nurses and providers remained relatively unchanged when comparing pre- and postimplementation survey results; however, of those responding, 78.8% of nurses indicated the OB HUB improved safety.

Clinical Implications:
There were few adverse events in either group, thus it was a challenge to demonstrate statistically significant improvement in neonatal outcomes even with a sample of nearly 5,000 births. A larger sample is needed to support clinical utility. The OB HUB was perceived favorably by most of the L&D nurses.
Relationships Between Remote Learning Modalities and Nursing Students' Perceptions of Their Sleep Quality During the COVID-19 Pandemic
Authors: Ngo Thye Peng , Antisdel J'Andra L. , Xing Kuan , Reising Deanna L. 
Published: February 2023

Background:
The relationship between learning modalities and nursing students' sleep quality during the coronavirus disease (COVID-19) pandemic is unknown.

Purpose:
This study examined the relationships between remote learning and the sleep quality of nursing students during the COVID-19 pandemic.

Methods:
Using a cross-sectional descriptive design, 890 nursing students were surveyed online to identify sleeping habits and learning modalities.

Results:
There were no significant correlations between remote learning hours, self-reported sleep hours, and sleep quality. The asynchronous-only group reported better sleep quality than the in-person and online hybrid group after controlling for health conditions and grade point average. Students who reported that remote learning had impacted their sleep had poorer sleep quality.

Conclusions:
This study provides insight into how different learning modalities impact nursing students' sleep quality during the pandemic.
Effect of Multiple-Patient Simulation on Baccalaureate Nursing Students' Anxiety and Self-confidence
Authors: Ross Jennifer Gunberg , Meakim Colleen H. , Latz Eleanor , Arcamone Angelina , Furman Gail , Prieto Patricia , Reynolds Kathryn , Franklin Ashley E. 
Published: February 2023

Background:
Multiple-patient simulation (MPS) allows nursing students to develop leadership skills. Limited research examining student outcomes following MPS exists.

Purpose:
This pilot study investigated the impact of MPS on (1) anxiety with transition to practice, (2) anxiety with clinical decision-making, (3) self-confidence with clinical decision-making, and (4) perceptions about MPS as a learning strategy.

Methods:
Twenty-two senior baccalaureate nursing students participated in this 2-group mixed-methods study. Data were collected before and after a leadership course using the State-Trait Anxiety Inventory, Nursing Anxiety and Self-Confidence with Clinical Decision-Making Scale, and a researcher-developed perceptions survey.

Results:
Self-confidence with clinical decision-making significantly increased for all participants regardless of group assignment. Anxiety and anxiety with clinical decision-making decreased without significant changes. No significant differences were found between groups. Qualitative findings yielded 3 themes: preparation for clinical practice, overcoming anxiety, and confidence.

Conclusion:
Research investigating additional student outcomes after MPS with larger, more diverse samples is needed.
Social Determinants of Health and Symptom Burden During Cancer Treatment
Authors: Badger Terry A. , Segrin Chris , Crane Tracy E. , Chalasani Pavani , Arslan Waqas , Hadeed Mary , Sikorskii Alla 
Published: February 2023

Background
Cancer survivors (defined as individuals from diagnosis to the end of life) in treatment experience multiple physical and psychological symptoms (e.g., fatigue, pain, depression, anxiety, disturbed sleep) that influence their well-being and treatment outcomes. Underrepresented cancer survivors may disproportionately experience greater symptom burden (number of symptoms, symptom severity, depression, anxiety).

Objectives
The aim of this study was to examine the relationships of social determinants of health, including age, ethnicity, education, income and whether income meets the survivor's needs, neighborhood (rural vs. urban), access to healthcare (e.g., insurance), and social isolation, with symptom burden in cancer survivors.

