bluuebunny/crossref_metadata_2025_split huggingface dataset:
Intravenous thrombolysis in acute ischemic stroke after antagonization of unfractionated heparin with protamine: case series and systematic review of literature
Authors: Kneer Katharina , Adeyemi Adedolapo Kamaldeen , Sartor-Pfeiffer Jennifer , Wilke Vera , Blum Corinna , Ziemann Ulf , Poli Sven , Mengel Annerose , Feil Katharina 
Published: January 2023

Background and aims: Intravenous thrombolysis (IVT) is standard of care for disabling acute ischemic stroke (AIS) within a time window of ⩽ 4.5 h. Some AIS patients cannot be treated with IVT due to limiting contraindications, including heparin usage in an anticoagulating dose within the past 24 h or an elevated activated prothrombin time (aPTT) > 15 s. Protamine is a potent antidote to unfractionated heparin. Objectives: The objective of this study was to investigate the safety and efficacy of IVT in AIS patients after antagonization of unfractionated heparin with protamine. Methods: Patients from our stroke center (between January 2015 and September 2021) treated with IVT after heparin antagonization with protamine were analyzed. National Institutes of Health Stroke Scale (NIHSS) was used for stroke severity and modified Rankin Scale (mRS) for outcome assessment. Substantial neurological improvement was defined as the difference between admission and discharge NIHSS of ⩾8 or discharge NIHSS of ⩽1. Good outcome at follow-up after 3 months was defined as mRS 0–2. Safety data were obtained for mortality, symptomatic intracerebral hemorrhage (sICH), and for adverse events due to protamine. Second, a systematic review was performed searching PubMed and Scopus for studies and case reviews presenting AIS patients treated with IVT after heparin antagonization with protamine. The search was limited from January 1, 2011 to September 29, 2021. Furthermore, we conducted a propensity score matching comparing protamine-treated patients to a control IVT group without protamine (ratio 2:1, match tolerance 0.2). Results: A total of 16 patients, 5 treated in our hospital and 11 from literature, [65.2 ± 13.1 years, 37.5% female, median premorbid mRS (pmRS) 1 (IQR 1, 4)] treated with IVT after heparin antagonization using protamine were included and compared to 31 IVT patients [76.2 ± 10.9 years, 45% female, median pmRS 1 (IQR 0, 2)]. Substantial neurological improvement was evident in 68.8% of protamine-treated patients versus 38.7% of control patients ( p = 0.028). Good clinical outcome at follow-up was observed in 56.3% versus 58.1% of patients ( p = 0.576). No adverse events due to protamine were reported, one patient suffered sICH after secondary endovascular thrombectomy of large vessel occlusion. Mortality was 6.3% versus 22.6% ( p = 0.236). Conclusion: IVT after heparin antagonization with protamine seems to be safe and, prospectively, may extend the number of AIS patients who can benefit from reperfusion treatment using IVT. Further prospective registry trials would be helpful to further investigate the clinical applicability of heparin antagonization.
Evaluation of rAAVrh74 gene therapy vector seroprevalence by measurement of total binding antibodies in patients with Duchenne muscular dystrophy
Authors: Goedeker Natalie L. , Dharia Sachi D. , Griffin Danielle A. , Coy Jesantha , Truesdale Todd , Parikh Rajan , Whitehouse Kasen , Santra Sourav , Asher Damon R. , Zaidman Craig M. 
Published: January 2023

