bluuebunny/crossref_metadata_2025_split huggingface dataset:
Unprofessional conduct by nurses: A document analysis of disciplinary decisions
Authors: Papinaho Oili , Häggman-Laitila Arja , Kangasniemi Mari 
Published: September 2021

Background: A small minority of nurses are investigated when they fail to meet the required professional standards. Unprofessional conduct does not just affect the nurse but also patients, colleagues and managers. However, it has not been clearly defined. Objective: The objective was to identify unprofessional conduct by registered nurses by examining disciplinary decisions by a national regulator. Design: A retrospective document analysis. Data and research context: Disciplinary decisions delivered to 204 registered nurses by the Finnish national regulatory authority from 2007 to 2016. The data were analysed with quantitative statistics. Ethical consideration: The study received permission from the Finnish National Supervisory Authority for Welfare and Health and used confidential documents that were supplied on the basis of complete anonymity and confidentiality. Findings: The mean age of the registered nurses who were disciplined was 44 years and 81% were female. Two-thirds had worked for their employer for 5 years or less, 53% had two or more employers and 18% had a criminal history. All the decisions included a primary reason for why the nurses were investigated, but there were also 479 coexisting reasons. In most cases, unprofessional conduct was connected to substance abuse (96%). In addition, stealing of medicine, a decreased ability to work and neglect of nursing guidelines were reported. Discussion: We found that the nurses were investigated for unprofessional conduct for complex combinations of primary and coexisting reasons. Our study highlighted that more attention needs to be paid to the key markers for unprofessional conduct. Conclusion: Unprofessional conduct is a complex phenomenon that is connected to nurses’ individual and working backgrounds and has an impact on their work performance. More research is needed to identify how nursing communities can detect, manage and limit the serious effects and consequences of unprofessional conduct.
Pre-decision regret before transition of dependents with severe dementia to long-term care
Authors: Hanssen Ingrid , Mkhonto Flora M , Øieren Hilde , Sengane Malmsey LM , Sørensen Anne Lene , Tran Phuong Thai Minh 
Published: September 2021

Background: To place a dependent with severe dementia in a nursing home is a painful and difficult decision to make. In collectivistic oriented societies or families, children tend to be socialised to care for ageing parents and to experience guilt and shame if they violate this principle. Leaving the care to professional caregivers does not conform with the cultural expectations of many ethnic groups and becomes a sign of the family’s moral failure. Research design: Qualitative design with individual in-depth interviews with nurses, family members and dementia care coordinators in Norway, Montenegro, Serbia and South Africa. Braun and Clarke’s six analytic phases were used. Ethical considerations: The project was approved by the Regional Committee for Research, South-Eastern Norway; the Norwegian Centre for Research Data; the Ethics Committee; University of Limpopo, MEDUNSA Campus, South Africa; and by the local heads of the respective nursing homes or home care services. Interviewees were informed orally and in writing and signed an informed consent form. Findings: Healthcare professionals tend to be contacted only when the situation becomes unmanageable. Interviewees talked about feelings of obligation, shame and stigma in their societies regarding dementia, particularly in connection with institutionalisation of family members. Many lacked support during the decision-making process and were in a squeeze between their own needs and the patients’ need of professional care, and the feeling of duty and worry about being stigmatised by their surroundings. This conflict may be a source of pre-decision regret. Conclusion: Family caregivers need help to understand the behaviours of persons with dementia and how to access the formal and informal services available. Thus, they may provide effective support to patients and family carers alike. Supportive interventions for caregivers need to be tailored to meet the individual needs of both the caregiver and the persons with dementia.
Competition and Banking Industry Stability: How Do BRICS and G7 Compare?
Authors: Oredegbe Abayomi 
Published: September 2021

This study examines banking industry stability in BRICS and G7 from the period 2005 to 2014. The results show that stability level in a prior period affects stability in the subsequent period. Also, the study reveals that competition improves stability, which validates the competition-stability proposition. Economic growth enhances stability in BRICS but not in G7. Inefficiency weakens stability in BRICS; however, its impact in G7 is insignificant. Profitability, capitalization, and inflation enhance stability in G7; however, they show no meaningful impacts in BRICS. These findings contribute to literature and policy discussion on banking industry stability JEL Codes: G21, G28, G32, L11
An Innovative Three-in-One Face Protective Gear (FPG): A Feasibility Study in a Neonatal Unit in Times of Pandemic!
Authors: Panghal Astha , Gupta Ashok Kumar , Gupta Girish , Naranje Kirti M. , Singh Anita 
Published: September 2021

