bluuebunny/crossref_metadata_2025_split huggingface dataset:
Impact of blended learning on manual defibrillator's use: A simulation‐based randomized trial
Authors: Siebert Johan N. , Glangetas Alban , Grange Marine , Haddad Kevin , Courvoisier Delphine S. , Lacroix Laurence 
Published: September 2021

AbstractBackgroundBlended learning, defined as the combination of traditional face‐to‐face instructor‐led learning and e‐learning course, has never been validated as a teaching method for the effective use of manual defibrillators in cardiopulmonary resuscitation.AimTo evaluate whether paediatric emergency and critical care providers exposed to a blended learning session performed better and recalled more defibrillator skills than those exposed to face‐to‐face learning only.Study designA two‐period prospective, stratified, single‐centre, simulation‐based, randomized, controlled trial.MethodsRegistered nurses and postgraduate residents from either a paediatric emergency department or an intensive care unit were randomly assigned to a blended learning or face‐to‐face learning sessions on the recommended use of a manual defibrillator. Participants' adherence to recommendations was assessed by testing defibrillator skills in three consecutive paediatric cardiopulmonary scenarios performed on the day of the training and once again 2 months later. The primary endpoint was the number of errors observed during defibrillation, cardioversion, and transcutaneous pacing at the time of the initial intervention.ResultsFifty participants were randomized to receive the intervention and 51 to the control group. When pooling all three procedures, the median total errors per participant was lower (2 [IQR: 1‐4]) in providers exposed to blended learning than in those exposed to face‐to‐face learning only (3 [IQR: 2‐5]; P = .06). The median of total errors per procedure was also lower. However, both training methods appeared insufficient to maintain appropriate skill retention over time as a repetition of procedures 2 months later without any refresher learning session yielded more errors in both groups.ConclusionsLearners exposed to blended learning showed a reduced number in the total amount of errors compared with those exposed to face‐to‐face learning alone, with waning of skills over time.Relevance to clinical practiceProficiently teaching the use of a manual defibrillator can be performed through blended learning.
Permanent His‐bundle pacing using distal His‐bundle electrogram‐guided approach in patients with atrioventricular block
Authors: Suga Kazumasa , Kato Hiroyuki , Inden Yasuya , Yanagisawa Satoshi , Murakami Hisashi , Kada Kenji , Tsuboi Naoya , Murohara Toyoaki 
Published: September 2021

AbstractBackgroundPermanent His‐bundle pacing (HBP) is effective and safe; however, the success rate of HBP is low, especially in patients with infranodal block. This study aimed to assess the efficacy and feasibility of HBP implantation using an electrophysiological guided approach targeting a distal His‐bundle electrogram (HBE) in patients with atrioventricular block (AVB).MethodsThirty‐four consecutive patients with AVB (infranodal block in 28 patients) who underwent HBP were enrolled. During implantation, we attempted to target the distal part of the HBE (distal HBE) beyond the block site based on unipolar mapping. The His‐capture threshold was evaluated for 1 year after implantation.ResultsHBP was achieved in 26 patients and in 21 patients (75%) with infranodal block. Detection of distal HBE was significantly higher in the successful HBP group than in the HBP failure group (65.4% vs. 0%, p = .001). Among 15 patients with intra‐Hisian block, 14 patients (93%) successfully achieved HBP with distal HBE detection. During the 1‐year follow‐up period, an increase in His‐capture threshold by ≥1.0 V at 1.0 ms occurred in five (19.2%) of 26 patients. The increased His‐capture threshold group exhibited significantly less detection of distal HBE (20% vs. 76.2%; odds ratio 0.078, 95% confidence interval 0.07–0.87, p = .038) and a higher His‐capture threshold at implantation (2.0 ± 1.1 V vs. 1.1 ± 0.9 V; odds ratio 1.702, 95% confidence interval 1.025–2.825, p = 0.04) than the non‐increased His‐capture threshold group.ConclusionHBP implantation guided by distal HBE approach may be feasible with subsequent stable pacing in patients with intra‐Hisian and atrioventricular nodal block.
Want: Still the easiest giant to attack?
Authors: McKay Stephen , Rowlingson Karen 
Published: September 2021

