bluuebunny/crossref_metadata_2025_split huggingface dataset:
Trends inStreptococcus pneumoniaeAntimicrobial Resistance in US Children: A Multicenter Evaluation
Authors: Mohanty Salini , Feemster Kristen , Yu Kalvin C , Watts Janet A , Gupta Vikas 
Published: March 2023

AbstractBackgroundAntimicrobial resistance (AMR) poses a significant challenge for treating pneumococcal disease. This study assessed AMR trends in Streptococcus pneumoniae from US children.MethodsWe evaluated antibiotic resistance, defined as facility antimicrobial susceptibility reports of intermediate/resistant, in 30-day nonduplicate S pneumoniae isolates from children (&lt;18 years of age) with invasive (blood or cerebrospinal fluid/neurological) or noninvasive (respiratory or ear/nose/throat) isolates at 219 US hospital inpatient/outpatient settings in the BD Insights Research Database (January 2011–February 2020). We used descriptive statistics to characterize the percentage of antimicrobial-resistant isolates and generalized estimating equations to assess variations in resistance over time.ResultsOf 7605 S pneumoniae isolates analyzed, 6641 (87.3%) were from noninvasive sources. Resistance rates were higher in noninvasive versus invasive isolates. Isolates showed high observed rates of resistance to ≥1 drug class (56.8%), ≥2 drug classes (30.7%), macrolides (39.9%), and penicillin (39.6%) and significant annual increases in resistance to ≥1 drug class (+0.9%), ≥2 drug classes (+1.8%), and macrolides (+5.0%).ConclusionsAmong US children over the last decade, S pneumoniae isolates showed persistently high rates of resistance to antibiotics and significant increases in ≥1 drug class, ≥2 drug classes, and macrolide resistance rates. Efforts to address AMR in S pneumoniae may require vaccines targeting resistant serotypes and antimicrobial stewardship efforts.
Adverse Impact of HIV-1 on Long-term Outcomes Following HCV DAA Treatment: Final Results of ACTG A5320, the Viral Hepatitis C Infection Long-term Cohort Study (VHICS)
Authors: Wyles David L , Kang Minhee , Matining Roy M , Murphy Robert L , Peters Marion G 
Published: March 2023

AbstractBackgroundLong-term outcome data after hepatitis C virus (HCV) treatment are limited, particularly for comparisons between persons with and without HIV.MethodsA5320 was a prospective cohort study that enrolled participants within 12 months of completing HCV DAA therapy, with or without sustained virologic response (SVR). The primary end point was composite: time to death or development of a targeted diagnosis. Component outcomes (death and targeted diagnosis) and liver-related events were also analyzed. The effects of HIV serostatus, HIV RNA and CD4, and liver disease stage on the outcomes were assessed. Follow-up was designated for 5 years.ResultsThree hundred thirty-two participants enrolled: 184 with HIV/HCV (130 SVR) and 148 with HCV (125 SVR). The primary analysis was dominated by targeted diagnoses. Increased rates of targeted diagnoses were seen in HCV-HIV/SVR compared with HCV/SVR (P = .016), with an incidence rate of 6.7 and 3.4 per 100 person-years, respectively. Among persons without HIV, higher rates of targeted diagnoses were observed in non-SVRs (P = .007), 10.8 vs 3.4/100 person-years. No significant difference was seen by SVR status among those with HIV. There were 15 deaths; all liver-related deaths (n = 4) occurred in non-SVR groups.ConclusionsHCV cure following therapy reduces subsequent development of new clinical events, supporting the use of SVR as a predictor for clinical outcomes. Despite HIV control, a significant decrease in incident events or mortality was not demonstrated for people with HIV who achieved SVR, suggesting that coinfection attenuates the beneficial impact of SVR. Research is needed to better define mechanisms accounting for the long-term negative impact of controlled HIV infection.
Evaluation of factors associated with the effectiveness of radiation protection glasses
Authors: Imai Shinya , Yamahata Asuka , Kakimoto Akihiro , Kawaji Yasuyuki , Gotanda Tatsuhiro , Akagawa Takuya , Yatake Hidetoshi 
Published: March 2023

