bluuebunny/crossref_metadata_2025_split huggingface dataset:
What is needed to sustain improvements in hospital practices post-COVID-19? a qualitative study of interprofessional dissonance in hospital infection prevention and control
Authors: Gilbert Gwendolyn L. , Kerridge Ian 
Published: April 2022

AbstractBackgroundHospital infection prevention and control (IPC) depends on consistent practice to achieve its purpose. Standard precautions are embedded in modern healthcare policies, but not uniformly observed by all clinicians. Well-documented differences in attitudes to IPC, between doctors and nurses, contribute to suboptimal IPC practices and persistence of preventable healthcare-associated infections. The COVID-19 pandemic has seriously affected healthcare professionals’ work-practices, lives and health and increased awareness and observance of IPC. Successful transition of health services to a ‘post-COVID-19’ future, will depend on sustainable integration of lessons learnt into routine practice.MethodsThe aim of this pre-COVID-19 qualitative study was to investigate factors influencing doctors’ IPC attitudes and practices, whether they differ from those of nurses and, if so, how this affects interprofessional relationships. We hypothesised that better understanding would guide new strategies to achieve more effective IPC. We interviewed 26 senior clinicians (16 doctors and 10 nurses) from a range of specialties, at a large Australian tertiary hospital. Interview transcripts were reviewed iteratively, and themes identified inductively, using reflexive thematic analysis.ResultsParticipants from both professions painted clichéd portraits of ‘typical’ doctors and nurses and recounted unflattering anecdotes of their IPC behaviours. Doctors were described as self-directed and often unaware or disdainful of IPC rules; while nurses were portrayed as slavishly following rules, ostensibly to protect patients, irrespective of risk or evidence. Many participants believed that doctors object to being reminded of IPC requirements by nurses, despite many senior doctors having limited knowledge of correct IPC practice. Overall, participants’ comments suggested that the ‘doctor-nurse game’—described in the 1960s, to exemplify the complex power disparity between professions—is still in play, despite changes in both professions, in the interim.ConclusionsThe results suggest that interprofessional differences and inconsistencies constrain IPC practice improvement. IPC inconsistencies and failures can be catastrophic, but the common threat of COVID-19 has promoted focus and unity. Appropriate implementation of IPC policies should be context-specific and respect the needs and expertise of all stakeholders. We propose an ethical framework to guide interprofessional collaboration in establishing a path towards sustained improvements in IPC and bio-preparedness.
Health complaints in individual visiting primary health care: population-based national electronic health records of Iran
Authors: Khatami Farnaz , Shariati Mohammad , Abbasi Zahra , Muka Taulant , Khedmat Leila , Saleh Narges 
Published: April 2022

Abstract
Background
The mission of medical schools is a sustainable commitment to orient education, research, and services based on the priorities and expectations of society. The most common complaints of patients from comprehensive health service centers (CHSCs) based on the data from electronic health records were assessed in order to determine primary health care (PHC) priorities for the educational planning of medical students in Iran.

Methods
A population-based national study was designed to assess clinical complaints of patients in all age groups who were referred to CHSCs at least once to be visited by physicians. All the data in the census were extracted from electronic health records in PHC system during 2015–2020, classified by the International Classification of Primary Care 2nd edition (ICPC-2e-English), and statistically analyzed. The total number of complaints that were recorded in the system was 17,430,139.

Results
59% of the referring patients were women. The highest number of referrals was related to the age group of 18–59 years (56.9%), while the lowest belonged to the elderly people (13.3%). In all age and sex groups, the first ten complaints of patients with three top priorities in each category included process (follow-up, consultation, and results exam), digestive (toothache and gum complaint, abdominal pain, and diarrhea), respiratory (cough, sore throat, and runny nose), general (fever, pain, and weakness and fatigue), musculoskeletal (back pain, leg complaint, and knee injuries), endocrine and nutritional (weight gain, Feeding problem, and weight loss), cardiovascular (hypertension, palpitations, and Postural hypotension), neurological (headache, dizziness, and paralysis), sexual dysfunction (vaginal complaint, discharge, and irregular menstruation), and dermatological (pruritus, rash, and inflammation) problems.

