bluuebunny/crossref_metadata_2025_split huggingface dataset:
Emergency Department Crowding as Contributing Factor Related to Patient‐Initiated Violence Against Nurses—A Literature Review
Authors: Xie Renting , Timmins Fiona , Zhang Mengting , Zhao Jinbo , Hou Yongchao 
Published: January 2025

ABSTRACTAimTo synthesise how ED crowding contributes to patient‐initiated violence against emergency nurses.DesignFramework synthesis.Data SourcesA systematic literature search was conducted in the PubMed, PsycINFO, CINAHL and Scopus databases, covering articles up to 21 March 2024.Review MethodsA total of 25 articles were reviewed, evaluating study quality using the Crowe Critical Appraisal Tool and employing a framework synthesis approach to chart and synthesise data.ResultsThe review identifies key factors linking emergency department crowding to patient‐initiated violence, focusing on crowding conditions, vulnerable populations and adverse outcomes. It emphasises the importance of multidimensional assessments, including input, throughput, output stages and staffing characteristics. Special attention is needed for patients with severe symptoms who are triaged into lower priority categories, as their perceptions of injustice and dissatisfaction may increase the risk of aggressive behaviour. However, limited information is available regarding the perspectives of patients' family members.ConclusionAccurate assessments of emergency department crowding and a thorough understanding of cognitive and emotional changes in high‐risk patients are essential to develop strategies to manage patient‐initiated violence effectively.ImpactThis review improves emergency nurses' understanding of the dynamics of patient‐initiated violence in crowded emergency departments, equipping them with knowledge to better anticipate and respond to such incidents. It also offers insights that are crucial for enhancing nursing practices and ensuring workplace safety, thereby supporting the development of future emergency safety strategies.No Patient or Public ContributionAs this is a systematic review and framework synthesis, there was no direct patient or public involvement.
Decision Regret About Treatment Amongst Women With Early Breast Cancer: An Integrative Review
Authors: Liu Jing , Hunter Sharyn , Lee Regina Lai Tong , Zhu Jiemin , Chan Sally Wai‐Chi 
Published: January 2025

ABSTRACTAimsTo synthesise evidence on decision regret about treatment amongst women with early breast cancer, including (1) the type of treatment related to decision regret, (2) the level of decision regret, and (3) factors associated with decision regret.DesignIntegrative review.MethodsStudies published between January 2000 and December 2023 were searched from five online databases to provide up‐to‐date evidence. The Joanna Briggs Institute critical appraisal tools were used to evaluate the quality of the studies. The constant comparison strategy was employed for data analysis.ResultsA total of 26 studies were included. Breast cancer surgery was the most frequently studied treatment in relation to decision regret amongst women with early breast cancer, while adjuvant therapies were less studied. Most studies reported low levels of decision regret, while several studies found high levels. The proportion of women reporting decision regret varied considerably from 2.5% to 69% across the included studies. Factors associated with decision regret included various socio‐demographic and clinical characteristics (age, ethnicity, employment, education, health literacy, cancer stage, and treatment types), decision‐making experiences (patient involvement, patient preference, accessing information, and the use of decision support tools), and mental health.ConclusionDecision regret occurs in women with early breast cancer after surgery and adjuvant therapies. A variety of factors should be considered during the treatment decision‐making process to minimise decision regret. More robust studies are needed to disaggregate decision regret by treatment type and to evaluate the effectiveness of decision support tools in reducing decision regret in women with early breast cancer.ImpactNurses and other healthcare professionals should be aware of the potential for decision regret related to surgery and adjuvant therapies in women with early breast cancer. The findings can help nurses and other healthcare professionals identify women at higher risk of experiencing decision regret and provide support during the treatment decision‐making process to mitigate it.Reporting MethodPRISMA 2020 Statement.Patient or Public ContributionNo patient or public contribution to this review.
Long‐term safety and efficacy of ritlecitinib in adults and adolescents with alopecia areata and at least 25% scalp hair loss: Results from the ALLEGRO‐LT phase 3, open‐label study
Authors: Tziotzios C. , Sinclair R. , Lesiak A. , Mehlis S. , Kinoshita‐Ise M. , Tsianakas A. , Luo X. , Law E. H. , Ishowo‐Adejumo R. , Wolk R. , Sadrarhami M. , Lejeune A. 
Published: January 2025

