bluuebunny/crossref_metadata_2025_split huggingface dataset:
Why are most colorectal cancers diagnosed outside of screening? A retrospective analysis of data from the English bowel screening programme
Authors: Kerrison Robert Stephen , Prentice Andrew , Marshall Sarah , von Wagner Christian 
Published: May 2022

Objective Despite several interventions to increase participation in England, most colorectal cancers (CRCs) are diagnosed outside of the screening programme. The aims of this study were to better understand why most CRCs are diagnosed externally, the extent to which this is due to suboptimal uptake of screening, and the extent to which it is due to other factors, such as false-negative test results. Setting / Methods We performed a clinical audit of 1011 patients diagnosed with CRC at St Mark's Hospital (Harrow, UK) between January 2017 and December 2020. Data on the diagnostic pathway and screening history of individuals were extracted from the bowel cancer screening system and assessed using descriptive statistics. Results 446/1011 (44.1%) patients diagnosed with CRC were eligible for screening at the time of diagnosis. Of these, only 115/446 (25.8%) were diagnosed through screening. Among those diagnosed via non-screening pathways, 210/331 (63.4%) had never taken part in screening, 31/331 (9.4%) had taken part but were not up to date, and 89/331 (26.9%) had taken part and were up-to-date (of these, 82/89 [92.2%] had received a normal or weak positive test result, and 5/89 [5.6%] had received a positive result and declined colonoscopy). Conclusion Nearly two-thirds of screening eligible patients diagnosed through a non-screening pathway had never taken part in screening. This represents the single largest source of inefficiency within the screening programme, followed by missed findings and inconsistent participation. Given the improved outcomes associated with screen-detected cancers, there is a strong public health mandate to encourage participation.
Ethical dilemmas experienced by midwives working in the delivery room
Authors: Türken Hazal , Çalım Selda İldan 
Published: May 2022

Background Midwives frequently encounter ethical dilemmas in a critical unit such as a delivery room. Determining these ethical dilemmas is very important to prevent ethical problems and develop an ethical approach. Aim This study aims to identify the ethical dilemma experiences of midwives working in delivery rooms in Turkey. Research design This study follows a qualitative phenomenological research design. Participants and research context The sample comprised 13 midwives with at least two years working experience in delivery rooms, having completed the midwifery program of Manisa Celal Bayar University Health Sciences Institute in the 2017–2018 academic year. Data were collected through audio-recorded semi-structured interviews to reveal their experiences. Content analysis was done using the Nvivo software package program. All interviews were digitally recorded, transcribed verbatim, and transferred into NVivo for analysis. Ethical considerations Ethical approval was granted by Manisa Celal Bayar University University Health Sciences Ethics Committee (Date: 16.12.2016 No: 372). Participation in this study was voluntary. Written and verbal consent was gained. These consents include protecting midwives’ privacy, keeping information confidential, and/or allowing the participant to remain anonymous. Findings Four themes were identified: differences of approach to the birth process, hospital management, communication, and differences in ethical approach. Several factors explained these ethical dilemmas while the midwives adopted different approaches to ethical decision making. Discussion These midwives experienced various dilemmas while working in the delivery room and are aware of most of them. They also took responsibility in the decision-making process and experienced many intense emotions that they had to cope with. Conclusion The ethical dilemmas faced by these midwives while working in delivery rooms were mainly caused by hierarchy. Future studies could investigate clarifying job descriptions of midwives, who are authorized to manage normal births under their own responsibility, within the hospital management and the health care team.
Nurses' attitudes toward, perceptions of, and experiences with conscientious objection
Authors: Karabulut Seyhan Demir , Gül Şenay , Keleş Şükrü , Baykara Zehra Göçmen , Yalım Neyyire Yasemin 
Published: May 2022