Background: Healthcare workers (HCWs) are at greatest risk of acquiring infection in times of global pandemic of COVID-19 disease. There is an unprecedented demand of several forms of personal protective equipment (PPE) for HCWs leading to possible acute shortage of these equipment. This has paved way for development of local innovative PPEs. Objective: To test feasibility of a low cost, indigenous three-in-one face protective gear (FPG) in HCWs of a neonatal unit of a tertiary care institute in northern India. Methodology: A three-in-one FPG was developed using the commonly available items in a ward or intensive care and few trash items. Items used were sterile surgical sheet, cling wrap piece/transparency sheet, cover of umbilical catheter/any sterile hollow plastic pipe, or straw and adhesive tape. The FPG was tested in 17 HCWs regarding its ease to use, comfort, and feasibility with the help of questionnaire. Results: A total of 17 HCWs participated in this study. Majority (10, 58.8%) were doctors. Eight (47%) participants have never used any form of PPE previously. Thirteen (76.4%) participants found the FPG comfortable to wear; 12 (70.5%) found it comfortable to wear up to 8 h. Three HCWs found it difficult to work when wear the FPG; 1 out of 3 found it suffocating. Conclusion: Three-in-one FPG is an indigenous, low cost, and may be a feasible alternative in low-risk situations when there is scarcity of conventional protective equipment.
Inhaled Nitric Oxide via High-Flow Nasal Cannula in Patients with Acute Respiratory Failure Related to COVID-19
Authors: Chandel Abhimanyu , Patolia Saloni , Ahmad Kareem , Aryal Shambhu , Brown A Whitney , Sahjwani Dhwani , Khangoora Vikramjit , Shlobin Oksana A , Cameron Paula C , Singhal Anju , Holtzclaw Arthur W , Desai Mehul , Nathan Steven D , King Christopher S 
Published: September 2021

INTRODUCTION Limited evidence exists regarding use of inhaled nitric oxide (iNO) in spontaneously breathing patients. We evaluated the effectiveness of continuous iNO via high-flow nasal cannula (HFNC) in COVID-19 respiratory failure. METHODS We performed a multicenter cohort study of patients with respiratory failure from COVID-19 managed with HFNC. Patients were stratified by administration of iNO via HFNC. Regression analysis was used to compare the need for mechanical ventilation and secondary endpoints including hospital mortality, length of stay, acute kidney injury, need for renal replacement therapy, and need for extracorporeal life support. RESULTS A total of 272 patients were identified and 66 (24.3%) of these patients received iNO via HFNC for a median of 88 h (interquartile range: 44, 135). After 12 h of iNO, supplemental oxygen requirement was unchanged or increased in 52.7% of patients. Twenty-nine (43.9%) patients treated with iNO compared to 79 (38.3%) patients without iNO therapy required endotracheal intubation ( P = .47). After multivariable adjustment, there was no difference in need for mechanical ventilation between groups (odds ratio: 1.53; 95% confidence interval [CI]: 0.74-3.17), however, iNO administration was associated with longer hospital length of stay (incidence rate ratio: 1.41; 95% CI: 1.31-1.51). No difference was found for mortality, acute kidney injury, need for renal replacement therapy, or need for extracorporeal life support. CONCLUSION In patients with COVID-19 respiratory failure, iNO delivered via HFNC did not reduce oxygen requirements in the majority of patients or improve clinical outcomes. Given the observed association with increased length of stay, judicious selection of those likely to benefit from this therapy is warranted.
Ethical decision-making of social workers in Spain during COVID-19: Cases and responses
Authors: Úriz María-Jesús , Viscarret Juan-Jesús , Ballestero Alberto 
Published: September 2021