AbstractBackgroundALLEGRO‐LT is an ongoing, long‐term, open‐label, multicentre, phase 3 study of ritlecitinib in adults and adolescents with alopecia areata (AA).ObjectivesTo evaluate ritlecitinib safety and efficacy through Month 24 in patients with AA and ≥25% scalp hair loss.MethodsALLEGRO‐LT enrolled rollover patients who previously received study intervention in either ALLEGRO phase 2a or 2b/3 studies and de novo patients who had not received treatment in either study. The de novo cohort results are reported here. Patients aged ≥12 years with AA and ≥25% scalp hair loss received a daily, 4‐week 200‐mg ritlecitinib loading dose, followed by daily 50‐mg ritlecitinib. Analyses are based on data up to the cut‐off (December 2022). Efficacy outcomes included proportions of patients achieving Severity of Alopecia Tool (SALT) scores ≤20 and ≤10, Patient Global Impression of Change (PGI‐C) score of ‘moderately improved’ or ‘greatly improved’ and eyebrow assessment (EBA) and eyelash assessment (ELA) response (≥2‐grade improvement from baseline or normal score in patients with abnormal baseline EBA/ELA).ResultsMean (SD) ritlecitinib exposure among the 449 de novo patients enrolled was 728.7 (273.81) days. At Month 24 (as observed), 73.5% and 66.4% of patients achieved SALT score ≤20 and ≤10; 82.4% had PGI‐C response; 60.8% and 65.7% had EBA and ELA response. 86.1% of patients reported treatment‐emergent adverse events (AEs); most were mild or moderate in severity, with the most frequent being positive SARS‐CoV‐2 test (24.2%), headache (20.8%) and pyrexia (13.0%). Rates of serious AEs, severe AEs and treatment discontinuations were 4.9%, 6.0% and 6.5%, respectively. Herpes zoster infection occurred in six patients, serious infections in four, malignancies (excluding nonmelanoma skin cancer) in three and major adverse cardiovascular events in three.ConclusionsIn patients with AA and ≥25% scalp hair loss, ritlecitinib demonstrated clinical efficacy and had an acceptable safety profile with long‐term treatment.Clinical Trial RegistrationClinicalTrials.gov NCT04006457.
Nurses' Knowledge, Attitude and Practice in Nutrition Management of Hospitalised Adults: A Mixed‐Methods Study
Authors: Ang Wei Lin Sandy , Zhang Di , Cai Huimei , Chew Han Shi Jocelyn 
Published: January 2025

ABSTRACTAim(s)To examine nurses' knowledge, attitude and practice regarding nutrition management in hospitalised adults and explore their views on it.DesignA mixed‐method approach combining cross‐sectional and descriptive qualitative methods.Methods379 enrolled/registered nurses working in acute or intensive units of a tertiary hospital were recruited between 24th August 2023 and 3rd December 2023. Participants completed a questionnaire on their sociodemographic profile, knowledge, attitude and practice (KAP) regarding nutrition management. Data analysis was conducted using R software, reporting levels of KAP and its associations with sociodemographic factors. Mann–Whitney U and Kruskal–Wallis tests were used for non‐normally distributed knowledge and practice scores (reported as median and interquartile range). Two‐sample t‐tests and ANOVA were used for normally distributed attitude scores (reported as mean and standard deviation). 21 of the participants from the quantitative study were either purposively sampled or snowballed from the quantitative study to undergo semi‐structured interviews (physically or virtually face‐to‐face), which were transcribed verbatim and analysed using content analysis.ResultsThe mean scores on KAP were 61.6, 19.4 and 22.8, respectively. Knowledge varied significantly by educational level (p < 0.001), while attitudes also differed based on education (p = 0.001) and years of employment (p = 0.019). Practice scores showed differences based on subspeciality (p = 0.032), nursing rank (p < 0.001) and years of employment (p = 0.004). Findings identified barriers to effective nutrition management, including prioritisation issues, varying professional roles, limited autonomy and resource shortages. It also emphasises nurses' roles in nutrition management and strategies such as nurses' autonomy and family members involvement to improve nutrition management.ConclusionSociodemographic factors significantly influence nurses' KAP in nutrition management, revealing knowledge deficits, low prioritisation and time constraints. Tailored education and training, increased autonomy, resource expansion and greater family involvement can enhance nurses' KAP in nutrition management.
Three‐Dimensional (3D) Printing in Non‐Industrial Spaces: A Summary of Emissions Evaluations in 11 School Settings
Authors: Li Jessica F. , Glassford Eric K. 
Published: January 2025

