bluuebunny/crossref_metadata_2025_split huggingface dataset:
How do primary care clinicians approach hospital admission decisions for people in the final year of life? A systematic review and narrative synthesis
Authors: Davies Rachel , Booker Matthew , Ives Jonathan , Huntley Alyson 
Published: August 2024

Background: The final year of life is often associated with increasing health complexities and use of health services. This frequently includes admission to an acute hospital which may or may not convey overall benefit. This uncertainty makes decisions regarding admission complex for clinicians. There is evidence of much variation in approaches to admission. Aims: To explore how Primary Care clinicians approach hospitalisation decisions for people in the final year of life. Design: Systematic literature review and narrative synthesis. Data sources: We searched the following databases from inception to April 2023: CINAHL, Cochrane Library, Embase, MedLine, PsychInfo and Web of Science followed by reference and forward citation reviews of included records. Results: A total of 18 studies were included: 14 qualitative, 3 quantitative and 1 mixed methods study. As most of the results were qualitative, we performed a thematic analysis with narrative synthesis. Six key themes were identified: navigating the views of other stakeholders; clinician attributes; clinician interpretation of events; the perceived adequacy of the current setting and the alternatives; system factors and continuity of care. Conclusion: This review shows that a breadth of factors influence hospitalisation decisions. The views of other stakeholders take great importance but it is not clear how these views are, or should be, should be balanced. Clinician factors, such as experience with palliative care and clinical judgement, are also important. Future research should focus on how different aspects of the decision are balanced and to consider if, and how, this could be improved to optimise patient-centred outcomes and use of health resources.
Experiences of Nurses and Midwives Who Support Bereaved Parents During Perinatal Deaths in Ghana: A Descriptive Phenomenological Study
Authors: Mohammed Latifa , Dzando Gideon , Awiagah Sherrif Kwame 
Published: August 2024

Introduction Globally, perinatal death presents a profound challenge for healthcare and healthcare professionals, requiring enormous clinical expertise and mental fortitude. The complexity involved in balancing professionalism, empathy, and the human face pose significant emotional challenges for nurses and midwives. Perinatal deaths in Ghana remain high and have adversely impacted the achievement of Sustainable Development Goal 3. Nurses and midwives play a central role in the Ghanaian healthcare system, and understanding their experiences in providing care to grieving mothers can provide valuable data for enhancing bereavement support as well as promoting quality improvement in clinical care. Objective To explore the experiences of nurses and midwives who support bereaved parents during perinatal deaths in Ghana. Methodology A descriptive-phenomenological approach was used to explore the lived experiences of the participants. Twelve participants were purposively recruited from the neonatal and intensive care unit of a District Hospital in northern Ghana. Interviews were conducted using a semi-structured interview guide. The data was analyzed iteratively using the thematic analysis approach. Findings Six themes emerged from the interviews with the study participants. The six themes were personal experience of perinatal death, emotional impact on the nurses and midwives, parental reactions and coping, blame and guilt, the impact on work, and long-lasting psychological impact. The themes reflect the emotional and practical experiences encountered by the nurses and midwives when supporting bereaved parents and the impact of such experiences on their well-being. Conclusion Perinatal bereavement support is a core responsibility of the nurses and midwives who work in maternal and neonatal units. Despite an improvement in perinatal death globally, the rates are still of great concern in Sub-Saharan Africa. Ironically, the experiences of nurses and midwives who support parents in times of perinatal death are lacking in Sub-Saharan Africa. This study sheds light on the experiences of nurses and midwives who support parents during perinatal death in a Ghanaian context, highlighting the importance of supporting these healthcare professionals.
Anatomical Feasibility of Percutaneous Arteriovenous Fistula Formation in Korea
Authors: Moon Ki Yoon , Jang Eun Ju , Lee Seung Hoon , Han Hong Suk , Park Sun Cheol , Kim Jang Yong , Yun Sang Seob 
Published: August 2024

