bluuebunny/crossref_metadata_2025_split huggingface dataset:
Medical interns’ views on the strategies for reducing antibiotic misuse in the hospitals—what guidelines do they follow?
Authors: Sun Kai Sing , Lam Tai Pong , Chan Tak Hon , Lam Kwok Fai , Kwok Kit Wing , Chan Hoi Yan , Ho Pak Leung 
Published: May 2022

Objectives Although the topic of antibiotic misuse is taught in medical schools, interns (fresh medical graduates) still encounter barriers to appropriate antibiotic prescription when they practice in hospitals under supervision. The impact of teaching in medical school, antibiotics stewardship program (ASP), and prescription guidelines was uncertain. This study explored the medical interns’ views on antibiotic use and resistance, and their perceived enablers to appropriate antibiotic prescription. Methods Two focus groups were conducted among medical interns with rotation experiences in different public hospitals of Hong Kong. The identified themes about attitudes to antibiotic resistance and enablers to appropriate antibiotic prescription were further examined by a questionnaire survey with 77 respondents. Results The interns had lower preferences for tackling antibiotic resistance as they feared of delayed prescriptions. Guidelines provided by international evidence-based clinical resources and the interns’ working hospitals were stronger enablers to appropriate antibiotic use than education materials from schools and the government. Qualitative findings revealed that the interns were aware of the existing ASP but doubted its effectiveness as it failed to get the prescribers’ attention. They followed guidelines in their wards but perceived guidelines from local health authorities user-unfriendly. Knowledge from medical school was not very applicable. Varying prescribing practices between hospitals and the densely placed hospital beds made it difficult to prevent the spread of antimicrobial resistance. Conclusions Minimizing delayed prescription is of a higher priority than tackling antibiotic resistance in medical interns’ perspective. Interventions should target guidelines in hospitals and simplify the interface of local guidelines.
Gout management and outcomes during established COVID-19 pandemic in 2020–2021: a cross-sectional Internet survey
Authors: Singh Jasvinder A. , Edwards N. Lawrence 
Published: May 2022

Objective: To assess the management of gout in established COVID-19 pandemic. Methods: We assessed medication use, health care utilization, gout-specific health-related quality of life (HRQOL), psychological distress using Patient Health Questionnaire–4 (PHQ-4), resilience, illness perception, and health literacy in people with physician-diagnosed self-reported gout in established COVID-19 pandemic in a cross-sectional Internet survey. Results: Among the 130 survey respondents with gout, the mean age was 62.8 years, 65% were male, 83% were White, 59% were prescribed urate-lowering therapy (ULT), and health literacy was adequate in 80%. A third of survey respondents reported more difficulty with their gout management since September 2020. Gout-specific HRQOL deficits were evident. Moderate-severe psychological distress was seen in 22%, and resilience score was 6.5 [standard deviation (SD), 1.9; range, 0–8]. Adjusted for age and sex, compared with no/mild psychological distress, moderate-severe psychological distress was associated with significantly higher odds ratio (OR; 95% confidence interval) of more difficulty with (1) getting health care for gout in clinic, 3.7 (1.0, 13.2); emergency room/urgent care, 8.1 (1.4, 45.0); and in the hospital, 9.8 (1.6, 59.6); (2) getting gout flares treated, 6.6 (1.6, 26.8); (3) avoiding gout complications, 4.5 (1.2, 16.7); and (4) daily activities at home, 4.2 (1.3, 14.1), and performing work, 4.1 (1.2, 13.6). Conclusion: Respondents with gout reported health care gaps, low rates of ULT prescription, high psychological distress, and HRQOL deficits during established COVID-19 pandemic. Moderate-severe psychological distress was associated with difficulties in health care access and gout management. Interventions to address these challenges in gout management are needed.
Patterns and Predictors Associated With Long-Term Glycemic Control in Pediatric and Young Adult Patients with Type 1 Diabetes
Authors: Jendle Johan , Agvall Björn , Galozy Alexander , Adolfsson Peter 
Published: May 2022