ABSTRACTBackgroundAdditive manufacturing or 3‐dimensional (3D) printing is an emerging technology with increasing prevalence in non‐industrial settings such as university and school settings. However, printers are often located in spaces not designed for this purpose.Methods3D‐printer use in 11 university and K‐12 schools was evaluated by identifying emissions using area air sampling for volatile organic compounds (VOCs) and particle counting instruments (PCIs) measuring ultrafine particulate (UFP) and evaluating controls to reduce potential exposure. Ventilation in printer locations was also characterized.ResultsVOCs and UFP were identified during 3D printing. Best‐practice recommendations were provided to school health and safety staff to protect users, including workers and students. Recommendations included installing and implementing engineering controls, administrative controls, and personal protective equipment (PPE) to minimize exposure to 3D printer emissions.ImplicationsSchool health and safety staff can translate findings and recommendations for these 11 evaluations to identify 3D‐printing areas on their campuses and use principles of industrial hygiene to protect workers and students and prevent the movement of emissions.ConclusionsVOCs and UFP were detected during 3D printing. There were opportunities to improve health and safety practices and reduce potential exposure when using 3D printing technologies.
Impact of COVID‐19 on Antimicrobial Stewardship Activities in Hospitalised Children: A Scoping Review
Authors: Mohammed Zabiuddin Ahad , Grant Gary , Irwin Adam D. , Hattingh Laetitia , Kalwaje Eshwara Vandana , Okonkwo Rose I. , Khan Sohil 
Published: January 2025

ABSTRACTAimCOVID‐19 has brought unprecedented challenges to the healthcare system. The rapid spread of the virus, laboratory burn‐out, exhausted staff, diagnostic uncertainty and lack of guidelines cumulatively disrupted hospital antimicrobial stewardship (AMS) programs. This scoping review evaluated how the COVID‐19 pandemic has impacted the implementation of AMS, particularly within the context of clinical audits.MethodsAn initial trend analysis was performed using a database search from 2000 to 2022. This review was developed following PRISMA‐Scr guidelines. Databases such as Medline, Embase, Cochrane Library and CINAHL were searched using Medical Subject Headings and free text for ‘Children’, ‘antimicrobial stewardship’ and ‘COVID‐19’. Primary studies that reported data on antimicrobial use among hospitalised children during COVID‐19 from December 2019 to December 2022 were considered.ResultsPaediatric AMS‐related research output changed annually by −4.94% in 2022 compared to 14.44% in 2019. Of 677 articles, 15 were included, with 3 added through snowballing technique. All the studies were observational and from countries of all income levels. A quantitative measure of antibiotic use was the commonly assessed sub‐category of AMS, while three studies performed the audit for a reason for antibiotic use, microbiological cultures, and surgical prophylaxis. Most studies reported antimicrobial use as prevalence, while two reported the days of therapy, and two used the AWaRe classification and the antibiotic spectrum index (ASI).ConclusionsPaediatric AMS activities were disrupted during the COVID‐19 pandemic. A basic quantitative measure of antibiotic use was the only measure of assessment, with other AMS components unreported. A robust paediatric‐focused AMS resilient to future pandemics and evidence‐informed stewardship approach is needed.
Antibiotic Prescription Trends in Dentistry: A Descriptive Study Using Japan's National Database
Authors: Hirayama Kaho , Kanda Naoki , Hashimoto Hideki , Yoshimoto Hiromasa , Goda Kazuo , Mitsutake Naohiro , Hatakeyama Shuji 
Published: January 2025