Background Conscientious objection is a person’s refusal to fulfill a legal duty due to their ethical values, religious beliefs, or ideological affiliations. In nursing, it refers to a nurse’s refusal to perform an action or participate in a particular situation based on their conscience. Conscientious objection has become a highly contested topic in recent years. Research objectives This study had four objectives: (1) eliciting information on how Turkish nurses perceive conscientious objection, (2) revealing whether their moral beliefs affect the care they provide, (3) determining their experiences with conscientious objection, and (4) identifying existing or potential issues of conscientious objection. Research design This qualitative study collected data through semi-structured interviews. The data were analyzed using thematic content analysis. Participants The sample consisted of 21 nurses. Ethical considerations The study was approved by an ethics committee. Confidentiality and anonymity were guaranteed. Participation was voluntary. Findings The analysis revealed four themes: (1) universal values of nursing (professional values), (2) experiences with conscientious objection (refusing to provide care/not providing care), (3) possible effects of conscientious objection (positive and negative), and (4) scope of conscientious objection (grounded and groundless). Conclusion Participants did not want to provide care due to (1) patient characteristics or (2) their own religious and moral beliefs. Participants stated that conscientious objection should be limited in the case of moral dilemmas and accepted only if the healthcare team agreed on it. Further research is warranted to define conscientious objection and determine its possible effects, feasibility, and scope in Turkey.
Changes in private psychiatric practice in Australia: An analysis of trends in claims for outpatient Medicare item numbers over 14 years
Authors: Forbes Malcolm , Sizer Holly , Khanna Rahul , Hopwood Malcolm , Green Jessica , Pring Bill 
Published: May 2022

Objective The Better Health Access Initiative added 32 Medicare Benefits Schedule (MBS) item numbers in 2006 to increase the number of people with access to mental health care. We investigated trends in the provision of outpatient Medicare-subsidised psychiatric services since the introduction of these item numbers in 2006 through 2019. Methods Medicare Benefits Schedule aggregated item-number claims data were obtained from the Services Australia Medicare website, between January 2006 and December 2019 inclusive, for face-to-face psychiatrist consultations. Item number rates were collated and graphed per 100,000 population according to year and item number. Results There has been an increase in the number of claims for new patient assessments (291–296) and a reduction in most ongoing care Medicare item numbers, especially longer appointments that are often associated with psychotherapy provision (306–308). Conclusion There have been changes in private psychiatric practice in Australia over the past 14 years. There are several possible causes for these changes and further research is required to determine the impact on patient care.
Using Simulation to Test Validity and Reliability of I-BIDS: A New Handoff Tool
Authors: Guido-Sanz Frank , Anderson Mindi , Talbert Steven , Diaz Desiree A. , Welch Gregory , Tanaka Alyssa 
Published: May 2022

Background Patient safety and improved outcomes are core priorities in healthcare, and effective handoffs are essential to these priorities. Validating handoff tools using simulation is a novel approach. Methods The construct validity and instrument reliability of the I-BIDS© tool were tested. In Phase I, construct validity was substantiated with a convenience sample of 21 healthcare providers through an electronic survey. Content Validity Ratio (CVR) was tabulated using Lawshe’s CVR. Interrater reliability was tested in a simulated handoff scenario, in Phase II, with graduate nursing students and two raters, and simulation effectiveness was assessed by students. Results Construct validity was evaluated, and 17 of the 25 items were found significant at the critical level (0.42). Items scoring below were removed, and the tool was reduced by one category. Weighted kappa (Kw) with quadratic weights was run from the scenario data to determine if there was an agreement between raters of handoff performance. There was a statistically significant agreement between the two raters, Kw = .627 (95% CI: .549–.705), p < .001) with good strength of the agreement. SET-M Total mean was 55.64 ( SD = 2.46). Discussion The tool showed beginning validity and interrater reliability. The SET-M Learning subscale showed the widest range of scores which suggests the most opportunity for improvement. Use of the tool in simulated scenarios may be one way to test the items further. Conclusions Simulation was effective in facilitating the evaluation of the tool.
Hospice Glassdoor and CAHPS® Scores—Glassdoor Scores and Hospice Financial Characteristics Predict Hospice Consumer Assessment of Healthcare Providers and Systems Scores
Authors: Hotchkiss Jason 
Published: May 2022