In this article we address the ethical decision-making processes of social work professionals in Spain during the first wave of COVID-19. We present some of the findings from a broader international research project led by professor Sarah Banks and carried out in collaboration with the International Federation of Social Workers. The first wave of COVID-19 had a major impact in Spain, hitting harder the most vulnerable groups. In this unprecedented and unexpected context, social workers had to make difficult ethical decisions on fundamental issues such as respecting service-user’s autonomy, prioritizing wellbeing, maintaining confidentiality or deciding the fair distribution of the scarce resources. There were moments of uncertainty and difficult institutional responses. The broader international project was carried out using an online questionnaire addressed to social work professionals in several countries. In this article, through several specific cases, we examine the ethical decision-making processes of social work professionals in Spain, as well as the way to resolve that situations. We have used a qualitative content analysis with a deductive approach to analyze the responses and cases. Findings show many difficult situations concerning the prioritization of the wellbeing of users without limiting their autonomy, the invention of new organizational protocols to provide support and resources for vulnerable people… Social workers had to manage the bureaucracy and had to solve some emergency situations getting personally involved or developing other cooperation mechanisms. The pandemic forced them to look for new forms of social intervention.
Brain herniation on computed tomography is a poor predictor of whether patients with a devastating brain injury can be confirmed dead using neurological criteria
Authors: Ray Andrew , Manara Alex R , Mortimer Alex M , Thomas Ian 
Published: September 2021

Background It is unclear if the presence of compartmental brain herniation on neuroimaging should be a prerequisite to the clinical confirmation of death using neurological criteria. The World Brain Death Project has posed this as a research question. Methods The final computed tomography of the head scans before death of 164 consecutive patients confirmed dead using neurological criteria and 41 patients with devastating brain injury who died following withdrawal of life sustaining treatment were assessed by a neuroradiologist to compare the incidence of herniation and other features of cerebral swelling. Results There was no difference in the incidence of herniation in patients confirmed dead using neurological criteria and those with devastating brain injury (79% vs 76%, OR 1.23 95%, CI 0.56–2.67). The sensitivity and specificity of brain herniation in patients confirmed dead using neurological criteria was 79% and 24%, respectively. The positive and negative predictive value was 81% and 23%, respectively. The most sensitive computed tomography of the head findings for death using neurological criteria were diffuse sulcal effacement (93%) and basal cistern effacement (91%) and the most specific finding was loss of grey-white differentiation (80%). The only features with a significantly different incidence between the death using neurological criteria group and the devastating brain injury group were loss of grey-white differentiation (46 vs 20%, OR 3.56, 95% CI 1.55–8.17) and presence of contralateral ventricular dilatation (24 vs 44%, OR 0.41, 95% CI 0.20–0.84). Conclusions Neuroimaging is essential in establishing the cause of death using neurological criteria. However, the presence of brain herniation or other signs of cerebral swelling are poor predictors of whether a patient will satisfy the clinical criteria for death using neurological criteria or not. The decision to test must remain a clinical one.
Impact of previous biologic use and body weight on the effectiveness of guselkumab in moderate-to-severe plaque psoriasis: a real-world practice
Authors: Hung Yi-Teng , Lin Yu-Jr , Chiu Hsien-Yi , Huang Yu-Huei 
Published: September 2021

Background: Real-life data on patients with psoriasis treated with guselkumab are few and are needed to compare with trial-based data. We investigated the effect of clinical factors on real-world effectiveness of guselkumab. Methods: This multicentre study retrospectively included 135 patients with psoriasis treated with guselkumab from June 2018 until November 2020. Effectiveness was assessed using the degree of improvement in the Psoriasis Area and Severity Index (PASI) scores at baseline and after 4, 12, 20, 28, and 36 weeks. Predictors of effectiveness were also evaluated. Results: At week 36, 67% of the patients achieved PASI 75. Multivariate logistic regression analysis revealed that heavier patients were less likely to achieve PASI 75 at week 4 than patients with lower body weights. Fewer patients exposed to only one biologic achieved PASI 75 at weeks 4, 20, 28, and 36 [odds ratio (OR) = 0.08 (95% CI, 0.01–0.48), 0.21 (95% CI, 0.05–0.74), 0.04 (95% CI, 0.00–0.35), and 0.07 (95% CI, 0.00–0.68), respectively] than biologic-naïve patients. Patients previously treated with more than one biologic were less likely to achieve PASI 75 at weeks 12, 20, 28, and 36 [OR = 0.05 (95% CI, 0.01–0.22), 0.03 (95% CI, 0.01–0.16), 0.00 (95% CI, 0.00–0.03), and 0.00 (95% CI, 0.00–0.044), respectively] than biologic-naïve patients. Patients with previous anti-interleukin (IL)-17 exposure, rather than tumour necrosis factor-α and IL-12/23 inhibitors, had lower PASI improvements to guselkumab than biologic-naïve patients at weeks 12, 20, and 28 [OR = 0.19 (95% CI, 0.03–0.90), 0.10 (95% CI, 0.02–0.55), and 0.03 (95% CI, 0.00–0.29), respectively]. Conclusions: The effectiveness of guselkumab was compromised in a real-world setting. Delayed onset of therapeutic response was noted in heavier patients. Biologic exposure, the number of previously used biologics, and previous exposure to IL-17 inhibitors were clinical predictors of a reduced response to guselkumab. Physicians may share this information with patients to make treatment decisions.
Self-Testing as an Invaluable Tool in Fighting the COVID-19 Pandemic
Authors: Goggolidou Paraskevi , Hodges-Mameletzis Ioannis , Purewal Satvinder , Karakoula Aikaterini , Warr Tracy 
Published: September 2021

