bluuebunny/crossref_metadata_2025_split huggingface dataset:
Original Research: The Impact of COVID-19 on Pain Care Among Older Adults
Authors: Booker Staja Q. , Sowicz Timothy Joseph , Knisely Mitchell R. , Saravanan Anitha , Bai Jinbing , St. Marie Barbara 
Published: May 2023

ABSTRACT

Purpose:
In this qualitative descriptive study, we sought to understand the professional experiences and perceptions of pain management nurses who cared for older adults in the United States during the height of the COVID-19 pandemic.

Methods:
Data were collected between July 2020 and July 2021 through individual, semistructured interviews with a nonprobability sample of 18 pain management nurses. An inductive content analysis approach, in which categories were derived from a coding process based on a close reading of data extracts from the interview transcripts, was used to reveal the major theme related to the study aim.

Results:
Notwithstanding the variable consequences of COVID-19 on patients' health, a single overarching theme was pronounced: “Pain management for older adults remained unchanged during the pandemic despite unpredictable survival, restrictions on human interactions, and communication challenges.” This theme was supported by four categories that emerged from the data: unpredictable survival, restriction-induced isolation, perceived continuity and equality of pain management, and communication challenges.

Conclusions:
During the COVID-19 pandemic, pain management nurses stepped in and joined interdisciplinary teams providing general and specialized pain care to ensure that older adults, whether inpatient or outpatient, continued to receive quality care. These study findings highlight the many challenges pain management nurses faced during this unprecedented public health crisis, as well as opportunities to improve the health system and enhance nursing practice to meet the needs of older patients.
Antiemetic Administration and Its Association with Race: A Retrospective Cohort Study
Authors: White Robert S. , Andreae Michael H. , Lui Briana , Ma Xiaoyue , Tangel Virginia E. , Turnbull Zachary A. , Jiang Silis Y. , Nachamie Anna S. , Pryor Kane O. ,   Multicenter Perioperative Outcomes Group Collaborators
Published: May 2023

Background
Anesthesiologists’ contribution to perioperative healthcare disparities remains unclear because patient and surgeon preferences can influence care choices. Postoperative nausea and vomiting is a patient- centered outcome measure and a main driver of unplanned admissions. Antiemetic administration is under the sole domain of anesthesiologists. In a U.S. sample, Medicaid insured versus commercially insured patients and those with lower versus higher median income had reduced antiemetic administration, but not all risk factors were controlled for. This study examined whether a patient’s race is associated with perioperative antiemetic administration and hypothesized that Black versus White race is associated with reduced receipt of antiemetics.

Methods
An analysis was performed of 2004 to 2018 Multicenter Perioperative Outcomes Group data. The primary outcome of interest was administration of either ondansetron or dexamethasone; secondary outcomes were administration of each drug individually or both drugs together. The confounder-adjusted analysis included relevant patient demographics (Apfel postoperative nausea and vomiting risk factors: sex, smoking history, postoperative nausea and vomiting or motion sickness history, and postoperative opioid use; as well as age) and included institutions as random effects.

Results
The Multicenter Perioperative Outcomes Group data contained 5.1 million anesthetic cases from 39 institutions located in the United States and The Netherlands. Multivariable regression demonstrates that Black patients were less likely to receive antiemetic administration with either ondansetron or dexamethasone than White patients (290,208 of 496,456 [58.5%] vs. 2.24 million of 3.49 million [64.1%]; adjusted odds ratio, 0.82; 95% CI, 0.81 to 0.82; P < 0.001). Black as compared to White patients were less likely to receive any dexamethasone (140,642 of 496,456 [28.3%] vs. 1.29 million of 3.49 million [37.0%]; adjusted odds ratio, 0.78; 95% CI, 0.77 to 0.78; P < 0.001), any ondansetron (262,086 of 496,456 [52.8%] vs. 1.96 million of 3.49 million [56.1%]; adjusted odds ratio, 0.84; 95% CI, 0.84 to 0.85; P < 0.001), and dexamethasone and ondansetron together (112,520 of 496,456 [22.7%] vs. 1.0 million of 3.49 million [28.9%]; adjusted odds ratio, 0.78; 95% CI, 0.77 to 0.79; P < 0.001).