Background: Recent public data transparency on both decedent caregiver satisfaction and employee satisfaction is impacting the three most essential needs of any hospice, admitting hospice enrollees, attracting hospice professionals and delivering on quality. Aim: Explore the relationship between Glassdoor hospice employee recommendation data, hospice financial characteristics, and Consumer Assessment of Healthcare Providers and Systems (CAHPS®) scores among the 50 largest US hospices. Design: Retrospective data with multivariate regression analysis. Data Sources: Provider CAHPS hospice survey data from 2019-2020 and Glassdoor employee recommendation data. Results: Glassdoor Composite and CAHPS Composite were positively correlated (r = .469, p < .01). Glassdoor scores, profit status, and acquisition status predicted Hospice CAHPS scores and explained 44% of the variation in CAHPS Composite. Being a large, for-profit hospice in acquisition status each predicted lower CAHPS scores. Non-profit hospices had significantly higher Glassdoor and CAHPS scores than for-profit hospices. CAHPS Composite and CAHPS Star Rating have potential as global indicators to inform customers of a given hospice’s overall quality on the Hospice Compare website of CMS. Conclusions: Hospice leaders seeking improvements in CAHPS scores are encouraged to seek feedback on whether their own employees would recommend their hospice to a friend. Communication and responsiveness were the strongest indicators of overall hospice quality. Skelton hospice staffing models must give way to realistic models that value company culture and employee satisfaction. Hospice quality and hospice profits are not necessarily mutually exclusive. Future research should explore the difference in themes emerging from positive and negative online caregiver reviews.
Relationship Between Mean Arterial Pressure and Furosemide Stress Test Success Rates: A Retrospective Cohort Study
Authors: Fox Haley M. , DeCleene Jacob H. 
Published: May 2022

Background The furosemide stress test (FST) is a safe and easy assessment of renal tubular function. Other factors, such as mean arterial pressure (MAP), which may influence the success rates of the FST, have not been well defined. Objective To evaluate the relationship between MAP and success rates of the FST in critically ill patients. Methods Retrospective, single-center, institutional review board (IRB)-approved cohort study. Critically ill adult patients given at least one dose of intravenous (IV) furosemide (≥1-1.5 mg/kg) were included. Primary outcome was whether a MAP ≥ 75 mm Hg would equate to a higher FST success rate. Secondary outcome was the success rates of patient on one or more vasopressors. Results Of 225 patients, 88 (39.1%) had a successful FST. In patients with a MAP ≥ 75 mm Hg, 60 out of 104 (57.7%) had a successful FST compared to 28 out of 121 (23.1%) of patients who had a MAP < 75 mm Hg (odds ratio [OR], 4.53, 95% CI, 2.55-8.74, P < 0.001). Patients on vasopressors at the time of the furosemide dose had lower rates of success compared to those not on vasoactive agents (30.4% versus 68.2%, p = 0.026). Limitations of this study include its retrospective design and reliance on documented urine output. Conclusion and Relevance Patients with a MAP ≥ 75 mm Hg were significantly more likely to have a successful FST compared to those with a MAP < 75 mm Hg. This represents the first report of factors that may influence FST success rates.
Intraluminal deposits: A rare cause of glaucoma drainage implant total obstruction
Authors: Välimäki Juha , Nukareddy Praveena , Uusitalo Hannu , Aapola Ulla 
Published: May 2022

Purpose To report the unforeseen complication of total obstruction of a glaucoma drainage implant (GDI) tube lumen by white deposit material and to present a preliminary report identifying the composition of this material. Methods Two subjects with a high IOP due to total obstruction of a GDI tube were reviewed. Both patients had a long history with brinzolamide and timolol maleate eye drops. The GDI tube was swept with a 5-0 polypropylene suture stent in order to open the tube. The intraluminal solid sample was successfully collected from the implant tube in one patient. High-performance liquid chromatography-mass spectrometry (HPLC-MS) was used to determine the origin of the intraluminal sample. Results Intraluminal deposits containing components of antiglaucoma drugs e.g., timolol and brinzolamide are a rare cause of total obstruction of GDI tubes. Conclusions Our study describes a new cause of total obstruction GDI tubes. The long-term use of timolol maleate and brinzolamide and their presence in the intraluminal solid sample collected from the blocked GDI tube suggest that the glaucoma medication may have a role in the pathogenesis. However, the exact mechanism is unknown and requires further studies.
Pseudoretinoblastoma: Distribution based on gender, age, and laterality
Authors: Mirzayev Ibadulla , Gündüz Ahmet Kaan , Özalp Ateş Funda Seher , Tetik Diğdem 
Published: May 2022

