bluuebunny/crossref_metadata_2025_split huggingface dataset:
Hand hygiene monitoring technology: A descriptive study of ethics and acceptance in nursing
Authors: Meng Michael , Seidlein Anna-Henrikje , Kugler Christiane 
Published: September 2021

Background: Nosocomial infections represent a serious challenge for healthcare systems worldwide. Adherence to hand hygiene plays a major role in infection prevention and control. These adherence rates can be improved through behaviour tracking innovations. This requires the systems to be widely implemented and accepted. Therefore, both a systematic analysis of the normative issues related and the evaluation of technology acceptance are equally important. Objectives: To explore and describe relevant aspects regarding the acceptance of technology and ethical implications using a tracking device to measure and improve adherence to hand hygiene. Research design: A quantitative study with a descriptive design was performed. Participants and research context: A total of 75 questionnaires were collected in three hospitals in Germany. Acceptance of technology was measured with n = 60 participants (n = 50 nurses; n = 9 physicians; n = 1 not disclosed) and ethical assessment with n = 15 participants (nurses only). Ethical considerations: Ethical approval for this study was obtained from the institutional review board. Findings: The acceptance of technologies improving hygiene in general was good (median = 80.5, interquartile range = 28, range: 0–100). The experience with technologies in general (median = 48.5, interquartile range = 57, range: 0–100) and the acceptance of the specific technology (mean = 82.23, standard deviation = 15.16 (range: 23–138)) was moderate. There was a significant positive correlation between the acceptance and experience of technology in general ( r = 0.217, p = .025). Ethical concerns played a minor role. The need for practical support was a key topic. Discussion: Study participants accepted technologies improving hygiene; however, the specific device implemented was only moderately accepted. This creates specific opportunities in the implementation process for higher later acceptance. More practical support and an increase in experience may create opportunities for device implementation with high acceptance and low ethical concerns. Conclusion: Study results indicate a vast potential for improving the implementation process of hand hygiene technologies. Ethical concerns in this study did not seem to be a relevant barrier for successful implementation of hand hygiene technologies.
Association of Ambient Fine Particulate Matter (PM2.5) with Elevated Fecal Hemoglobin Concentration and Colorectal Carcinogenesis: A Population-Based Retrospective Cohort Study
Authors: Ku Mei-Sheng , Liu Chen-Yu , Hsu Chen-Yang , Chiu Han-Mo , Chen Hsiu-Hsi , Chan Chang-Chuan 
Published: September 2021

The roles of ambient fine particulate matter (PM2.5) in the prevention of colorectal cancer (CRC) have been scarcely highlighted as there is short of empirical evidence regarding the influences of PM2.5 on multistep carcinogenic processes of CRC. A retrospective cohort design with multistate outcomes was envisaged by linking monthly average PM2.5 concentrations at 22 city/county level with large-scale cohorts of cancer-screened population to study the influences of PM2.5 on short-term inflammatory process and multistep carcinogenic processes of CRC. Our study included a nationwide CRC screening cohort of 4,628,995 aged 50–69 years who attended first screen between 2004 and 2009 and continued periodical screens until 2016. We aimed to illustrate the carcinogenesis of PM2.5 related to CRC by applying both hierarchical logistical and multistate Markov regression models to estimate the effects of air pollution on fecal immunochemical test (FIT) positive (a proxy of inflammatory marker) and pre-clinical and clinical states of CRC in the nationwide cohort. We found a significant association of high PM2.5 exposure and FIT-positive by an increased risk of 11% [95% confidence interval (CI), 10–12]. PM2.5 enhanced the risk of being preclinical state by 14% (95% CI, 10–18) and that of subsequent progression from pre-clinical to clinical state by 21% (95% CI, 14–28). Furthermore, the elevated risks for CRC carcinogenesis were significantly higher for people living in high PM2.5 pollution areas in terms of yearly averages and the number days above 35 µg/m3 than those living in low PM2.5 pollution areas. We concluded that both short-term and long-term PM2.5 exposure were associated with multistep progression of CRC, which were useful to design precision primary and secondary prevention strategies of CRC for people who are exposed to high PM2.5 pollution.
OCT-A evaluation of radiation vasculopathy following slotted plaque brachytherapy
Authors: Fam Anthony , Tomar Ankit S , Finger Paul T 
Published: September 2021

