bluuebunny/crossref_metadata_2025_split huggingface dataset:
Are virtual wards for children safe and effective? A 3-year retrospective service evaluation of an urban Hospital at Home service for children and young people
Authors: Cheung C Ronny , Farnham Laura , Al-Mukhtar Rania , Chahal Anudeep , Karcz Klaudia , Nagano Chihiro , Abraham Beth 
Published: November 2024

ObjectiveService evaluation of an urban ‘Hospital at Home’ service which provides care in patients’ homes that would traditionally be delivered in the hospital setting.DesignRetrospective longitudinal review of routinely collected data recorded contemporaneously for clinical use, analysed to elicit utilisation patterns and service impact.SettingA paediatric ‘Hospital at Home’ service delivered across two large acute hospitals, treating a total of 4427 patients across both primary and secondary care in South London from January 2018 to June 2022.PatientsChildren managed by the Hospital at Home service, aged 0–16 yearsMain outcome measuresWe describe patient outcomes and service performance including data on demographics, diagnoses, referral sources, hospital reattendances and bed day savings.ResultsOver the evaluation period, 11 092 bed days were saved as a direct result of this service at a cost of 1.09–1.25 nursing contacts required per bed day. Reattendance to hospital was 11.1% over the study period, however, parent/carer-initiated reattendance resulting in hospital admission was only 2.7%.ConclusionHospital at Home services are a policy priority for the English National Health Service because of their potential to reduce admissions to and enable early discharge from hospital. This evaluation provides insight into an urban population of children managed under Hospital at Home care and demonstrates its feasibility and effectiveness. Our novel approach to the analysis of hospital reattendance data may have the potential as a template for future performance analysis of similar services.
Earliest location of glaucomatous retinal nerve fibre layer damage is determined by intact baseline RNFL thickness profile
Authors: Lee Eun Jung , Park Do Young , Han Jong Chul , Kee Changwon 
Published: November 2024

Background/aimsTo identify whether an intact retinal nerve fibre layer (RNFL) thickness profile could determine the location of the earliest RNFL defect in glaucoma.MethodsRetrospective longitudinal cohort study of patients with initial unilateral glaucoma who eventually developed new glaucoma in the fellow eye. Guided progression analysis (GPA) of serial optical coherence tomography (OCT) examinations was used to identify the angular locations of the earliest RNFL defect, peak and temporal edge of the baseline RNFL profile and major vessels based on the peripapillary OCT scan circle.ResultsWe identified 112 new RNFL defects in 109 fellow eyes of 109 consecutive patients. The locations of new defects were superotemporal (22 eyes), inferotemporal (87 eyes) and papillomacular bundle (3 eyes), respectively. Overall, the midpoint location of the earliest RNFL defect strongly coincided with the RNFL peak (p<0.001). Specifically, the location was mildly (4.3±12.0°) temporal to, rather than at the peak thickness, particularly in eyes with a focal thinning pattern of arcuate bundles (7.8±10.8°). The close topographical relationship was consistent regardless of the interindividual variability in the RNFL profile and vessels, as well as hemispheric locations, and after adjusting for potential factors including age, refractive error, baseline intraocular pressure, tilt ratio, tilt axis and glaucoma diagnosis.ConclusionThe location of the earliest RNFL defect in glaucoma showed a close relationship with the intact RNFL profile within the same eye, regardless of variations in RNFL, hemispheric location and vessel distribution. In addition, the earliest defect was located mildly temporal to, rather than at, the peak RNFL thickness. The baseline RNFL profile may have a significant role in the regional vulnerability of glaucoma.
Safety of inpatient care in surgical settings: cohort study
Authors: Duclos Antoine , Frits Michelle L , Iannaccone Christine , Lipsitz Stuart R , Cooper Zara , Weissman Joel S , Bates David W 
Published: November 2024

Abstract

Objectives
To estimate the frequency, severity, and preventability of adverse events associated with perioperative care, and to describe the setting and professions concerned.

Design
Multicenter retrospective cohort study.

Setting
11 US hospitals.