Conclusion
High priorities in referring to PHC had a key role in assessing the country's health needs. Since this study was in line with the national pattern of complaints and patients' profile, the present findings can be helpful to amend policy-making, educational planning and curricula development in medical schools.
Effect of RG (Coptis root and ginseng) formula in patients with type 2 diabetes mellitus: a study protocol for a randomized controlled and double-blinding trial
Authors: Jiang Li , Fu Qiang , Wang Shidong , Chen Yu , Li Jiayue , Xiao Yonghua , Sun Ruixi , Shen Esther Aijia , Wang Junheng , Zhang Yaofu , Li Zhuang , Liu Jiangteng , Fu Xiaozhe , Liu Yuanyuan , Zhao Yu , Su Guanxun , Huang Weijun , Zhao Jinxi 
Published: April 2022

Abstract
Background
Type 2 diabetes mellitus (T2DM) is a common metabolic disease with significant health, social, and economic consequences. Traditional Chinese medicine (TCM) could effectively regulate blood sugar and influence gut microbiota in T2DM patients. Preliminary studies showed that the Coptis root and ginseng (RG) formula could relieve insulin resistance and prevent the progression of diabetes in mice.

Objectives
The purpose of this study is to explore the efficacy and safety of RG formula in the treatment of adult patients with T2DM, as well as observing its effects on gut microbiota.

Methods and analysis
This trial is a randomized, double-blind, placebo-controlled study. A total of 60 participants will be randomized in a 1:1 ratio into an experiment group (RG formula) and a control group (placebo). Patients in both groups will be given diabetes education and basic blood glucose control. Glucose-lowering drugs with significant influence on gut microbiota will be avoided. This trial will last 25 weeks including 1-week run-in, 12-week intervention, and 12-week follow-up visit. The primary outcome is the change in the HbA1c. The secondary outcomes comprise the change in the fasting blood glucose (FBG), postprandial blood glucose (PBG), fasting insulin (FIL), fasting C-peptide(C-P), insulin resistance index (IRI), inflammatory factors, and species abundance of gut microbiota between the two groups. Safety of medication will also be evaluated. The correlation analysis will be explored between the glycemic indicators, inflammatory factors, and abundance of gut microbiota.

Discussion
This study will provide the clinical evidence for the efficacy of RG formula in regulating blood sugar and influencing gut microbiota, which will be beneficial to form the integrated therapeutic regimen in T2DM with TCM.

Trial registration
“Clinical Study on the Intervention of Coptis Root and Ginseng,” Chinese Clinical Trials Registry ChiCTR 2100042126. Registered on 14 January 2021
Application of image recognition technology in digital twinning technology: Taking tangram splicing as an example
Authors: Yang Yifan , Yang Xuezhou , Li Yuefeng , Zou Jun , Shi Mingming , Yang Bobo , Guo Chunfeng , Hu Rongrong , Shi Chengzhang , Lu Xin , Li Yang 
Published: April 2022

Background: With the rapid development of digital twinning technology, the compatibility of digital twinning technology to other technologies is continuously enhanced. It is because of this that the application of image recognition technology in digital twinning technology becomes a reality. However, the key technology of digital twin, the virtual-actual mutual control technology, is not mature enough, and the image recognition technology applied in digital twin technology also has the problem of coordinate system transformation, which becomes an important link of image recognition technology in digital twin. Methods: Based on the above two problems, we take the tangram splicing project as an example to realize a virtual-actual mutual control method, so that the digital twinning technology can be well presented. Furthermore, we implement an image recognition applied to the conversion of digital twinning technology, so that digital twinning technology and image recognition have a seamless connection, allowing the application range of digital twinning technology to be further expanded. Results: In this paper, image recognition technology is successfully applied to digital twin technology by adopting the conversion between different coordinate systems and the real and virtual real time control, which makes the applicability of digital twin technology in high-tech fields such as smart factories and smart manufacturing to a higher level. Conclusions: Finally, through the tangram splicing project, the motion trajectories of the robotic arm and the tangram are consistent with the virtual robotic arm and the tangram in the computer. It is proved that our method can well combine digital twinning technology and image recognition technology.
Factors associated with knowledge and awareness of stroke among the Lebanese population: A cross-sectional study
Authors: Malaeb Diana , Dia Nada , Haddad Chadia , Hallit Souheil , Sacre Hala , Barakat Muna , Mansour Sara , Salameh Pascale , Hosseini Hassan 
Published: April 2022