AbstractBeveridge claimed that ‘want’ was ‘in some ways the easiest [giant] to attack’ and yet 80 years after his report was published, poverty persists and indeed, has been increasing in recent years. In this article, we review both the key features of the Beveridge Report in relation to poverty and its implementation by the Labour government 1945–51, before turning to an analysis of how social security policy has changed since then. We then review changes in poverty levels since World War Two and attitudes to poverty. We conclude that Beveridge's plan helped to reduce poverty in the immediate post‐war years not least because of full employment. Nevertheless, poverty was not eradicated even at this time due to low levels of wages in work and low levels of benefits out of work. Since then, a number of reforms have generally moved further away from the Beveridge plan including a renewed focus on means testing and cuts in benefit levels. These have also contributed to increased levels of poverty, particularly for those of working age in recent years.
Carrots or sticks? A multilevel analysis of active labour market policies and non‐standard employment in Europe
Authors: Haapanala Henri 
Published: September 2021

AbstractSpending on active labour market policies (ALMPs) has increased across Europe following the 2007 flexicurity strategy which emphasised smooth and rapid transitions from unemployment to work. Despite broad scholarly coverage of the activation turn, the connection between labour market policies and changes in non‐standard employment remains unclear. Applying random effects within‐between regression analysis, this paper finds that coercive, ‘hard’ ALMP instruments incentivising rapid re‐employment with the threat of withdrawing unemployment benefits are associated with higher likelihood of involuntary part‐time employment, whereas supportive, ‘soft’ ALMP strategies with a focus on upskilling and public sector occupation are associated with higher voluntary but lower involuntary part‐time employment. The results from 25 countries over two decades shed light on the heterogeneous results of past ALMP research which has not adopted a consistent line on the supportive‐coercive dichotomy. With European employment policy increasingly applying hard activation instruments to achieve full employment, an unintended consequence might be the expansion of precarious employment.
Cytokine expression in feline allergic dermatitis and feline asthma
Authors: Older Caitlin E. , Diesel Alison B. , Heseltine Johanna C. , Friedeck Amanda , Hedke Carolyn , Pardike Stephanie , Breitreiter Katrina , Rossi Michael A. , Messamore James , Bammert Gary , Gonzales Andrea J. , Rodrigues Hoffmann Aline 
Published: September 2021

BackgroundThe pathogenesis of feline allergic dermatitis (FAD) is unclear, with several differences from allergic dermatitis in dogs and humans.Hypothesis/objectivesTo survey cytokine expression levels in healthy cats and cats affected with allergic dermatitis or asthma.AnimalsFormalin‐fixed, paraffin‐embedded skin biopsies from 22 cats with allergic dermatitis and 21 cats without allergic dermatitis were used for cutaneous assays. Serum was obtained from 17 healthy cats, 18 cats with allergic dermatitis, and 18 cats with a presumptive diagnosis of asthma.Methods and materialsCutaneous mRNA expression was evaluated with quantitative PCR [interleukin (IL)‐31 and IL‐31 Receptor A] and RNA in situ hybridisation (ISH) [IL‐5, IL‐31, IL‐31RA, IL‐33 and Oncostatin M receptor (OSMR)‐β]. IL‐31 protein concentrations were evaluated in serum with an enzyme‐linked immunosorbent assay. Serum levels of 19 additional cytokines were evaluated using a Luminex panel.ResultsIL‐31, IL‐31RA, IL‐5 and IL‐33 mRNA expression were either expressed in low quantities or undetectable in most samples. By contrast, OSMR‐β expression was significantly higher in the skin of allergic versus healthy cats (P < 0.0001). Although serum IL‐31 was detected in a larger number of cats with allergic dermatitis than healthy cats, and concentrations appeared to be higher in cats with allergies, this difference was not statistically significant. Cats affected by asthma also exhibited insignificantly higher concentrations of IL‐31 in the serum.Conclusions and clinical relevanceOur results suggest that feline allergic diseases may exhibit different pathomechanisms from allergic diseases affecting other species. These findings are useful in guiding further therapeutic development toward targets that may have a role in the pathogenesis of feline allergic skin disease.
Focusing of X-Rays with a Photon Energy of 9.5 keV by an Ellipsoid with a HOPG Crystal
Authors: Zhidkov N. V. , Pozdnyakov E. V. , Suslov N. A. 
Published: September 2021