Purpose: To determine a reliable diagnostic method to reveal and monitor subclinical progression of neural and perineural radiation vasculopathy. Methods: A retrospective cross-sectional study, where optical coherence tomography angiography (OCT-A) imaging data was collected and analyzed from 22 consecutive patients that had been treated with circumneural slotted plaque brachytherapy for peripapillary, juxtapapillary, or circumpapillary choroidal melanomas. Pre-operative dosimetry of palladium-103 radiation dose to the optic nerve and fovea were collected. Quantified differences in OCT-A-measured vessel density and length in treated verses untreated contralateral control eyes were collected. Vessel density and length were correlated to radiation dose, plaque slot depth, visual acuity outcomes, and circumpapillary retinal nerve fiber layer thickness. Results: Patients had post-irradiation follow-up of median 39 months, interquartile range 62 months). The mean optic disc radiation dose was 89.9 Gy ± 39.2 (86.5, 30.8–189.0). In comparison to controls, OCT-A imaging revealed significant differences in radial peripapillary capillary vessel density (18 μm2 in case eyes, 34 μm2 in control eyes; p < 0.001) and length (10 μm in case eyes, 14 μm in control eyes; p < 0.001). Change in vessel density did not show a significant correlation to radiation dose, slot depth, or visual acuity. However, change in vessel length was significantly correlated to radiation dose ( p = 0.049) and change in visual acuity ( p < 0.001). Conclusions: OCT-A imaging revealed that radial peripapillary capillary vessel density and length were significantly reduced after circumneural irradiation for choroidal melanoma. Therefore, OCT-A imaging can be used to monitor progression of papillary vasculopathy associated with radiation optic neuropathy.
To what extent is pregnancy-induced keratoconus progression reversible? A case-report and literature review
Authors: Toprak Ibrahim 
Published: September 2021

Purpose: This report aims to present a case with pregnancy-induced keratoconus (KC) progression and recovery in topographical parameters after a period from delivery/breastfeeding. Methods: A 29-year-old woman with bilateral KC experienced progression in maximum keratometry (Kmax; from 47.6 to 48.2 D in the OD and from 53.7 to 55.2 D in the OS) and several Pentacam indices in both eyes. Results: The Belin ABCD progression score remained unchanged in the right eye (A0B2C0D0) but increased in the left eye (from A2B3C1D1 to A2B4C1D1) (Pentacam HR, Oculus Optikgeräte GmbH, Wetzlar, Germany) during pregnancy/breastfeeding. About 6-months after cessation of breastfeeding, Kmax improved to baseline values in both eyes. Although there were improvements in “A” and “B” scores, final ABCD stage remained higher than the baseline value in the left eye. Conclusions: The current report shows asymmetrically bilateral progression of KC during pregnancy and early post-delivery period, which was followed by a partial recovery in Pentacam parameters after discontinuation of breastfeeding. These findings seem to confirm the postulated link between pregnancy and KC progression. On the other hand, in patients with KC, pregnancy-induced corneal alterations might recover after delivery/breastfeeding and clinician should wait for stabilization of corneal parameters to determine treatment strategy.
Agrochemicals Use Practices and Health Challenges of Smallholder Farmers in Ghana
Authors: Demi Suleyman M , Sicchia Suzanne R 
Published: September 2021

Background: Globally, Africa is one of the continents that uses the lowest quantity of agrochemicals in farming. However, unsafe chemical use practices are high among farmers in Africa, posing serious health and environmental consequences. This study seeks to address three questions: (1) What factors motivate/compel smallholder farmers in Ghana to use agrochemicals? (2) What safety precautions or unsafe chemical use practices can be found in the communities? (3) What are the health implications of agrochemical use among smallholder farmers in Ghana? Methodology: The study used purposive and simple random sampling techniques to select 136 individuals for the survey, out of which 31 individuals were eliminated, and 105 participants were selected for in-depth interviews and focus group discussions. Additionally, participants’ observations were collected, workshops were facilitated, and documents analyses were conducted. Qualitative data were analyzed using NVivo software and the quantitative data were analyzed using SPSS version 23.0. Findings: The study found that environmental challenges, activities of NGOs, government policy, lack of or high cost of labor, and competition among farmers were major factors influencing farmers’ decisions to use agrochemicals. Present agrochemical use in Ghana poses a risk to health and the environment. Finally, the study discovered chemical poisoning and low self-reported health quality as major health implications of agrochemical use in the communities.
Damping estimation using free decays response in short telecom structures
Authors: Jimenez Capilla Jose A , Wang Ying , Brownjohn James Mark William 
Published: September 2021

