bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical outcomes of stromal lenticule rotation to correct mixed astigmatism
Authors: Sun Xiyu , Shen Di , Jiang Haixiang , Wang Yani , Wang Rui , Wei Wei 
Published: December 2023

Purpose To describe a stromal lenticule rotation surgical technique to correct mixed astigmatism and evaluate the initial clinical outcomes of this innovative approach. Methods This retrospective case series included five eyes from five patients with mixed astigmatism that underwent intrastromal lenticule rotation surgery. The eyes were evaluated for uncorrected visual acuity, corrected distance visual acuity, manifest refraction, central corneal thickness, corneal volume, anterior and posterior K readings, and corneal higher order aberrations (HOAs) (including total HOAs, spherical aberrations, coma, and trefoil) using the Scheimpflug-Placido topographer before and 3 months after surgery. The corneal epithelium and stroma were imaged using anterior segment optical coherence tomography (AS-OCT) postoperatively. A paired-sample t-test was used to analyse the data. Results Clinical improvement was found in the uncorrected distance visual acuity (0.64 ± 0.11 logMAR vs. 0.20 ± 0.17 logMAR) and spherical and cylindrical diopters (D) (+2.65 ± 1.32 D vs. −0.05 ± 0.51 D and −4.95 ± 0.94 D vs. −1.10 ± 0.78 D, respectively). Anterior flat keratometry readings showed a steep trend (40.65 ± 1.24 D vs. 42.73 ± 0.63 D). Anterior corneal astigmatism decreased from 4.50 ± 0.55 D to 2.05 ± 0.73 D. According to the AS-OCT images, no significant epithelial remodelling was observed postoperatively. Although no significant differences were found among the increased corneal HOAs, the coma and trefoil changed much more than spherical aberrations 3 months postoperatively. Conclusions The results for these five eyes suggest that the autologous stromal lenticule rotation technique is safe and effective; it may be an economical and feasible surgical option for correcting mixed astigmatism.
What is the best way to evaluate social prescribing? A qualitative feasibility assessment for a national impact evaluation study in England
Authors: Ayorinde Abimbola , Grove Amy , Ghosh Iman , Harlock Jenny , Meehan Edward , Tyldesley-Marshall Natalie , Briggs Adam , Clarke Aileen , Al-Khudairy Lena 
Published: December 2023

Objectives Despite significant investment in social prescribing in England over the last decade, we still do not know if it works, or how models of social prescribing fit within wider health and care policy and practice. This study explores current service delivery structures and assesses the feasibility of a national evaluation of the link worker model. Methods Semi-structured interviews were conducted between May and September 2020, with 25 key informants from across social prescribing services in England. Participants included link workers, voluntary, community and social enterprise staff, and those involved in policy and decision-making for social prescribing services. Interview and workshop transcripts were analysed thematically, adopting a framework approach. Results We found differences in how services are provided, including by individual link workers, and between organisations and regions. Standards, referral pathways, reporting, and monitoring structures differ or are lacking in voluntary services as compared to clinical services. People can self-refer to a link worker or be referred by a third party, but the lack of standardised processes generated confusion in both public and professional perceptions of the link worker model. We identified challenges in determining the appropriate outcomes and outcome measures needed to assess the impact of the link worker model. Conclusions The current varied service delivery structures in England poses major challenges for a national impact evaluation. Any future rigorous evaluation needs to be underpinned with national standardised outcomes and process measures which promote uniform data collection.
High health care use prior to elective surgery for osteoarthritis is associated with poor postoperative outcomes: A Canadian population-based cohort study
Authors: Canizares Mayilee , Power J Denise , Perruccio Anthony V , Paterson Michael , Mahomed Nizar N , Rampersaud Y Raja 
Published: December 2023