Participants
1009 patients from a randomly selected sample of 64 121 adults admitted for surgery during 2018.

Main outcome measures
Adverse events during inpatient perioperative care were assessed using a trigger method, identifying information previously associated with similar events, and from a comprehensive review of electronic health records. Trained nurses reviewed all records and flagged admissions with possible adverse events, which were then adjudicated by physicians, who confirmed the occurrence and characteristics of the events. Adverse events were classified as major if they resulted in serious harm requiring substantial intervention or prolonged recovery, involved a life threatening event, or led to a fatal outcome. Potentially preventable events included those definitively, probably, or possibly preventable.

Results
Among 1009 patients reviewed, adverse events were identified in 38.0% (95% confidence interval 32.6 to 43.4), with major adverse events occurring in 15.9% (12.7 to 19.0). Of 593 identified adverse events, 353 (59.5%) were potentially preventable and 123 (20.7%) were definitely or probably preventable. The most common adverse events were related to surgical procedures (n=292, 49.3%), followed by adverse drug events (n=158, 26.6%), healthcare associated infections (n=74, 12.4%), patient care events (n=66, 11.2%), and blood transfusion reactions (n=3, 0.5%). Adverse events were most frequent in general care units (n=289, 48.8%), followed by operating rooms (n=155, 26.1%), intensive care units (n=77, 13.0%), recovery rooms (n=20, 3.3%), emergency departments (n=11, 1.8%), and other in-hospital locations (n=42, 7.0%). Professions most involved were attending physicians (n=531, 89.5%), followed by nurses (n=349, 58.9%), residents (n=294, 49.5%), advanced level practitioners (n=169, 28.5%), and fellows (n=68, 11.5%).

Conclusions
Adverse events were identified in more than one third of patients admitted to hospital for surgery, with nearly half of the events classified as major and most potentially preventable. These findings emphasize the critical need for ongoing improvement in patient safety, involving all health professionals, throughout perioperative care.
What are the risk factors for ascending aorta dilatation in the non-diabetic normotensive population? A cross-sectional study in China
Authors: Yang Xiangyu , Li Xinran , Ul Hassan Naeem , Ye Runyu , Zhang Xin , Ma Jun , Liao Hang , Zhang­ Xin , Wang Si , Chen Xiaoping 
Published: November 2024

ObjectivesAscending aorta dilatation (AAD) has been suggested as a surrogate marker for vascular organ damage in the hypertensive population. However, limited data are available on AAD in normotensive individuals. This study aims to preliminarily explore the correlation between ascending aorta (AAO) and other established clinically significant target organ damage parameters and to investigate the possible risk factors of AAD in the non-diabetic normotensive individuals.DesignOur study has a cross-sectional design.SettingAll participants were recruited from the inpatient and outpatient departments of our hospital.ParticipantsWe recruited 634 normotensive participants (52.26±16.22 years, 39.43% male) who underwent both ambulatory blood pressure monitoring (ABPM) and echocardiography. The whole study population was divided into AAD and non-AAD groups according to age-gender-specific criteria. The baseline mean blood pressure (BP) of the two groups was 126.92/77.72 and 124.16/77.61 mm Hg, respectively.Primary and secondary outcome measuresThe relationship between AAO and other acknowledged cardiac damage indicators, as well as the associations of AAD with ABPM indexes in the non-diabetic normotensive individuals.ResultsWe observed that AAO exhibited a significant correlation with left ventricular mass index (β=1.905, p<0.001), e’ (β=−0.324, p<0.001) and E/e’ (β=0.221, p<0.001). Among all the ABPM indexes, only those related to diastolic BP (DBP), specifically 24-hour DBP (OR=1.056, 95% CI 1.004 to 1.110, p<0.05) and night-time DBP (OR=1.071, 95% CI 1.011 to 1.134, p<0.05), were associated with AAD after adjustment for age, gender and other confounders. Furthermore, in the multivariate forward logistic regression analysis, night-time DBP was most strongly associated with AAD (OR=1.064, 95% CI 1.008 to 1.124, p<0.05).ConclusionsWe found that AAO was correlated with alterations in other acknowledged cardiac parameters, both structural and functional, in non-diabetic normotensive individuals, indicating AAD may be significant in these individuals. Notably, DBP, especially night-time DBP, showed a more significant correlation with AAD.Trial registration numberChiCTR2000030677.
Intracytoplasmic sperm injection compared with in vitro fertilisation in patients with non-male factor infertility with low oocyte retrieval: a single-centre, retrospective cohort study
Authors: Zhu Shaomi , Li Hengli , Lv Zili , Liang Xin , Dong Liang , Tian Dongmei 
Published: November 2024