The constant changes to which telecommunications have accustomed us in recent decades oblige a similar adaptation in other branches of engineering. Structures such as monopoles and short lattice towers are becoming increasingly wind-sensitive and dynamically active with the introduction of 5G technology, which will require new larger and heavier antenna equipment. Expert consultants agree the need to revise the current accounting for structural damping that has not changed in design codes after more than 30 years. A complete set of full-scale field tests is presented to obtain reliable structural damping values in short communications structures. The described methodology analyses free-decaying responses obtained after excitation of the main analysed cantilevered modes in the time domain. A standardized acquisition system based on local accelerometers and an external innovative system using the Video GaugeTM system are required to obtain the desired responses, which use curve-fitting and the eigensystem realization algorithm to estimate modal properties such as the corresponding modal structural damping. The results obtained using the presented methodology agree on higher values of structural damping for both damping estimators and perfectly converge with consultant feedback, which suggested over-conservative (i.e. low) values of structural damping as compared to the conventional values used in civil engineering.
Triple powerlessness traps and old age: Implications for social work practice
Authors: Kam Ping Kwong 
Published: September 2021

Summary Over the last two decades older people in Hong Kong have experienced increased powerlessness. This article argues that the prevalent use of structural analysis, mainly the political economy approach, provides an inadequate explanation of the strong sense of powerlessness experienced by older people in a Chinese society like Hong Kong. The article extends structural level analysis by embracing two additional levels, cultural and professional practice, to examine old age powerlessness in Hong Kong. Theoretical advances This paper contributes to increasing knowledge relating the concept of powerlessness to aging through a new analytical perspective, the “triple powerlessness traps” that include the structural, cultural, and professional practice levels of analysis. Applications The inclusion of two additional levels—cultural and professional practice—adds a necessary new dimension and depth to the analysis by suggesting that cultural explanations and the disempowering effects of professional practice should be afforded increased weight in the study of old age powerlessness in the Chinese context. The “triple powerlessness traps” help enhance analysis of old age powerlessness in societies facing cultural changes and the erosion of cultural values. They also have the practical value of arousing the awareness of social work professionals of the negative effects of the disempowered professional practice in producing or sustaining old age powerlessness and the need for changing social work practice at the policy, societal, agency, or organizational and personal levels.
Alternative Tendon Coaptations to the Pulvertaft Weave Technique: A Systematic Review and Meta-Analysis of Biomechanical Studies
Authors: Graham Emily M. , Oliver Jeremie D. , Hendrycks Russell , Maglic Dino , Mendenhall Shaun D. 
Published: September 2021

Background The Pulvertaft weave technique (PT) is frequently used during tendon repairs and transfers. However, this technique is associated with limitations. In this systematic review and meta-analysis, quantitative and qualitative analyses were performed on in vitro, biomechanical studies that compared the PT with alternative techniques. Methods Articles included for qualitative and/or qualitative analysis were identified following Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Studies included in the meta-analysis were analyzed either as continuous data with inverse variance and random effects or as dichotomous data using a Mantel-Haenszel analysis assuming random effects to calculate an odds ratio. Results A comprehensive electronic search yielded 8 studies meeting inclusion criteria for meta-analysis. Two studies with a total of 65 tendon coaptations demonstrated no significant difference in strength between the PT and traditional side-to-side (STS) techniques ( P = .92). Two studies with a total of 43 tendon coaptations showed that the STS with 1 weave has a higher yield strength than the PT ( P = .03). Two studies with a total of 62 tendon repairs demonstrated no significant difference in strength between the PT and the step-cut (SC) techniques ( P = .70). The final 2 studies included 46 tendon repairs and demonstrated that the wrap around (WA) technique has a higher yield strength than the PT ( P < .001). Conclusions The STS, SC, and WA techniques are preferred for improving tendon form. The STS and WA techniques have superior yield strengths than the PT, and the SC technique withstands similar stress to failure as the PT.
The impact of pre-existing blood pressure control in patients with acute aortic dissections
Authors: Reed Amy B , Faizer Rumi , James Valentine R. 
Published: September 2021