Abstract
The arrangement and results of full-power experiments on the Iskra-5 laser facility (the laser energy is 150 J, the pulse length is 0.3 ns, and the laser-radiation intensity on the target is 1.6 × 1015 W/cm2) on focusing of hard X rays from a laser-plasma source with a Ga target using an ellipsoid with a HOPG crystal are described. The design of an ellipsoid focus pointer is described that made it possible to create an X-ray source at the focus of the ellipsoid with an accuracy of no worse than 100 μm. Focusing X-ray radiation into a 1-mm-diameter spot in full-power experiments was achieved at a distance of 250 mm. An eighty-fold increase in the X-ray flux density with a photon energy of 9.5 keV was attained.
Associations of ophthalmic and systemic conditions with incident dementia in the UK Biobank
Authors: Shang Xianwen , Zhu Zhuoting , Huang Yu , Zhang Xueli , Wang Wei , Shi Danli , Jiang Yu , Yang Xiaohong , He Mingguang 
Published: September 2021

AimsTo examine independent and interactive associations of ophthalmic and systemic conditions with incident dementia.MethodsOur analysis included 12 364 adults aged 55–73 years from the UK Biobank cohort. Participants were assessed between 2006 and 2010 at baseline and were followed up until the early of 2021. Incident dementia was ascertained using hospital inpatient, death records and self-reported data.ResultsOver 1 263 513 person-years of follow-up, 2304 cases of incident dementia were documented. The multivariable-adjusted HRs (95% CI) for dementia associated with age-related macular degeneration (AMD), cataract, diabetes-related eye disease (DRED) and glaucoma at baseline were 1.26 (1.05 to 1.52), 1.11 (1.00 to 1.24), 1.61 (1.30 to 2.00) and (1.07 (0.92 to 1.25), respectively. Diabetes, heart disease, stroke and depression at baseline were all associated with an increased risk of dementia. Of the combination of AMD and a systemic condition, AMD-diabetes was associated with the highest risk for incident dementia (HR (95% CI): 2.73 (1.79 to 4.17)). Individuals with cataract and a systemic condition were 1.19–2.29 times more likely to develop dementia compared with those without cataract and systemic conditions. The corresponding number for DRED and a systemic condition was 1.50–3.24. Diabetes, hypertension, heart disease, depression and stroke newly identified during follow-up mediated the association between cataract and incident dementia as well as the association between DRED and incident dementia.ConclusionsAMD, cataract and DRED but not glaucoma are associated with an increased risk of dementia. Individuals with both ophthalmic and systemic conditions are at higher risk of dementia compared with those with an ophthalmic or systemic condition only.
Evaluating risk stratification scoring systems to predict mortality in patients with COVID-19
Authors: Chu Kelly , Alharahsheh Batool , Garg Naveen , Guha Payal 
Published: September 2021

BackgroundThe COVID-19 pandemic has necessitated efficient and accurate triaging of patients for more effective allocation of resources and treatment.ObjectivesThe objectives are to investigate parameters and risk stratification tools that can be applied to predict mortality within 90 days of hospital admission in patients with COVID-19.MethodsA literature search of original studies assessing systems and parameters predicting mortality of patients with COVID-19 was conducted using MEDLINE and EMBASE.Results589 titles were screened, and 76 studies were found investigating the prognostic ability of 16 existing scoring systems (area under the receiving operator curve (AUROC) range: 0.550–0.966), 38 newly developed COVID-19-specific prognostic systems (AUROC range: 0.6400–0.9940), 15 artificial intelligence (AI) models (AUROC range: 0.840–0.955) and 16 studies on novel blood parameters and imaging.DiscussionCurrent scoring systems generally underestimate mortality, with the highest AUROC values found for APACHE II and the lowest for SMART-COP. Systems featuring heavier weighting on respiratory parameters were more predictive than those assessing other systems. Cardiac biomarkers and CT chest scans were the most commonly studied novel parameters and were independently associated with mortality, suggesting potential for implementation into model development. All types of AI modelling systems showed high abilities to predict mortality, although none had notably higher AUROC values than COVID-19-specific prediction models. All models were found to have bias, including lack of prospective studies, small sample sizes, single-centre data collection and lack of external validation.ConclusionThe single parameters established within this review would be useful to look at in future prognostic models in terms of the predictive capacity their combined effect may harness.
Defining clinical empathy: a grounded theory approach from the perspective of healthcare workers and patients in a multicultural setting
Authors: Tan Laurence , Le Mai Khanh , Yu Chou Chuen , Liaw Sok Ying , Tierney Tanya , Ho Yun Ying , Lim Evelyn , Lim Daphne , Ng Reuben , Ngeow Colin , Low James 
Published: September 2021