ObjectiveTo investigate the effects of in vitro fertilisation (IVF) and intracytoplasmic sperm injection (ICSI) on the clinical outcomes of non-male factor patients aged >35 with three or fewer oocytes retrieved.DesignRetrospective cohort study.SettingReproductive centre of a university-affiliated hospital in China.Participants547 women with non-male factor infertility who underwent assisted reproductive technology (ART) treatment with three or fewer oocytes retrieved were identified from June 2019 to May 2022. Of these 547 patients, 334 were treated with IVF and 213 with ICSI.Outcome measuresThe primary outcomes were normal fertilisation rate, live birth rate per transfer and cumulative live birth rate per retrieval.ResultsThe baseline characteristics were comparable between the two groups, except for the proportion of primary infertility, which was higher in the ICSI group (17.66% vs 32.86%, p=0.000). Compared with the IVF group, the ICSI group showed higher normal fertilisation rate and lower cycle cancellation rate (65.99% vs 76.56%, p=0.002; 33.53% vs 24.41%, p=0.023). However, no significant differences were found in clinical pregnancy rate per transfer (23.86% vs 18.92%, p=0.545), miscarriage rate per fresh embryo transfer (19.05% vs 28.57%, p=0.595), live birth rate per transfer (17.05% vs 13.51%, p=0.623), cumulative clinical pregnancy rate per retrieval (12.87% vs 11.27%, p=0.576) and cumulative live birth rate per retrieval (9.28% vs 6.57%, p=0.261) between the two groups (p>0.05).ConclusionsIn non-male factor ART cycles, ICSI was not associated with improved pregnancy outcomes in older women with a low number of oocytes retrieved. Routine use of ICSI is not recommended in older women who are infertile due to non-male factors.
Exploring the lived experiences of deep vein thrombosis patients in Lahore, Pakistan: a qualitative phenomenological study on healthcare challenges, resilience and social support
Authors: Zameer Ahtasham , Saleem Javeria , Yazdani Naveed , Fatima Rabia , Shahzad Ruhma Binte , Zafar Afia , Ishaq Muhammad , Butt Muhammad Salman 
Published: November 2024

ObjectiveThis study aimed to explore and describe the lived psychological and emotional experiences of sufferers of deep vein thrombosis (DVT) and to narrate the effect of those experiences on their daily lives.Design, setting and participantsFor data collection, a phenomenological qualitative design was used using semistructured, in-depth interviews of patients with DVT aged 18–70 years. Data were transcribed and analysed using the interpretative inductive approach to identify emergent themes.ResultsThe five major themes emerged were as follows: (1) experiences and challenges of managing pain and physical limitations in patients; (2) the high out-of-pocket cost of care as a financial challenge to access healthcare; (3) the struggle of patients with social isolation and lack of emotional support; (4) resilience and self-reliance in the face of illness for navigation through life and (5) inadequate healthcare system and challenges in accessing proper treatment.ConclusionsConclusively, chronic disease such as, DVT, negatively impacts the life of its sufferers in terms of their physical health, lifestyle and psychological behaviour. There is a high need to introduce rehabilitative services as a regular part of healthcare system, so that self-management strategies are promoted and the burden of long-term psychological, emotional and behaviour problems can be avoided.
Adherence to secondary antibiotic prophylaxis among patients with acute rheumatic fever and/or rheumatic heart disease: a systematic review and meta-analysis
Authors: Bimerew Melaku , Araya Freweyni Gebreegziabher , Ayalneh Manay 
Published: November 2024