Background: Adeno-associated virus (AAV) vectors are a promising platform for in vivo transfer of transgenes designed to treat diseases. Pre-existing humoral immunity to these vectors can potentially impact the safety and efficacy of gene therapies. Consequently, individuals with pre-existing antibodies to the specific AAV serotypes used may be excluded from clinical trials and treatments. Recombinant AAV serotype rh74 (rAAVrh74), a vector originally isolated from rhesus monkeys and potentially less immunogenic than other serotypes isolated from humans (e.g. AAV2, AAV5, and AAV9), efficiently transduces muscle and is being investigated for use in gene therapy for Duchenne muscular dystrophy (DMD). Objective: To evaluate prevalence of total binding antibodies (neutralizing and non-neutralizing) against rAAVrh74 in patients with DMD. Methods: Eligible individuals ( N = 107) were ⩾ 4 to < 18 years old with genetically confirmed DMD and were excluded from the study if they lived with a person who had known exposure to rAAVrh74 or other gene transfer therapy, or if they received prior treatment with gene transfer therapy. A single blood sample was obtained from each participant, and anti-rAAVrh74 total binding antibodies were measured by enzyme-linked immunosorbent assay. Total binding antibody level < 1:400 was defined as not elevated or seronegative. Primary endpoint was the percentage of subjects with elevated total antibody titers to rAAVrh74. Results: A large preponderance (86.1%) of patients with DMD in this data set was seronegative for anti-rAAVrh74 total binding antibodies. These patients would potentially meet the antibody status eligibility criterion for entry into rAAVrh74-based gene therapy clinical trials. Conclusion: Measuring total binding antibodies is a more comprehensive approach to assess pre-existing immune response versus measuring neutralizing antibodies alone. The low seroprevalence of total binding antibodies against rAAVrh74 shown here supports the broad applicability of rAAVrh74-based gene transfer therapy for patients with DMD and potentially other neuromuscular diseases.
Association of Diaphragm Contractility and Postural Control in a Chronic Ankle Instability Population: A Preliminary Study
Authors: Terada Masafumi , Kosik Kyle B. , Gribble Phillip A. 
Published: January 2023

Background: Altered reorganization of the sensorimotor system after an initial lateral ankle sprain may lead to a chronic neuromuscular maladaptation in multiple body locations. Specifically, decreased diaphragm contractility has been observed in patients with chronic ankle instability (CAI). The diaphragm has an essential role in postural control. Decreased diaphragm contractility could associate with diminished postural control commonly observed in patients with CAI. However, no study has determined if diaphragm contractility contributes to postural control in a CAI population. Hypothesis: Decreased diaphragm contractility would be negatively associated with static postural control in patients with CAI. Study Design: Cross-sectional study design. Level of Evidence: Level 4. Methods: A total of 15 participants with CAI participated voluntarily. An ultrasonography assessment was performed to quantify the right and left hemidiaphragm thickness at the end of resting inspiration and expiration in supine while breathing quietly. The degree of diaphragm contractility was calculated from the diaphragm thickness. Participants performed 3 eyes-open trials of a 20-second single-leg balance task on the involved limb. Static postural control measures included the center of pressure velocity (COPV) and mean of time-to-boundary (TTB) minima in the anteroposterior (AP) and mediolateral directions. Results: Moderate correlations of the right hemidiaphragm contractility were observed with COPV (ρ = -0.54) and TTB mean minima (ρ = 0.56) ( P < 0.05) in the AP direction. The left hemidiaphragm contractility was moderately correlated with COPV (ρ = −0.56) and TTB mean minima (ρ = 0.60) ( P < 0.05) in the AP direction. Conclusion: Lower diaphragm contractility may be associated with diminished static postural control in the AP direction in patients with CAI. Clinical Relevance: This study highlights diaphragm contractility could be a potential connection with diminished static postural control in patients with CAI. Our data raise new avenues for future exploration including potential beneficial effects of implementation of diaphragm breathing exercises and techniques for restoring static postural control in patients with CAI.
Ischemia of the parotid gland and adjacent muscles of mastication following middle meningeal artery embolization
Authors: Vilanilam George K , Pokhylevych Halyna , Kamran Mudassar , Patro Satya N , Vattoth Surjith 
Published: January 2023

