bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessment of Safety Requirements and Their Practices Among Teaching Laboratories of Health Institutes
Authors: Aliyo Alqeer , Edin Alo 
Published: May 2023

Background: Laboratory work provides students with the ability to process skills, perform experiments and tests, and interpret experimental data. Instead of traditional teaching methods, there are good laboratory experiences to develop a conceptual understanding of science. A lack of laboratory safety requirements and practice can affect the health of students, staff, and the environment. Therefore, the current study provides updated safety requirements and practice information. Objective: The purpose of this study was to evaluate safety requirements and practices among teaching laboratories at the Health Institute 2021. Methods: An institutional-based descriptive study design was conducted on November 15-20, 2020, among staff members of the Bule Hora University Institute of Health. Seventeen randomly selected academic staffs and laboratory assistants from 2 departments participated in the study. Data were collected through a self-administered questionnaire and an observational checklist. Finally, the data were coded and entered into Statistical Package for Social Sciences (SPSS) version 20 for analysis. Data were then analyzed using simple quantitative descriptions such as frequency counts and percentages. The data are presented in a table. Results: Of the safety requirements evaluated, only 33.3% (6) were available in the laboratory. Of the safety practices evaluated, 44.6% were used all the time, 37.7% were used occasionally, and 17.6% were never practiced in the laboratory by the respondents. Of his respondents, 58.8% had never been regularly inspected for laboratory safety, and 77% had never received training in laboratory safety. Observations show that teaching laboratories in health organizations lack safety manuals/first aid diaries or guidelines, laboratory building drainage systems, adequate ventilation, water flow, and appropriate laboratory sizes. Conclusions: This study reveals poor laboratory safety practices and safety requirements in teaching laboratories. These limitations may cause health problems, environmental pollution, contamination, and chemical spills. Stakeholders should improve safety requirements and create awareness among staff, students, and lab assistants.
Accessing Dementia Care in Brazil: An Analysis of Case Vignettes
Authors: Figueiredo Da Mata Fabiana Araújo , Oliveira Déborah , Mateus Elaine , Franzon Ana Carolina Arruda , Godoy Carolina , Salcher-Konrad Maximilian , De-Poli Chiara , Comas-Herrera Adelina , Ferri Cleusa P , Lorenz-Dant Klara 
Published: May 2023

Background and Objectives Despite the rapid increase in the number of people living with dementia in Brazil, dementia care is limited. This study describes how people living with dementia and their carers access care, treatment, and support, and identifies what characteristics are likely to enable or prevent access. Research Design and Methods We created 10 vignettes to illustrate fictitious but realistic scenarios involving people living with dementia in Brazil. The vignettes explore a combination of socioeconomic and demographic variables. They were completed using an in-depth desk review of the dementia care landscape in Brazil; a Strengths, Opportunities, Weaknesses, and Threats (SWOT) analysis of the desk review; and expert knowledge. The analysis focused on identifying common sources of service provision, barriers of access to care and support, and specific issues experienced by some population groups. Findings Access to a dementia diagnosis, care, and support for people living with dementia in Brazil is limited. Demographic and socio-economic circumstances play a role in determining the type of services to which a person might have access. Poor knowledge about dementia, lack of capacity in the health system, and lack of formal long-term care support are among the identified barriers to accessing timely diagnosis, care, and support in the country. Discussion and Implications Understanding the barriers and facilitators of access to diagnosis, treatment, and support for people with dementia and families with different demographic and socioeconomic characteristics is crucial for designing dementia policies that are context-specific and responsive to the care needs of different socioeconomic groups in Brazil.
Dutch first in Dutch higher education policy
Authors: Schiltmans Jessica 
Published: May 2023

In the past 15 years, the number of international students in tertiary education doubled to reach 5.6 million students in 2018 and is expected to grow to 6.9 million in 2030 (Choudaha and Van Rest, 2018). In the Netherlands, the percentage of international degree seeking students is relatively high and growing fast from 4% in 2010 to more than 10% in 2017 where the average in OECD countries was 6% (OECD, 2020). Initially, this growth was perceived as positive, seen as a sign of good quality of Dutch higher education, and it was stimulated by government policy. However in the past few years, this development has led to a public debate on the downsides of this growth; the accessibility- and the quality of higher education (IBO, 2019). The latter being impacted by increased pressure on HEI because of growing student numbers. The use of the English language is also part of the discussion on quality. The debate eventually resulted in a policy proposal called Taal en Toegankelijkheid which translates into Language and Accessibility that was sent to the House of Representatives by the Minister of Education, Culture and Science (OCW) in September 2019 (Van Engelshoven, 2019b). The aim of the bill is to safeguard the quality of education, promote Dutch language skills, to guarantee accessibility of higher education and to control the influx of international students in the Netherlands (Van Engelshoven, 2019a). Before the bill was approved by the Senate, the Dutch Cabinet stepped out of power in January 2021 and the bill was declared controversial which means no decision will be made until a new Cabinet is installed (Bikker, 2021). Using the Multiple Streams Framework (MSF), this paper unravels the agenda-setting process that has led to the aforementioned government policy proposal.
Symptoms burden and rehabilitation preference after an episode of COVID-19: A patients survey
Authors: Alhotye Munyra , Daynes Enya , Gerlis Charlotte , Singh Sally J 
Published: May 2023