Background: Evaluation of the knowledge about stroke in the general population is extremely vital as it prevents stroke development, limits complications, and achieves better quality of life. We assume that the general Lebanese population lacks awareness about stroke and its associated complications. This study aims to evaluate stroke knowledge and determine the factors associated with stroke awareness among the general Lebanese population. Methods: This cross-sectional study assessed respondents’ sociodemographic characteristics and the identification of risk factors, warning signs, stroke consequences, and early response to stroke symptoms. A total of 551 Lebanese adults without a history of stroke filled in an online self-reported questionnaire publicly shared on social applications. Logistic regression analysis was performed to identify the factors associated with poor knowledge of stroke. Results: Among the 551 participants enrolled, 403 (74.2%) were females and 312 (56.7%) were under 30 years of age. Females compared to males and employed compared to unemployed had significantly higher odds of identifying at least one risk factor (OR=4.3 [95%CI=1.1;16.8] and 6 [95%CI=1.2;29.6], respectively). Also, when compared to unemployed, employed participants had significantly higher odds of recognizing at least one of the early stroke symptoms (OR=3.3 [95%CI=1.2;8.9]) and identifying at least one of the stroke consequences (OR=5.3 [95%CI=1.1;25.9]). Reaching a university level of education compared to a school level was associated with significantly higher odds (OR=2.3 [95%CI=1.1;4.8]) of taking a patient to a hospital. Conclusion: Well-educated, employed, and female participants were more knowledgeable about stroke. Tailored interventions focusing on individuals with inadequate stroke literacy are needed. Further studies, more representative of the general Lebanese population with a larger sample size, are necessary to confirm our findings.
Quality care process metrics for nurses working in general practice, mapping the evidence: a scoping review protocol
Authors: Loftus Moran Orla , Casey Mary , O'Connor Laserina , Cullen Walter 
Published: April 2022

Background: Irish general practice nursing roles have developed and grown exponentially in response to changing policy, clinical and workforce demands, this is reflective of international primary healthcare nursing trends. However, as nursing care in general practice advances, comprehensive evaluation of the general practice nurse (GPN) role has not been undertaken. Therefore, processes which enable robust data collection to assess the role and facilitate development of services are required. Nursing quality care metrics are an established mechanism which evaluate quality of care. Nursing quality care process metrics (QCP-Ms) specifically refer to measurement of care delivered directly to patients by nurses, benchmarking these interventions adherence to best practice guidance. The use of nursing metrics has been adopted within seven distinct healthcare settings in Ireland but not general practice. This scoping review is the first stage of a project which aims to inform development and implementation of QCP-Ms by Irish GPNs. Aim: To explore and map the literature regarding the development and implementation of QCP-Ms within general practice settings. Methods: The following five-stage methodological framework for scoping reviews proposed by Arksey and O’Malley will be used: (1) identifying the research question, (2) identifying relevant studies, (3) study selection, (4) charting/mapping the data and (5) collating, summarizing, and reporting results. The review will be conducted and reported in accordance with the PRISMA Extension for Scoping Reviews (PRISMA-ScR). Conclusions: The focus of this scoping review relates to QCP-Ms which specifically measure the work of general practice nurses. It is envisioned that synthesis of international literature will give a broad perspective about nursing QCP-Ms, their use in general practice or primary healthcare settings, enriching understanding regarding their development. It is anticipated that findings will provide key information to policy makers and health professionals interested in planning, strengthening, and delivering primary healthcare.
Sickness absence, medical and workplace conditions during pregnancy in a cohort of healthcare workers
Authors: Villar Vinuesa Rocío , Serra Consol , Serra Laura , Benavides Fernando G. 
Published: April 2022