Methods
This secondary analysis included baseline data from 400 cancer survivors of solid tumor cancers undergoing chemotherapy or targeted therapy who participated in a larger randomized trial of symptom management interventions. Symptom burden was measured by the Center for Epidemiological Studies–Depression scale for depression and Patient-Reported Outcomes Measurement Information System scores for anxiety and social isolation, summed severity index of 16 symptoms from the General Symptom Distress Scale, and the total number of symptoms. Self-reported comorbid conditions were measured using the Bayliss tool. General linear models were used to relate symptom measures (one at a time) to age, number of comorbid conditions, level of education, marital status, income meeting needs, and size of metropolitan neighborhood. Additional covariates included site of cancer, its treatment, and whether the cancer was metastatic.

Results
Non-Hispanic White survivors (n = 191) were older and had more comorbid conditions, a higher proportion of metastatic cancers, and higher levels of education and income compared with Hispanic survivors (n = 168) and non-Hispanic survivors of other races (n = 41). Compared with the other two groups, Hispanic survivors had the lowest rate of health insurance availability, and non-Hispanic survivors of other races had the lowest social isolation. Age, number of comorbid conditions, and social isolation were significantly associated with number of symptoms, symptom severity, and depression. Age and social isolation were associated with anxiety. In addition, the symptom severity of non-Hispanic White survivors was lower than that of Hispanic survivors and non-Hispanic survivors of other races.

Discussion
These findings highlight the health disparities in symptom burden experienced among cancer survivors when considering their social determinants of health. Assessing these may help clinicians address health disparities in cancer care.
Lumbosacral Radiculoplexus Neuropathy After COVID-19
Authors: Aragon Pinto Catarina , Pinto Marcus V. , Engelstad JaNean K. , Dyck P. James B. 
Published: February 2023

Introduction:
Lumbosacral Radiculoplexus Neuropathy (LRPN) is a subacute, painful, paralytic, asymmetric immune-mediated lower-limb neuropathy associated with weight loss and diabetes mellitus (called DLRPN). Approximately one-third of LRPN cases have a trigger. Our purpose is to show that COVID-19 can trigger LRPN.

Case Report:
We describe the clinical, neurophysiological, radiologic, and pathologic findings of a 55-year-old man who developed DLRPN after severe acute respiratory syndrome coronavirus-2 infection. Shortly after mild coronavirus disease 2019 (COVID-19), the patient developed severe neuropathic pain (allodynia), postural orthostasis, fatigue, weight loss, and weakness of bilateral lower extremities requiring wheelchair assistance. One month after COVID-19, he was diagnosed with type 2 diabetes mellitus. Neurological examination showed bilateral severe proximal and distal lower extremity weakness, absent tendon reflexes, and pan-modality sensation loss. Electrophysiology demonstrated an asymmetric axonal lumbosacral and thoracic radiculoplexus neuropathies. Magnetic resonance imaging showed enlargement and T2 hyperintensity of the lumbosacral plexus. Cerebral spinal fluid (CSF) showed an elevated protein (138 mg/dL). Right sural nerve biopsy was diagnostic of nerve microvasculitis. He was diagnosed with DLRPN and treated with intravenous methylprednisolone 1 g weekly for 12 weeks. The patient had marked improvement in pain, weakness, and lightheadedness and at the 3-month follow-up was walking unassisted.

Conclusion:
COVID-19 can trigger postinfectious inflammatory neuropathies including LRPN.
Successful Treatment of Persistent 5-Nitroimidazole–Resistant Trichomoniasis With an Extended Course of Oral Secnidazole Plus Intravaginal Boric Acid
Authors: McNeil Candice J. , Williamson John C. , Muzny Christina A. 
Published: February 2023

Abstract
We describe a case of persistent 5-nitroimidazole–resistant trichomoniasis cured after 14 days of oral secnidazole and intravaginal boric acid. Secnidazole may be an important treatment option for resistant trichomoniasis, particularly in women who fail other regimens, including higher doses of oral metronidazole and tinidazole for longer durations of time.
Epidemiologic Evidence on the Role of Lactobacillus iners in Sexually Transmitted Infections and Bacterial Vaginosis: A Series of Systematic Reviews and Meta-Analyses
Authors: Carter Kayla A. , Fischer Molly D. , Petrova Mariya I. , Balkus Jennifer E. 
Published: February 2023

