bluuebunny/crossref_metadata_2025_split huggingface dataset:
South-East Asian Nurses’ Experiences Under the Economic Partnership Agreement (EPA) in Japan: How Language Ability Affects Self-Confidence and Interpersonal Relationships
Authors: Nagaya Yoshiyuki , Gillin Nicola , Smith David 
Published: August 2024

Introduction: Since 2009, nurses have relocated to Japan from Indonesia, the Philippines, and Vietnam under the auspices of the Economic Partnership Agreement (EPA). We asked why some migrant nurses remain in Japan whereas others leave. Method: We applied the methodology of Constructivist Grounded Theory. All participants were internationally educated nurses (IENs) currently or formerly working in Japan after passing the National Nursing Examination. Results: Difficulty in mastering the Japanese language was established as one of the main themes. Initial coding elicited two explanatory sub-categories: lack of confidence in communication and effects of language difficulty on workplace relationships. One explains how practical experience in the workplace affected nurses’ confidence in communication. The other explains how levels of Japanese language attainment shaped relationships with colleagues. Discussion: These findings suggest a need to regulate the working conditions of foreign nurses, and a need for training schemes to optimize IEN retention.
Combined Therapy of Chemotherapy and Radiofrequency Ablation for Pancreatic Cancer Patients With Metachronous Hepatic Metastatic Lesions After Radical Pancreatic Resection
Authors: Wang L. T. , Yang J. , Wu J. , Lu W. J. 
Published: August 2024

Purpose Hepatic metastasis frequently occurs in patients who have undergone radical pancreatic resection for pancreatic cancer. Besides chemotherapy, various local treatment approaches targeting hepatic lesions have been explored. However, research on radiofrequency ablation (RFA) as a localized therapy for hepatic metastasis is limited. Therefore, we conducted this retrospective study to provide clinical evidence. Methods This is a single-center, retrospective, cohort study. After radical pancreaticoduodenectomy, 32 patients developed metachronous hepatic metastasis with fewer than 3 lesions, the largest of which was less than 3 cm in diameter. These patients underwent combined treatment with chemotherapy and RFA. After 8 weeks of chemotherapy, patients received RFA for hepatic lesions. Additional chemotherapy was administered, and the patients’ tumor status and survival were monitored. The primary endpoint of this study was overall survival (OS). Factors affecting OS were analyzed using the Cox risk model. Results Among the 32 patients, the mean OS was 28.4 months. Univariate and multivariate Cox regression analysis revealed that the time (in months) of liver metastasis (HR = 0.04, 95% CI: 0.01 to 0.19; P < 0.001), the number of liver metastases (HR = 7.08, 95% CI: 1.85 to 27.08, P = 0.004), and PD (progressive disease) response to the second round of chemotherapy (HR = 29.50, 95% CI: 1.46 to 597.27; P = 0.027) were independent predictors of poorer survival. Conclusion Combined therapy with RFA and chemotherapy is safe in patients with hepatic metastasis after radical pancreaticoduodenectomy. Early recurrence (≤12 months), three liver metastatic lesions, and a poor response to the second round of chemotherapy were associated with poor survival.
Ankylosing spondylitis in patients undergoing total hip arthroplasty increases the risk of medical and implant-related complications: a case control analysis
Authors: Mekkawy Kevin L , Rodriguez Hugo C , Mercadal Gino , Gosthe Raul G , Khanuja Harpal S , Corces Arturo , Roche Martin W 
Published: August 2024