Introduction Currently, there are two types of percutaneous arteriovenous fistula (pAVF) formation systems approved by the FDA: Ellipsys and WavelinQ. Although these systems are already in use in Europe or the United States, they have not been approved for use in Korea yet. For this reason, this study aimed to check anatomical feasibility of these systems for Korean population prior to their actual use. Methods Consecutive patients who received ultrasound vein mapping for arteriovenous fistula formation from June 2021 to June 2022 were included. The anatomical feasibility of each system was confirmed according to the manufacturer’s instructions for use (IFU). Results Upper extremity ultrasonography was performed for a total of 83 patients to determine their feasibility for pAVF formation. Of these patients, 65.1% were feasible for pAVF formation with appropriate deep communicating vein (DCV) and outflow. Among them, 57.8% were feasible for the Ellipsys system and 54.2% were feasible for the WavelinQ system. Most patients who were infeasible for pAVF formation had a DCV of small size. Ulnar vessels were more suitable than radial vessel for WavelinQ (54.2% vs 33.7%, P-value = .012). The most common reason for not meeting the criteria was a small vein size at the access site. Conclusions More than half of all patients were feasible for pAVF formation in this study. Ellipsys had a higher feasibility than WavelinQ, although they showed no significant difference in the feasibility. If these devices are imported into Korea, it will be a good opportunity for many patients to reduce the surgical burden and create AVFs more easily through these procedures.
The effects of attentional focus instructions on approach jump performance
Authors: Liu Hanwen , Arnett Scott , Tolusso Dano , Woodard Kaylee 
Published: August 2024

Introduction Attentional focus has been shown to significantly influence motor learning and performance, with external focus instructions enhancing performance compared to internal focus instructions. Research has also demonstrated that novice performance is improved when instructed to focus on skill execution processes rather than outcomes. However, this effect remains untested in complex jumping skills crucial to numerous sports. Purpose This study aimed to investigate the effect of internally and externally directed process and outcome focus instructions on approach jump height and approach speed in novice participants. Methods Twelve individuals aged 18 to 22 participated across three sessions: Familiarization, Test Session 1, and Test Session 2. During the test sessions, participants executed approach jumps in various conditions, each emphasizing specific cues: External Focus-Outcome, Internal Focus-Outcome, External Focus-Process, and Internal Focus-Process. Jump-and-Reach Height, Estimated Jump Height by Flight Time, and Approach Speed were assessed through 2 × 2 repeated measures ANOVAs. Results External focus and outcome conditions led to the highest jump-and-reach height ( p < .05). Process conditions yielded faster approach speed compared to outcome conditions ( p < .001), irrespective of internal or external focus direction. Estimated jump height by flight time was similar across all conditions. Conclusions The study suggests that benefits of external focus and process instructions for novices may apply only to certain performance variables in complex motor skills. Practical Applications Practitioners can optimize novices’ performance using various process- and outcome-based instructions. External, outcome-based cues enhance overall task performance, while process-based cues may improve specific technical components.
Anterior Labrum Periosteal Sleeve Avulsion Lesions of the Shoulder: A Scoping Review
Authors: Rajagopalan Senthilvelan , Chodavarapu Mounika N.S. , Kambhampati Srinivas B.S. , Chinta Shyam Kumar , Kamineni Srinath 
Published: August 2024