Background The characterization and influence of preoperative health care use on quality-of-care indicators (e.g., readmissions) has received limited attention in populations with musculoskeletal disorders. The purpose of this study was to characterize preoperative health care use and examine its effect on quality-of-care indicators among patients undergoing elective surgery for osteoarthritis. Methods Data on health care use for 124,750 patients with elective surgery for osteoarthritis in Ontario, Canada, from April 1, 2015 to March 31, 2018 were linked across health administrative databases. Using total health care use one-year previous to surgery, patients were grouped from low to very high users. We used Poisson regression models to estimate rate ratios, while examining the relationship between preoperative health care use and quality-of-care indicators (e.g., extended length of stay, complications, and 90-day hospital readmissions). We controlled for covariates (age, sex, neighborhood income, rural/urban residence, comorbidities, and surgical anatomical site). Results We found a statistically significant trend of increasing worse outcomes by health care use gradients that persisted after controlling for patient demographics and comorbidities. Findings were consistent across surgical anatomical sites. Moreover, very high users have relatively large numbers of visits to non-musculoskeletal specialists. Conclusions Our findings highlight that information on patients’ preoperative health care use, together with other risk factors (such as comorbidities), could help decision-making when benchmarking or reimbursing hospitals caring for complex patients undergoing surgery for osteoarthritis.
The power of ethnographic toolkit in understanding transnational culture
Authors: Dogan Akkaya Fatma 
Published: December 2023

Intergenerational ethnographic research poses several practical, epistemological, and ethical challenges. This study seeks to address these complexities by encouraging researchers to construct personalised ethnographic toolkits that provide insights into uncovering the complex subjectivities of research populations through intergenerational narratives. Based on over two years of research among the Turkish community in London, the study reveals compelling examples of symbolic communication used by individuals of different generations, genders, and social roles. Using various data collection methods, including interviews, observation, drawing, and television viewing, the research illustrates how this ethnic community uses language, fashion, and religion to integrate into multicultural environments and manifest their belonging in transnational contexts. By incorporating methodological tools such as unplanned moments, reflexivity, and positionality, the study aims to understand the underpinnings of cultural identity by examining how different generations respond to social conditions shaped by migration.
Outcomes of Clampless Real Chimney Technique with Dacron Graft and Sleeve Banding of the Ascending Aorta for Total Debranching Endovascular Arch Repair
Authors: Matsuura Sohei , Motoki Manabu , Akai Atsushi , Kato Masaaki 
Published: December 2023

Background: Hybrid aortic arch repair with debranching of the supra-aortic vessels carries a high risk of cerebral infarction and fatal complications associated with side clamping of the ascending aorta. A previous study had reported the “real chimney” technique, a novel method for clamp-free total debranching thoracic endovascular aortic repair with the ascending aortic sleeve banding with dacron. In this study, we aim to build upon this foundation by presenting our experience with the early and midterm outcomes of this technique. Methods: We retrospectively reviewed the medical records of 61 consecutive older adult patients with aortic arch pathologies and a high risk of open repair who underwent total debranching thoracic endovascular aortic repair using the real chimney technique at our institution between January 2014 and June 2022. This technique was used to anastomose the ascending aorta with the main trunk of the triple-branched prosthetic graft. Results: The mean patient age was 75.1 years, and 54% of patients were transferred from medical facilities with cardiothoracic surgery departments. The comorbidities included chronic obstructive pulmonary disease (49.2%), chronic kidney disease (63.9%), coronary artery disease (27.9%), and history of stroke (31.1%). No 30-day mortality was observed. Complications included postoperative renal failure requiring permanent hemodialysis (4; 6.6%), stroke (modified Rankin scale score: ≥2 in 5; 8.2%), permanent paraplegia (1; 1.6%), and permanent paraparesis (4; 6.6%). The median follow-up period was 40.5±28.5 months. The postoperative survival rates at 5 years were 66.8%. No patients experienced complications associated with the aorta or anastomosis site; only 1 patient required an additional procedure for stenosis of the anastomosis site (midterm). An aneurysmal diameter reduction of ≥3 mm was observed in 37 cases (60.7%), and the mean aneurysmal diameter reduction was 5.3 mm. Conclusions: The postoperative outcome of total debranching thoracic endovascular aortic arch repair is not only acceptable but also promising, particularly in patients at high risk of open repair. Clinical Impact Our novel real chimney technique for total debranching thoracic endovascular aortic repair of aortic arch pathologies in patients who were at a high-risk for open repair resulted in no 30-day mortality and no complications related to the aorta or the real chimney anastomosis site. The real chimney technique is effective for managing aortic arch pathologies and enables less invasive total debranching thoracic endovascular aortic arch repair without the need for extracorporeal circulation and clamping of the ascending aorta
Anti-discrimination legislation and protection of working conditions of the self-employed
Authors: Muszyński Karol 
Published: December 2023