Purpose To investigate the distribution of pseudoretinoblastoma (PSRB) cases based on gender, age, and laterality Materials and Methods The clinical records of 607 patients (851 eyes) who were referred for diagnosis of retinoblastoma or simulating conditions between October 1998 and May 2021 were retrospectively evaluated. Patients were stratified by age as follows: ≤1 year, >1–3 years, >3–5 years, and >5 years. Results Of 190/607 PSRB patients, 129 (67.9%) were males and 61 (32.1%) females ( p = 0.001). The 3 most common diagnoses in males were Coats disease (20.2%), persistent fetal vasculature (PFV, 14.0%), and chorioretinal coloboma (6.2%). In females, the 3 most common diagnoses included PFV (21.3%), retinal dysplasia, congenital glaucoma, and combined hamartoma (each 6.6%). PFV was the most common diagnosis in ≤1 year old patient group (26.6%). Coats disease and PFV were the most common diagnoses in >1–3 years old patient group (each 16.7%). Coats disease was the most common diagnosis in >3–5 years old (30.8%) and >5 years old patient groups (13.1%). PSRBs were unilateral in 121/190 (63.7%) patients. Coats disease usually presented unilaterally (p < 0.001) while PFV, optic nerve head drusen, and retinopathy of prematurity as bilateral diseases ( p = 0.019, p = 0.001, and p = 0.001 respectively). Discussion PSRB diagnoses show differences depending on gender, age, and laterality. In our study, the most common PSRB lesions were Coats disease in males and PFV in females. PFV was the most frequent diagnosis in ≤3 years and Coats disease in >3 years of age groups. Coats disease and PFV were the most common unilateral and bilateral PSRB diagnoses respectively.
Perioperative time and economic impact of an intracameral combination of mydriatics and anaesthetics in routine cataract surgery
Authors: Zaluski Serge , Amzallag Thierry , Bouchut Pierre , Pinsard Loïc , Theron Jean-Philippe , Tellouck-Morincomme Joy , Baffert Sandrine 
Published: May 2022

Purpose The aim of this study was to compare the perioperative time and economic impact of a licensed intracameral anaesthetic/mydriatic combination (Mydrane) during routine cataract surgery. Methods A real-life, prospective, comparative study was performed in 3 clinical centres in France. Preoperative, surgical, and post-operative times were determined for two mydriasis strategies using conventional preoperative mydriatics/anaesthetics eye drops (control regimen) or Mydrane administered at time of surgery. Staff, surgery schedules and drugs utilisation were collected over 12 surgery half-days. The total cost of each strategy was estimated based on treatment cost and nursing costs. Results The analysis included 112 routine cataract surgeries (57 surgeries using Mydrane and 55 using the topical regimen) without protocol deviations or complicated surgery. Overall, the mean time between administration of the first mydriatic eye drops or Mydrane and the end of the surgery was 27.4 ± 21.1 min in the Mydrane group vs. 90.3 ± 30.4 min in the control group (P < 0.0001). The total time of the procedure (from admission to discharge) was not significantly different between groups (P = 0.1611). On average, the extra cost of drugs per patient in the Mydrane group (€5.81) was almost balanced by the reduced nursing time (€5.57) with some variations between centres, due to different organisation including staff resource and consumable. Conclusions The Mydrane strategy produced perioperative nursing time saving and cost reduction provided that adaptation and reorganisation of routine cataract surgery are implemented.
Teleophthalmology research: Where do we stand?
Authors: Elubous Khaled , Alryalat Saif Aldeen , Qawasmeh Sarah , Al-Ebous Ali , Abu-Ameereh Mohammed 
Published: May 2022