ABSTRACTObjectivesAntibiotic prescription trends in dentistry in Japan remain underexplored. This study aimed to describe these trends and evaluate the impact of the national antimicrobial stewardship program launched in 2016.MethodsUsing Japan's national administrative claims database from fiscal year (FY) 2015 to FY 2020, this cross‐sectional study comprehensively analyzed trends in antibiotic prescription by dentists. Prescription rates were computed per 1000 inhabitants yearly and standardized to the FY 2015 national population. Changes in prescription rates were evaluated using Poisson regression analysis.ResultsIn FY 2020, the total number of antibiotic prescriptions was 134.4 per 1000 inhabitants per year, showing a 6% decline over the 6‐year period (95% confidence interval, 6%–6%). Third‐generation cephalosporins constituted 52.3% of dental antibiotic prescriptions in FY 2020, though the proportion had slightly decreased. In hospitals, prescriptions of third‐generation cephalosporins decreased from 64.9% in 2015 to 20.3% in 2020, being replaced by penicillin (from 15.0% to 64.0%). However, in clinics, the magnitude of the change was small (third‐generation cephalosporins, 60.5%–53.1%; penicillin, 10.2%–22.2%).ConclusionsThird‐generation cephalosporins continue to dominate dental antibiotic prescriptions. The increase in penicillin use was much more pronounced in hospitals than in clinics. Strengthening antimicrobial stewardship, particularly in clinics where the majority of dental care is provided, is crucial.
Effects of the Transcutaneous Electrical Stimulation System on Heartburn, Regurgitation and Esophageal Acid Exposure in GERD Patients—An Uncontrolled Feasibility Study
Authors: Dickman Ram , Brun Rita , Levy Sigal , Ron Yishai , Rainis Tova , Naftali Timna , Hazani‐Pauker Maor , Boltin Doron , Perets Tsachi Tsadok , Fass Ronnie , Gingold‐Belfer Rachel 
Published: January 2025

ABSTRACTBackgroundProton pump inhibitors (PPI) for gastroesophageal reflux disease (GERD) are associated with a high failure rate. Our uncontrolled feasibility study aimed determining the effect of a transcutaneous electrical stimulation system (TESS) on GERD symptoms and acid exposure time (AET).MethodsRecruited patients with heartburn and regurgitation. During the first phase (one‐week, run‐in period, off‐PPI's), patients completed symptom diaries and demographic questionnaires. Thereafter, all patients underwent gastroscopy with subsequent placement of a wireless esophageal pH capsule, off‐PPI. Based on pH analysis in the first 24 h, only those with increased AET (percent total time pH < 4 above 6%) continued to the next phase. During that phase, patients were treated for up to 3 weeks with TESS and documented their symptoms. The Primary endpoint was the magnitude of reduction in GERD‐related symptoms. The secondary endpoints were the magnitude of reduction of AET and DeMeester score, as compared with their baseline values.ResultsIncluded 31 patients and of those, 26 patients (42% females, aged 49 ± 15 years, mean BMI 25 ± 3 kg/m2) completed the first two phases of the study.At baseline, mean number of daily heartburn and regurgitation episodes was 2.55 ± 1.79 and 1.40 ± 1.73, respectively. Following TESS, mean number of daily heartburn and regurgitation episodes dropped to 0.77 ± 0.75 and 0.36 ± 0.8, respectively (p < 0.001). At base line, mean AET and DeMeester score were 12.4 ± 5.6 and 32.1 ± 12.7, respectively. Following TESS mean AET dropped to 6.0 ± 3.5 and DeMeester score dropped to 16.2 ± 8.2 (p < 0.001).ConclusionsTESS is effective in reducing both symptoms and esophageal AET in GERD patients.
Osteoradionecrosis Incidence in the Site of Pre‐Radiotherapy Tooth Extraction
Authors: Eaton James J. , Hodgson Alexander , Richards Jessica A. , Collins Timothy , Godden Daryl R. P. , Beech Andrea N. 
Published: January 2025

ABSTRACTAimsTo identify the incidence of osteoradionecrosis (ORN) in the site of extraction in patients who had pre‐radiotherapy extractions over a 10‐year period and the important predictive patient and treatment factors.Material and MethodsA retrospective review was performed on all patients who were prescribed pre‐radiotherapy extractions over 10 years in the oral and maxillofacial surgery department of a UK district general hospital. Notes were examined for predictive factors, whether ORN developed or not, and if ORN did develop to what extent and what treatment, if any, was required. The number of patients receiving one or more extractions was 140 from 2009 to 2019.ResultsThe incidence of ORN was higher than expected in the site of a pre‐radiotherapy extraction. ORN developed relatively quickly, and in some cases within 12 months after completion of radiotherapy. Important risk factors were radiation dose, anatomical site of the primary tumour and social factors, namely, smoking and high alcohol intake. The number of pre‐radiotherapy extractions prescribed overall gradually reduced over the 10‐year period.ConclusionsThere is little information in the available literature to indicate the material risk of ORN in the region of a pre‐radiotherapy extraction site after oncological treatment. With our results, we are able to warn patients more appropriately about their risk of ORN to allow them to give informed consent for pre‐radiotherapy extractions.
Characteristics of Resection Parameters in Robot‐Assisted Total Knee Arthroplasty With the Ligament Balancing Workflow
Authors: Wei Qing‐Da , An Hao‐Ming , Gu Wang , Sun Wei , Li Rui , Chai Wei 
Published: January 2025