Objectives: The United Kingdom and a number of European Union countries are offering and distributing rapid antigen detection tests (RADTs) for self-test use to detect SARS-CoV-2. For instance, Greece, in the midst of its third wave of COVID-19, announced the provision of RADTs for self-testing through retail pharmacies. With the aim to determine the acceptability and feasibility of COVID-19 self-testing, we ran a cross-sectional survey on residents of Greece and Cyprus, aged over 18 years. Methods: An online survey using the JISC platform was distributed to 1000 individuals who completed the survey anonymously. Data was collated and analyzed for complete responses by chi-squared and logistic regression analyses. Results: A total of 248 complete responses were obtained, with balanced gender distribution and particular demographics representative of the 2 countries. The majority of participants (79%; n = 196) reported willingness to self-test and the remaining individuals reported no (10.5%; n = 26) or don’t know (10.5%; n = 26). Being a university graduate significantly predicted the likelihood of being willing to self-test (odds ratio [OR] = 3.455, P < .001). Pearson Chi-square test found significant differences between university graduates versus non-graduates on the type of COVID-19 test preferred (χ2 = 8.95, df = 3, P < .03); graduates were more likely to prefer saliva testing and less likely to prefer the finger prick test than non-graduates. Conclusions: Our survey data evidences the acceptability of home-based self-testing, with a preference for saliva as choice of biological material for sampling. A number of factors, such as accessible reporting, contact tracing infrastructures, central registration, and validation for the implementation of different RADTs need to be taken collectively into consideration before self-testing can be universally and reliably scaled up.
Perioperative haematological outcomes following total knee arthroplasty in haemophiliacs
Authors: Mohan Kunal , Broderick James M , Raftery Nicola , McAuley Nuala F , McCarthy Tom , Hogan Niall 
Published: September 2021

Purpose: Patients with haemophilia suffer from recurrent joint haemarthrosis. This can progress to symptomatic arthropathy commonly affecting the knee. While modern coagulation strategies have reduced those proceeding to end-stage arthropathy, total knee arthroplasty (TKA) remains the optimal treatment for some patients. Despite innovation in perioperative haematological management, concerns about the potential for excessive haemorrhage still exist. The aim of this study is to quantify immediate postoperative blood loss and haematological complications in haemophiliacs following TKA. Methods: A retrospective study of patients with haemophilia types A or B who underwent a TKA over a 12-year period at a single institution was conducted. These patients were compared to both a non-haemophiliac control group and to published standards in non-haemophiliacs undergoing TKA. Results: Twenty-one TKA procedures in 18 patients (72% haemophilia A, 28% haemophilia B) were suitable for inclusion with a mean age of 44 years. The mean haemoglobin drops at 24 and 48 h postoperatively were 2.7 g/dl and 3.8 g/dl respectively. There was no significant difference in haemoglobin drop at 48 h postoperatively when compared to the non-haemophiliac control group ( P = 0.2644). There were no immediate perioperative complications and two patients (9.6%) required postoperative transfusion. Conclusion: Haemophiliacs undergoing a unilateral primary TKA in a specialised tertiary referral centre appear to have comparable rates of perioperative blood loss when compared to both a non-haemophiliac control group as and published haemostatic standards in non-haemophiliac patients following TKA. Perioperative management with expert orthopaedic and haematological input is recommended to optimise outcomes in this complex patient group.
Translation, Cross-Cultural Adaptation, Validity, and Reliability of the Indonesian Version of the IKDC Subjective Knee Form
Authors: Deviandri Romy , van der Veen Hugo C. , Lubis Andri M.T. , Postma Maarten J. , van den Akker-Scheek Inge 
Published: September 2021