ObjectivesWorldwide, a number of studies have been conducted to assess the prevalence of adherence to secondary antibiotic prophylaxis and to identify the associated factors (reasons) for poor adherence among patients with rheumatic heart disease or acute rheumatic fever (RHD/ARF). However, results were highly inconsistent with a prevalence ranging from 10% to 93%; and the reported reasons or associated factors have not been systematically reviewed. Therefore, this study aimed to assess the prevalence of adherence to secondary antibiotic prophylaxis among patients with RHD/ARF; and to review the associated factors (reasons) for poor adherence.DesignSystematic review and meta-analysis.Data sourcesPubMed/Medline, Google Scholar, Cochrane Review and African Journals Online databases.Eligibility criteriaArticles published in English from 1 January 2005 to 1 December 2022 and reported the prevalence of adherence using ≥80% cut-off points were included.Data extraction and synthesisData were extracted using the Microsoft Excel and analysed by STATA V.11.0. A meta-analysis was conducted using the weighted inverse-variance random-effects model. Reasons for poor adherence were identified through thematic analysis.Results33 articles with a total sample size of 7158 patients were included. The pooled prevalence of adherence to secondary antibiotic prophylaxis among patients with RHD/ARF was found to be 58.5% (95% CI: 48.2% to 68.7%; I2=99.2%; p<0.001). Rural residency, lack of money, distance from the health institutions, inaccessibility, poor counselling, forgetting schedules, lack of disease knowledge and fear of injection pain were the reported factors or reasons for poor adherence.ConclusionAbout 41.5% of patients with RHD/ARF were found to have poor adherence. Long distance from health institutions, forgetting schedules, poor counselling and lack of knowledge and skill among healthcare workers were some of the modifiable reasons for poor adherence. Therefore, decentralisation of the follow-up care, creating schedule reminding systems and providing targeted health education might help to improve adherence.
Trends and patterns of antimicrobial consumption at Benjamin Mkapa Zonal Referral Hospital, Dodoma, Tanzania: a cross-sectional retrospective analysis
Authors: Zimbwe Kauke Bakari , Yona Yusto Julius , Chiwambo Charity Alphonce , Chandika Alphonce Bilola , Kiwelu Humphrey Sawira , Shabani Moshi Moshi 
Published: November 2024

ObjectiveThis study assessed the trends and patterns of antimicrobial consumption (AMC) from 2020 to 2021, 2021–2022 and 2022–2023 at the Benjamin Mkapa Zonal Referral Hospital (BMH) in Dodoma, Tanzania.DesignA retrospective cross-sectional study was conducted to collect AMC data for three financial years with respective denominators. The data were computed using the AMC Tool 2019 v1.9.0 and defined daily dose per 1000 inhabitants per day (DID).SettingThe BMH, Dodoma, Tanzania.ParticipantsThis study surveyed quantities of antimicrobials procured at the BMH. It did not have any human participants.Outcome measuresAMC was quantified in DID. The comparisons were made based on the DID of all surveyed antimicrobials, taking into account oral and parenteral administration and based on pharmacological classes. Further, DIDs were presented based on the 2023 WHO Access (A), Watch (W) and Reserve (R) (AWaRe) classification.ResultsIn 29 assessed antimicrobials, the DIDs for 2020–2021, 2021–2022 and 2022–2023 were 3.0852, 3.5892 and 3.9213, respectively. The average DID per year was 3.5319, with a mean of 2.4207±1.9765 DID per year. The topmost consumed antimicrobials over the 3 years (doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitors, ampicillin/cloxacillin, amoxicillin/flucloxacillin, ceftriaxone, nitrofurantoin and clarithromycin) account over 90% of consumption. The most highly consumed therapeutic classes were beta-lactam antibacterial penicillins (34.71%), macrolides, lincosamides, streptogramins and others (25.75%), followed by tetracycline (23.88%). The AWaRe categorisation and antimicrobials not recommended (ANR) distribution were as follows: Access-51.61%, Watch-31.96%, Reserve-0.00%, and ANR-16.43%, respectively.ConclusionFor every 1000 patients attending the BMH per day, our study found 2.4207±1.9765 DIDs of an antimicrobial were consumed. The most consumed antimicrobials include doxycycline, azithromycin, amoxicillin/beta-lactamase inhibitor, ceftriaxone and metronidazole. To combat antimicrobial resistance effectively, it is imperative to institute a hospital policy for antimicrobial stewardship that prioritises the utilisation of a hospital formulary and antibiograms for the procurement of antimicrobials at the BMH.
Analysis of clinical characteristics and risk factors on serrated polyps with synchronous advanced adenoma in elderly and non-elderly people: a retrospective cohort study
Authors: Chi Tianyu , Liu Ying , Yang Cuicui , Jia Qing , Zhao Quchuan 
Published: November 2024