Objectives Arterial hypertension (HTN) is considered a seminal risk factor for aortic dissection (AD). The purpose of this study is to evaluate whether pre-existing blood pressure (BP) control lessens the extent of dissection and has a favorable impact on outcome of patients with acute AD. Methods Consecutive acute AD patients who had at least two BPs recorded within the 12 months preceding the AD were retrospectively analyzed. The two most recent BPs were averaged and defined per published guidelines as normal (BP≤ 130/80), Stage I HTN (BP >130/80 and <139/89), or Stage 2 or greater HTN (BP > 140/90). The number of hypertensive medications (MEDs) was also used as a surrogate marker of HTN severity. Patients with known genetic causes of AD were excluded. Results 89 subjects (55% men, 45% women; mean age, 64±14 years) with acute AD (58% Stanford type A and 42% Stanford type B) were included. Two most recent BPs were recorded a mean of 5±3 and 3±2.7 months before the AD, respectively. Twenty-nine (33%) subjects had normal BP, including nine subjects with no history of HTN and on no MEDs. Sixty (67%) subjects had elevated BP, including 21 (35%) with Stage I HTN and 39 (65%) with Stage 2 HTN. Compared to subjects with normal BP, subjects with Stage 1 and Stage 2 HTN were younger (70±13 years vs 62±1 year, p = 0.01), but there were no differences in other demographics, risk factors, comorbidities, or history of drug use. There were no group differences in the distal extent of the dissections, complications requiring thoracic endograft repair, mean length of hospital stay, final discharge status, or 30-day mortality. Compared to the number of MEDs before AD, all three groups had a higher mean number of MEDs to achieve normal BP at discharge that persisted at a mean follow-up of 18±15 months. Conclusions These data show that approximately one-third of patients with acute AD had well controlled or no antecedent history of HTN. The degree of pre-existing HTN control had no bearing on the type or extent of AD, length of stay, or early outcome. Regardless of the state of HTN control before AD, the consistent and sustained increase in the severity of HTN after AD suggests that the dissection process has a profound and lasting effect on BP regulation. Further studies are indicated to elucidate the pathologic mechanisms involved in AD.
Right ventricular function is associated with 28-day mortality in myocardial infarction complicated by cardiogenic shock: A retrospective observational study
Authors: Lashin Hazem , Olusanya Olusegun , Bhattacharyya Sanjeev 
Published: September 2021

Background Right ventricular (RV) function is increasingly being recognised as an important factor influencing outcomes in ST elevation myocardial infarction (STEMI) complicated by cardiogenic shock (CS). In this study, we investigated RV echocardiographic parameters’ association with 28-day mortality in patients admitted to intensive care with STEMI complicated by CS with reduced left ventricle ejection fraction (LVEF). Method We performed a retrospective analysis of patients admitted to intensive care unit (ICU) in a single tertiary cardiac centre over a 34-month period with STEMI complicated by CS and LVEF < 40%. Clinical and echocardiographic data were collected and correlated with 28-day mortality. Results One-hundred patients were included with a mean age of 62.6 ±12.7 years and 78% were male. Mortality at 28 days was 37%. Respectively, 85%, 40% and 25% of patients required mechanical ventilation, mechanical circulatory support and renal replacement therapy. Tricuspid annulus peak systolic velocity (RV S’) was significantly higher in survivors (12 ± 3.3 v 10 ± 3.5 cm/s, p = 0.03) and was an independent predictor of mortality (odds ratio 1.2, 95% confidence interval 1.1–1.4, p = 0.04). RV S’ of 10.5 cm/s exhibited best sensitivity and specificity (64% and 65%, respectively; p = 0.02) for mortality. The Kaplan–Meier curve demonstrated 85% risk of 28-day mortality for RV S’ < 10.5 cm/s v 53% for RV S’ > 10.5 cm/s ( p = 0.02). Conclusion RV function is associated 28-day mortality in patients admitted to ICU with STEMI complicated by CS with reduced LVEF. RV S’ predicted mortality with good sensitivity and specificity.
Comparative Analysis of Non-Full and Full Endoscopic Spine Technique via Interlaminar Approach for the Treatment of Degenerative Lumbar Spinal Stenosis: A Retrospective, Single Institute, Propensity Score-Matched Study
Authors: Jiang Qiang , Ding Yu , Lu Zhengcao , Cui Hongpeng , Zhang Jianjun , Fu Bensheng , Du Wei , Cao Shiqi 
Published: September 2021