Abstract
The effects of lead equivalent and lens area of radiation-protective eyewear on lens exposure control were examined. The simulated patient underwent 10-min X-ray fluoroscopy, and the lens dose of the simulated surgeon wearing radiation protection glasses was measured using lens dosemeters attached to the corner of the eye and eyeball. In total, 10 types of radiation protection glasses were selected for measurement. Correlation analysis of the equivalent dose in the lens of the eye with lead equivalence and lens area was performed. The equivalent dose in the lens of the eye of the corner of the eye was negatively correlated with the area of the lens. The equivalent dose in the lens of the eye and the eyeball showed a strong negative correlation with lead equivalence. Lens dosemeters worn at the corner of the eye may overestimate the equivalent dose in the lens of the eye. Moreover, the reduction in exposure of the lens was significantly influenced by the lead equivalent.
A two-night polysomnography preliminary study in pregnant women with insomnia: suicidal ideation and nocturnal cognitive arousal prospectively predict objective nocturnal wakefulness
Authors: Kalmbach David A , Cheng Philip , Roth Thomas , Fellman-Couture Cynthia , Sagong Chaewon , Drake Christopher L 
Published: March 2023

AbstractStudy objectivesSleep disruption is common in pregnancy, manifesting as insomnia in half of pregnant women as well as increasing objective nocturnal wakefulness across gestation. Despite potential overlap between insomnia and objective sleep disturbances in pregnancy, objective nocturnal wakefulness and its potential contributing factors remain uncharacterized in prenatal insomnia. The present study described objective sleep disturbances in pregnant women with insomnia and identified insomnia-related predictors of objective nocturnal wakefulness.MethodsEighteen pregnant women with clinically significant insomnia symptoms (n = 12/18 with DSM-5 insomnia disorder) underwent two overnight polysomnography (PSG) studies. Insomnia symptoms (Insomnia Severity Index), depression and suicidal ideation (Edinburgh Postnatal Depression Scale), and nocturnal cognitive arousal (Pre-Sleep Arousal Scale, Cognitive factor) were assessed before bedtime on each PSG night. Unique to Night 2, participants were awakened after 2 minutes of N2 sleep and reported their in-lab nocturnal (i.e. pre-sleep) cognitive arousal.ResultsDifficulty maintaining sleep was the most common objective sleep disturbance affecting 65%–67% of women across both nights, which contributed to short and inefficient sleep. Nocturnal cognitive arousal and suicidal ideation were the most robust predictors of objective nocturnal wakefulness. Preliminary evidence suggested nocturnal cognitive arousal mediates the effects of suicidal ideation and insomnia symptoms on objective nocturnal wakefulness.ConclusionsNocturnal cognitive arousal may facilitate upstream effects of suicidal ideation and insomnia symptoms on objective nocturnal wakefulness. Insomnia therapeutics reducing nocturnal cognitive arousal may benefit objective sleep in pregnant women presenting with these symptoms.
Innovative Learning
Authors: Cieslowski Bethany , Haas Tanya 
Published: March 2023

Abstract
The development of critical thinking and decision-making skills is essential to link knowledge to practice in prelicensure nursing education. Immersive virtual reality (VR) is a teaching modality that provides students with an interactive way to develop their knowledge and skills. Faculty at a large mid-Atlantic university developed an innovative strategy to deploy immersive VR in a senior-level advanced laboratory technologies course with 110 students. Implementation of this approach to VR was intended to augment clinical learning in a safe learning environment.
Two-Year Outcomes of Cochlear Implant Use for Children With Unilateral Hearing Loss: Benefits and Comparison to Children With Normal Hearing
Authors: Park Lisa R. , Dillon Margaret T. , Buss Emily , Brown Kevin D. 
Published: March 2023

Objectives:
Children with severe-to-profound unilateral hearing loss, including cases of single-sided deafness (SSD), lack access to binaural cues that support spatial hearing, such as recognizing speech in complex multisource environments and sound source localization. Listening in a monaural condition negatively impacts communication, learning, and quality of life for children with SSD. Cochlear implant (CI) use may restore binaural hearing abilities and improve outcomes as compared to alternative treatments or no treatment. This study investigated performance over 24 months of CI use in young children with SSD as compared to the better hearing ear alone and to children with bilateral normal hearing (NH).