Background After COVID-19 infection, individuals can experience a variety of symptoms that might require further treatment. Early data showed the value of adapted pulmonary rehabilitation programmes and technology-based interventions. To develop appropriate services, it is important to understand the symptom burden and the preferred mode of rehabilitation delivery. Methods Post-hospital discharge (H) and post-community-managed (C) individuals received a follow-up call. A survey was completed to assess the most burdensome symptoms for which the patients would require support and their preference for the mode of rehabilitation delivery. Results Overall, 160 individuals who received a follow-up call completed the survey (51.2% male, mean [SD] age 54 [15] years) and 126 (78.8%) were post-hospital, while 34 (21.3%) had community-managed infections. A total of 101 (63.1%) reported that COVID-19-related symptoms were affecting their daily activities, and 106 (66.3%) reported their desire to be more active. The most common symptoms identified as needing support were fatigue and shortness of breath. Both groups expressed a preference for a face-to-face group programme (C: 54.8%; H: 46.8%), while (38.7%) of post-community-managed individuals and (40.3%) post-hospital patients preferred a supported digital rehabilitation programme. Few opted a non-digital home-based programme (C: 3.2%; H:12.9%, respectively). Conclusion The survey responses indicated a significant symptom burden that may benefit from an intervention such as rehabilitation. Preferences for rehabilitation indicated that a face-to-face intervention was preferred by the majority, with a large proportion preferring digital intervention.
Determining the Optimal Dosage of Corticosteroid Injection in Trigger Finger
Authors: Bookman Jared , Rocks Madeline , Noh Karen , Ayalon Omri , Hacquebord Jacques , Catalano Louis , Glickel Steven 
Published: May 2023

Background: Corticosteroid injection is the mainstay of nonoperative treatment for trigger finger (stenosing tenosynovitis), but despite substantial experience with this treatment, there is minimal available evidence as to the optimal corticosteroid dosing. The purpose of this study is to compare the efficacy of 3 different injection dosages of triamcinolone acetonide for the treatment of trigger finger. Methods: Patients diagnosed with a trigger finger were prospectively enrolled and treated with an initial triamcinolone acetonide (Kenalog) injection of 5 mg, 10 mg, or 20 mg. Patients were followed longitudinally over a 6-month period. Patients were assessed for duration of clinical response, clinical failure, Visual Analog Scale (VAS) pain scores, and Quick Disabilities of the Arm, Shoulder, and Hand (QuickDASH) scores. Results: A total of 146 patients (163 trigger fingers) were enrolled over a 26-month period. At 6-month follow-up, injections were still effective (without recurrence, secondary injection, or surgery) in 52% of the 5-mg group, 62% of the 10-mg group, and 79% of the 20-mg group. Visual Analog Scale at final follow-up improved by 2.2 in the 5-mg group, 2.7 in the 10-mg group, and 4.5 in the 20-mg group. The QuickDASH scores at final follow-up improved by 11.8 in the 5-mg group, 21.5 in the 10-mg group, and 28.9 in the 20-mg group. Conclusions: Minimal evidence exists to guide the optimal dosing of steroid injection in trigger digits. When compared with 5-mg and 10-mg doses, a 20-mg dose was found to have a significantly higher rate of clinical effectiveness at 6-month follow-up. The VAS and QuickDASH scores were not significantly different between the 3 groups.
Incidence of surgical site infection, bacterial isolate, and their antimicrobial susceptibility pattern among patients who underwent surgery at Dessie Comprehensive Specialized Hospital, Northeast Ethiopia
Authors: Ali Abdurrahman , Gebretsadik Daniel , Desta Kassu 
Published: May 2023