ObjectiveTo define clinical empathy from the perspective of healthcare workers and patients from a multicultural setting.DesignGrounded theory approach using focus group discussions.SettingA health cluster in Singapore consisting of an acute hospital, a community hospital, ambulatory care teams, a medical school and a nursing school.Participants69 participants including doctors, nurses, medical students, nursing students, patients and allied health workers.Main outcome measuresA robust definition of clinical empathy.ResultsThe construct of clinical empathy is consistent across doctors, nurses, students, allied health and students. Medical empathy consists of an inner sense of empathy (imaginative, affective and cognitive), empathy behaviour (genuine concern and empathic communication) and a sense of connection (trust and rapport). This construct of clinical empathy is similar to definitions by neuroscientists but challenges a common definition of clinical empathy as a cognitive process with emotional detachment.ConclusionsThis paper has defined clinical empathy as ‘a sense of connection between the healthcare worker and the patient as a result of perspective taking arising from imaginative, affective and cognitive processes, which are expressed through behaviours and good communication skills that convey genuine concern’. A clear and multidimensional definition of clinical empathy will improve future education and research efforts in the application and impact of clinical empathy.
Association between dispositional empathy and self-other distinction in Irish and Belgian medical students: a cross-sectional analysis
Authors: Bukowski Henryk , Ahmad Kamal Nor Faizaah , Bennett Deirdre , Rizzo Gabriella , O'Tuathaigh Colm 
Published: September 2021

ObjectivePhysicians’ cognitive empathy is associated with improved diagnosis and better patient outcomes. The relationship between self-reported and performance-based measures of cognitive empathic processes is unclear.DesignCross-sectional analysis of the association between medical students’ empathy scale scores and their empathic performance in a visuospatial perspective-taking (VPT) task.ParticipantsUndergraduate medical students across two European medical schools (n=194).Primary and secondary outcome measuresTwo self-report empathy and one performance-based perspective-taking outcome: Jefferson Scale of Physician Empathy (JSPE); Empathy Quotient (EQ); Samson’s level-1 VPT task.ResultsHigher scores on the ‘standing in patient’s shoes’ subscale of the JSPE were associated with a lower congruency effect (as well as lower egocentric and altercentric biases) in the VPT (B=−0.007, 95% CI=−0.013 to 0.002, p<0.05), which reflects an association with better capacity to manage conflicting self-other perspectives, also known as self-other distinction. Lower egocentric bias was also associated with higher scores on the ‘social skills’ EQ subscale (B=−10.17, 95% CI=−17.98 to 2.36, p<0.05). Additionally, selection of a ‘technique-oriented’ clinical specialty preference was associated with a higher self-perspective advantage in the VPT, reflecting greater attentional priority given to the self-perspective.ConclusionsWe show that self-assessment scores are associated with selected performance-based indices of perspective taking, providing a more fine-grained analysis of the cognitive domain of empathy assessed in medical student empathy scales. This analysis allows us to generate new critical hypotheses about the reasons why only certain self-report empathy measures (or their subscales) are associated with physicians’ observed empathic ability.
Global epidemiology of COVID-19 knowledge, attitude and practice: a systematic review and meta-analysis
Authors: Siddiquea Bodrun Naher , Shetty Aishwarya , Bhattacharya Oashe , Afroz Afsana , Billah Baki 
Published: September 2021

ObjectiveTo assess the knowledge, attitude and practice (KAP) of the global general population regarding COVID-19.DesignSystematic review and meta-analysis.MethodsMEDLINE, Embase, CINAHL and PsycINFO were used to identify articles published between 1 January and 30 June 2021 assessing KAP regarding COVID-19 in the global general population. The quality of eligible studies was assessed. Random effects model was used to obtain the pooled proportion of each component of KAP of COVID-19. Heterogeneity (I2) was tested, and subgroup and correlation analyses were performed.ResultsOut of 3099 records, 84 studies from 45 countries across all continents assessing 215 731 participants’ COVID-19 KAP were included in this study. The estimated overall correct answers for knowledge, good attitude and good practice in this review were 75% (95% CI 72% to 77%), 74% (95% CI 71% to 77%) and 70% (95% CI 66% to 74%), respectively. Low-income countries, men, people aged below 30 years and people with 12 years of education or less had the lowest practice scores. Practice scores were below 60% in Africa and Europe/Oceania. Overall heterogeneity was high (I2 ≥98%), and publication bias was present (Egger’s regression test, p<0.01). A positive significant correlation between knowledge and practice (r=0.314, p=0.006), and attitude and practice (r=0.348, p=0.004) was observed.ConclusionsThis study’s findings call for community-based awareness programmes to provide a simple, clear and understandable message to reinforce knowledge especially regarding efficacy of the preventive measures in low and lower middle-income countries, and in Africa and Europe/Oceania, which will translate into good practice. Targeted intervention for men, people with low education, unemployed people and people aged below 30 years should be recommended. As most of the included studies were online surveys, underprivileged and remote rural people may have been missed out. Additional studies are needed to cover heterogeneous populations.PROSPERO registration numberCRD42020203476.
Demographic, occupational and societal risk exposures to physical injuries in a rural community in Western Kenya: a 12-week longitudinal study
Authors: Chweya Reagan Ngoge , Mambo Susan Njoki , Gachohi John Mwangi 
Published: September 2021

