Asynchronous Transitions from Hepatoblastoma to Carcinoma in High-Risk Pediatric Tumors.

Most malignant hepatocellular tumors in children are classified as either hepatoblastoma (HB) or hepatocellular carcinoma (HCC), but some tumors demonstrate features of both HB and HCC. These tumors have been recognized under a provisional diagnostic category by the World Health Organization and are distinguished from HB and HCC by a combination of histological, immunohistochemical, and molecular features. Their outcomes and cellular composition remain an open question.

Cultural Conversations in Therapy: How Often Clients Talk About Their Identities.

Objective: The purpose of this study was to examine how often clients report discussing cultural identities during counseling sessions; the extent to which discussion of cultural identities during treatment varies across therapists; whether identifying as BIPOC (Black, Indigenous, and people of color) predicts clients' discussion of cultural identities in sessions; and whether differences in the frequency of cultural conversations (i.e., dialogue that focuses on client cultural identities) across client groups depend on the therapist.

Identification of cultural conversations in therapy using natural language processing models.

Researchers have historically focused on understanding therapist multicultural competency and orientation through client self-report measures and behavioral coding. While client perceptions of therapist cultural competency and multicultural orientation and behavioral coding are important, reliance on these methods limits therapists receiving systematic, scalable feedback on cultural opportunities within sessions. Prior research demonstrating the feasibility of automatically identifying topics of conversation in psychotherapy suggests that natural language processing (NLP) models could be trained to automatically identify when clients and therapists are talking about cultural concerns and could inform training and provision of rapid feedback to therapists.

Nurses navigating moral distress, resilience, and team dynamics: A literature review.

Background: This manuscript explores the pervasive issue of moral distress among nurses and its impact on their well-being and professional satisfaction. Focusing on diverse factors contributing to moral distress, the review spans various experience levels and patient care settings.

Method: Utilizing integrative reviews and sourcing from PubMed, CINAHL, SCOPUS, PsycINFO, and ProQuest, the study synthesizes findings from studies worldwide.

Evaluation of Gram Stain-Guided Antibiotic Therapy for Methicillin-Resistant Pneumonia in Intensive Care Unit Patients.

Despite high negative predictive values (NPVs) seen with methicillin-resistant (MRSA) nares polymerase chain reaction (PCR) assays, utilization of both respiratory sample Gram stain and MRSA nares PCR in patients with pneumonia may contribute to overuse of laboratory resources. The purpose of this study was to evaluate if a Gram stain demonstrating no Gram-positive organisms from a respiratory sample is sufficient to allow for de-escalation of vancomycin therapy. This single center study retrospectively identified intensive care unit (ICU) patients started on vancomycin for presumed pneumonia at University of Wisconsin (UW) Health in Madison, WI between August 2022 and March 2023.