Objective: Surgical site infection is the most common postoperative complication worldwide, representing a major burden for patients and health systems. The aim of the study is to determine the incidence and bacterial profile that cause surgical site infection among patients who underwent surgery in parts of Northeast Ethiopia. Methods: A health facility-based cross-sectional study was conducted in Dessie Comprehensive Specialized Hospital from July 22 to October 25, 2016. A total of 338 patients from the obstetrics and gynecology and general surgical wards were included, through consecutive sampling technique. The specimens were collected aseptically on the first day when the patients had presented with clinical evidence of infection and then sent to the microbiology laboratory. The data were entered and analyzed by SPSS version 20, and the results were explained by frequency distribution in tables and figures. Results: The majority of participants were female (74.3%) and more than half (61.2%) of the surgeries were performed in the gynecology and obstetrics ward. Clinically, 49 patients (14.5%) were diagnosed as developing surgical site infection, and wound swabs were taken for bacteriological study. About 41 (83.7%) swabs showed bacterial growth, indicating 12.13% overall prevalence of bacterial surgical site infection. Out of 48 bacterial isolates, more than half (56.25%) of them were Gram negative. The most frequent isolate was Staphylococcus aureus, 14 (66.67%), followed by Escherichia coli, 9 (33.33%). Out of the total bacterial isolates, 38 (79.2%) isolates were found to be multidrug resistant, and the rate of multidrug resistant was higher among Gram-negative isolates. Conclusion: An average rate of surgical site infection was found to be reported and significant numbers of bacterial isolates were also detected. The highest rate of surgical site infection was reported in prostate surgery, followed by small bowel, vaginal hysterectomy, and exploratory laparotomy surgical procedures. Periodic surveillance on the incidence rate and bacterial profile along with the determination of their antibiotic susceptibility should be performed.
Implementing an Innovative Lipid Management Technique Using siRNA LDL-C Lowering Therapy: Lessons Learned in an NHS Primary Care Practice With Worked Case Examples
Authors: Deaney Carl , Donaldson Meredith , Meskauskiene Agne 
Published: May 2023

Introduction: The UK Government partnered with industry to tackle cardiovascular disease (CVD) in the first NHS population health agreement. The ambition was to prevent 150 000 strokes, heart attacks and dementia cases over the next 10 years with a new siRNA LDL-C lowering therapy (Inclisiran) delivered within Integrated Care Services by primary care to support a comprehensive approach to lipid management. Following the approval of inclisiran, and guidance published by the National Institute for Health & Care Excellence (NICE) on its use, this paper has been created by a UK general practice to share real-world observations of cases and the potential service benefits of rolling out this innovative drug treatment. The process of identifying patients at risk of atherosclerotic cardiovascular disease (ASCVD) and lessons learned from implementing in practice is also addressed. Workstreams were developed to rapidly roll out a low clinical burden enhanced lipid management program incorporating siRNA LDL-C lowering therapy into primary care practice. Approach/Method: (1) Multi-disciplinary team (MDT) education program based on freely available Academic Health Science Network (AHSN), National Institute for Health & Care Excellence (NICE), and commercial materials. (2) Automated searches using a software program were run to identify “at-risk” patients alongside manual case-finding in everyday clinics. (3) Patients were invited for review using multi-channel modalities. (4) Where appropriate, treatment was commenced after consent was obtained. (5) Automated recall systems are used to ensure follow-up; initially at 3 months, then every 6 months. Discussion and Conclusions: Enhanced lipid management as a secondary prevention measure is achievable in line with national guidance and objectives. The methodology and education/training processes used in combination with reconstructing the management process can help practice staff realize the program benefits, which in turn can lead to a shift in behavior where all staff embed manual case-finding of high-risk patients into everyday consultations and reviews; enabling rapid identification of eligible patients. Taking a multi-disciplinary, holistic approach to new initiatives reduces service burden, particularly for GPs. Leveraging resources from the AHSN and others removes additional training pressures often associated with new initiatives and provides a wealth of educational material to support primary care MDT upskilling.
The Effectiveness of the Multiple-Attending-Physicians System Compared With the Single Attending-Physician System in Inpatient Setting: A Mixed-Method Study
Authors: Park Daeho , Son Daisuke , Hamada Toshihiro , Imaoka Shintaro , Lee Young , Kamimoto Minako , Inoue Kazuoki , Matsumoto Hiromi , Shimosaka Takuya , Sasaki Shuichi , Koda Masahiko , Taniguchi Shin-ichi 
Published: May 2023

