bluuebunny/crossref_metadata_2025_split huggingface dataset:
‘If you didn't chart it, you didn't do it’: a retrospective chart review of errors omission in endoscopy care
Authors: Rican TS , George Mini 
Published: April 2023

Background: Patients put themselves in the care of a competent healthcare team. Missed nursing care is a universal phenomemon, and endoscopy is no exception. Although endoscopic procedures for the diagnosis and treatment of gastrointestinal diseases are usually minimally invasive, highest standards of nursing care and documentation are to be ensured for patient safety. Aim: This study aimed to identify and quantify the type and frequency of nursing care that was documented. Methods: A descriptive retrospective chart review was conducted after formal approval and ethics clearance at a tertiary hospital. Documentation on the nurses' records (n=717) for the period January to December 2019 that met the sampling criteria were audited for a full range of nursing care activities during endoscopy. Data was extracted using a validated (CVI 0.87-1), reliable (Kappa 0.83; ICC 0.98) data abstraction form. Data were analysed using descriptive statistics. Results: Of 47 care activities in each of 717 records, 41.5% were undocumented. More care went undocumented in the intra-procedure (56.1%) and post-procedure (54.2%) periods than the pre-procedure period (15.4%). The proportion of each activity going undocumented ranged widely from 0% to 100%. Conclusion: The findings demonstrate that many aspects of care related to endoscopy were not documented and thus likely omitted. Proper care and documentation can help identify and mitigate any harm to patients.
What are the barriers and facilitators to community handwashing with water and soap? A systematic review
Authors: Ezezika Obidimma , Heng Jennifer , Fatima Kishif , Mohamed Ayman , Barrett Kathryn 
Published: April 2023

Handwashing with water and soap (HWWS) is an effective method of cleaning and disinfecting the surface of the hands. HWWS is effective in infection control and prevention transmission, such as in Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2). However, rates of handwashing compliance vary globally. This systematic review aimed to identify the barriers and facilitators to community HWWS globally. We conducted a comprehensive search strategy in OVID Medline, OVID Embase, Web of Science Core Collection, and Scopus using keywords and subject headings related to handwashing. Studies were excluded if they reported hand hygiene among healthcare or food service workers, considered the use of alcohol rubs, or involved an intervention in a healthcare or food preparation setting. The quality of eligible studies was assessed using the Mixed Methods Appraisal Tool, and data were extracted from the articles and analyzed using the Theoretical Domains Framework and inductive thematic analysis. The search strategy yielded a total of 11,696 studies, and 46 studies met the eligibility criteria. Study dates ranged from 2003 to 2020 and included 26 countries; the most frequently represented were Bangladesh, India, and Kenya. A total of 21 barriers and 23 facilitators to HWWS were identified and organized into the Theoretical Domains Framework. The most frequently cited domains were environmental context and resources, goals, and knowledge. Nine themes emerged from these barriers and facilitators: resource availability, cost and affordability, handwash station design and infrastructure, accessibility, gender roles, champions, health promotion, time management, and knowledge, beliefs, and behaviors. This review uncovered multiple barriers and facilitators around a determinant framework to observe and create an in-depth, multidimensional image of a community-based hand hygiene situation. New comprehensive interventions and implementation strategies can be developed using the findings to target the contextual barriers and facilitators to improve and increase HWWS rates. Stakeholders (i.e., practitioners, researchers, policymakers) can use the findings to revise, design, or evaluate new or existing projects, interventions, and policies to improve HWWS.
Registration: A protocol for this systematic review was developed and uploaded onto the PROSPERO—International prospective register of systematic reviews database (Registration number: CRD42020221210).
Perspectives of patients and healthcare professionals on metabolic monitoring of adult prescribed second-generation antipsychotics for severe mental illness: A meta-synthesis
Authors: Poojari Pooja Gopal , Khan Sohil , Shenoy Sonia , Shetty Sahana , Pai Keshava , Acharya Leelavathi D. , Bose Swarnali , Thunga Girish 
Published: April 2023

Objectives
We conducted a meta-synthesis of qualitative studies to synthesize the views of psychiatric patients on second-generation antipsychotics (SGAs) and the healthcare providers about the metabolic monitoring of adult-prescribed SGAs.

