bluuebunny/crossref_metadata_2025_split huggingface dataset:
A new children’s hospital with a larger floor space, single rooms, and V-shaped ward design: A pre–post evaluation of nurse time providing patient care and nurse, patient, and family experiences
Authors: Gill Fenella J , Nelson Helen , Bear Natasha , Tallon Mary , Pienaar Catherine , Ferullo Jade , Baker Sue 
Published: January 2023

Background The impact of hospital building design on patients, families and nurses related to nursing care interactions is not well understood. This study reports a pre–post intervention study to understand the effects of the move to a new children’s hospital in Perth, Australia, on nurse workflow activities and on patient, family, and nurse experiences. Methods We used a pre–post explanatory sequential design involving observation of nurse work tasks; measurement of the Practice Environment Scale and Nurse Work Index; weekly surveys of nurse, patient and family experiences; and nurse focus groups and interviews with patients and families. Survey data were analysed using linear regression; qualitative data analysis used a thematic approach. Results Nurse time spent walking almost doubled ( p < 0.001), from an estimated 10 min at T1 (pre-move) to around 20 min at T4 (12 months post-move), but there was no difference in nurse time providing patient care ( p = 0.114). The Practice Environment Scale and Nurse Work Index showed significantly reduced scores for nursing foundations for quality of care (adjusted mean difference −0.08, p = 0.016) and staffing and resource adequacy (adjusted mean difference −0.19, p < 0.001).This fall was mirrored in nurse experience surveys with a reduction in mean scores from T1 to T3 (3 months post-move) of −0.7 ( p < 0.001) and from T1 to T4 of −0.4 ( p = 0.002). Thematic analysis of qualitative data found that initial challenges appeared to reduce over time. Nurses reported difficulties managing workflow in the new wards and feelings of exhaustion at T3, but this changed to more positive accounts at T4. For patients and families there was a tension between leaving the old and familiar, enjoying the light and space of the new and shared observations that nurses appeared to be busier at T3. At T4, these experiences had changed to ‘being a family in hospital’ and confidence that a nurse was always close by. Conclusions Both benefits and challenges of the new hospital design were encountered from the perspective of nurses, patients, and families. Nurses spent double the time walking in the new environment, but time spent providing patient care was unchanged. Over time, the initial practice challenges reduced as nurses adapted to working in the new environment. Trial Registration ACTRN12618000775213.
pCONUS 2 and pCONUS 2-HPC in the treatment of wide-necked intracranial aneurysms: Multicentre UK experience
Authors: Yeomans James , Gatt Simon , Habeeb Mohamed Ezaz , Crossley Robert , Keston Peter , Minks David , Dobbs Nicholas , Mortimer Alexander , Downer Jonathan , Sastry Anand 
Published: January 2023

Background/purpose pCONUS 2 and pCONUS 2-HPC are neck-bridging devices that provide coiling support in the endovascular treatment of wide-necked intracranial aneurysms. To date, limited multicentre data has been published. This study provides the first pooled data from multiple UK centres regarding outcomes for these devices covering the periprocedural period to 6-month follow-up. Materials/methods This retrospective, single-arm study assessed 65 patients treated over 3 years from the time of procedure to 6 months post-procedure across four UK centres. Data collected included patient demographics, aneurysm characteristics and antiplatelet regimens. Outcome measures were angiographic results and procedure-related complications from the immediate periprocedural period to 6-month follow-up. Results Fifty-four unruptured (83.1%) and 11 ruptured (16.9%) aneurysms were treated. Fifty-five aneurysms were located in the anterior circulation (87.7%). There were four device-related intraprocedural complications: three cases of asymptomatic, temporary thrombus formation and one mortality associated with branch vessel occlusion and aneurysm re-bleeding in a ruptured case. There were no post-procedural device-related complications. Satisfactory occlusion was achieved in 58/65 procedures (89.2%) at time of treatment and in 44/60 (73.3%) at 6 months. Satisfactory occlusion correlated with aneurysm size and coiling packing density. Retreatment was required for five unruptured cases (7.7%) and was straightforward with the device in situ. Conclusion pCONUS 2 and pCONUS 2-HPC have good short-term safety profiles. The use of pCONUS 2-HPC in the acute treatment of ruptured aneurysms with postprocedural SAPT is feasible. The devices have an intraprocedural complication rate of 4/65 (6.2%) across multiple UK centres, including a single death (1.5%).
Neutrophilia and its correlation with increased inflammatory response in COVID-19 in diabetic and pre-diabetic patients
Authors: Alhuthali Hayaa M. , Almehmadi Mazen , Ataya Eman F. , Alzahrani Hind A. , Alrehaili Amani A. , Bakhuraysah Maha M. , Alsaeedi Fouzeyyah Ali , Alsaiari Ahad Amer , Khalifa Mohamed M. , Gharib Amal F. 
Published: January 2023