Background: The development of diabetes technology is rapid and requires education and resources to be successfully implemented in diabetes care management. Method: In an observational study, we evaluated the use of advanced diabetes technology, resource utilization, and glycemic control. The study population was 725 individuals with type 1 diabetes (T1D) living in Region Halland, Sweden. The study cohort was followed for 7 years between 2013 and 2019. Results: Children aged 0 to 17 years were associated with significantly better glucose control than young adults aged 18 to 25 years. The mean HbA1c in children and young adults was 53 mmol/mol (7.0%) compared to 61 mmol/mol (7.7%) ( P < .0001), respectively. Comorbidities such as attention deficit hyperactivity disorder (ADHD), autism, and coelic disease were associated with higher HbA1c. All groups, regardless of age and comorbidity, showed a positive effect on glucose control after visiting a dietitian or psychologist. Differences were found between the age groups in terms of more use of advanced diabetes technology and more frequent visits to a physician in children compared to young adults. Conclusions: More frequent visits to physicians, and a visit to dietitians, and psychologists were associated with improved glucose control in individuals with T1D 0 to 25 years. Increased resources, including access to more advanced technologies, may be required in young adults with T1D.
Early Emergent and Progressive Aberrant Subchondral Bone Remodeling Coupled with Aggravated Cartilage Degeneration in Developmental Dysplasia of the Hip
Authors: Ye Teng , Xue Feng , Hu Hai , He Zihao , Wang Minqi , Yu Zhifeng , Zhao Bizeng , Chu Linyang 
Published: May 2022

Objective Developmental dysplasia of the hip (DDH) is the most common skeletal development in children and could result in secondary osteoarthritis. This study aims to clarify the alternations of subchondral trabecular bone remodeling and microstructural properties during the development of DDH, and the potential influence of these alternations on the overlying cartilage degeneration and DDH progression. Design Traditional straight-leg swaddling method was adopted to establish DDH model in newborn Sprague Dawley rats. Hip joint specimens from normal or DDH rats were used. Typical features of DDH in radiological examination were observed by x-ray analysis. Micro–computed tomography analysis was applied to evaluate the microstructural properties of subchondral bone at postnatal weeks 2, 4, and 6. Histological and immunohistochemical analyses were adopted to appraise subchondral bone remodeling activity and cartilage degeneration. The associations among subchondral bone, articular cartilage, and DDH severity were analyzed via multiple linear regression analysis. Results Compared with control group, the subchondral bone in DDH group displayed a gradual trend of deteriorated microstructure and worsening biomechanical properties along with aberrant bone remodeling, which might be responsible for the inhibition of stress transmission from the articular cartilage to the subchondral bone and thus leading to the cartilage degeneration and accelerated DDH progression. Conclusions Our findings indicate that alternations of subchondral trabecular bone in a time-dependent manner could contribute to the DDH progression and the amelioration on subchondral bone might be a favorable therapeutic candidate for DDH.
Availability of tracheal shift in the chest X-ray image as pre-treatment evaluation of mechanical thrombectomy
Authors: Ohgaki Fukutaro , Shimizu Nobuyuki , Suenaga Jun , Tateishi Kensuke , Ikegaya Naoki , Suzuki Ryosuke , Yamamura Koji , Yamamoto Tetsuya 
Published: May 2022