Conclusions
In a perioperative registry data set, Black versus White patient race was associated with less antiemetic administration, after controlling for all accepted postoperative nausea and vomiting risk factors.

Editor’s Perspective

What We Already Know about This Topic

What This Article Tells Us That Is New
Postoperative Impedance-Based Estimation of Cochlear Implant Electrode Insertion Depth
Authors: Schraivogel Stephan , Aebischer Philipp , Wagner Franca , Weder Stefan , Mantokoudis Georgios , Caversaccio Marco , Wimmer Wilhelm 
Published: May 2023

Objectives:Reliable determination of cochlear implant electrode positions shows promise for clinical applications, including anatomy-based fitting of audio processors or monitoring of electrode migration during follow-up. Currently, electrode positioning is measured using radiography. The primary objective of this study is to extend and validate an impedance-based method for estimating electrode insertion depths, which could serve as a radiation-free and cost-effective alternative to radiography. The secondary objective is to evaluate the reliability of the estimation method in the postoperative follow-up over several months.Design:The ground truth insertion depths were measured from postoperative computed tomography scans obtained from the records of 56 cases with an identical lateral wall electrode array. For each of these cases, impedance telemetry records were retrieved starting from the day of implantation up to a maximum observation period of 60 mo. Based on these recordings, the linear and angular electrode insertion depths were estimated using a phenomenological model. The estimates obtained were compared with the ground truth values to calculate the accuracy of the model.Results:Analysis of the long-term recordings using a linear mixed-effects model showed that postoperative tissue resistances remained stable throughout the follow-up period, except for the two most basal electrodes, which increased significantly over time (electrode 11: ~10 Ω/year, electrode 12: ~30 Ω/year). Inferred phenomenological models from early and late impedance telemetry recordings were not different. The insertion depth of all electrodes was estimated with an absolute error of 0.9 mm ± 0.6 mm or 22° ± 18° angle (mean ± SD).Conclusions:Insertion depth estimations of the model were reliable over time when comparing two postoperative computed tomography scans of the same ear. Our results confirm that the impedance-based position estimation method can be applied to postoperative impedance telemetry recordings. Future work needs to address extracochlear electrode detection to increase the performance of the method.
Smoking is associated with surgical site infection, unplanned reoperation, and unplanned 30-day readmission with distal upper extremity fractures
Authors: Johnson Charles A. , Heffron Walker M. , Newton William N. , Daley Dane N. 
Published: May 2023

Background:
The purpose of this study is to 1) determine the effect of smoking status on the rate of acute postoperative complications and 2) evaluate smoking as an independent risk factor for complications following open reduction and internal fixation (ORIF) of distal upper extremity fractures.

Methods:
The National Surgical Quality Improvement Program (NSQIP) database was queried to identify adult patients (>18 yr old) who underwent open reduction and internal fixation (ORIF) of distal upper extremity fractures between 2005 and 2018. Closed fractures of the distal radius, distal ulna, carpals, metacarpals, and phalanx were included. Open fractures, closed reduction and percutaneous pinning (CRPP) procedures, and operations with concomitant procedure codes were excluded. Patients were classified as either current smokers or non-smokers. Univariate analysis and multivariate logistic regression were used to assess the risk of perioperative complications based on current smoking status.

Results:
A total of 22,002 patients met inclusion criteria. Smoking was independently associated with an increased risk of post-operative complications (OR 1.43, 1.15-1.78, P<0.001), specifically, superficial surgical site infections (OR 2.11, CI 1.23–3.60, P=0.007). Current smokers were additionally associated with an increased risk of unplanned reoperation (OR 1.65, CI 1.10–2.48, P=0.022), and unplanned readmission (OR 1.39, CI 1.02-1.90, P=0.037).

Conclusions:
Smoking independently increases the risk for overall complications including superficial infections, unplanned reoperation, and unplanned readmission following ORIF of distal upper extremity fractures.