Middle meningeal artery (MMA) embolization is commonly performed as either a first-line or adjunct treatment for chronic subdural hematomas (cSDH). We present the case of a 59 year-old male patient who presented with right hemibody weakness and cognitive impairment and was diagnosed with left-sided cSDH. A left MMA embolization was performed due to the recurrent nature of the chronic subdural hemorrhage and the history of prior craniotomy. On postoperative day 1, the patient developed sudden onset left facial swelling and tenderness, and a contrast computed tomography (CT) of the neck revealed acute ischemia in the left parotid gland, adjacent superior aspect of the left masseter muscle, the left lateral pterygoid, and left temporalis muscles. The patient was treated conservatively with antibiotics, steroids, and analgesics and reported resolution of symptoms on the three-month follow-up. To our knowledge, this is the first reported case of the ipsilateral parotid gland, temporalis muscle, adjacent superior aspect of the masseter muscle, and pterygoid muscle ischemia secondary to non-target particle embolization following MMA embolization in cSDH. Knowledge of normal and variant origin of the MMA and various anastomoses of this vessel with branches of the internal carotid artery (ICA), external carotid artery (ECA), and vertebrobasilar system is crucial to avoid complications during embolization.
Knowledge and practice toward hospital-acquired infections prevention and associated factors among nurses working at university referral hospitals in Southern Nations, Nationalities, and Peoples’ Region, Ethiopia 2021
Authors: Foga Sebro Sisay , Birhanu Mengistu , Bilal Addis , Sahle Tadesse 
Published: January 2023

Objective: Hospital-acquired infection is higher in low- and middle-income countries because of inadequate knowledge of hospital-acquired infection prevention and poor adherence to standard infection prevention practices. Methods: A facility-based cross-sectional study was conducted among 423 randomly selected nurses working at university referral hospitals in Southern, Nations, Nationalities and Peoples’ Region, Ethiopia from 01 to 30 April 2021. Data was collected by self-administer questionnaires. Multivariable binary logistic regressions were used to assess the association between the outcome variables and explanatory variables. The adjusted odds ratio was calculated and variables with a 95% confidence interval were declared as statistically significant. Results: The study found that 45.5% (95% confidence interval: 40.6%–50.4%) and 64.8% (95% confidence interval: 60.1%–69.5%) of nurses had good knowledge and practices toward hospital-acquired infection prevention, respectively. Being male (adjusted odd ratio: 2.2, 1.41–3.40), having a degree and above in nursing (adjusted odd ratio: 3.6, 1.73–7.38), having more than 5 years of work experience (adjusted odd ratio: 2.0, 1.24–3.26), having training on infection prevention (adjusted odd ratio: 2.6, 1.58–4.37) and adequate materials supplies (adjusted odd ratio: 2.2, 1.08–4.45) had associated with nurses’ knowledge about hospital-acquired infection prevention. On the other hand, having a degree and above in nursing (adjusted odd ratio: 1.98, 1.07–3.66), consistent water supply (adjusted odd ratio: 3.4, 1.58–7.30), and being aware of the existence of infection prevention guidelines in their institution (adjusted odd ratio: 1.80, 1.14–2.87) had associated with good practices of nurses toward hospital-acquired infections prevention. Conclusion: Less than half of the nurses had adequate knowledge and approximately two-thirds of nurses had good practice for hospital-acquired infection prevention.
Needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia
Authors: Tsegaye Amlak Baye , Tesfa Shegaw , Tesfamichael Betelhem , Abebe Haimanot , Zewudie Bitew Tefera , Mewahegn Agerie Aynalem , Chekole Temere Bogale , Terefe Tamene Fetene , GebreEyesus Fisha Alebel , Tsehay Tadesse , Solomon Mamo 
Published: January 2023