Background The use of mechanical thrombectomy (MT) for treatment of acute large vessel occlusion has recently increased. Prompt and timely guiding catheter (GC) induction is necessary to improve prognosis of MT and reduce the time for recanalization. However, difficulties in GC induction are encountered in some patients. This GC induction depends mainly on the aortic arch structure. Therefore, this study focused on assessing presence of tracheal shift on chest X-ray images as pre-treatment evaluation method for GC induction due to its wide availability as an indicator for status of the mediastinum. Methods: We retrospectively examined 33 patients who underwent MT at our facilities between April 2017 and March 2021. The patients were divided into two groups according to presence or absence of tracheal shift on chest X-ray images. Background characteristics and treatment courses in these two groups were compared. Results: Among 33 patients, tracheal shift was observed on the chest X-ray images of 14 patients. Furthermore, tracheal shift was positively correlated with the time of GC induction (32.9 min vs. 11.6 min, [ p < 0.05]) and the female sex ( p = 0.03). Additionally, tracheal shift exhibited correlations with multiple risk factors of atherosclerosis ( p = 0.04). Conclusions: In patients with tracheal shift, GC induction could be expectedly difficult. Therefore, advanced disinfection of the right upper arm and affected side of the neck during MT in preparation for changing an approach route is required.
Non-traumatic acute myelopathies: Clinical and imaging features in a real world emergency setting
Authors: Stasolla Alessandro , Prosperini Luca , Haggiag Shalom , Pezzella Francesca R , Pingi Alberto , Cozzolino Valeria , Pampana Enrico , Cotroneo Enrico , Tortorella Carla , Menniti Agazio , Gasperini Claudio 
Published: May 2022

Objective The aetiologic diagnosis of non-traumatic acute myelopathies (AMs), and their differentiation from other mimicking conditions (i.e. ‘mimics’), are clinically challenging, especially in the emergency setting. Here, we sought to identify: (i) red flags suggesting diagnoses alternative to AMs and (ii) clinical signs and magnetic resonance imaging (MRI) features differentiating non-compressive from compressive AMs. Materials and methods We retrospectively retrieved MRI scans of spinal cord dictated at emergency room from January 2016 to December 2020 in the suspicion of AMs. Patients with traumatic myelopathies and those with subacute/chronic myelopathies (i.e. MRI scans acquired >48 h from symptom onset) were excluded from analysis. Results Our search retrieved 105 patients; after excluding 16 cases of traumatic myelopathies and 14 cases of subacute/chronic myelopathies, we identified 30 cases with non-compressive AMs, 30 cases with compressive AMs and 15 mimics. The presence of pyramidal signs ( p = 0.012) and/or pain ( p = 0.048) correctly identified 88% of cases with AMs. We failed to identify clinical indicators for distinguishing non-compressive and compressive AMs, although cases with inflammatory AMs were younger than cases with all the remaining conditions ( p < 0.05). Different MRI patterns could be described according to the final diagnosis: among non-compressive AMs, inflammatory lesions were more often posterior or central; vascular malformation had a fairly widespread distribution; spine ischaemia was more often central. Anterior or lateral compression were more often associated with neoplasms and disc herniation , whereas hemorrhages and infections produced spine compression on all sides. Conclusion We propose a simple clinical indicator (i.e. pyramidal signs and/or pain) to distinguish AMs from their mimics in an emergency setting. Urgent spinal cord MRI remains essential to discriminate compressive and non-compressive aetiologies.
More Than Asthma: A Case Report of Eosinophilic Bronchiolitis
Authors: Khoo Sophie Su Hui , Yii Anthony Chau Ang 
Published: May 2022

Eosinophilic bronchiolitis (EB) is a rare disease that may mimic or coexist with asthma, but EB typically fails to improve with guideline-based asthma treatments. A 52-year-old man presented with wheezing and shortness of breath for 5 months. He was found to have elevated peripheral blood eosinophils and moderately severe airflow obstruction but did not improve with high-dose inhaled corticosteroids in combination with long-acting beta2-agonist and long-acting muscarinic antagonist. Computed tomography revealed diffuse and widespread “tree-in-bud” changes. Transbronchial lung biopsy demonstrated eosinophilic bronchiolitis. The patient improved with a prolonged course of systemic corticosteroids. EB is distinguished from eosinophilic asthma by the presence of florid bronchiolitis on radiologic imaging or histopathology. The mainstay of treatment is systemic corticosteroids, with a possible role for biologics.
Non-inferiority of 1 month versus longer dual antiplatelet therapy in patients undergoing PCI with drug-eluting stents: a systematic review and meta-analysis of randomized clinical trials
Authors: Bajraktari Gani , Bytyçi Ibadete , Bajraktari Artan , Henein Michael Y. 
Published: May 2022