Level of Evidence:
III.
Hormone therapy for sexual function in perimenopausal and postmenopausal women: a systematic review and meta-analysis update
Authors: Meziou Nadia , Scholfield Clare , Taylor Caroline A. , Armstrong Heather L. 
Published: May 2023

Abstract

Importance
Distressing sexual problems are a common complaint of menopausal women. In 2013, a Cochrane review assessed the effect of hormone therapy on sexual function in menopausal women; however, new evidence has since been published, which should be considered.

Objective
This systematic review and meta-analysis aims to update the evidence synthesis on the effect of hormone therapy, compared with control, on sexual function in perimenopausal and postmenopausal women.

Evidence Review
Thirteen databases and clinical trial registries (Cochrane Central Register of Controlled Trials, EMBASE, Medical Literature Analysis and Retrieval System Online, PsycINFO, Web of Science, Cumulative Index to Nursing and Allied Health Literature, Literatura Latino-Americana e do Caribe em Ciéncias da Saúde, Database of Abstracts of Reviews of Effects, ClinicalTrials.gov, International Clinical Trials Registry Platform, Iranian Registry of Clinical Trials, Chinese Clinical Trial Registry, ISRCTN) were searched from December 2012 to March 30, 2022. Backward reference searching on all retrieved full texts was also performed. Study quality was assessed using the Cochrane ROB.2 tool. Data were pooled in random-effect model meta-analyses, which included all studies identified in the present search and all studies previously included in the 2013 Cochrane review.

Findings
Forty-seven randomized controlled trials (35,912 participants) were included in the systematic review, and 34 randomized controlled trials (15,079 participants) were included in the meta-analysis. The meta-analysis revealed that, in comparison to control, estrogen therapy (standardized mean difference [SMD], 0.16; 95% confidence interval [CI], 0.02 to 0.29; I
2 = 59%; 2,925 participants, 16 studies), estrogen plus progestogen therapy (SMD, 0.11; 95% CI, −0.07 to 0.29; I
2 = 65%; 2,432 participants, 7 studies), tibolone (SMD, 0.15; 95% CI, 0.02 to 0.28; I
2 = 0%; 916 participants, 2 studies), and selective estrogen receptor modulators (SMD, 0.18; 95% CI, 0.06 to 0.30; I
2 = 0%; 1,058 participants, 4 studies) may result in no effect to small benefit on sexual function composite score.

Conclusion and Relevance
Hormone therapy may slightly improve sexual functioning. This potential small benefit should be considered when discussing treatment options for other menopausal symptoms.
Single-cell RNA sequencing of liver fine-needle aspirates captures immune diversity in the blood and liver in chronic hepatitis B patients
Authors: Genshaft Alex S. , Subudhi Sonu , Keo Arlin , Sanchez Vasquez Juan Diego , Conceição-Neto Nádia , Mahamed Deeqa , Boeijen Lauke L. , Alatrakchi Nadia , Oetheimer Chris , Vilme Mike , Drake Riley , Fleming Ira , Tran Nancy , Tzouanas Constantine , Joseph-Chazan Jasmin , Arreola Villanueva Martin , van de Werken Harmen J. G. , van Oord Gertine W. , Groothuismink Zwier M. A. , Beudeker Boris J. , Osmani Zgjim , Nkongolo Shirin , Mehrotra Aman , Spittaels Kurt , Feld Jordan , Chung Raymond T. , de Knegt Robert J. , Janssen Harry L. A. , Aerssens Jeroen , Bollekens Jacques , Hacohen Nir , Lauer Georg M. , Boonstra Andre , Shalek Alex K. , Gehring Adam J. 
Published: May 2023

Background and Aims:
HBV infection is restricted to the liver, where it drives exhaustion of virus-specific T and B cells and pathogenesis through dysregulation of intrahepatic immunity. Our understanding of liver-specific events related to viral control and liver damage has relied almost solely on animal models, and we lack useable peripheral biomarkers to quantify intrahepatic immune activation beyond cytokine measurement. Our objective was to overcome the practical obstacles of liver sampling using fine-needle aspiration and develop an optimized workflow to comprehensively compare the blood and liver compartments within patients with chronic hepatitis B using single-cell RNA sequencing.