ABSTRACTObjectiveRobotic‐assisted total knee arthroplasty (TKA) is a novel orthopedic technique. The workflow of robotic‐assisted TKA is quite different from that of traditional manual TKA and may result incompletely different resection parameters. Understanding these parameters may help surgeons better perform robotic‐assisted TKA. This study aims to analyze the specific resection parameters of robotic‐assisted TKA.MethodsWe retrospectively reviewed 85 MAKO‐assisted TKA surgeries performed by three surgeons at our institution between May 2021 and November 2023. All patients had unilateral primary knee arthritis, and a Triathlon PS (Stryker) knee prosthesis was used. Intraoperative resection plan, radiological outcomes, and clinical outcomes were collected among them. The angle between the transepicondylar axis (TEA) and the femoral prosthesis axis was defined as rTEA, the angle between the posterior condylar axis (PCA) and the femoral prosthesis axis was defined as rPCA. The t‐test and the Chi‐square test (or Fisher's exact probability test) were used to determine differences in categorical variables.ResultsrTEA averaged 2.7° (range, 0°–6.7°), and rPCA averaged 4.9° (range, 0.2°–9.6°). The mean resection of the medial distal femur was 7.7 mm (range, 3.0–12.5), that of the lateral tibial plateau was 6.4 mm (range, 1.5–13.0), and that of the medial posterior condyle of the femur was 10.6 mm (range, 6.5–17.5), whereas that of the lateral posterior condyle of the femur was 6.7 mm (range, 2.0–13.0).ConclusionRobotic‐assisted TKA using the ligament balancing workflow generally resulted in greater external rotation than reported reference values for conventional manual TKA within the existing literature, with reference to both the TEA and PCA. In addition, tibial resection was generally less, and the joint line was generally shifted upwards.
Morphological Characteristics of Inferior Pole Patellar Fractures and a Finite‐Element Analysis Combined With a Retrospective Clinical Study of Anchor Suture and Titanium Cable Cerclage Treatment
Authors: Hu Zhenghui , Sun Chen , Heng Hongquan , Li Jian , Chen Hainan , Chen Fuchao , Su Peng , Wang Dengfeng 
Published: January 2025

ABSTRACTObjectiveInferior pole patellar fractures (IPPFs) pose a significant challenge due to their complex fracture patterns and high risk of complications associated with current treatment methods. This study aims to (1) characterize the fracture patterns of IPPFs using fracture mapping and (2) compare the biomechanical stability and clinical outcomes of treatment with anchor suture with patellar cerclage versus Kirschner‐wire tension band combined with patellar cerclage.Methods(1) A retrospective analysis was conducted on 61 patients with IPPF. For each case, fracture reduction was manually simulated, with fracture lines and fragments overlaid onto a complete patella template to identify fracture patterns. (2) Finite‐element models were used to analyze the mechanical properties of anchor suture and titanium cable cerclage treatment and Kirschner‐wire tension band combined with patellar cerclage in treating IPPFs. Additionally, a retrospective analysis of clinical data was performed on 57 patients with IPPF (AO/OTA 34 A1) treated at our institution between January 1, 2023, and December 25, 2023. Of these, 18 patients underwent anchor suture and titanium cable cerclage (Group A), and 39 underwent Kirschner‐wire tension band combined with patellar cerclage (Group B). We compared operative time, final knee range of motion, incidence of secondary surgery, postoperative complications, and functional recovery between the two groups based on medical records and follow‐up results.Results(1) IPPFs were predominantly comminuted, with fracture lines on the anterior view concentrated laterally and near the superior surface of the inferior pole. Fracture lines became more sparse as they approached the distal patella. The posterior view was similar to the anterior, with the majority of fractures near the superior surface of the inferior pole. (2) Finite‐element analysis revealed no significant differences between the two groups in terms of displacement and stress. Operative time was similar between the groups (p > 0.05), as were final knee range of motion (p > 0.05) and postoperative Bostman scores (p > 0.05). Group A had no postoperative complications or readmissions, while Group B had two cases of hardware irritation and one case of knee joint infection.ConclusionThe fracture lines of IPPF are varied, often comminuted, and correlate with the mechanism of injury. Biomechanical and clinical outcomes suggest that anchor suture with patellar cerclage is a viable option for stabilizing IPPF.Trial Registration: ClinicalTrials.gov identifier: NCT06736639