Background: Hyperglycemic patients are at a high risk of COVID-19 severity. Neutrophils have been considered critical effector cells in COVID-19 development. Vitamin D deficiency is prevalent in hyperglycemic patients and was found to adversely associate with the neutrophil count. Aim: The goal of this work was to evaluate the characteristics of diabetic and pre-diabetic COVID-19 patients and discovered changes in neutrophils and their correlation, if any, with disease clinical presentation. Patients and Methods: The study included total of (514) Covid-19 positive patients confirmed by PCR and recruited from the Prince Mohammad Bin Abdulaziz Hospital in Riyadh, Saudi Arabia. Patient’s clinical characteristics were collected for all patients. Laboratory tests include HbA1c, neutrophil count, C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), ferritin, D- dimer, 25 hydroxy vitamin D (25(OH)D), and folate. Results: The results found that 286 patients (55.6%) were diabetic, 77 patients (15%) were pre-diabetic and 151 (29.4%) were normoglycaemic. A significant difference was exhibited regarding the neutrophil count and inflammatory factors of COVID-19 severity. Furthermore, the neutrophil count was found to be directly correlated with the severity monitoring biochemical markers for Covid-19: CRP, ESR, ferritin, and D-dimer and inversely associated with vitamin D levels in diabetic and pre-diabetic patients. Conclusion: Our findings highlight the change of neutrophils in COVID-19 diabetic and pre-diabetic patients that was found to correlate positively with CRP, ESR, ferritin, and D-dimer, and negatively with 25(OH)D, but their correlation with the clinical presentation of the disease need further large investigations.
Combined 3-Dimensional CT and Multidirectional CT Arthrography for Femoroacetabular Impingement and Hip Lesions: A Cross-sectional Study Comparing Imaging and Hip Arthroscopic Surgery Findings
Authors: Chuang Chieh-An , Sheu Huan , Yang Cheng-Pang , Tang Hao-Che , Wu Chen-Te , Fu Chen-Ju , Chan Yi-Sheng 
Published: January 2023

Background: There is limited research investigating the diagnostic strength of 3-dimensional computed tomography (3D-CT) and multidirectional CT arthrography (CTA) for femoroacetabular impingement (FAI) and related hip lesions. Purpose: To evaluate the diagnostic strength of combined 3D-CT and CTA in patients with FAI and related hip lesions by comparing it with hip arthroscopic surgery findings. Study Design: Cohort study (diagnosis); Level of evidence, 2. Methods: This study included patients who were suspected of having FAI and related hip lesions and who underwent a combination of 3D-CT and CTA and subsequent hip arthroscopic surgery between December 2013 and December 2017. The CT and intraoperative arthroscopic findings were recorded and compared. The sensitivity, specificity, and accuracy of 3D-CT for FAI and those of CTA for related hip lesions were calculated. Results: A total of 114 patients with 114 hips were included in our study. There were 101 patients with positive findings and 13 patients with negative findings for FAI (including cam, pincer, and combined morphology) according to 3D-CT. The sensitivity, specificity, and accuracy of 3D-CT for FAI were 91.58%, 57.14%, and 89.47%, respectively. The sensitivity, specificity, and accuracy of CTA for labral tears were 94.64%, 100.00%, and 94.73%, respectively. For acetabular cartilage defects, the sensitivity, specificity, and accuracy of CTA were 60.71%, 91.37%, and 76.31%, respectively. For femoral cartilage defects, the sensitivity, specificity, and accuracy of CTA were 82.22%, 76.81%, and 78.94%, respectively. Conclusion: The study results indicated that 3D-CT was able to provide excellent accuracy for FAI compared with hip arthroscopic surgery findings. In addition, multidirectional CTA demonstrated promising diagnostic strength for hip lesions such as labral tears and chondral defects.
“I am not a Good Woman?” Exploring the Views and Challenges of Nurses When Discussing HPV Testing and Associated Cervical Screening with Women in Iraq
Authors: Ali Suhailah M. , Lawes Rebecca , Ghalib Ayla Khedher 
Published: January 2023