Objetivo: Evaluar la asociación entre trayectorias de ausencia por enfermedad (SA) según diagnóstico y exposición a factores de riesgo laborales durante el embarazo.
Métodos: Estudio de cohortes (367 trabajadoras sanitarias embarazadas). Se identificaron trayectorias de ausencia por enfermedad según los diagnósticos más frecuentes mediante análisis de secuencias (2010-2014). La trayectoria 1 incluía SA principalmente por trastornos musculoesqueléticos (58,86%), la 2 por trastornos relacionados con el embarazo (25,07%) y la 3 incluía ausencias por la prestación por riesgo durante el embarazo (POR) y pocas SA (16,08%). La exposición a factores de riesgo laborales fue evaluada por expertos y se analizó la asociación con las trayectorias mediante regresión logística. Los riesgos relativos (RR) y sus intervalos de confianza (IC95%) se ajustaron por edad, contrato y turno.
Resultados: La trayectoria 1 se asoció negativamente con la exposición a riesgos de seguridad y ergonómicos (RR=0,56, IC95%=0,35-0,90; RR=0,50, IC95%=0,33-0,77) y con índice de riesgo global más bajo (RR=0,68, IC95%=0,49-0,96). La tercera se asoció a riesgos de seguridad y ergonómicos (RR=2,75, IC 95 %=1,59-4,75; RR=3,64, IC 95 %=2,18-6,06) y con el riesgo más alto (RR=2,69, 95 % IC=1,43-5,01). El personal de enfermería tuvo mayor probabilidad de pertenecer a la trayectoria 3 (RR 5,58, IC95%=2,09-14,95 y RR 5,00, IC95% 2,18-6,06).
Conclusiones: Los trastornos musculoesqueléticos y por trastornos relacionados con el embarazo son los grupos diagnósticos de SA más frecuentes. Bajos niveles de exposición a riesgos laborales se relacionaron con ausencias cubiertas principalmente por SA. Las prestaciones sociales parecen utilizarse complementariamente para equilibrar el trabajo y la salud.
Socioeconomic variations in rates of hospitalisation and mortality from COVID-19 in England
Authors: Gharaibeh Sara Abdul-Karim Qasim , Zarei Mohammad Hossein 
Published: April 2022

Background/Aims As well as age and presence of comorbidities, research has suggested that socioeconomic factors, such as income and ethnicity, may affect an individual's risk of severe COVID-19. This study looked at the geographical variations in rates of hospitalisation and death from COVID-19, exploring whether socioeconomic factors were linked to these variations. Methods A cross-sectional retrospective quantitative study was conducted using data regarding the number of cases of COVID-19 cases during the first wave of the pandemic in England (March–July 2020). A total of 242 624 confirmed cases of COVID-19 from across England were analysed. The extent to which predisposing factors, such as population density, age and comorbities, affected morbidity and mortality rates in the different regions was calculated. The impact of socioeconomic factors, such as employment status and ethnicity, were also analysed. Results There was a significant association between long unemployment and likelihood of death from COVID-19. Areas with higher proportions of individuals from Black, Asian and ethnic minority backgrounds were also more likely to have higher rates of hospitalisations and deaths from COVID-19. Overall, London was the region with the highest standardised rates of hospitalisation (67.73%) and mortality (20%). Conclusions Socioeconomic factors have contributed to the geographical variations in COVID-19 mortality across different areas of England. This implies that these factors should be taken into account when planning healthcare and public health strategies.
Two-year death prediction models among patients with Chagas Disease using machine learning-based methods
Authors: Ferreira Ariela Mota , Santos Laércio Ives , Sabino Ester Cerdeira , Ribeiro Antonio Luiz Pinho , Oliveira-da Silva Léa Campos de , Damasceno Renata Fiúza , D’Angelo Marcos Flávio Silveira Vasconcelos , Nunes Maria do Carmo Pereira , Haikal Desirée Sant´Ana 
Published: April 2022