Introduction: Ankylosing spondylitis (AS) is an inflammatory spondyloarthropathy, often involving the spine and sacroiliac joints. Total hip arthroplasty (THA) has been shown to be effective in improving pain and function in patients with AS with hip involvement. However, extraskeletal manifestations and altered mechanics in those with AS leads to increased complications. Thus, the aims of this study were to assess the effects that AS has on medical and implant complications, falls, length of stay, and readmissions following THA. Methods: A retrospective review of the Mariner private insurance claims database was conducted from 2010 to 2020. All cases of THA and those with AS were identified using Current Procedural Terminology, and International Classification of Disease 9th and 10th revision codes. Patients who underwent THA with a diagnosis of AS were matched to non-AS patients 1:5 based on demographic and comorbidity profiles. 90-day medical complications, falls, and readmission rates, as well as 2-year implant complications were compared between cohorts. Results: A total of 6509 AS patients were matched to 32,489 control patients. The AS group had significantly higher rates of myocardial infarction, cerebrovascular accident, deep vein thrombosis, pulmonary embolism, urinary tract infection, wound complications, acute kidney injury, pneumonia, sepsis, transfusions, and falls when compared to the control group. The AS group had significantly higher rates of prosthetic joint infection, dislocation, mechanical loosening, and periprosthetic fracture (all p < 0.0001). Likewise, mean length of stay and readmissions were significantly greater in the AS group. Conclusions: Ankylosing spondylitis in patients undergoing THA is associated with significant risk of medical and implant complications, as well as fall risk, length of stay, and readmission rates. These findings may allow orthopaedic surgeons to be more attentive in identifying those patients at risk and allow for more educated patient counseling and perioperative planning.
Outcomes of balloon-assisted maturation with large-diameter balloons
Authors: Juneja Amandeep , Wang David E , Whitaker Litton , Hoffstaetter Tabea , Silpe Jeffrey , Landis Gregg S , Etkin Yana 
Published: August 2024

Objectives: Balloon-assisted maturation (BAM) is a well-established technique for maturation of inadequate arteriovenous fistulas (AVF). The objective of this study was to evaluate outcomes of initial BAM using large-diameter angioplasty balloons. Methods: Charts of patients who underwent BAM between 2018 and 2021 at a single academic institution were reviewed. AVF maturation rate was the primary outcome. Secondary outcomes included procedural complications, re-intervention rates, post-procedure vein diameter, and time to catheter-free hemodialysis (HD). Outcomes of patients that underwent initial BAM with ⩾7 mm diameter balloons (Group I) were compared to those of patients that had initial BAM with <7 mm balloons (Group II). Results: Group I ( n = 149) was a significantly younger cohort and had more men compared to Group II ( n = 90). There were no significant differences associated with procedural details and complication rates. Median vein diameter was larger (5.9 mm, IQR: 5–6.4) in Group I compared to Group II (5.1 mm, IQR: 4.2–5.9; p = 0.03) on post-procedure Duplex ultrasound. There was also a higher incidence of vein stenosis in Group II. The overall maturation rate was higher in Group I (97% vs 88%, p = 0.003), and a larger proportion of patients in Group II required more than one BAM to achieve maturation (33% vs 16%, p = 0.002). The median time to catheter-free HD after first BAM was 29 days (IQR: 19–47) in Group I and 42 days (IQR: 24–75) in Group II ( p = 0.002). At 60 days after first BAM, the incidence of catheter-free HD was 83% in Group I versus 67% in Group II ( p = 0.001). Conclusions: Our study demonstrates that the ability to utilize large angioplasty balloons during initial BAM is associated with higher rates of AVF maturation with fewer re-interventions and shorter time to catheter-free dialysis. AVFs that can tolerate this procedure often have more favorable baseline characteristics.
Assessment of Sonographic Parameters for Predicting Primary Patency Rate in Hemodialysis Patients With Venous Valve-Related Stenosis
Authors: Xiong Yu , Gao Xuejing , Cui Lin , Lyu Qiong , Tu Bo , Chen Bo , Wan Ziming 
Published: August 2024