This contribution discusses the CJEU ruling in C-356/21 J.K. v TP S.A. It concludes that the ruling contributes to the ongoing development that disentangles the concept of the protection of working conditions from the employment relationship, granting self-employed workers who provide work on a personal basis protection against discrimination. It further discusses the ruling in the context of the spread of non-standard forms of employment on the labour market and policy initiatives to tackle them. Case Case C-356/21 J.K. v TP S.A. Related cases C-587/20 – HK/Danmark and HK/Privat; C-507/18 - Associazione Avvocatura per i diritti LGBTI
Strengthening the evidence base for mHealth in clinical practice: Conducting research with standalone or interoperable systems – a viewpoint
Authors: Kooij Laura , van Harten Wim H 
Published: December 2023

Objective The aim of this viewpoint is to inform mobile health (mHealth) evidence development in using standalone or interoperable systems in hospital practice. Methods There is a gap between mHealth research and its widespread uptake in clinical practice. Evidence generation is not keeping up with the introduction and implementation of technologies. This is partly a consequence of the technology characteristics and the way research is conducted in a clinical setting. Research and development of mHealth technology can be conducted standalone in a laboratory like setting, standalone in a clinical setting or interoperable with already existing technology in hospital practice. Results Standalone systems operate relatively independent from an organizations' existing infrastructure. Using laboratory settings does not reflect the complexity of real-life, but in clinical practice this may be suitable for research assessing usability, feasibility or even clinical and process outcomes at a small scale. Realizing research and development on interoperable mHealth technology solutions, especially with operational EMR systems, is a challenging, time- and resource intensive process and requires large(r) investments, as it is often complicated by a myriad of interfering factors. Interoperable systems are however a more sustainable option in the long run, and generated evidence reflects the real hospital care setting and this option may therefore facilitate dissemination. Choosing either a standalone or interoperable setting affects the research design, the implementation pace and ultimately widespread adoption of the mHealth technology. Conclusion We recommend to include these technology characteristics in implementation frameworks and think of evaluation research designs in an early phase.
Using human-centered design to develop a nurse-to-family telehealth intervention for pediatric transfers
Authors: Rosenthal Jennifer L , Ketchersid Audriana , Horath Elva , Sanders April , Harper Thomas A , Hoyt-Austin Adrienne E , Haynes Sarah C 
Published: December 2023

Objective To develop a nurse-to-family telehealth intervention for pediatric inter-facility transfers using the human-centered design approach. Methods We conducted the inspiration and ideation phases of a human-centered design process from July 2022 to December 2022. For the inspiration phase, we conducted a qualitative cross-sectional case study design over 3 months. We used thematic analysis with the framework approach of parent and provider interviews. Five team members individually coded transcripts and then met to discuss memos, update a construct summary sheet, and identify emerging themes. The team adapted themes into “How Might We” statements. For the ideation phase, multidisciplinary stakeholders brainstormed solutions to the “How Might We” statements in a design workshop. Workshop findings informed the design of a nurse-to-family telehealth intervention, which was iteratively revised over 2 months based on stakeholder feedback sessions. Results We conducted interviews with nine parents, 11 nurses, and 13 physicians. Four themes emerged supporting the promise of a nurse-to-family telehealth intervention, the need to effectively communicate the intervention purpose, the value of a user-friendly workflow, and the essentiality of ensuring that diverse populations equitably benefit from the intervention. “How Might We” statements were discussed among 22 total workshop participants. Iterative adaptations were made to the intervention until feedback from workshop participants and 67 other stakeholders supported no further improvements were needed. Conclusion Human-centered design phases facilitated stakeholder engagement in developing a nurse-to-family telehealth intervention. This intervention will be tested in an implementation phase as a feasibility and pilot trial.
Assessing Functional Cognition and Health During COVID-19 Pandemic: Gender Differences Among Community-Dwelling Adults
Authors: Josman Naomi , Atiya Yael , Dagan Tal , Issa Elizabeth , Demeter Naor 
Published: December 2023