Methods
A systematic search was conducted in four databases through SCOPUS, PubMed, EMBASE, and CINAHL to identify qualitative studies of patients’ and healthcare professionals’ perspectives on the metabolic monitoring of SGAs. Initially, titles and abstracts were screened to exclude articles that were not relevant followed by full-text reading. Study quality was assessed by using Critical Appraisal Skills Program (CASP) criteria. Themes were synthesized and presented as per the Interpretive data synthesis process (Evans D, 2002).

Results
A total of 15 studies met the inclusion criteria and were analyzed in meta-synthesis. Four themes were identified: 1. Barriers to metabolic monitoring; 2. Patient related concerns to metabolic monitoring; 3. Support system by mental health services to promote metabolic monitoring; and 4. Integrating physical health with mental health services. From the participants’ perspectives, barriers to metabolic monitoring were accessibility of services, lack of education and awareness, time/resource constraints, financial hardship, lack of interest on metabolic monitoring, patient capacity and motivation to maintain physical health and role confusion and impact on communication. Education and training on monitoring practices as well as integrated mental health services for metabolic monitoring to promote quality and safe use of SGAs are the most likely approaches to promote adherence to best practices and minimize treatment-related metabolic syndrome in this highly vulnerable cohort.

Conclusion
This meta-synthesis highlights key barriers from the perspectives of patients and healthcare professionals regarding the metabolic monitoring of SGAs. These barriers and suggested remedial strategies are important to pilot in the clinical setting and to assess the impact of the implementation of such strategies as a component of pharmacovigilance to promote the quality use of SGAs as well as to prevent and/or manage SGAs-induced metabolic syndrome in severe and complex mental health disorders.
Opioid-related deaths during hospital admissions or shortly after discharge in the United Kingdom: A thematic framework analysis of coroner reports
Authors: Lewer Dan , Brothers Thomas D. , Harris Magdalena , Rock Kirsten L. , Copeland Caroline S. 
Published: April 2023

Background
People who use heroin and other illicit opioids are at high risk of fatal overdose in the days after hospital discharge, but the reasons for this risk have not been studied.

Methods
We used the National Programme on Substance Abuse Deaths, a database of coroner reports for deaths following psychoactive drug use in England, Wales, and Northern Ireland. We selected reports where the death occurred between 2010 and 2021, an opioid was detected in toxicology testing, the death was related to nonmedical opioid use, and death was either during an acute medical or psychiatric hospital admission or within 14 days after discharge. We used thematic framework analysis of factors that may contribute to the risk of death during hospital admission or after discharge.

Results
We identified 121 coroners’ reports; 42 where a patient died after using drugs during hospital admission, and 79 where death occurred shortly after discharge. The median age at death was 40 (IQR 34–46); 88 (73%) were male; and sedatives additional to opioids were detected at postmortem in 88 cases (73%), most commonly benzodiazepines. In thematic framework analysis, we categorised potential causes of fatal opioid overdose into three areas: (a) hospital policies and actions. Zero-tolerance policies mean that patients conceal drug use and use drugs in unsafe places such as locked bathrooms. Patients may be discharged to locations such as temporary hostels or the street while recovering. Some patients bring their own medicines or illicit opioids due to expectations of low-quality care, including undertreated withdrawal or pain; (b) high-risk use of sedatives. People may increase sedative use to manage symptoms of acute illness or a mental health crisis, and some may lose tolerance to opioids during a hospital admission; (c) declining health. Physical health and mobility problems posed barriers to post-discharge treatment for substance use, and some patients had sudden deteriorations in health that may have contributed to respiratory depression.

Conclusion
Hospital admissions are associated with acute health crises that increase the risk of fatal overdose for patients who use illicit opioids. Hospitals need guidance to help them care for this patient group, particularly in relation to withdrawal management, harm reduction interventions such as take-home naloxone, discharge planning including continuation of opioid agonist therapy during recovery, management of poly-sedative use, and access to palliative care.
Dissecting eustachian tube dysfunction: From phenotypes to endotypes
Authors: Alper Cuneyt M. , Teixeira Miriam S. , Mandel Ellen M. , Swarts J. Douglas 
Published: April 2023

Objective
A broad spectrum of complaints, symptoms and manifestations has been assigned to Eustachian tube (ET) dysfunction (ETD). While such presentations may manifest as ETD phenotypes, underlying mechanisms are defined as endotypes. Our goal is to develop a diagnostic approach to differentiate the endotypes and guide clinicians in the workup and selection of treatments targeting the mechanism of ETD.