Objectives: Medical facilities have been required to effectively utilize insufficient human resources in many countries. Therefore, we qualitatively and quantitively compared physicians’ working burden, and assessed advantages and disadvantages of the single- and the multiple-attending physicians systems in inpatient care. Methods: In this cross-sectional study, we extracted electronic health record of patients from a hospital in Japan from April 2017 to October 2018 to compare anonymous statistical data between the single-attending and multiple-attending-physicians system. Then, we conducted a questionnaire survey for all physicians of single and multiple-attending systems, asking about their physical and psychiatric workload, and their reasons and comments on their working styles. Results: The average length of hospital stay was significantly shorter in the multiple-attending system than in the single-attending system, while patients’ age, gender, and diagnoses were similar. From the questionnaire survey, no significant difference was found in all categories although physical burden in multiple-attending system tended to be lower than that in single-attending system. Advantages of multiple-attending system extracted from qualitative analysis are (1) improvement of physicians’ quality of life (QOL), (2) lifelong-learning effect, and (3) improving the quality of medical care, while disadvantages were (1) risk of miscommunications, (2) conflicting treatment policies among physicians, and (3) patients’ concern. Conclusions: The multiple-attending physician system in the inpatient setting can reduce the average length of stay for patients and also reduce the physical burden on physicians without compromising their clinical performance.
L1CAM expression in human gastrointestinal tract development: From tongue to colon-rectum
Authors: Flaviana Cau , Monica Piras , Terenzio Congiu , Raffaele Murru , Valentina Aimola , Giulia Cerrone , Peter Van Eyken , Giorgio La Nasa , Massimo Castagnola , Ferdinando Coghe , Germano Orru’ , Daniela Fanni , Clara Gerosa 
Published: May 2023

Background: L1CAM (L1 cell adhesion molecule) is a member of the L1 family of neural adhesion molecules, involved in the development of multiple organs and tissues, including kidneys, the enteric nervous system, and adrenal glands. The aim of this study was to analyze, at the immunohistochemical level, the expression of L1CAM in the human tongue, parotid glands, and the different segments of the gastrointestinal tract during human development. Design and method: Immunohistochemical analysis for L1CAM was performed in the human tongue, parotid glands, and in the different segments of the gastrointestinal tract during development, starting from the 8th up to the 32nd week of gestation. Results: Our results were given by the expression of the L1CAM protein in different segments of the gastrointestinal tract during development, starting from the 8th week up to the 32nd week of gestation. L1CAM-reactive cells appeared aggregated in small bodies, irregular in shape, showing L1CAM storage in the cytoplasm. L1CAM expressing bodies were frequently found to be connected one to the next by thin fibers, a finding suggestive of the existence of an L1CAM network inside the developing tissue. Conclusion: Our study confirms that L1CAM is involved in gut development, as well as in tongue and salivary gland development. These findings confirm that the role of L1CAM in fetal development is not restricted to the central nervous system and are necessary for further studies on the role of this molecule in human development.
Influence of Medial Patellofemoral Ligament Reconstruction on Patellofemoral Contact in Patients With Low-Flexion Patellar Instability: An MRI Study
Authors: Siegel Markus , Taghizadeh Elham , Lange Thomas , Fuchs Andreas , Yilmaz Tayfun , Maier Philipp , Meine Hans , Schmal Hagen , Izadpanah Kaywan 
Published: May 2023

Background: Medial patellofemoral ligament (MPFL) reconstruction is a well-established procedure for the treatment of patients with patellofemoral instability (PFI) at low flexion angles (0°-30°). Little is known about the effect of MPFL surgery on patellofemoral cartilage contact area (CCA) during the first 30° of knee flexion. Purpose/Hypothesis: The purpose of this study was to investigate the effect of MPFL reconstruction on CCA using magnetic resonance imaging (MRI). We hypothesized that patients with PFI would have a lower CCA than patients with healthy knees and that CCA would increase after MPFL reconstruction over the course of low knee flexion. Study Design: Cohort study; Level of evidence, 2. Methods: In a prospective matched-paired cohort study, the CCA of 13 patients with low-flexion PFI was determined before and after MPFL reconstruction, and the data were compared with those of 13 healthy volunteers (controls). MRI was performed with the knee at 0°, 15°, and 30° of flexion in a custom-designed knee-positioning device. To suppress motion artifacts, motion correction was performed using a Moiré Phase Tracking system via a tracking marker attached to the patella. The CCA was calculated on the basis of semiautomatic cartilage and bone segmentation and registration. Results: The CCA (mean ± SD) at 0°, 15°, and 30° of flexion for the control participants was 1.38 ± 0.62, 1.91 ± 0.98, and 3.68 ± 0.92 cm2, respectively. In patients with PFI, the CCA at 0°, 15°, and 30° of flexion was 0.77 ± 0.49, 1.26 ± 0.60, and 2.89 ± 0.89 cm2 preoperatively and 1.65 ± 0.55, 1.97 ± 0.68, and 3.52 ± 0.57 cm2 postoperatively. Patients with PFI exhibited a significantly reduced preoperative CCA at all 3 flexion angles when compared with controls ( P ≤ .045 for all). Postoperatively, there was a significant increase in CCA at 0° of flexion ( P = .001), 15° of flexion ( P = .019) and 30° of flexion ( P = .026). There were no significant postoperative differences in CCA between patients with PFI and controls at any flexion angle. Conclusion: Patients with low-flexion patellar instability showed a significant reduction in patellofemoral CCA at 0°, 15°, and 30° of flexion. MPFL reconstruction increased the contact area significantly at all angles.