Introduction Cervical cancer is mostly caused by high-risk Human papillomavirus HPV, with an estimation prevalence of HPV of 99.7% worldwide. The US Food and Drug Administration (FDA) approved an HPV test for primary cervical screening in 2014. An HPV-DNA test, which provides higher protection against invasive cervical carcinomas, is replacing the long-standing Pap smear as the primary method of cervical cancer screening. Objective To explore nurses’ experience and knowledge of HPV DNA testing and how screening impacts on women's health through increasing awareness and proposing actions for health education strategies. Method A qualitative exploratory study was conducted on a purposeful sample of 25 qualified nurses, who were all employed in regional hospitals within a gynecological department in Kirkuk, Iraq. The nurses were interviewed with a semi-structured topic guide between November 2021 and February 2022. Responses were transcribed verbatim, translated into English and analysed using a content thematic analysis approach. Results Four themes with associated sub-themes emerged following coding and peer review. Participants had lack of experience and fragmented knowledge of HPV DNA testing/screening. Culturally sensitive resources for patients and training for nurses was identified key requirements. Conclusions Currently, there are no facilities for a HPV testing/screening services available in Iraq. The role of nurses undertaking HPV screening is not established and yet nurses represent the largest sector of health professionals. The dissemination of a collaborative HPV screening training programme to include clinical competence and knowledge for nurses and gynaecologists may improve knowledge, and could also be effective in improving patient awareness and engagement with cervical health.
Aligning Talent and Business: A Key for Sustainable HRM in SMEs
Authors: Kandukuri Vinutha 
Published: January 2023

Talent search and its management are ongoing processes that are key to organizational progress. This article reviews the literature on the HR and talent management practices and concepts of larger business firms and small and medium enterprises (SMEs). The challenges faced by the talent acquisition team have been changing invariably throughout industrial development. In this context, the individuals search for stability and recognition in the organization, and the organizations search for talent, retention and consistent performance. The study attempts to identify the reasons for attrition and importance of sustainable HR practices such as talent management and its business alignment, with particular reference to SMEs. It carries out descriptive and exploratory research. The study highlights the reasons for the increased attrition rate in SMEs compared to the larger firms that follow better, affordable talent management practices. Secondary data from several government websites and survey reports have been used for the study.
Relapsing polychondritis in systemic sclerosis: A rare vasculitic mimic
Authors: Teles Carolina , Liyanage Chiranthi Kongala , Chow Geoffrey , Denton Christopher P , Ong Voon 
Published: January 2023

Introduction: Relapsing polychondritis is a rare, immune-mediated disease characterised by inflammation of cartilaginous structures. Auricular chondritis, sparing the fatty lobule, is the most typical feature, followed by nose and laryngotracheal involvement. Albeit rare, neurologic involvement is reported with relapsing polychondritis. Cranial nerve involvement is the most frequent neurologic manifestation and is probably due to an underlying vasculitic process. Approximately one-third of relapsing polychondritis patients can overlap with other systemic diseases, including other autoimmune connective tissue diseases, but association with systemic sclerosis has very rarely been described. Case description: A 63-year-old woman presented with acute new-onset severe dysphagia, accompanied by hoarseness and preceded by pain, swelling and erythema of the left pinna, unresponsive to antibiotics. She had a history of long-standing limited cutaneous systemic sclerosis. Cranial nerve examination revealed right-sided palatal palsy, and left vocal cord palsy was found on fibreoptic nasendoscopy. Magnetic resonance imaging of the head and neck showed bilateral enhancement of an extracranial segment of the glossopharyngeal and vagus nerves. Clinical features and imaging findings were consistent with relapsing polychondritis, which successfully responded to high-dose steroids. Conclusions: This is a case of relapsing polychondritis mimicking progression of systemic sclerosis, showcasing its challenging features. It emphasises the importance of early diagnosis and prompt management with potential impact on the outcome, while highlighting the complex interplay between these two disease entities and vasculitic mechanisms, which may reflect the shared network of genetic predisposition across autoimmune rheumatic diseases.
A Zur-mediated transcriptional regulation of the zinc export system in Pseudomonas aeruginosa
Authors: Ducret Verena , Gonzalez Diego , Leoni Sara , Valentini Martina , Perron Karl 
Published: January 2023