Design:
Eighteen children with SSD who received a CI between the ages of 3.5 and 6.5 years as part of a prospective clinical trial completed assessments of word recognition in quiet, masked sentence recognition, and sound source localization at regular intervals out to 24-month postactivation. Eighteen peers with bilateral NH, matched by age at the group level, completed the same test battery. Performance at 24-month postactivation for the SSD group was compared to the performance of the NH group.

Results:
Children with SSD have significantly poorer speech recognition in quiet, masked sentence recognition, and localization both with and without the use of the CI than their peers with NH. The SSD group experienced significant benefits with the CI+NH versus the NH ear alone on measures of isolated word recognition, masked sentence recognition, and localization. These benefits were realized within the first 3 months of use and were maintained through the 24-month postactivation interval.

Conclusions:
Young children with SSD who use a CI experience significant isolated word recognition and bilateral spatial hearing benefits, although their performance remains poorer than their peers with NH.
Attrition and Retention of Rehabilitation Professionals: A Scoping Review
Authors: Mak Susanne , Hunt Matthew , Riccio Serena Speranza , Razack Saleem , Root Kelly , Thomas Aliki 
Published: March 2023

Introduction:
Attrition is defined as a permanent departure from one's profession or the workforce. Existing literature on retention strategies, contributing factors to the attrition of rehabilitation professionals and how different environments influence professionals' decision-making to stay in/leave their profession, is limited in scope and specificity. The objective of our review was to map the depth and breadth of the literature on attrition and retention of rehabilitation professionals.

Methods:
We used Arksey and O'Malley's methodological framework. A search was conducted on MEDLINE (Ovid), Embase (Ovid), AMED, CINAHL, Scopus, and ProQuest Dissertations and Theses from 2010 to April 2021 for concepts of attrition and retention in occupational therapy, physical therapy, and speech-language pathology.

Results:
Of the 6031 retrieved records, 59 papers were selected for data extraction. Data were organized into three themes: (1) descriptions of attrition and retention, (2) experiences of being a professional, and (3) experiences in institutions where rehabilitation professionals work. Seven factors across three levels (individual, work, and environment) were found to influence attrition.

Discussion:
Our review showcases a vast, yet superficial array of literature on attrition and retention of rehabilitation professionals. Differences exist between occupational therapy, physical therapy, and speech-language pathology with respect to the focus of the literature. Push, pull, and stay factors would benefit from further empirical investigation to develop targeted retention strategies. These findings may help to inform health care institutions, professional regulatory bodies, and associations, as well as professional education programs, to develop resources to support retention of rehabilitation professionals.
Early Quality-of-Life Changes in Mild Traumatic Brain Injury: A Prospective Study
Authors: Mulyadi Mulyadi , Harianto Susilo , Tonapa Santo Imanuel , Lee Bih-O 
Published: March 2023

BACKGROUND:
Postinjury symptoms and decreased quality of life are common after mild traumatic brain injury. However, few studies have examined how soon, after injury, these changes dissipate.

OBJECTIVES:
This study aimed to compare changes in postconcussion symptoms, posttraumatic stress, and illness representations and identify predictors of health-related quality of life before and 1 month after hospital discharge for mild traumatic brain injury.

METHODS:
A prospective, multicenter, correlational design was used to measure postconcussion symptoms, posttraumatic stress, illness representations, and health-related quality of life. The survey was administered to 136 patients with mild traumatic brain injury between June 2020 and July 2021 at three hospitals in Indonesia. Data were collected at discharge and 1 month later.