Purpose To identify global research trends in teleophthalmology, as well as productivity and its association with Human development index (HDI). Methods A cross-sectional study. The main outcome measures were publication count, citation count, and publications count per million populations. Bibliographic data were derived from the Web of Science website. HDI data were derived from Human Development Report [2020]. One-way ANOVA test was used to examine the association between HDI and the outcome measures. We studied the correlation between continuous variables using Spearman's. Bibliometric analysis software's VOSviewer and Citspace were used to analyse results and creating visualizing maps. Results The results retrieved 355 publications, one-third of them have been published in the year of the COVID-19 pandemic; (2020). The USA has contributed to one-half of all publications, and just five countries have contributed to about 90% of all records. Very high HDI countries had significantly more publications count per million populations, than high (p-value = 0.0047), medium (p-value = 0.0081) or low HDI countries (p-value = 0.002). The main themes are screening programmes, reliability, photography, COVID-19, access, artificial intelligence, and cost-effectiveness. The leading countries in terms of both publications and citation count are the USA and India. In terms of publications count per million populations, the leading countries are Singapore and Australia. Conclusion Most of the contribution in teleophthalmology research was confined to a small number of countries. More effort is needed to expand the global contribution. The hotspots in this field are artificial intelligence applications and COVID-19 impact.
Ray tracing biometry in post radial keratotomy eye
Authors: Srujana Dubbaka , Shankar Sandeep , Bhanot Rohit , Mohandas Renu , Srikanth S , Kumar Ashok 
Published: May 2022

Objective To report a case of post radial keratotomy (RK) cataract in a 55-year-old lady wherein biometry was done by ray-tracing method incorporated in scheimpflug topographer (Sirius + Scheimpflug Analyzer, CSO, Italy). Method In our case, we performed intraocular lens (IOL) power calculation using a recent concept of ray tracing with scheimpflug topographer and compared with traditional methods available at American Society of Cataract and Refractive Surgery(ASCRS) website ( www.ascrs.org ) for eyes with prior RK. Phacoemulsification was performed and a monofocal + 24.5D IOL implanted in the capsular bag. Result Manifest refraction at six weeks postoperative period was + 1.0DS/-2.0DC × 75° with spherical equivalence of 0. On comparison of all the methods used to calculate IOL power, the absolute errors of ray tracing and Barrett true K were found to be the least, 0.14 and 0.18 respectively. Conclusion Ray tracing biometry with scheimpflug topographer seems to provide accurate IOL power in post RK eyes.
Understanding the 30-day mortality burden after revision total hip arthroplasty
Authors: Rullán Pedro J , Orr Melissa N , Emara Ahmed K , Klika Alison K , Molloy Robert M , Piuzzi Nicolas S 
Published: May 2022

Background: Revision total hip arthroplasty (THA) is a challenging procedure that burdens the healthcare system. Despite being associated with worse outcomes relative to its primary counterpart, postoperative mortality after revision THA remains ill-defined. The present study aimed to (1) establish the overall 30-day mortality rate after revision THA and (2) explore the mortality rate stratified by age, comorbidity burden, and aseptic versus septic failure. Methods: The American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) database was retrospectively reviewed for all patients who underwent revision THA from 2011 to 2019. A total of 23,501 patients were identified and grouped into mortality ( n  = 161) and mortality-free ( n  = 23,340) cohorts. Patient demographics, comorbidities, and aseptic/septic failure were evaluated. Results: The overall 30-day mortality was 0.69%. The mortality rate by age group (normalised per 1000 patients) was 0 (18–39 years [Y]), 0.67 (40–49 Y), 1.10 (50–59 Y), 2.58 (60–69 Y), 6.15 (70–79 Y) 19.32 (80–89 Y), and 58.22 (90+Y) ( p  < 0.001). The mortality rate by ASA classification (normalised per 1000 patients) was 0 (ASA I), 1.47 (ASA II), 6.94 (ASA III), 45.42 (ASA IV), and 200 (ASA V) ( p  < 0.001). The 30-day mortality rate for the septic and aseptic cohorts was 1.03% and 0.65%, respectively ( p  = 0.038). CCI scores ( p  < 0.001), diabetes ( p  < 0.001), systematic sepsis ( p  < 0.001), poor functional status ( p  < 0.001), BMI < 24.9 kg/m2 ( p  < 0.001), and dirty/infected wounds ( p  < 0.001) were all associated with increased mortality risk. Conclusions: 1 in 145 patients will suffer mortality during the 30 days after revision THA. PJI-related revision THA was associated with 1.5-fold increase in 30-day mortality rate compared to its aseptic counterpart. Certain patient determinants and baseline comorbidities, as measured by ASA and CCI scores, were associated with higher 30-day mortality rates. Therefore, it is imperative to identify such risk factors and implement perioperative patient optimisation pathways to mitigate the risk among vulnerable patients.