Background: Anterior labrum periosteal sleeve avulsion (ALPSA) lesion of the shoulder is defined as a labral avulsion with an intact periosteum of the glenoid neck resulting in medial malattachment of the labrum, which is both nonanatomic and nonfunctional. It is relatively rare compared with Bankart lesions, and its results are usually reported in combination with other anterior labroligamentous lesions in the literature. Purpose: To (1) assess the size and scope of the literature on ALPSA lesions, (2) highlight the importance of this lesion, and (3) distinguish between ALPSA and Bankart lesions in diagnostic and treatment strategies. Study Design: Scoping review; Level of evidence, 4. Methods: The PubMed, Scopus, Embase, and Google Scholar databases were searched with the keywords “ALPSA,”“anterior labrum periosteal sleeve avulsion,”“anterior labral periosteal sleeve avulsion,” and “anterior labroligamentous periosteal sleeve avulsion” lesion. Duplicate articles and those that did not meet the inclusion criteria were excluded, resulting in the identification of 42 relevant articles. Their references were analyzed for further data curation. Results: This scoping review demonstrated that ALPSA lesions are difficult to clinically identify. Magnetic resonance angiography in the adduction internal rotation position is the most sensitive and specific imaging modality for identification. Optimal views are the anterosuperior portal for accurate identification and the anteroinferior portal for surgical repair during arthroscopy. Treatment begins with correctly identifying the labrum, in contradistinction to dense reactive fibrous tissue, and reattaching the labrum to the correct anatomic glenoid footprint. Chronic lesions with bone loss require either bone block or soft tissue augmentation procedures. Conclusion: There is paucity of exclusive literature on ALPSA lesions. It is important to distinguish this lesion from the Bankart lesion as it is associated with worse outcomes. The higher failure rates of ALPSA lesion repair indicate that the current repair techniques require further refinement to improve the outcomes to the standard of Bankart lesions.
Association between personality type and patient-reported outcomes (PRO) in patients with atrial fibrillation
Authors: Yan Qing , Liang Jiaqi , Yuan Yide , Li Yuan , Fan Jiali , Wu Wenhuan , Xu Pan , Wang Qunrang , Xue Jiahong 
Published: August 2024

Abstract
Background
Atrial Fibrillation (AF) is known to be associated with a negative emotional state. Patient-reported outcomes (PROs) are important tools for evaluating the endpoints of AF management. This study aims to examine the correlation between personality types and PROs in patients with AF.

Methods
All included subjects were newly diagnosed with AF fewer than one month, and their personality types were assessed using the Eysenck Personality Questionnaire (EPQ). Quality of life (QoL) was measured using the Atrial Fibrillation Effect on Quality of Life (AFEQT) questionnaire. Anxiety and depression were assessed using the General Anxiety Scale (GAD-7) and the 9-item Patient Health Questionnaire (PHQ-9), respectively. We constructed stepwise linear regression analyses for factors related to the QoL and emotional state in patients with AF.

Results
A total of 531 AF patients completed the survey and were categorized into four groups based on their personality types. Of these patients (mean age: 67.12 ± 10.93 years, 50.28% male), 357 (67.23%) had paroxysmal AF, and 16.95% (n = 90) had a sanguine personality. Compared to patients with other personality types, those with a sanguine personality had the highest average AFEQT scores (P < 0.001) and the lowest scores of GAD-7 and PHQ-9 scales (P < 0.05). Furthermore, multiple linear regression analyses suggested that sanguine personality was also independently associated with better QoL and emotional states (P < 0.05).

Conclusion
There is a significant association between the personality types and PROs in AF patients.
Antibiotic utilization at an orthopedic inpatient department in a large governmental hospital in the north of the West Bank, Palestine; a retrospective observational study
Authors: Masalma Raed , Ghanim Ahmad , Jarrar Mahmoud , Zidan Thabet , Alkaiyat Abdulsalam , Abdalla Mazen , M. Jaber Mohammad , Qattawi Ismail , Joudeh Nagham , Khayyat Rasha 
Published: August 2024

Abstract
Background
Studies evaluating the patterns of antibiotic consumption are becoming increasingly necessary as a result of the increased use of antibiotics and development of antibiotic resistance globally. This study aimed to evaluate the use of antibiotics in in terms of both quantity and quality at the largest surgical hospital in the north of the West Bank, Palestine.

Methods
An observational retrospective study with a total population sampling method was conducted to collect data from the inpatients of the orthopedic departments of a large governmental hospital in the northern West Bank, Palestine. The data were collected from patients’ files and evaluated using the anatomical therapeutic chemical and defined daily dose (ATC/DDD) methodology, and the drug utilization 90% (DU90%) index. The ATC/DDD methodology, designed by the World Health Organization (WHO), as a well-trusted and standardized tool that allows measuring and comparing antibiotic utilization across different contexts. Antibiotic prescriptions were classified using the World Health Organization Access, Watch and Reserve classification (WHO AWaRe).