Background: No questionnaire is currently available for use in patients with anterior cruciate ligament (ACL) injuries in an Indonesian population. The most-used questionnaire in clinical research for these patients is the International Knee Documentation Committee (IKDC) Subjective Knee Form, as its psychometric properties are considered to be excellent. Purpose: To translate the IKDC into Indonesian and assess its validity for use in Indonesian-speaking patients with ACL injuries. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: After a forward-and-backward translation procedure and cross-cultural adaptation, the validity and reliability of the questionnaire were investigated. The responses of ACL injury patients on 3 questionnaires, the Indonesian-IKDC (I-IKDC), 36-Item Short Form Health Survey, and Kujala Anterior Knee Pain Scale, were compared. Following consensus-based standards for the selection of health measurement instruments guidelines, construct validity, test-retest reliability, internal consistency, floor and ceiling effects, and measurement error were determined. The Bland-Altman method was used to explore absolute agreement. Results: Of 253 ACL injury patients, 106 (42%) responded to the invitation. Construct validity was considered good, as all predefined hypotheses on correlations between the I-IKDC and other scores were confirmed. Reliability proved excellent, with a high test-retest correlation (intraclass correlation coefficient = 0.99). Bland-Altman analyses showed no systematic bias between test and retest. Internal consistency was good (Cronbach α = .90). There were no floor or ceiling effects. Standard error of measurement was 2.1, and the minimal detectable change was 5.8 at the individual level and 0.7 at the group level. Conclusion: The I-IKDC, as developed, appeared to be a good evaluation instrument for Indonesian patients with ACL injuries.
Genome-wide CRISPR-Cas9 screen identifies rationally designed combination therapies for CRLF2-rearranged Ph-like ALL
Authors: Sasaki Kensuke , Yamauchi Takuji , Semba Yuichiro , Nogami Jumpei , Imanaga Hiroshi , Terasaki Tatsuya , Nakao Fumihiko , Akahane Koshi , Inukai Takeshi , Verhoeyen Els , Akashi Koichi , Maeda Takahiro 
Published: September 2021

Abstract
Acute lymphoblastic leukemia (ALL) harboring the IgH-CRLF2 rearrangement (IgH-CRLF2-r) exhibits poor clinical outcomes and is the most common subtype of Philadelphia chromosome-like acute lymphoblastic leukemia (Ph-like ALL). While multiple chemotherapeutic regimens, including ruxolitinib monotherapy and/or its combination with chemotherapy, are being tested, their efficacy is reportedly limited. To identify molecules/pathways relevant for IgH-CRLF2-r ALL pathogenesis, we performed genome-wide CRISPR-Cas9 dropout screens in the presence or absence of ruxolitinib using 2 IgH-CRLF2-r ALL lines that differ in RAS mutational status. To do so, we employed a baboon envelope pseudotyped lentiviral vector system, which enabled, for the first time, highly efficient transduction of human B cells. While single-guide RNAs (sgRNAs) targeting CRLF2, IL7RA, or JAK1/2 significantly affected cell fitness in both lines, those targeting STAT5A, STAT5B, or STAT3 did not, suggesting that STAT signaling is largely dispensable for IgH-CRLF2-r ALL cell survival. We show that regulators of RAS signaling are critical for cell fitness and ruxolitinib sensitivity and that CRKL depletion enhances ruxolitinib sensitivity in RAS wild-type (WT) cells. Gilteritinib, a pan-tyrosine kinase inhibitor that blocks CRKL phosphorylation, effectively killed RAS WT IgH-CRLF2-r ALL cells in vitro and in vivo, either alone or combined with ruxolitinib. We further show that combining gilteritinib with trametinib, a MEK1/2 inhibitor, is an effective means to target IgH-CRLF2-r ALL cells regardless of RAS mutational status. Our study delineates molecules/pathways relevant for CRLF2-r ALL pathogenesis and could suggest rationally designed combination therapies appropriate for disease subtypes.