RESULTS:
Compared with before hospital discharge, data collected 1 month after discharge showed that patients experienced reduced postconcussion symptoms, posttraumatic stress, better illness perceptions, and quality of life. Those with postconcussion symptoms (β =−.35, p < .001), more posttraumatic stress symptoms (β =−.12, p = .044), more identity symptoms (β = .11, p = .008), worsened personal control (β =−.18, p = .002), worsened treatment control (β =−.16, p = .001), and negative emotional representations (β =−.17, p = .007) were significantly related to worsened health-related quality of life.

CONCLUSION:
This study shows that within 1 month of hospital discharge, patients with mild traumatic brain injury had decreased postconcussion symptoms, posttraumatic stress, and improved illness perceptions. Efforts to impact mild brain injury quality of life should focus on inhospital care to optimize the transition to discharge.
Trauma Team High-Fidelity Simulation Training in a Rural Level III Trauma Center: An Interprofessional Experience
Authors: Knapp Ginger M. 
Published: March 2023

BACKGROUND:
Emergency department trauma resuscitation requires teamwork and high-stakes clinical decision-making. Rural trauma centers with low trauma activation volumes must ensure that resuscitations are efficient and safe.

OBJECTIVE:
The purpose of this article is to describe the implementation of high-fidelity, interprofessional simulation training to foster trauma teamwork and role identification for trauma team members responding to trauma activations in the emergency department.

METHODS:
High-fidelity, interprofessional simulation training was developed for members of a rural Level III trauma center. Subject matter experts created trauma scenarios. An embedded participant led the simulations using a guidebook that outlined the scenario and learner objectives. The simulations were implemented from May 2021 through September 2021.

RESULTS:
Postsimulation survey results identified that participants found training with other professions valuable and that knowledge was gained.

CONCLUSION:
Interprofessional simulations enhance team communication and skills. Combining interprofessional education with high-fidelity simulation creates a learning environment that optimizes trauma team function.
Forum Theater: An Innovative Strategy to Enhance Clinician Communication With Marginalized Trauma Patients
Authors: Schombs Michele , Khedr Shahenda , Sullivan Francesca , Alkattan Abdulaziz , Brown Candace , Morgan Liz , Norful Allison A. , Sample Jason , Chen Chun-Cheng 
Published: March 2023

BACKGROUND:
Marginalized groups experience a higher frequency of traumatic injury and are more likely to report negative experiences in the health care setting. Trauma center staff are prone to compassion fatigue, which impairs patient and clinician interactions for these groups. Forum theater (a form of interactive theater designed for addressing social issues) is proposed as an innovative method of exploring bias and has never been applied in the trauma setting.

OBJECTIVE:
This article aims to determine the feasibility of implementing forum theater as an adjunct to enhance clinician understanding of bias and its influence on communication between clinicians and trauma populations.

METHODS:
This is a descriptive qualitative analysis of adopting forum theater at a Level I trauma center in a New York City borough with a racially and ethnically diverse population. The implementation of a forum theater workshop was described, including our work with a theater company to address bias in the health care setting. Volunteer staff members and theater facilitators participated in an 8-hr workshop leading to a 2-hr multipart performance. Participant experiences were collected in a postsession debrief to understand the utility of forum theater.

RESULTS:
Debriefing sessions after forum theater performances demonstrated that forum theater is a more engaging and effective method for dialogue surrounding bias than personal past experiences with other educational models.

CONCLUSION:
Forum theater was feasible as a tool to enhance cultural competency and bias training. Future research will examine the impact it has on levels of staff empathy and its impact on participants' level of comfort communicating with diverse trauma populations.
An international telehealth experience in Guatemala
Authors: Lyerla Frank , Sobczak Bernadette , Jennings Greg 
Published: March 2023