Results
Of the 896 patients who were admitted to the hospital in the year 2020 and included in the study, 61.9% were males, and 38.1% were females. The percentage of patients who received antibiotics was 97.0%, and the overall antibiotic usage was 107.91 DDD/100 bed days. The most commonly prescribed antibiotic was cefazolin (50.30 DDD/100 bed days), followed by gentamicin (24.15 DDD/100 bed days) and ceftriaxone (17.35 DDD/100 bed days). The DU90% segment comprised four different agents. Classification of antibiotics according to the WHO AWaRe policy revealed that 75.9% of antibiotics were prescribed from the access list.

Conclusion
This study comes as part of the efforts exerted to combat the growing problem of antibiotic resistance in Palestine. Our results showed that the consumption of antibacterial agents in the orthopedic unit at a large governmental hospital in Palestine was relatively high. The results of this study provide valuable insights for the decision-makers to create policies aimed at regulating antibiotic prescriptions. This study also aims to provide a look into the antibiotic prescription patterns, offering a clearer understanding of the current situation of antibiotic consumption in Palestine. It also emphasizes the need for antibiotic stewardship and surveillance programs.
Molecular characterization of NDM and OXA-48-like-producing Klebsiella pneumoniae ST16 and hypervirulent ST337 clone among two patients; a case report
Authors: Sokhanvari Sarvenaz , Bagheri Atiyeh , Badmasti Farzad , Solgi Hamid 
Published: August 2024

AbstractCarbapenem-resistant Klebsiella pneumoniae (CRKP) infections are a major public health problem, requiring the use of last-resort antibiotics such as colistin. However, there is concern regarding the emergence of isolates resistant to this agent. The report describes two patients with urinary tract infection (UTI) and ventilator-associated pneumonia (VAP) infection caused by CRKP strains. The first case was a 23-year-old male with UTI caused by a strain of ST16 co-harboring blaCTX-M, blaTEM, blaSHV, blaNDM, blaOXA-48-like genes. The second case was a 39-year-old woman with VAP due to hypervirulent ST337-K2 co-harboring blaSHV, blaNDM, blaOXA-48-like,iucA, rmpA2 and rmpA. The patients’ general condition improved after combination therapy with colistin (plus meropenem and rifampin, respectively) and both of them recovered and were discharged from the hospital. This study highlights the necessary prevention and control steps to prevent the further spread of CRKP strains should be a priority in our hospital.
Peritoneal and renal DKK3 clearance in peritoneal dialysis
Authors: Ehleiter Hagen , Miranda Julia , Boes Dominik , Scheidt Uta , von Vietinghoff Sibylle , Schwab Sebastian 
Published: August 2024

Abstract
Background
Urinary Dickkopf 3 (DKK3) excretion is a recently established biomarker of renal functional development. Its excretion into the peritoneal cavity has not been reported. We here studied DKK3 in peritoneal dialysis.

Methods
DKK3 was assessed in serum, urine and dialysate in a prevalent adult peritoneal dialysis cohort and its concentration analyzed in relation to creatinine and clinical characteristics.

Results
Highest DKK3 concentrations were found in serum, followed by urine. Dialysate concentrations were significantly lower. Dialysate DKK3 correlated with both other compartments. Serum, dialysate and urine values were stable during three months of follow-up. Continuous ambulatory dialysis (CAPD) but not cycler-assisted peritoneal dialysis (CCPD) volume-dependently increased peritoneal DKK3 in relation to creatinine. RAAS blockade significantly decreased urinary, but not serum or peritoneal DKK3.