Approach and Results:
We developed a workflow that enabled multi-site international studies and centralized single-cell RNA sequencing. Blood and liver fine-needle aspirations were collected, and cellular and molecular captures were compared between the Seq-Well S3 picowell-based and the 10× Chromium reverse-emulsion droplet–based single-cell RNA sequencing technologies. Both technologies captured the cellular diversity of the liver, but Seq-Well S3 effectively captured neutrophils, which were absent in the 10× dataset. CD8 T cells and neutrophils displayed distinct transcriptional profiles between blood and liver. In addition, liver fine-needle aspirations captured a heterogeneous liver macrophage population. Comparison between untreated patients with chronic hepatitis B and patients treated with nucleoside analogs showed that myeloid cells were highly sensitive to environmental changes while lymphocytes displayed minimal differences.

Conclusions:
The ability to electively sample and intensively profile the immune landscape of the liver, and generate high-resolution data, will enable multi-site clinical studies to identify biomarkers for intrahepatic immune activity in HBV and beyond.
Increasing risk of cannabis use disorder among U.S. veterans with chronic pain: 2005-2019
Authors: Mannes Zachary L. , Malte Carol A. , Olfson Mark , Wall Melanie M. , Keyes Katherine M. , Martins Silvia S. , Cerdá Magdalena , Gradus Jaimie L. , Saxon Andrew J. , Keyhani Salomeh , Maynard Charles , Livne Ofir , Fink David S. , Gutkind Sarah , Hasin Deborah S. 
Published: May 2023

Abstract
In the United States, cannabis is increasingly used to manage chronic pain. Veterans Health Administration (VHA) patients are disproportionately affected by pain and may use cannabis for symptom management. Because cannabis use increases the risk of cannabis use disorders (CUDs), we examined time trends in CUD among VHA patients with and without chronic pain, and whether these trends differed by age. From VHA electronic health records from 2005 to 2019 (∼4.3-5.6 million patients yearly), we extracted diagnoses of CUD and chronic pain conditions (International Classification of Diseases [ICD]-9-CM, 2005-2014; ICD-10-CM, 2016-2019). Differential trends in CUD prevalence overall and age-stratified (<35, 35-64, or ≥65) were assessed by any chronic pain and number of pain conditions (0, 1, or ≥2). From 2005 to 2014, the prevalence of CUD among patients with any chronic pain increased significantly more (1.11%-2.56%) than those without pain (0.70%-1.26%). Cannabis use disorder prevalence increased significantly more among patients with chronic pain across all age groups and was highest among those with ≥2 pain conditions. From 2016 to 2019, CUD prevalence among patients age ≥65 with chronic pain increased significantly more (0.63%-1.01%) than those without chronic pain (0.28%-0.47%) and was highest among those with ≥2 pain conditions. Over time, CUD prevalence has increased more among VHA patients with chronic pain than other VHA patients, with the highest increase among those age ≥65. Clinicians should monitor symptoms of CUD among VHA patients and others with chronic pain who use cannabis, and consider noncannabis therapies, particularly because the effectiveness of cannabis for chronic pain management remains inconclusive.
Supportive Care Needs Trajectories in Patients With Advanced Non-Small-Cell Lung Cancer Receiving Chemotherapy: A Longitudinal Study
Authors: YEN Chun-Ju , HSU Hsin-Tien , HSIEH Hsiu-Fen , CHEN Ying-Ju , HUANG Ming-Shyan , LIN Pei-Chao 
Published: May 2023

ABSTRACT

Background
The supportive care needs trajectories in patients with advanced non-small-cell lung cancer (NSCLC) during chemotherapy and the related factors have yet to be explored or addressed in the literature.

Purpose
This study was designed to investigate supportive care needs trajectories in patients with advanced NSCLC receiving chemotherapy and the association between the sociodemographic and disease characteristics of these patients over the four cycles of chemotherapy.

Methods
For this longitudinal study, 95 patients with advanced NSCLC were recruited using convenience sampling at a medical center in Taiwan. The supportive care needs of the participants were assessed in each of the four chemotherapy cycles using the Needs Evaluation Questionnaire–Chinese version (NEQ-C) with 23 dichotomous items on the day before and the seventh day after the end of each cycle. Group-based trajectory modeling was applied to identify the classes of supportive care needs trajectories, whereas chi-square tests were used to examine the factors related to these classes.