ABSTRACT
An increase in competition for nurse practitioner preceptors and United States–based clinical practicum sites along with an increase in required direct patient care clinical hours demand innovative methods for gaining valuable nurse practitioner clinical experiences. Involving nurse practitioner students in medical mission trips to low-resource countries and follow-up telehealth clinics have been beneficial for all involved. Guatemala is a developing country in Latin America that has a high rate of poverty, malnutrition, and a lack of health care. Annual medical mission trips are beneficial in meeting the health care needs of Guatemalans but lack the frequent follow-up necessary to promote a more sustained impact. A monthly telehealth program was established in a rural area of Guatemala to promote the continuity of care for children with malnutrition. This article discusses associated barriers, strategies to overcome those barriers, and the inclusion of nurse practitioner students to meet the needs of the Guatemalan children with malnutrition using a telehealth program.
Subjective Toxicity Profiles of Children With Cancer During Treatment
Authors: Ruan Haishan , Sun Jiwen , Zhao Kangjia , He Mengxue , Yuan Changrong , Fu Lijuan , Shen Nanping 
Published: March 2023

BackgroundChildren and adolescents may experience a variety of subjective adverse events (AEs) caused by cancer treatment. The identification of distinct groups of patients is crucial for guiding symptomatic AE management interventions to prevent AEs from worsening.ObjectiveThe aim of this study was to identify subgroups of children with cancer experiencing similar patterns of subjective toxicities and evaluate differences among these subgroups in demographic and clinical characteristics.MethodsA cross-sectional survey was conducted of 356 children in China with malignancies who received chemotherapy within the past 7 days using the pediatric Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events. A latent class analysis (LCA) was conducted to identify subgroups of patients with distinct profiles of symptomatic AE occurrence.ResultsNausea (54.5%), anorexia (53.4%), and headache (39.3%) were the top 3 AEs children experienced. Nearly all participants (97.8%) experienced ≥1 core AEs, and 30.3% experienced ≥5 AEs. The LCA results identified 3 subgroups (“high gastrotoxicity and low neurotoxicity” [53.2%], “moderate gastrotoxicity and high neurotoxicity” [23.6%], and “high gastrotoxicity and high neurotoxicity” [22.8%]). The subgroups were differentiated by monthly family per-capita income, time since diagnosis, and Karnofsky Performance Status score.ConclusionsChildren experienced multiple subjective toxicities during chemotherapy, especially gastrotoxicity and neurotoxicity. Heterogeneity was found in the LCA in the patients’ toxicities. The prevalence of toxicities could be distinguished by the children’s characteristics.Implications for PracticeThe results showing different subgroups in our study may assist clinical staff in focusing on patients with higher toxicities to provide effective interventions.
A Cross-sectional Study of Regret in Cancer Patients After Sharing Test Results for Pathogenic Germline Variants of Hereditary Cancers With Relatives
Authors: Fukuzaki Naomi , Kiyozumi Yoshimi , Higashigawa Satomi , Horiuchi Yasue , Matsubayashi Hiroyuki , Nishimura Seiichiro , Mori Keita , Notsu Akifumi , Suishu Izumi , Ohnami Sumiko , Kusuhara Masatoshi , Yamaguchi Ken , Doorenbos Ardith Z. , Takeda Yuko 
Published: March 2023

Background
Research on whole genome/exome sequencing is increasing worldwide. However, challenges are emerging in relation to receiving germline pathogenic variant results and sharing them with relatives.

Objective
The aim of this study was to investigate the occurrence of and reasoning related to regret among patients with cancer who shared single-gene testing results and whole exome sequencing with family members.

Methods
This was a single-center, cross-sectional study. The Decision Regret Scale was administered, and descriptive questionnaires were used with 21 patients with cancer.

Results
Eight patients were classified as having no regret, 9 patients were classified as having mild regret, and 4 patients were classified as having moderate to strong regret. Reasons patients felt that sharing was the right decision included the following: to allow relatives and children to take preventive measures, the need for both parties to be aware of and ready for the hereditary transmission of cancer, and the need to be able to discuss the situation with others. On the other hand, some patients did not think it was a good decision to share the information because of the associated anxiety.

Conclusions
Regret over sharing test results for pathogenic germline variants of hereditary cancers with relatives tended to be low. The main reason was that patients believed that they were able to benefit others by sharing.

Implications for Practice
Healthcare professionals need to understand the postsharing perceptions and experiences of patients and support them throughout the sharing process.