Objectives: Ultrasonography is more frequently used in patients with arteriovenous fistula (AVF) stenosis. The aim of this study is to use sonographic parameters for predicting primary patency in hemodialysis patients with venous valve-related stenosis (VVRS) who are treated by ultrasound-guided percutaneous transluminal angioplasty (PTA). Methods: A total of 229 VVRS patients who underwent PTA between January 2017 and December 2021 were enrolled. Clinical characteristics were retrospectively collected. Sonographic parameters were measured both before and after PTA. Univariate and multivariate Cox analyses were performed to identify independent factors associated with primary patency rate. Results: All measured sonographic parameters improved after PTA compared to before PTA. Before PTA, the diameter of VVRS > 1.0 mm, age ≤ 57 years, and body mass index (BMI) > 21.57 kg/m2 were associated with better outcomes. While the diameter of radial artery, proximal radial artery close to the anastomosis, brachial artery, the flow volume of brachial artery, the length and peak velocity (PV) of the VVRS, and the diameter and PV after the VVRS had no association with the primary patency rate. After PTA, only patients with a diameter of VVRS > 4.0 mm had favorable outcome. In addition, patients with a gain of diameter of VVRS > 2.4 mm after PTA had a trend of better outcomes. Conclusions: The diameter of VVRS before and after PTA could be served as markers to predict primary patency rate and second patency rate in AVF patients with VVRS. The gain of diameter of VVRS could also be a potential marker. Clinical Impact Using simple markers of sonographic parameters, we could quickly identify patients with a higher risk of restenosis. These patients should be followed more closely in case of restenosis at early. It is also beneficial to the prevention of thrombosis. These measures help to preserve more valuable vascular for a long-term dialysis. Additionally, the physician should pay more attention on the dialysis-related complications in these risky patients, such as hemodialysis-related hypotension.
Advancing Emergency Department Triage Prediction With Machine Learning to Optimize Triage for Abdominal Pain Surgery Patients
Authors: Chai Chen , Peng Shu-zhen , Zhang Rui , Li Cheng-wei , Zhao Yan 
Published: August 2024

Background The development of emergency department (ED) triage systems remains challenging in accurately differentiating patients with acute abdominal pain (AAP) who are critical and urgent for surgery due to subjectivity and limitations. We use machine learning models to predict emergency surgical abdominal pain patients in triage, and then compare their performance with conventional Logistic regression models. Methods Using 38 214 patients presenting with acute abdominal pain at Zhongnan Hospital of Wuhan University between March 1, 2014, and March 1, 2022, we identified all adult patients (aged ≥18 years). We utilized routinely available triage data in electronic medical records as predictors, including structured data (eg, triage vital signs, gender, and age) and unstructured data (chief complaints and physical examinations in free-text format). The primary outcome measure was whether emergency surgery was performed. The dataset was randomly sampled, with 80% assigned to the training set and 20% to the test set. We developed 5 machine learning models: Light Gradient Boosting Machine (Light GBM), eXtreme Gradient Boosting (XGBoost), Deep Neural Network (DNN), and Random Forest (RF). Logistic regression (LR) served as the reference model. Model performance was calculated for each model, including the area under the receiver-work characteristic curve (AUC) and net benefit (decision curve), as well as the confusion matrix. Results Of all the 38 214 acute abdominal pain patients, 4208 underwent emergency abdominal surgery while 34 006 received non-surgical treatment. In the surgery outcome prediction, all 4 machine learning models outperformed the reference model (eg, AUC, 0.899 [95%CI 0.891-0.903] in the Light GBM vs. 0.885 [95%CI 0.876-0.891] in the reference model), Similarly, most machine learning models exhibited significant improvements in net reclassification compared to the reference model (eg, NRIs of 0.0812[95%CI, 0.055-0.1105] in the XGBoost), with the exception of the RF model. Decision curve analysis shows that across the entire range of thresholds, the net benefits of the XGBoost and the Light GBM models were higher than the reference model. In particular, the Light GBM model performed well in predicting the need for emergency abdominal surgery with higher sensitivity, specificity, and accuracy. Conclusions Machine learning models have demonstrated superior performance in predicting emergency abdominal pain surgery compared to traditional models. Modern machine learning improves clinical triage decisions and ensures that critically needy patients receive priority for emergency resources and timely, effective treatment.
Should the beach chair position have national guidelines to reduce the risk of cerebrovascular complications? Results from a National Survey of Surgeons and Anaesthetists
Authors: Ensor David , Gwilym Stephen E , Imam Mohamed , West Simeon , Elgebaly Ahmed , Baring Tobias 
Published: August 2024