Results
Seventy-one participants completed all eight questionnaire sessions across the four cycles. The mean NEQ-C scores for these participants ranged between 14.4 and 14.6. Three classes of supportive care needs trajectories (low, moderate, and high) were identified for the entire NEQ-C and for each domain. Marital status was found to be associated with the classes of trajectories related to supportive care and assistance/care needs, spouse as the primary caregiver was found to be associated with the classes of trajectories related to information needs, and educational level was found to be associated with the classes of trajectories related to psychoemotional support needs.

Conclusions
The results of this study indicate that marital status and spouse as primary caregiver relate significantly to supportive care needs trajectories in patients with advanced NSCLC during chemotherapy. Healthcare professionals should provide continuous, tailored supportive care interventions that address the needs of patients and their spouses/partners.
Workplace Social Support and Work Engagement Among Japanese Workers
Authors: Mori Takahiro , Nagata Tomohisa , Odagami Kiminori , Nagata Masako , Adi Nuri Purwito , Mori Koji ,   for the W2S-Ohpm Study
Published: May 2023

Objectives
We investigated the relationship between employees’ perceptions of the number of sources of workplace social support and work engagement and whether each type of workplace social support is independently related to work engagement.

Methods
A cross-sectional study was conducted using a questionnaire survey in Japan. In total, 12,017 participants were analyzed. Participants were asked about 4 sources of workplace social support: supervisors, colleagues/subordinates, occupational health staff, and external counselors contracted by the workplace. Work engagement was measured using the 9-item Utrecht Work Engagement Scale. Coefficients were estimated using multiple regression analyses.

Results
The coefficient of work engagement increased as the number of sources of perceived workplace social support increased. Each support was also positively related to work engagement.

Conclusions
Organizations should develop systems comprising various sources of workplace social support to increase employee work engagement.
Nurse practitioners' preferences for online learning regarding driving and dementia
Authors: Stasiulis Elaine , Tymianski Dawn , Byszewski Anna , Gélinas Isabelle , Naglie Gary , Rapoport Mark J. , Vrkljan Brenda ,   on behalf of the Canadian Consortium on Neurodegeneration in Aging Driving and Dementia Team
Published: May 2023

ABSTRACT
With a growing population of older adults living with dementia in the community, nurse practitioners (NPs) are increasingly expected to address issues of medical fitness to drive (MFTD) and driving cessation within their clinical practice. With their expertise in clinical assessment and communication skills, NPs are well suited to this area of practice. Studies that examined MFTD and/or driving cessation suggest that NPs want and need further knowledge and training with this population. As part of our aim to develop an online educational program on driving and dementia for health care providers, including NPs, this mixed-methods study explored NPs' preferences regarding the format and content for the proposed online program. Results from an online survey completed by 90 NPs and interviews with six NPs highlighted key areas of focus for virtual modules, where communication strategies, tools to assess MFTD, and the reporting process for medically unfit drivers were emphasized. Reflecting on their team approach to care, participants in this study preferred a hybrid approach of asynchronous and synchronous learning delivery for this educational program. The next step will be to evaluate this program and its impact on both NP knowledge and skills in terms of its real-world application.
The Role of Care Coordination
Authors: JaKa Meghan M. , Beran Mary Sue , Andersen Julia A. , Whitebird Robin R. , Bergdall Anna R. , Kindt Joan M. , Dehmer Steven P. , Winger Melissa , Solberg Leif I. 
Published: May 2023

Background:
Care coordination is important for patients with complex needs; yet, little is known about the factors impacting implementation from the care coordinator perspective.

Purpose:
To understand how care coordination implementation differs across clinics and what care coordinators perceive as barriers and facilitators of effective coordination.

Methods:
Nineteen care coordinators from primary care clinics in Minnesota participated in interviews about their perceptions of care coordination. A team of analysts coded interviews using inductive thematic analysis.

Results:
Four major themes emerged: variety in care coordination implementation; importance of social needs; necessity for leader buy-in; and importance of communication skills.

Conclusions:
Described differences in care coordination implementation were often logistical, but the implications of these differences were foundational to care coordinator perceived effectiveness.