Study design
Retrospective.

Setting
Tertiary care.

Subjects and methods
Children and adults with suspected ETD were evaluated with a thorough examination, otomicroscopy, otoendoscopy, trans-nasal videoendoscopy and testing of passive and active ET dilatory properties. Degree of weakness in soft palate elevation and ET orifice widening (muscular weakness, ETD-M), presence of inflammation (ETD-I) and/or adenoid tissue impinging and restricting the ET opening (ETD-R) were assessed with video-endoscopy. The Forced Response Test, Inflation-Deflation Test and Pressure Chamber Test were used as applicable to quantify the degree and type of difficulty (Stricture, ETD-S or adhesive, ETD-A) or ease (patulous or semi-patulous, ETD-P/SP) in opening the ET, and degree of active muscular strength/weakness (ETD-M) was measured. Ears with normal function (ETF-N) findings were also identified.

Results
Video-endoscopic and ETF test results were obtained for 71 ears of 40 subjects (22 males, 18 females; 38 white, 2 black), with an average age of 22.9 ± 16.5 years (min:6.2, max:64.1). Videoendoscopy (21, 13, 33, 16, 13, 0, 0 ETs) and ETF testing analysis (20, 24, 0, 38, 0, 3, 13 ears) were categorized as ETF-N and the ETD endotypes ETD-S, ETD-R, ETD-M, ETD-I, ETD-A, and ETD-P/SP, respectively. Some phenotypes had features consistent with more than one endotype.

Conclusion
A systematic approach of examination and testing may differentiate the specific underlying mechanisms, lead to a treatment targeted to the ETD endotype and may establish novel ways to diagnose and treat ETD.
Factors influencing return to work 3 months after percutaneous coronary intervention in young and middle-aged patients with coronary heart disease: A single-center, cross-sectional study
Authors: Hu Yaoyao , Zhou Taihua , Li Xiaojing , Chen Xiaoxiao , Wang Xiaoyan , Xu Jiahui , Gu Danfeng 
Published: April 2023

Background
Today, patients with coronary heart disease (CHD) are becoming younger and younger, and after percutaneous coronary intervention (PCI), most patients want to resume their occupations. The return to work of patients with CHD post PCI in China, however, has received little research attention. So, the goal of this study was to investigate the variables impacting the return to work following PCI in young and middle-aged patients with CHD in Wuxi and to offer a reference basis for the development of targeted interventions.

Methods
This study was executed at the Affiliated Hospital of Jiangnan University. We selected 280 young and middle-aged patients who underwent PCI for CHD as the study subjects and gathered general data about them while they were hospitalized. At 3 months after PCI, we surveyed the subjects with the return to work self-efficacy questionnaire, the Chinese version of the brief fatigue inventory, and the social support rating scale, and obtained information about their return to work. The factors affecting patients’ returning to work were analyzed using binary logistic regression.

Results
The final 255 cases were included in the study, of which 155 (60.8%) were successfully returned to work. Binary logistic regression showed that women (OR = 0.379, 95%CI:0.169,0.851), ejection fraction ≥50% (OR = 2.053, 95%CI:1.085,3.885), the brain-based job types (OR = 2.902, 95%CI:1.361,6.190), the kind of employment requiring both mental and physical capacity (OR = 2.867, 95%CI:1.224,6.715), moderate fatigue (OR = 6.023, 95%:1.596,22.7251), mild fatigue (OR = 4.035, 95%:1.104,14.751), return to work efficacy (OR = 1.839, 95%:1.140,3.144), and social support (OR = 1.060, 95%:1.003,1.121) were independent influences on patients’ return to work at 3 months after PCI (All P<0.05).

Conclusion
In order to help patient return to work as soon as possible, healthcare professionals should focus on those who are female, have worked mainly in physical activities, have low return-to-work self-efficacy, have severe fatigue, have low social support, and have poor ejection fraction.
Effect of relative weight limit set as a body weight percentage on work-related low back pain among workers
Authors: Iwakiri Kazuyuki , Sasaki Takeshi , Sotoyama Midori , Du Tanghuizi , Miki Keiichi , Oyama Fuyuki 
Published: April 2023

Introduction
A quarter of work-related low back pain (LBP) cases result from handling heavy loads in Japan. The maximum weight male/female workers can handle is 40%/24% of their body weight but has set a constant load weight in ISO 11228–1 and NIOSH lifting equation. The preventive effect of the relative weight limit on LBP has not been clarified. This study aimed to identify the effect of relative weight limits set as body weight percentages on LBP prevalence.