Background: Needlesticks and sharp injuries are occupational hazards for healthcare workers that result from the accidental piercing of the skin. Needlestick injuries expose healthcare workers to blood and body fluids that may be infected and can be transmitted to them. Healthcare workers have been exposed to blood-borne pathogens through contaminated needles and other sharp materials every day. Around 20 blood-borne diseases can be transmitted through casual needlesticks and sharp injuries. Objective: To assess needlestick and sharp injuries and its associated factors among healthcare workers in Southern Ethiopia, 2021. Methods: The hospital-based cross-sectional study design was conducted among 341 healthcare workers in Worabe Comprehensive Specialized Hospital from June 10 to July 6, 2021. A stratified sampling technique was used and data were collected using standardized structural questionnaires by BSc nursing professionals. The collected data were checked for completeness and consistency by the investigator. The completed questionnaire was given an identification number and entered into EpiData version 3.5.1. The data were coded and analyzed using SPSS version 26 using a binary logistic regression model and presented with texts, tables, and graphs. Results: The finding revealed that 30.6% of healthcare workers had experienced needlestick and sharp injuries within their working area. Healthcare workers not trained on safety measures of needlestick and sharp injury (adjusted odds ratio: 7.179 (3.494–14.749)), working in the delivery unit (adjusted odds ratio: 6.528 (3.171–11.834)), being older age (adjusted odds ratio: 3.394 (1.775–7.126)), working in inpatient unit (3.278 (1.804–5.231)), working in an emergency unit (adjusted odds ratio: 5.718 (4.326–6.398)), working in an operation room theater (adjusted odds ratio: 2.359 (1.781–4.430)), working as a medical laboratory technician (adjusted odds ratio: 1.070 (1.432–3.304)), working in pediatrics unit (adjusted odds ratio: 1.063 (1.431–2.843)), working as cleaners (adjusted odds ratio: 0.018 (0.002–0.195)), working <40 h per week (adjusted odds ratio: 0.036 (0.004–0.345)), and seldom needle recapping (adjusted odds ratio: 0.043 (0.015–0.125)) were statistically associated with needlestick and sharp injury. Conclusions: In this study, there is a high magnitude of needlestick or sharp injuries among healthcare workers. Lack of training on work-related safety measures; working in delivery; being older age; working in the inpatient unit, emergency, operation room, and pediatrics units; being laboratory technicians, and cleaners; working hours per week; and seldom needle recapping were significant predictors of needlestick and sharp injury.
Factors associated with the level of Knowledge and self-reported Practice toward safety precautions among Factory Workers in East Gojjam Zone, Northwest Ethiopia
Authors: Mengesha Yeshiemebet , Dagnew Zewdu , Aderaw Zewdie , Telayneh Animut Takele , Temesgen Tegegne , Tegegne Eniyew , Yirdaw Getasew 
Published: January 2023

Background: According to the International Labor Organization, occupational accidents and diseases kill millions of workers every year. Objective: To assess factors associated with the level of knowledge and self-reported practice toward safety precautions among factory workers in the East Gojjam Zone, Northwest Ethiopia, 2021. Methods: An institution-based, cross-sectional study was conducted on 420 randomly selected factory workers. Data were collected through face-to-face interviews using structured questionnaires and an observation checklist. The data were analyzed using the descriptive statistical method and using bivariate binary and multivariable logistic regression models. Variables with a p-value <0.05 with a 95% confidence interval were considered to have statistical significance. Results: The study had a response rate of 99.0%, with a total of 416 respondents. 53.4% of respondents were aware of safety precautions, and 56.0% of them rated the use of personal protective equipment as an indicator of the practice of safety precautions. Factory workers’ educational status (adjusted odds ratio: 4.3, 95% confidence interval: 2.4, 7.8), job satisfaction (adjusted odds ratio: 4.7, 95% confidence interval: 2.1, 10.4), and having training on safety issues (adjusted odds ratio: 12.8, 95% confidence interval: 6.3, 26.1) were determinant factors of knowledge regarding safety precautions, while the type of factory (adjusted odds ratio: 16.0, 95% confidence interval: 5.8, 44.1), the presence of regular supervision (adjusted odds ratio: 3.8, 95% confidence interval: 2.1, 6.8), and overall knowledge about safety precautions (adjusted odds ratio: 7.2, 95% confidence interval: 3.9, 13.2) were the independent determinants of the practice of safety precautions. Conclusions: Workers’ knowledge and practice regarding safety precautions were low as compared to studies in developing countries. Interventions targeted at the provision of training, promotion, and enforcement of issues regarding safety precautions should be in place. Employers, the government, and employees should work together to address these workplace safety issues.
Ageing in place – exploring the safety of the environment of Slovenian older adults
Authors: Galof Katarina 
Published: January 2023