AbstractThe control of cellular zinc (Zn) concentrations by dedicated import and export systems is essential for the survival and virulence of Pseudomonas aeruginosa. The transcription of its many Zn transporters is therefore tightly regulated by a known set of transcription factors involved in either the import or the export of Zn. In this work, we show that the Zur protein, a well-known repressor of Zn import, plays a dual role and functions in both import and export processes. In a situation of Zn excess, Zur represses Zn entry, but also activates the transcription of czcR, a positive regulator of the Zn export system. To achieve this, Zur binds at two sites, located by DNA footprinting in the region downstream the czcR transcription start site. In agreement with this regulation, a delay in induction of the efflux system is observed in the absence of Zur and Zn resistance is reduced. The discovery of this regulation highlights a new role of Zur as global regulator of Zn homeostasis in P. aeruginosa disclosing an important link between Zur and zinc export.
Studies with statistically significant effect estimates are more frequently published compared to non-significant estimates in oral health journals
Authors: Seehra Jadbinder , Khraishi Hadil , Pandis Nikolaos 
Published: January 2023

Abstract
Background
Studies reporting statistically significant effect estimates tend to be more frequently published compared to studies reporting non-significant or equivalent estimates. Consequently, this may lead to distortion of the literature. The aim of this study is to assess the prevalence of reporting statistically significant effect estimates in leading oral health journals and to explore associations between the effect estimates and record characteristics.

Methods
An electronic database search was undertaken of a selection of leading oral health journals including general oral health journals to identify primary oral health records published in 2019. Descriptive statistics and population average GEE logistic regression model was used to assess associations between articles reporting a statistically significant effect estimate and the record characteristics.

Results
In 1335 records, 82.4% records reported a statistically significant effect estimate. All speciality journals compared to general oral health journals were less likely to publish a record with significant effect estimates. Authors based in Asia or other (OR 1.49; 95% CI :1.02,2.19; p = 0.037) were more likely to report significant effect estimates compared to those based in Europe. Interventional (OR 0.35; 0.22,0.58; p < 0.001) and observational (OR 0.56; 0.36, 0.89; p = 0.013) records were less likely to report significant effect estimates compared to in-vitro studies. Registered records were less likely to report significant effect estimates when compared to non-registered studies (OR 0.22; 95% CI :0.14,0.32; p < 0.001).

Conclusion
The publishing of records with significant effect estimates is prevalent within the oral health literature. To reduce dissemination bias and overestimation of effect sizes in systematic reviews, the publishing of studies with non-significant or equivalent effect estimates should be encouraged.
The effects of the coronavirus disease pandemic on intravenous thrombolytic therapy among patients with acute ischemic stroke in Dalian, China
Authors: Pan Xin , Ma Shubei , Sui Xiaowen , Xie Lili , Li Furong , Cheng Zhengping , Cui Li , Zhao Hongling 
Published: January 2023

Abstract
Background
We investigated the influence of the coronavirus disease 2019 (COVID-19) pandemic on the number of patients with acute ischemic stroke who received intravenous thrombolytic therapy (ITT) in Dalian, China, in 2020.