Aim: The aim of this meta-analysis was to evaluate the safety of 1-month dual antiplatelet therapy (DAPT) followed by aspirin or a P2Y12 receptor inhibitor, after percutaneous coronary intervention (PCI) with drug-eluting stents (DES), based on the available evidence. Methods: PubMed, MEDLINE, Embase, Scopus, Google Scholar, CENTRAL, and ClinicalTrials.gov database search identified four RCTs of 26,431 patients who underwent PCI with DES and compared 1-month versus >1-month DAPT. The primary endpoint was major bleeding and co-primary endpoint stent thrombosis, and secondary endpoints included all-cause mortality, cardiovascular death, myocardial infarction (MI), stroke, and major adverse clinical events (MACE). Results: Compared with >1-month DAPT, the 1-month DAPT was associated with a similar rate of major bleeding (OR = 0.74, 95%CI: 0.51–1.07, p = 0.11, I2 = 67%), stent thrombosis (OR = 1.10, 95%CI: 0.82–1.47, p = 0.53, I2 = 0.0%), similar risk for all-cause mortality (OR = 0.89, 95%CI: 0.77–1.04, p = 0.14, I2 = 0%), CV death (OR = 0.80, 95% CI: 0.55–1.60, p = 0.24, I2 = 0.0%), MI (OR = 1.02, 95% CI: 0.88–1.19, p = 0.78, I2 = 0.0%), and stroke (OR = 0.76, 95% CI: 0.54–1.08, p = 0.13, I2 = 29%). The risk of MACE was lower (OR = 0.84, 95% CI: 0.73–0.98, p = 0.02, I2 = 39%) in the 1-month DAPT compared with the >1-month DAPT. Only patients with stable CAD had lower risk of MACE with 1-month DAPT (OR = 0.81, 95% CI: 0.67–0.98, p = 0.03, I2 = 21%) compared with >1-month DAPT. Conclusion: This meta-analysis proved the non-inferiority of 1-month DAPT followed by aspirin or a P2Y12 receptor inhibitor compared with long-term DAPT in patients undergoing PCI with DES.
Child-sensitive water, sanitation, and hygiene composite score and its association with child nutritional outcomes in St. Martin’s Island, Bangladesh
Authors: Jubayer Ahmed , Islam Md. Hafizul , Nayan Md. Moniruzzaman 
Published: May 2022

Objectives: This study aimed to outline water, sanitation, and hygiene (WASH) practices for children under 5 years of age among the households of St. Martin’s Island as well as examine the role of water, sanitation, and hygiene on child nutritional outcomes. Methods: A total of 256 children under 5 years of age were anthropometrically measured, and multiple linear regression was performed to understand the relationship between combined water, sanitation, and hygiene score and child nutritional outcomes: height-for-age, weight-for-age, weight-for-height z-scores. Results: The majority of the sampled households had improved drinking water facilities. Over one-third of the participants (36.5%) did not have access to better sanitation, and 12.4% reported defecating in open places. Just over one-third of those surveyed reported washing their hands with soap or detergents after defecation, with more than 22% of people not having access to a handwashing station on their premises. Stunting, wasting, and underweight were found to be prevalent in 34.4%, 17.6%, and 18.9% of the sampled children, respectively. Height-for-age (0.08 SDs) and weight-for-age (0.014 SDs) were greater on average in children from households with improved water, sanitation, and hygiene conditions, but weight-for-height did not significantly differ from those from WASH-unimproved households. Conclusion: Certain aspects of WASH, particularly, sanitation facilities and hygiene practices were not up to the mark in St. Martin’s Island, and consistent with findings from other studies, our study findings underlined the potential benefits of improved water, sanitation, and hygiene practices in addressing child undernutrition.
Familiarity with emergency preparedness and its predictors among nurses and physicians working at public hospitals in east Gojjam zone, northwest Ethiopia
Authors: Ayenew Temesgen , Gedfew Mihretie , Afenigus Abebe Dilie , Amha Haile , Mulugeta Henok , Mengist Belayneh , Bewket Bekalu , Melese Yidersal Hune , Teym Abraham , Bishaw Keralem Anteneh , Yitayew Meseret 
Published: May 2022