Chagas disease (CD) is recognized by the World Health Organization as one of the thirteen most neglected tropical diseases. More than 80% of people affected by CD will not have access to diagnosis and continued treatment, which partly supports the high morbidity and mortality rate. Machine Learning (ML) can identify patterns in data that can be used to increase our understanding of a specific problem or make predictions about the future. Thus, the aim of this study was to evaluate different models of ML to predict death in two years of patients with CD. ML models were developed using different techniques and configurations. The techniques used were: Random Forests, Adaptive Boosting, Decision Tree, Support Vector Machine, and Artificial Neural Networks. The adopted settings considered only interview variables, only complementary exam variables, and finally, both mixed. Data from a cohort study with CD patients called SaMi-Trop were analyzed. The predictor variables came from the baseline; and the outcome, which was death, came from the first follow-up. All models were evaluated in terms of Sensitivity, Specificity and G-mean. Among the 1694 individuals with CD considered, 134 (7.9%) died within two years of follow-up. Using only the predictor variables from the interview, the different techniques achieved a maximum G-mean of 0.64 in predicting death. Using only the variables from complementary exams, the G-mean was up to 0.77. In this configuration, the protagonism of NT-proBNP was evident, where it was possible to observe that an ML model using only this single variable reached G-mean of 0.76. The configuration that mixed interview variables and complementary exams achieved G-mean of 0.75. ML can be used as a useful tool with the potential to contribute to the management of patients with CD, by identifying patients with the highest probability of death.
Trial Registration: This trial is registered with ClinicalTrials.gov, Trial ID: NCT02646943.
Performance of COVID-19 case-based surveillance system in FCT, Nigeria, March 2020 –January 2021
Authors: Umeozuru Chikodi Modesta , Usman Aishat Bukola , Olorukooba Abdulhakeem Abayomi , Abdullahi Idris Nasir , John Doris Japhet , Lawal Lukman Ademola , Uwazie Charles Chukwudi , Balogun Muhammad Shakir 
Published: April 2022

IntroductionThe emergence of novel SARS-CoV-2 has caused a pandemic of Coronavirus Disease 19 (COVID-19) which has spread exponentially worldwide. A robust surveillance system is essential for correct estimation of the disease burden and containment of the pandemic. We evaluated the performance of COVID-19 case-based surveillance system in FCT, Nigeria and assessed its key attributes.MethodsWe used a cross-sectional study design, comprising a survey, key informant interview, record review and secondary data analysis. A self-administered, semi-structured questionnaire was administered to key stakeholders to assess the attributes and process of operation of the surveillance system using CDC’s Updated Guidelines for Evaluation of Public Health Surveillance System 2001. Data collected alongside surveillance data from March 2020 to January 2021 were analyzed and summarized using descriptive statistics.ResultsOut of 69,338 suspected cases, 12,595 tested positive with RT-PCR with a positive predictive value (PPV) of 18%. Healthcare workers were identified as high-risk group with a prevalence of 23.5%. About 82% respondents perceived the system to be simple, 85.5% posited that the system was flexible and easily accommodates changes, 71.4% reported that the system was acceptable and expressed willingness to continue participation. Representativeness of the system was 93%, stability 40%, data quality 56.2% and timeliness 45.5%, estimated result turnaround time (TAT) was suboptimal.ConclusionThe system was found to be useful, simple, flexible, sensitive, acceptable, with good representativeness but the stability, data quality and timeliness was poor. The system meets initial surveillance objectives but rapid expansion of sample collection and testing sites, improvement of TAT, sustainable funding, improvement of electronic database, continuous provision of logistics, supplies and additional trainings are needed to address identified weaknesses, optimize the system performance and meet increasing need of case detection in the wake of rapidly spreading pandemic. More risk-group persons should be tested to improve surveillance effectiveness.