Introduction/Objectives: The COVID-19 pandemic has long-term implications for adult health and function, whether or not people were infected with the disease. Although cognitive disruptions are among the major symptoms of COVID-19, most research focused on managing medical symptoms, such as respiratory symptoms or pain. Thus, less is known about the pandemic’s long-term implications for assessing functional cognition. This study aimed to examine COVID-19’s effects on community-dwelling adults’ functional cognition and health, comparing gender differences. Methods: This cross-sectional study divided 118 community-dwelling adults (25 previously infected with COVID-19) into gender groups. Primary outcome measures included the Daily Living Questionnaire (DLQ) and short form health status survey, SF-12. Results: No significant differences were found in functional cognition or health between participants who had contracted COVID-19 and those who remained healthy, but men had better functional cognition and health measures in comparison with women. Conclusions: Gender differences in functional cognition and health state may relate to gender-based family roles. It is essential to assess functional cognition of young adults who were exposed to a pandemic, such as COVID-19, because it may significantly affect their health and functional status. The DLQ is a reliable, valid assessment of functional cognition that may suit individuals who previously contracted COVID-19.
Examining Determinants of Regional Inflation Heterogeneity — A Robust Panel Data Analysis
Authors: Abbas Syed Jaffar , Arshed Noman 
Published: December 2023

This study examines the impact of different factors on inflation in six regions of the world between 2002 and 2021, analyzing variables such as control of corruption, political stability, broad money growth, GDP growth, and imports to exports ratio. This study seeks to investigate the crucial factors that cause inflation and their significance in different regions. The feasible generalized least square (FGLS) results indicate that the determinants of inflation vary in different regions, but broad money growth consistently increases inflation across all six regions, while control of corruption and political stability reduce inflation in most regions. The study has business implications for political stability and its contribution to inflation control. This should be taken into account when making investment choices by businesses operating in politically insecure regions. The study also highlights how crucial it is to control the growth of broad money and comprehend how GDP growth and inflation are related. Policymakers should establish effective inflation control measures that take into consideration the unique elements driving inflation in their region. JEL Classification: E31, P24, P44
Patient safety near misses – Still missing opportunities to learn
Authors: Woodier Nick , Burnett Charlotte , Sampson Paul , Moppett Iain 
Published: December 2023