ObjectivesSerrated polyps (SPs) with synchronous advanced adenoma (AA) may increase the incidence of colorectal cancer. However, current studies do not address this combination of SPs and AAs in detail with regard to their clinical characteristics in different age groups. The aim was to assess clinical characteristics and risk factors for SPs with synchronous AA in different age groups.DesignRetrospective cohort study.SettingElectronic medical record data from January 2011 to January 2022 at three grade III class A hospitals were enrolled in the study.ParticipantsA total of 1605 patients with SPs with synchronous AA, including 484 patients in the elderly group and 1121 patients in the non-elderly group, were studied.Main exposure measureThe elderly group and the non-elderly group.Main outcome measureSex, smoking history, drinking history, body mass index (BMI), SP location, size, morphology and pathology.ResultsThe incidence of hyperplastic polyps (HPs) with synchronous AA in the elderly group was higher than that in the non-elderly group, while the incidence of sessile serrated adenomas/polyps (SSAs/Ps) with synchronous AA in the non-elderly group was higher than that in the elderly group. Male sex, drinking history and HP size (≤20 mm) were independent risk factors for HPs with synchronous AA in the non-elderly group, while drinking history and HP size (≤15 mm) were independent risk factors in the elderly group. For SSAs/Ps with synchronous AA, male sex, smoking history, drinking history, and SSA size (≥16 mm) were independent risk factors in the non-elderly group; high BMI was an independent risk factor in the elderly group.ConclusionsSPs with synchronous AA showed different clinical characteristics and risk factors in different age groups.
Measurement of climate change-related food (in)security and food sovereignty in Canada’s northern communities and the circumpolar region: a scoping review protocol
Authors: Seto Iva , Worby Nicholas , Szurmak Joanna , Gerstle David , Tough Rebecca , Galloway Tracey 
Published: November 2024

IntroductionClimate change impacts the circumpolar region (including northern Canada) at a greater magnitude than other parts of the world. This affects food (in)security as well as food sovereignty. This scoping review aims to map the methods of measuring food (in)security and food sovereignty across northern Canada and the circumpolar region in support of the Yukon Government’s climate change adaptation strategy.Methods and analysisWe will adhere to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews, and work will be conducted according to the Joanna Briggs Institute (JBI) manual chapter on scoping reviews. Academic librarians develop the academic literature and grey literature search strategies, and the search strategies are further revised through iterative stages of peer review. The search strategy includes 7 academic literature databases, 11 grey literature databases, over 50 websites and the University of Toronto Libraries catalogue. Covidence, an evidence synthesis software, will be used for screening and extraction. The extraction chart will be developed and piloted by our team. A minimum of two reviewers will conduct screening, and conflicts will be resolved through discussion. Data will be extracted by one reviewer and verified by a second. Conflicts will be resolved through discussion or by a third reviewer.Ethics and disseminationThis project does not require ethical approval as it is secondary research; data will be extracted from published academic research papers, dissertations, and publicly available reports and documents. Our dissemination plan includes presentations at conferences, submission to international peer-reviewed journals and a workshop on the search strategies.