Study Design: Retrospective study. Objective: To compare the clinical efficacy of posterior lumbar laminectomy decompression under full endoscopic technique (Endo-LOVE) and percutaneous endoscopic medial foraminal decompression (PE-MFD) in the treatment of degenerative lumbar spinal stenosis (DLSS). Methods: Between April 2017 and April 2018, 96 patients with DLSS underwent Endo-LOVE or PE-MFD, including 58 with Endo-LOVE and 38 with PE-MFD. After propensity score matching (PSM), patient characteristics, operation time, intraoperative fluoroscopy times, postoperative bedridden time, hospital stay and postoperative complications were recorded and compared. The clinical efficacy was evaluated according to Oswestry disability index (ODI), visual analogue scale (VAS), lumbar disease JOA and modified MacNab criteria. Results: A total of 96 patients with DLSS were included in the study. After PSM, the 2 groups were comparable in patient demographic and baseline characteristics. The operation time and intraoperative fluoroscopy times in PE-MFD group were significantly more than those in Endo-LOVE group ( P < .05). The operation time in PE-MFD group was significantly less than that in Endo-LOVE group ( P < .05). The intraoperative fluoroscopy times in PE-MFD group were significantly more than that in Endo-LOVE group ( P < .05). The ODI, VAS and lumbar disease JOA in the 2 groups were significantly improved comparing with those before operation ( P < .05). According to the modified MacNab criteria, the excellent and good rates of the 2 groups were 93.5% in Endo-LOVE group and 87.1% in PE-MFD group ( P > .05). Conclusion: Endo-LOVE and PE-MFD technique can both effectively treat DLSS, and the short-term follow-up results are positive. Endo-LOVE technique has the advantages of fast puncture positioning, less radiation exposure and wider indications. However, PE-MFD needs more radiation exposure and has the possibility of incomplete decompression for complex multiplanar spinal stenosis.
The Impact of Implementing a Radiation-Sparing Protocol for Percutaneous Kyphoplasty—A Prospective Dosemetric Study
Authors: Klingler Jan-Helge , Hubbe Ulrich , Scholz Christoph , Volz Florian , Roelz Roland , Beck Jürgen , Watzlawick Ralf , Brönner Johannes , Hoedlmoser Herbert , Krüger Marie T. , Hohenhaus Marc , Naseri Yashar 
Published: September 2021

Study Design: Prospective cohort study. Objectives: The purpose of this prospective study was to evaluate a protocol for radiation-sparing kyphoplasty by assessing dosemetrically recorded radiation exposures to both patient and surgeon. Methods: This prospective clinical study examines the radiation exposure to patient and surgeon during single-level kyphoplasty in 32 thoracolumbar osteoporotic vertebral body fractures (12 OF 2, 9 OF 3, 11 OF 4 types) using a radiation aware surgical protocol between May 2017 and November 2019. The radiation exposure was measured at different locations using film, eye lens and ring dosemeters. Dose values are reported under consideration of lower detection limits of each dosemeter type. Results: A high proportion of dosemeter readings was below the lower detection limits, especially for the surgeon (>90%). Radiation exposure to the surgeon was highest at the unprotected thyroid gland (0.053 ± 0.047 mSv), however only slightly above the lower detection limit of dosemeters (0.044 mSv). Radiation exposure to the patient was highest at the chest (0.349 ± 0.414 mSv) and the gonad (0.186 ± 0.262 mSv). Fluoroscopy time, dose area product and number of fluoroscopic images were 46.0 ± 17.9 sec, 124 ± 109 cGy×cm2, and 35 ± 13 per kyphoplasty, respectively. Back pain significantly improved from 6.8 ± 1.6 to 2.5 ± 1.7 on the numeric rating scale on the first postoperative day ( P < 0.0001). Conclusions: The implementation of a strict intraoperative radiation protection protocol allows for safely performed kyphoplasty with ultra-low radiation exposure for the patient and surgeon without exceeding the annual occupational dose limits. Trial registration: The study was registered in the German Clinical Trials Register (DRKS00011908, registration date 16/05/2017).