Objectives A patient safety near miss is a safety event that had the potential to cause harm, but did not reach the patient. For over 20 years healthcare has been exhorted to learn from patient safety near misses to support improvements in patient safety. The belief is that, by addressing the factors that contribute to patient safety near misses, harmful incidents will be avoided. However, there seems to have been little progress made to learn from patient safety near misses. This study aimed to explore why there has been limited progress, and how best patient safety near misses may be learned from. Methods A qualitative case study was undertaken to explore the learning from patient safety near misses in different National Health Service contexts. Semi-structured interviews were conducted with patient safety leads in secondary care, primary care, and regional/national bodies. Interviews were recorded, transcribed, and thematically analysed. Results Seventeen interviews were undertaken across the National Health Service, with further data collected from policy, guidance, field notes, and research memos. Thematic analysis identified the following: variations in safety event schema; limited processes for patient safety near misses; unsupportive reporting contexts; and assumed, but non-evidenced improvements in patient safety. Participants also shared their thoughts on how learning from patient safety near misses could be improved. Conclusion A lack of progress has been made to learn from patient safety near misses in the National Health Service. This is contributed to by a lack of agreement about what is and how best to learn from a patient safety near miss. The learning value of patient safety near misses lies in the focus they place on controls to hazards, but they should not be learned from in isolation.
Impacts of social restrictions on mental health and health behaviours of individuals with multimorbidity during Covid-19 pandemic
Authors: Chauvin Valérie , Villarino Resti Tito H , Bernard Paquito , Yazbek Hanan , Kern Laurence , Hokayem Marie , Mattar Lama , Kotbagi Gayatri , Rizk Melissa , Morvan Yannick , Baillot Aurélie , Romain Ahmed Jérôme 
Published: December 2023

Background Social restrictions and their possible impact on lifestyle make people with multimorbidity (≥2 co-existing chronic conditions) more vulnerable to poor perceived mental health and health behaviours modifications during the COVID-19 pandemic. Objective To understand the mental health status and health behaviour modifications among individuals with multimorbidity during different levels of COVID-19 social restrictions. Methods Longitudinal multinational cohort study consisting of two online questionnaires with its first wave taken place while social restrictions were imposed (May 2020), and its second wave with less social restrictions in place (November 2020). Including 559 participants (wave 1) and 147 participants from wave 1 (wave 2) with an average age of 34.30±12.35 and 36.21±13.07 years old. Mostly females living in Canada, France, India and Lebanon. Results The prevalence of multimorbidity was 27.68% (wave 1) and 35.37% (wave 2). While social restrictions were imposed, people with multimorbidity were 2 to 3 times more likely to experience psychological distress, depressive symptoms, increased stress or isolation than those without multimorbidity. Health behaviours were also modified during this period with people with multimorbidity being more likely to reduce their physical activity and increased their fruit and vegetable consumption. In wave 2, regardless of multimorbidity status, sexual desire continuously decreased while stress and psychological distress increased. Conclusion Mental health and health behaviours modifications occurred while social restrictions were imposed and people with multimorbidity were more severely impacted than those without multimorbidity, indicating a need for a more adapted approach of care during socially restrictive periods for this population.
How have we measured trial outcomes of asthma attack treatment? A systematic review
Authors: Howell Imran , Howell Aleksandra , Ramakrishnan Sanjay , Bafadhel Mona , Pavord Ian 
Published: December 2023

BackgroundAsthma attacks are a common problem for people with asthma and are responsible for significant healthcare costs. There is interest in a precision medicine approach to treatment. However, the choice of trial outcome measures for asthma attack treatment is hampered by the absence of a consensus on suitability. We carried out a systematic review to understand the characteristics of outcome measures used in randomised controlled trials of asthma attack treatment. Have randomised controlled trials of asthma attack treatment measured outcomes that are useful to patients and healthcare providers?MethodsThe protocol was registered on PROSPERO (CRD42022311479). We searched for randomised controlled trials comparing treatments for adults with asthma attacks, published in English between 1972 and 2022 on MEDLINE, Embase and Cochrane Library databases. We recorded the outcome measures and study characteristics.ResultsWe identified 208 eligible randomised controlled trials from 35 countries. Trials ranged from 12 to 1109 participants, with a median of 60. The most common settings were the emergency department (n=165) and hospital admission (n=33). Only 128 studies had primary and secondary outcomes defined clearly. In those that did, 73% of primary outcomes measured change in lung function or other physiological parameters over a short period (usually <24 h). Patient-reported and healthcare utilisation outcomes were the primary outcome in 27%.ConclusionsOutcomes in randomised controlled trials of asthma attack treatment focus on short-term changes in lung function and may not capture patient-centred and economically important longer-term measures. More work is needed to investigate patient and other stakeholder preferences on core outcome sets.