Methods
Data from 21924 workers were collected via a web-based survey in 2022. The workers were categorized into three groups: group A, “no handling,” group B, “handling loads up to 40%/24% or less of body weight,” and group C, “handling loads over 40%/24% of body weight.” Moreover, they were categorized into eight groups: no handling, 1–5 kg, 5–10 kg, 10–15 kg, 15–20 kg, 20–25 kg, 25–30 kg, and ≥30 kg. Multiple logistic regression analysis was used to identify the effects of the limits set to body weight percentages and constant load weights on LBP.

Results
In groups A, B, and C, 25.5%, 39.2%, and 47.3% of males or 16.9%, 26.4%, and 38.0% of females had LBP, respectively. The odds ratio (OR) of LBP was significantly greater in group B than in group A and even greater in group C. The OR of LBP among workers handling loads under 10 kg was not significantly different compared to no-handling workers.

Conclusions
LBP prevalence was greater in group B than in group A but lesser than in group C. Weight limits based on body weight percentages could not eliminate the factor of handling loads. However, handling loads under 10 kg suppressed LBP. Relative weight limits set as body weight percentages were inappropriate and ineffective for preventing LBP.
Academic achievement after a CT examination toward the head in childhood: Follow up of a randomized controlled trial
Authors: Salonen Elina , Bujila Robert , af Geijerstam Jean-Luc , Nyman Håkan , Flodmark Olof , Aspelin Peter , Kaijser Magnus 
Published: April 2023

Introduction
Increasing use of CT examinations has led to concerns of possible negative cognitive effects for children. The objective of this study is to examine if the ionizing radiation dose from a CT head scan at the age of 6–16 years affects academic performance and high school eligibility at the end of compulsory school.

Materials and methods
A total of 832 children, 535 boys and 297 girls, from a previous trial where CT head scan was randomized on patients presenting with mild traumatic brain injury, were followed. Age at inclusion was 6–16 years (mean of 12.1), age at follow up 15–18 years (mean of 16.0), and time between injury and follow up one week up to 10 years (mean of 3.9). Participants’ radiation exposure status was linked with the total grade score, grades in mathematics and the Swedish language, eligibility for high school at the end of compulsory school, previously measured GOSE-score, and their mothers’ education level. The Chi-Square Test, Student’s t-Test and factorial logistics were used to analyze data.

Results
Although estimates of school grades and high school eligibility were generally higher for the unexposed, the results showed no statistically significant differences between the exposed and unexposed participants in any of the aforementioned variables.

Conclusions
Any effect on high school eligibility and school grades from a CT head scan at the age of 6–16 years is too small to be detected in a study of more than 800 patients, half of whom were randomly assigned to CT head scan exposure.
Dissecting the role of plasmalogen lipids in synapse function and neurodegeneration by interdisciplinary lipidomics
Authors: Gane Iwan , Sinclair Kathryn , Hunter Ann , Angelini Roberto 
Published: April 2023