Abstract
Although Lactobacillus crispatus–dominated vaginal microbiotas are thought to protect against bacterial vaginosis (BV) and sexually transmitted infections, the role of Lactobacillus iners–dominated microbiotas is less clear. To better understand the impact of L. iners on common cervicovaginal infections, we conducted systematic reviews of the associations between L. iners compared with L. crispatus and 8 outcomes: Chlamydia trachomatis (Ct), BV, human papillomavirus, cervical dysplasia, human immunodeficiency virus, genital herpes, Trichomonas vaginalis, and Neisseria gonorrhoeae. On April 30, 2021, we searched PubMed, Embase, Cochrane Library, and Web of Science for epidemiologic studies of reproductive-age, nonpregnant, cisgender women that used marker gene sequencing to characterize vaginal microbiota composition and presented an effect estimate for the association between L. iners, compared with L. crispatus, and outcomes of interest. For outcomes with ≥3 eligible results presenting the same form of effect estimate, we conducted random-effects meta-analysis. The review protocol was registered prospectively (PROSPERO CRD42020214775). Six Ct studies were included in meta-analysis, which showed L. iners–dominated microbiotas were associated with 3.4-fold higher odds of Ct compared with L. crispatus–dominated microbiotas (95% confidence interval, 2.1–5.4). Three BV studies were included in meta-analysis, which indicated L. iners–dominated microbiotas were associated with 2.1-fold higher prevalence of BV compared with L. crispatus–dominated microbiotas (95% confidence interval, 0.9–4.9). Evidence was too sparse to perform meta-analysis for the remaining outcomes. L. iners–dominated vaginal microbiotas may be suboptimal compared with L. crispatus–dominated microbiotas for BV and Ct. These reviews highlight evidence gaps regarding the remaining outcomes and opportunities to improve epidemiologic rigor in vaginal microbiome science.
ROAR ED-SANE: A Retrospective Observational Assessment Review of an Emergency Department Sexual Assault Nurse Examiner Program's Adherence to Centers for Disease Control and Prevention Guidelines for Sexually Transmitted Infections
Authors: Nelson Jennifer M. , Woolever Nathan , Meyer Lisa , Hall Scott , Stakston Jaclyn , Dababneh Ala , Roush Kathleen , Van Sistine Michael , Tempelis Jennifer , Dierkhising Ross A. , Lessard Sarah 
Published: February 2023

Background
Sexual assault survivors are at increased risk for sexually transmitted infections. Sexual Assault Nurse Examiner programs guide sexually transmitted infection treatment, monitoring, and follow-up scheduling according to guidelines by the Centers for Disease Control and Prevention (CDC). Reported low rates of provider adherence to CDC treatment guidelines and patient adherence to follow-up necessitate a review of medication prescribing and follow-up scheduling practices, especially at smaller community hospitals in the United States.

Methods
A retrospective medical record review was conducted to assess adherence rates to CDC guidelines for prescribing practices, scheduling, and follow-up of sexual assault survivors. We included pediatric and adult patients presenting to the emergency department (ED) and participating in the ED Sexual Assault Nurse Examiner program at a rural, community-based teaching hospital in La Crosse, WI, from January 2018 to December 2021. Descriptive statistics were used to evaluate results.

Results
Analysis included 103 patients. Prescribing adherence to CDC guidelines was >80% for all except human immunodeficiency virus (53.4%), trichomoniasis (68.1%), and hepatitis B (69%). Of the 38 patients who had a follow-up scheduled during their ED encounter, 78.9% attended their scheduled follow-up and 94.7% of those appointments were scheduled within the CDC-recommended time frame, leading to an overall adherence of 40%.

Conclusions
Adherence rates were high for most prescribing practices, and attendance of scheduled follow-up was higher than expected. Opportunities to improved adherence to CDC guidelines were identified in prescribing for 3 disease states (human immunodeficiency virus, trichomoniasis, and hepatitis B) and in scheduling of follow-up.