Background The beach chair position is frequently used in UK shoulder surgeries, but cerebrovascular complications, while rare, can have severe consequences. No consensus exists on best practices due to limited evidence. Methods An online cross-sectional survey was conducted with a convenience sampling method among the British Elbow and Shoulder Society and Regional Anaesthesia UK members to gauge the need for guidelines. It aims to assess the need for standardised guidelines, covering topics such as demographics, current clinical practises in anaesthetics and surgery and the prevalence of cerebrovascular complications post-surgery. Results Of 534 respondents, 67% were anaesthetists and 33% surgeons. Twelve percent currently use local guidelines. 40% conduct all shoulder surgeries in the beach chair position. The most common bed angle is 45°, but 30% choose 60° or higher. 12.4% of respondents have local guidelines available. Only 20% of anaesthetists use cerebrovascular monitoring, with 6% of surgeons and 2% of anaesthetists reporting postoperative neurological issues. Eighty-five percent of respondents recommended the need for a national guidelines. Conclusions Current practices in the use of beach chair position vary considerably. There is a desire from both surgeons and anaesthetists for a consensus approach to guideline development based on current available evidence and practice.
A scoping review of the educator role performed by Health Information Managers in health workplace-based education: The practitioner Health Information Manager-educator
Authors: Lee Jenn , Boyd James , Khalil Hanan 
Published: August 2024

Background: Health Information Managers (HIMs) play a crucial role in the management and governance of health information ensuring the accuracy, confidentiality and accessibility of health data for clinical care and business operational purposes. This role also extends to education and training in the workplace. Objective: The aim of this scoping review was to explore and elucidate the role played by HIMs when they undertake a health workplace-based (healthcare organisation or service) educational role and/or functions as evidenced in the existing body of literature. Method: A scoping review of the literature to investigated the importance of the educator role for HIM health workplace-based educators. A three-step search strategy was designed to ensure a comprehensive exploration of relevant research. Results: Of 63 articles assess for eligibility, 14 were included in the final analysis. All included articles acknowledged the importance of the HIM-educator workplace-based role. Half of the included articles had been published within the last 7 years. Only 8 of the 14 articles provided some description of HIM-educator attributes, suggesting that these characteristics remain unexplored. Discussion: Findings from this scoping review have shed light on the limitations within the current available literature concerning the attributes of HIM health workplace-based educators. The findings also highlight an important gap in knowledge concerning the qualities of these HIM-educators. Conclusion: This identified gap in the literature signals a need for further exploration and investigation into the specific attributes, skills, and characteristics that define effective HIM-educators undertaking a health workplace-based educational role.
Connected health services: Health professionals’ role as seen by parents of a child with inflammatory bowel disease
Authors: Christen Aline , Benedetti Franzisca Domeisen , Händler-Schuster Daniela 
Published: August 2024

Objective Connected health services will change the scope of health professionals’ roles. It is unclear how parents of a child with inflammatory bowel disease perceive the role of health professionals in relation to these services and what their experiences and needs are. The purpose of this study is to highlight parents’ experiences with this role. Furthermore, it aims to outline the fundamental needs that parents have regarding this role, in order to promote audience-specific access to these services and derive overarching action measures. Methods Fourteen parents of children with inflammatory bowel disease from seven different clinics in Switzerland were recruited. Between August 2022 and February 2023, these parents were interviewed in semi-structured interviews. The interviews were analyzed using a structured qualitative content analysis. Results Five main categories were identified, with few parents having prior experience with the role of health professionals in this area. Parents saw health professionals in the role of gatekeepers, transferers of knowledge and in a supporting function for these services. From the parents’ perspective, health professionals should recognize the limitations of these services and use them as a complement to standard treatment. Conclusion The role of health professionals in relation to connected health services needs to be adapted from the parents’ perspective. To meet the needs of parents, health professionals must have access to these services. In addition to health professionals’ personal engagement with these services, institutional and policy changes, as well as research on role development from the perspective of other stakeholders are needed.
Knowledge and Practice of Intestinal Ostomy Care Among Nurses in Bahir Dar City, Ethiopia: A Cross-Sectional Study
Authors: Endeshaw Destaw , Tesfaye Tadesse Dagget , Afewerk Sahileslassie , Adal Ousman , Belayneh Asnake Gashaw , Bogale Eyob Ketema , Yohannes Senay 
Published: August 2024