Introduction
More than 520,000 people in the UK suffer from dementia caused by Alzheimer’s Disease (AD), a number set to rise towards 1 million by 2025 with the resultant cost to the economy expected to surpass £25 billion. With currently no effective treatments for patients with AD or dementia, it is crucial that research advances our understanding of these conditions with an aim to bring therapies to the fore. Synaptic dysfunction develops early in neurodegeneration, driving the gradual impairment of memory, sensation, and cognition. This correlates with the loss of plasmalogen phospholipids, which are enriched at synapses where their conical geometry is believed to ease synaptic vesicle fusion. Direct assessment of the role of plasmalogens at synapses has yet to be carried out, which is our goal.
Methods
We have developed a neuronal model using the neuroblastoma cell line, SH-SY5Y, to study the effects of plasmalogen levels on synapse formation and function following post-transcriptional silencing of plasmalogen biosynthetic enzymes. We are developing a novel quantitative shotgun lipidomics approach for the study of plasmalogens in neuronal cells, and with this data in parallel with immunocytochemistry, Western-blot and neurotransmitter assays, we will determine and characterise the role of plasmalogens at synapses. Furthermore, we will assess the capacity of plasmalogen precursor supplementation to restore plasmalogen levels and hence to abrogate disruption of synapse formation and function, endeavouring to open a future treatment direction for AD.
Approach for Statistical Analysis
Based on our preliminary data and previous literature, we expect the data from lipidomic and synaptic assays to be normally distributed. Comparison of multiple groups at one time point (e.g., normal vs plasmalogen-deficient vs plasmalogen-supplemented groups) will use one-way ANOVA with Bonferroni correction (GraphPad Software). Estimating a 50% decrease of plasmalogen levels and/or synaptic puncta upon KD and a 50% increase upon supplementation, SD=20%, eq
Synchronous Pancreatic Masses
Authors: Chatterjee Arjun , Sharma Neha , Singh Amandeep , Franklin Matthew , Garg Rajat , Chahal Prabhleen 
Published: April 2023

ABSTRACT
Any mass lesion in the pancreas usually raises the possibility of undiagnosed pancreatic cancer. With the advancement of imaging modalities, we are seeing an increasing number of incidental findings, some of which may be clinically significant. When dealing with incidental pancreatic findings, it is critical to keep a broad differential in mind in addition to ruling out pancreatic malignancy. We present 3 rare cases of patients with 2 or more synchronous solid masses in the pancreas caused by pancreatic cancer, type 1 autoimmune pancreatitis, and sarcoidosis.
Not Your Everyday Duodenal Ulcer: Massive Gastrointestinal Bleed Secondary to Extramedullary Plasma Cell Myeloma
Authors: Fiske Hannah , Dougherty Brian , Ward Christopher , Claus Jessica , Dannheim Katelyn , Chen Sonja , Ferreira Jason 
Published: April 2023

ABSTRACT
The differential for gastrointestinal (GI) bleeding is broad, ranging from peptic ulcers and Helicobacter pylori infection to variceal hemorrhage and neoplasms. The rarer causes of GI bleeds are frequently overlooked and as such can ultimately be more dangerous. Extramedullary multiple myeloma, an atypical plasma cell dyscrasia arising outside of the bone marrow, involves the GI tract in <5% of cases and often presents with nonspecific symptoms. We describe a rare case of such GI involvement of a plasma cell tumor, with subsequent transmural duodenal ulceration involving the gastroduodenal artery, ultimately resulting in a fatal GI bleed.
Nursing students’ attitudes towards cancer and affecting factors in Turkey: A descriptive study
Authors: Kutlutürkan Sevinç , Kırca Kamile , Sözeri Öztürk Elif 
Published: April 2023

Aim:The aim of this study was to investigate the attitudes of nursing students towards cancer as well as affecting factors.
Method:This descriptive study was conducted with 949 nursing students at two state universities in Turkey. The population of this study included 1st, 2nd, 3rd, and 4th year students in the nursing programs in two universities in the academic year. In collecting data, “Demographic Information Form” and “Questionnaire for Measuring Attitudes Toward Cancer - Community Version” scales were used. The data were analysed by number, percentage, mean, standard deviation, Mann-Whitney U test, Kruskall-Wallis H test and linear regression analysis. Mann Whitney U test with Bonferroni correction was used as post-hoc test.
Findings: While 63.3% of the students were at the range of 17-20 years, 87.8 % of them were female and 36.8% of them were first year students. It was determined that 51.4% of the students participated in the care and treatment practices of a patient diagnosed with cancer during clinical practices. The mean score of the Questionnaire for Measuring Attitudes Toward Cancer was 3.23±0.47. In this study, a statistically significant relationship was found between the students’ year in the program and the subscale of impossibility of recovery, between gender and the scale, having an individual diagnosed with cancer among family members and his/her immediate environment with disclosure, and the dissemination of cancer diagnosis (p< 0.05). According to the stepwise method completed in the linear regression analysis, gender and informing a patient about his/her cancer diagnosis had a significant effect on the scale (p< 0.05).
Conclusions: In this study, the students were found to have negative attitudes toward cancer. In this regard, healthcare professionals should organise training programs in order to change negative thoughts and attitudes of the students during educational processes.