Objective: Emergency preparedness and response operations for all types of catastrophes rely heavily on healthcare facilities and their staff. On the other hand, hospital employees suffer significant gaps in emergency preparedness knowledge and skills when it comes to treating mass casualties. The objective of this study was to assess the nurses’ and physicians’ familiarity with emergency preparedness and identify the associated factors. Methods: A facility-based cross-sectional survey was conducted by census utilizing a self-administered questionnaire among all nurses and physicians working in emergency departments in East Gojjam zone public hospitals. The collected data were entered into Epi-data version 4.2 and exported to SPSS 25.0 for further analysis. Frequency, mean, and standard deviation were computed to describe individual and other characteristics of the sample. A simple and multiple linear regression model was fitted to identify factors associated with familiarity with emergency preparedness. An unstandardized adjusted beta ( β) coefficient with a 95 % confidence level was used to report the result of the association at a p-value of 0.05 statistical significance. Results: In this study, a total of 237 individuals completed the questionnaire, yielding a response rate of 94 %. The mean score of familiarity with emergency preparedness was 106.1 ± 31.8 (95% CI: 102, 110.1), with approximately 52.3 % scoring higher than the mean score. Self-regulation (B = 3.8, 95% CI: 2.6, 5), health care climate (B = 1.4, 95% CI: 0.4, 2.43) and participation in actual major disaster event (B = 15.5, 95% CI: 7.8, 23.2) were significant predictors of familiarity. Conclusion: According to the findings of this study, nurses’ and physicians’ expertise in emergency and disaster preparedness is inadequate. Previous engagement in actual disaster events, self-regulation, and the healthcare climate were significant predictors of familiarity. As a result, the responsible stakeholders should develop strategy to enhance self-regulation (motivation), job satisfaction of emergency department employees, and drills and hands-on training in mass casualty management.
Patients’ perceptions of nurses’ communication in public hospitals of Harari Regional State, Eastern Ethiopia
Authors: Bekele Yazew , Worku Teshager , Atnafe Genanaw , Debella Adera , Habte Sisay , Goshu Abel Tibebu , Assebe Tesfaye 
Published: May 2022

Introduction: The quality of nursing care has been evaluated using patient perception. Patients’ participation in nursing care and decision-making is regarded as a prerequisite for effective clinical practice; however, poor communication can lead to incorrect diagnosis and delayed, or ineffective medical treatment. Objectives: This study sought to assess admitted adult patients’ perceptions of, and factors influencing, nurse communication at public hospitals in Harar, eastern Ethiopia. Methods: Facility-based cross-sectional study was conducted among 377 admitted adult patients in Harar Town public Hospitals from 15 April to 30 May 2020. A proportionate stratified sampling technique was used to select the study participants. A pretested and structured questionnaire was used to collect data through a face-to-face interview and which were entered into EpiData and analyzed using SPSS. Bivariate and multivariate logistic regression analyses were conducted, odds ratio and confidence intervals were calculated and statistical significance was declared at p < 0.05. Results: This study outlined that the overall prevalence of good perception toward nurses’ communication was 41.9% (95% confidence interval = 37.1%, 46.9%). Patients whose age group were 26–35 years (adjusted odds ratio = 0.46 (95% confidence interval: 0.24, 0.86), Being female patients (adjusted odds ratio = 1.89; 95% confidence interval: 1.20, 2.98), admitted in private room (adjusted odds ratio = 3.25; 95% confidence interval: 1.91, 5.51), patients who have family support (adjusted odds ratio = 2.56; 95% confidence interval: 1.16, 3.64), urban residence (adjusted odds ratio = 0.65; 95% confidence interval: 0.02, 0.66) and language difference (adjusted odds ratio = 0.61; 95% confidence interval: 0.40, 0.94) were statistically significant. Conclusion: This study pointed out that less than half of the study participants had good perceptions toward nurses’ communication. As a result, increasing the number of health care providers who speak the same language as the patients and communication and behavioral change training must be prioritized.