Background Globally, ostomy creation rates are rising. Stomas, while life-saving, pose significant challenges. Nurses are vital in providing care and support to stoma patients. However, ostomy care practice and knowledge among Ethiopian nurses remain understudied. This study aimed to assess these aspects among nurses in Bahir Dar City, Ethiopia, in 2022. Methods An institutional-based cross-sectional study was conducted in three public hospitals in Bahir Dar City from September 19 to September 30, 2022. A simple random sampling technique was used to select 423 nurses. Binary logistic regression analysis was employed to identify associated factors toward dependent variables by considering p-value <0.05 to be statistically significant. Result From the total samples, 382(90.3%) responded to the questionnaire. The overall good knowledge and practice level of nurses regarding ostomy care was 55.2% and 52.1%, respectively. Taking ostomy care training {AOR = 2.44; 95% CI (1.29, 4.61)} and high level of a monthly income of study participants {AOR = 2.90; 95% CI (1.72, 4.91)} had a significant association with knowledge of ostomy care. On the other hand, taking courses on ostomy care {AOR = 1.76; 95% CI (1.06, 2.93)}, receiving training on ostomy care {AOR = 4.15; 95% CI (2.12, 8.09)} and good knowledge level on ostomy care {AOR = 2.13; 95% CI (1.32, 3.45)} were significantly associated with expressed practice of ostomy care. Conclusion The study found that only half of nurses exhibit good knowledge and practice in ostomy care. Training and monthly income significantly influence nurses’ knowledge, while practice level is associated with training, course attendance, and knowledge. These findings highlight the importance of targeted training programs and education initiatives to enhance nurses’ competence in ostomy care. It is also crucial to address factors like nurses’ income levels to ensure equitable access to educational resources and opportunities for professional development, thus enhancing their knowledge.
Nursing Leaders’ Knowledge and Awareness of Bullying and Lateral Violence: A Qualitative Study
Authors: Luca Corina Elena , Pezzoli Giovanna , Kunz Stefan , Bianchi Monica 
Published: August 2024

Introduction Bullying and lateral violence are prevalent phenomena within the nursing profession, exerting significant impacts on patient safety, the nursing profession and the organisation. The pivotal role of nurse leaders is paramount in both the prevention and resolution of these issues. Aim The aim is to explore the level of awareness and knowledge of bullying and lateral violence of nurse leaders in a public hospital in Switzerland. Methods A qualitative descriptive study has been conducted. Data were collected from February to August 2020 using semi-structured interviews and focus groups that were recorded and transcribed verbatim. Two researchers independently utilised Braun and Clarke's thematic analysis to code, categorise and synthesise the data. The sample of nursing middle-management leaders was purposive. Results The study involved 35 nurse leaders as participants. Through data analysis, 15 themes were identified, which were further grouped into five major themes: characteristics of the phenomena, facilitating and hindering factors, emotions/experiences, strategies and supports. The results highlighted that nurse leaders may have a lack of knowledge about these phenomena, leading to challenges in their identification. The awareness achieved by the nurse leaders highlighted their need to understand what they were ‘fighting against’. Conclusion It is essential to consider the impact of these phenomena on employees’ well-being and their potential consequences for patient safety, quality of care and financial performance. A preventive approach by increasing nurse leaders’ competence in observing everyday working realities and identifying strategies for addressing bullying is required. Further research on the construction and implementation of specific interventions is essential, aimed at preventing and addressing these phenomena comprehensively.