Objective: The importance of subjective and objective living environment was investigated. Methods: A new questionnaire was developed, validated and distributed to community-dwelling adults in various Slovenian counties. Data were analysed using descriptive statistics and t-tests in SPSS Statistics 24. Older adults ( N = 358), 33% men and 67% women, mean age 74.3 years, participated in the cross-sectional study. Results: Statistically significant differences (at 5% significance level) in subjective opinions of older adults regarding views on appropriate design of the living environment between the group with and without risk factors exist only for the statement that a thermostat to regulate room temperature should be placed in a visible and accessible location ( p = 0.014). Conclusion: The living environment has some risk factors, but they are not statistically significant between groups. The results may prompt occupational therapists to develop innovative strategies to facilitate occupational participation of users, increase participation in preventive services and obtain policy support.
Development and Validation of Patient Education Tools for Deprescribing in Patients on Hemodialysis
Authors: Cho Thomas Hyunwoo , Ng Patrick C. K. , Lefebvre Melissa J. , Desjarlais Arlene , McCann Dennis , Waldvogel Blair , Tonelli Marcello , Garg Amit X. , Wilson JoAnne , Beaulieu Monica , Marin Judith , Orsulak Cali , Talson Melanie , Sharma Monica , Feldberg Jordanne , Bohm Clara , Battistella Marisa 
Published: January 2023

Background: Deprescribing is a patient-centered solution to reducing polypharmacy in patients on hemodialysis (HD). In a deprescribing pilot study, patients were hesitant to participate due to limited understanding of their own medications and their unfamiliarity with the concept of deprescribing. Therefore, patient education materials designed to address these knowledge gaps can overcome barriers to shared decision-making and reduce hesitancy regarding deprescribing. Objective: To develop and validate a medication-specific, patient education toolkit (bulletin and video) that will supplement an upcoming nationwide deprescribing program for patients on HD. Methods: Patient education tools were developed based on the content of previously validated deprescribing algorithms and literature searches for patients’ preferences in education. A preliminary round of validation was completed by 5 clinicians to provide feedback on the accuracy and clarity of the education tools. Then, 3 validation rounds were completed by patients on HD across 3 sites in Vancouver, Winnipeg, and Toronto. Content and face validity were evaluated on a 4-point and 5-point Likert scale, respectively. The content validity index (CVI) score was calculated after each round, and revisions were made based on patient feedback. Results: A total of 105 patients participated in the validation. All 10 education tools achieved content and face validity after 3 rounds. The CVI score was 1.0 for most of the tools, with 0.95 being the lowest value. Face validity ranged from 72% to 100%, with majority scoring above 90%. Conclusion: Ten patient education tools on deprescribing were developed and validated by patients on HD. These validated, medication-specific education tools are the first of its kind for patients on HD and will be used in a nationwide implementation study alongside the validated deprescribing algorithms developed by our research group.
Implementation and impacts of virtual team-based care planning for older persons in formal care settings: A scoping review
Authors: Gao Harrison , Yous Marie-Lee , Connelly Denise , Hung Lillian , Garnett Anna , Hay Melissa , Snobelen Nancy 
Published: January 2023

Objective This scoping review aimed to summarize current knowledge about the implementation, impacts, facilitators and barriers of virtual team-based care planning for older persons in formal care settings (e.g. home and community, primary, long-term and acute care). Methods The Joanna Briggs Institute (JBI) methodology was used. The Arksey and O’Malley and Levac, Colquhoun, and O’Brien methodologies provided additional frameworks. Databases accessed included PubMed, EMBASE, CINAHL, AgeLine, PsycInfo and Scopus. Reference lists of selected articles and grey literature retrieved through Google and Google Scholar were also reviewed. Three researchers screened titles, abstracts and conducted full-text reviews. Extracted data were mapped in a table and analysed for summative themes. Older persons and family partners assisted in interpreting findings based on their lived experiences. Results A total of 27 studies were included. Virtual team-based care planning led to many positive outcomes for older persons (e.g. decreased depression, reduced falls and improved medication management) and their families (e.g. reduced caregiver stress and improved caregiving skills). Only four studies reported the involvement of older persons and/or families in virtual team-based care planning. Multiple barriers to adopting virtual team-based care planning were found including lack of education/training for older persons and families in using technology. Conclusion Despite the multiple advantages that virtual team-based care planning offers for older persons and families, it is important to ensure that this care can be offered to all. There is a need to ensure that health equity is addressed to promote access to care and respond to social determinants of health.