Methods
This retrospective descriptive study, conducted from February 1, 2020, to August 31, 2020, examined 13 hospitals in Dalian that participated in the “stroke emergency map”. To use this “stroke emergency map” of China, patients followed the official “Stroke Map” WeChat account and dialed 120 for emergency medical services. We analyzed the number of patients with acute ischemic stroke who underwent ITT. In particular, we examined the onset-to-door time (ODT), door-to-needle time (DNT), onset-to-needle time (ONT), mode of transportation to the hospital, and National Institutes of Health Stroke Scale (NIHSS) scores before and after ITT. Data were collected for the aforementioned period and compared with the 2021 baseline data from the same time of year. The Mann‒Whitney U test was performed for data analysis.

Results
Compared with the data from 2020, the number of patients with acute ischemic stroke who underwent ITT increased (from 735 to 1719 cases) in 2021, but the DNT decreased (from 59 to 45 min; P = 0.002). Moreover, 83.9% of patients in 2020 presented to the hospital without ambulance transport, compared to 81.1% of patients in the 2021 non-COVID-19 pandemic period. Patients with NIHSS scores of 6–14 were more likely to call an ambulance for transport to the hospital than to transport themselves to the emergency department.

Conclusions
During the 2020 COVID-19 pandemic, the DNT was prolonged as a result of strengthened fever surveillance. In 2021, the number of patients with acute ischemic stroke who underwent ITT increased compared to the previous year. Notably, the growth in the number of patients with acute ischemic stroke who underwent ITT benefited from both the “stroke emergency map” of China and the “green channel,” a novel treatment approach that focuses on the rational design of the rescue process.
Trial registration.
Our study was a retrospective descriptive study, not a clinical trial, thus we did not have to register for clinical trials.
Cancer incidence in immunocompromised patients: a single-center cohort study
Authors: Ilham Sabrina , Willis Connor , Kim Kibum , Chung Karen C. , Wood Brenda M. , Tan Malinda S. , Tan Chia Jie , Nguyen Danielle T. , Brixner Diana I. , Stenehjem David D. 
Published: January 2023

Abstract
Background
Diminished immune defense plays an important role in cancer development. Cancer risk in immunocompromised patients may differ. Identifying individuals with elevated cancer risk can inform strategies for routine cancer screening. This study aimed to understand and compare cancer incidence and risk in three patient groups: recipients of solid organ transplant (SOT) or hematopoietic stem cell transplant (HSCT); diagnosis of primary or secondary immunodeficiency disorder (PID/SID); and recipients of tumor necrosis factor inhibitor (TNF-i) therapy.

Methods
This retrospective cohort study used the University of Utah Health System database and Huntsman Cancer Institute tumor registry. Patients aged ≥18 years with SOT/HSCT, PID/SID or ≥ 3 months of TNF-i therapy were included. The date of transplant, diagnosis of PID/SID, or 1st TNF-i medication order date was defined as the index date. We calculated cumulative cancer incidence by Kaplan-Meier method. A Cox-proportional hazard regression model with a stepwise variable selection process was used to identify independent risk factors associated with the time to onset of a new primary cancer.

Results
In total, 13,887 patients were included which comprised of 2982 (21%) SOT/HSCT, 7542 (54%) PID/SID and 3363 (24%) patients receiving TNF-i. The mean (SD) age ranged from 46.8 (15) years - 50.4 (18.2) years. The proportion of white patients ranged from 72.3–84.8%. The estimated cumulative cancer incidence was 11.5% in the SOT/HSCT cohort, 14.3% in the PID/SID cohort, and 8.8% in the TNF-i cohort. The multivariable model adjusted for age, benign in-situ disease, Charlson Comorbidity Index, hypertension/cardiovascular disease/end stage renal disease, gender, race/ethnicity, and renal cyst as significant risk factors. The adjusted hazard ratios for cancer development in SOT/HSCT and PID/SID cohorts compared to the TNF-i cohort over the full follow-up period were 1.57 (95% CI: 1.16–2.13) and 2.14 (95% CI: 1.65–2.77), respectively.

Conclusion
A significantly increased risk of cancer was observed in PID/SID patients and SOT/HSCT patients compared to TNF-i patients. Age ≥ 50 years, male gender, and clinical comorbidities were additional factors impacting cancer risk. PID/SID and SOT/HSCT patients may benefit from more intensive cancer screening.