Conclusion
Our data provide a detailed characterization of DKK3 in peritoneal dialysis. They support the notion that the RAAS system is essential for renal DKK3 handling.
Navigating weight, risk and lifestyle conversations in maternity care: a qualitative study among pregnant women with obesity
Authors: Sandsaeter Heidi L. , Eik-Nes Trine Tetlie , Getz Linn Okkenhaug , Magnussen Elisabeth Balstad , Rich-Edwards Janet W. , Horn Julie 
Published: August 2024

Abstract
Background
Pregnant women with obesity face heightened focus on weight during pregnancy due to greater risk of medical complications. Closer follow-up in maternety care may contribute to reduce risk and promote health in these women. The aim of this study was to gain a deeper insight in how pregnant women with obesity experience encounters with healthcare providers in maternity care. How is the received maternity care affected by their weight, and how do they describe the way healthcare providers express attitudes towards obesity in pregnancy?

Methods
We conducted in-depth interviews with 14 women in Trøndelag county in Norway with pre-pregnancy BMI of ≥ 30 kg/m2, between 3 and 12 months postpartum. The study sample was strategic regarding age, relationship status, education level, obesity class, and parity. Themes were developed using reflexive thematic analysis. The analysis was informed by contextual information from a prior study, describing the same participants’ weight history from childhood to motherhood along with their perceptions of childhood quality.

Results
This study comprised of an overarching theme supported by three main themes. The overarching theme, Being pregnant with a high BMI: a vulnerable condition, reflected the challenge of entering maternity care with obesity, especially for women unprepared to be seen as “outside the norm”. Women who had grown up with body criticism and childhood bullying were more prepared to have their weight addressed in maternity care. The first theme, Loaded conversations: a balancing act, emphasizes how pregnant women with a history of body criticism or obesity-related otherness proactively protect their integrity against weight bias, stigma and shame. The women also described how some healthcare providers balance or avoid weight and risk conversations for the same reasons. Dehumanization: an unintended drawback of standardized care makes apparent the pitfalls of prioritizing standardization over person-centered care. Finally, the third theme, The ambivalence of discussing weight and lifestyle, represent women’s underlying ambivalence towards current weight practices in maternity care.

Conclusions
Our findings indicate that standardized weight and risk monitoring, along with lifestyle guidance in maternity care, can place the pregnant women with obesity in a vulnerable position, contrasting with the emotionally supportive care that women with obesity report needing. Learning from these women’s experiences and their urge for an unloaded communication to protect their integrity highlights the importance of focusing on patient-centered practices instead of standardized care to create a safe space for health promotion.
Higher phosphate concentrations as in aqueous humor of diabetic patients increase intraocular lens calcification
Authors: Buhl Rebecca , Yildirim Timur Mert , Schickhardt Sonja Katrin , Britz Leoni , Lieberwirth Ingo , Auffarth Gerd Uwe , Khoramnia Ramin 
Published: August 2024

Abstract
Background
Clinical evidence suggests an association between phosphate concentrations in aqueous humor and the risk of intraocular lens (IOL) calcification. To test this hypothesis the influence of different phosphate concentrations on IOL calcification was evaluated in an in vitro electrophoresis model.

Methods
20 IOLs of two hydrophilic IOL models (CT Spheris 204, Zeiss; Lentis L-313, Oculentis) and one hydrophobic control IOL model (Clareon CNA0T0, Alcon) were exposed to physiologic and elevated phosphate concentrations, similar to diabetic aqueous humor. IOL calcification was analyzed by alizarin red staining, von Kossa staining, scanning electron microscopy, energy dispersive x-ray spectroscopy and transmission electron microscopy with electron diffraction.

Results
Higher phosphate concentrations were associated with IOL calcification. Analyses of IOL surfaces and cross-sections documented calcification in no CT Spheris and 4 Lentis IOLs following exposure to 10 mM Na2HPO4, compared with 7 and 11 positive analyses following exposure to 14 mM Na2HPO4, respectively. Furthermore, a clear association between IOL calcification and the duration of electrophoresis was demonstrated, confirming increased phosphate concentrations and duration of exposure as risk factors of IOL calcification.

Conclusions
Findings suggest that higher phosphate concentrations in aqueous humor, as seen in diabetic patients, contribute to an increased IOL calcification risk, potentially explaining clinical observations showing an increased risk of IOL calcification in patients with diabetes.