ObjectiveWe studied factors associated with the weekly occurrence of physical injuries in a rural setting to determine injury-related burden and risk exposures.DesignProspective cohort study.SettingSuna-West subcounty, Migori County, Western Kenya.Participants390 study participants (subjects) cluster sampled from 92 households, recruited and followed up for 12 weeks, between August and October 2019.MethodsWe collected data weekly on occurrence of injuries, individual-level and household-level independent variables using a standard interviewer-administered questionnaire adapted from the WHO survey tool for injuries. Analyses related occurrence of injuries and independent variables using a multilevel Poisson regression model, adjusting for age and sex.Outcome measuresQuantifying injury-related burden and patterns by demographic, occupational and societal risk exposures.ResultsWe documented 44 injuries, coming from 38 subjects dwelling in 30 of the 92 study households. On average, each study subject and household experienced 1.2 and 1.5 episodes of injuries across the 12 study weeks. Open wounds and bruises were the most frequent injuries commonly reported among middle-aged (18–54 years) and young (5–17 years) subjects at 32.2 and 7.6 episodes per 1000-person week, respectively. The common cause of injuries among young, middle-aged and old subjects (>54 years) were falls, road accidents and person-related assault or being hit by an object, each at 15.2, 18.9, and 11.4 episodes per 1000-person week, respectively. Subjects not domesticating animals (incidence rate ratio (IRR)=7.6, 95% CI 1.4 to 41.7) and those making a visit outside the local subcounty of residence (IRR=2.2, 95% CI 1.5 to 3.1) were at higher risk of reporting injuries.ConclusionWe provide evidence of a higher burden of physical injuries associated with demographic, occupational and societal risk exposures with the most injuries resulting from falls. Further studies could better define granular characteristics constituting these factors.
Ventriculolumbar perfusion and inhalational anesthesia with sevoflurane in an accidental intrathecal injection of tranexamic acid: unreported treatment options
Authors: Godec Sergej , Gradisek Michael Jozef , Mirkovic Tomislav , Gradisek Primoz 
Published: September 2021

BackgroundTranexamic acid (TXA) decreases hemorrhage-related mortality in trauma patients and is increasingly being used during obstetric and orthopedic surgeries. Inadvertent intrathecal injection of TXA is a rare, potentially lethal event leading to dose-dependent cardiotoxicity and neurotoxicity. TXA enhances neuronal excitation by antagonizing inhibitory γ-aminobutyric acid type A and glycine receptors. Until now, mechanistic-based pharmacological treatments targeting multiple central nervous system receptors have been advocated for use in such cases, with no data on intrathecal TXA elimination techniques.Case presentationA patient scheduled for hip surgery accidentally received 350 mg of intrathecal TXA instead of levobupivacaine. The clinical picture progressed from spinal segmental myoclonus to generalized convulsions and malignant arrhythmias. The treatment consisted of ventriculolumbar perfusion with normal saline at a rate of 50 mL/hour starting 5 hours after TXA administration and inhalational sedation with sevoflurane, in addition to drugs acting on multiple receptors at different central nervous system levels. Over 2 months the neurological status improved, although it was not complete.ConclusionsFor the first time, the feasibility and possible clinical efficacy of combined treatment with ventriculolumbar perfusion and inhalational sedation with sevoflurane were demonstrated. A referral to a neurosurgical facility is recommended in patients with acute TXA-induced neurotoxicity and cardiotoxicity.