bluuebunny/crossref_metadata_2025 huggingface dataset:
What Makes Life Meaningful? Combinations of Meaningful Commitments Among Nonreligious and Religious Americans
Authors: Edgell Penny , Miller Mahala , Frost Jacqui
Published: April 2023

Having a sense that one’s life is meaningful is related to, but distinct from, happiness, satisfaction, or living a moral life. Scholars across disciplines have investigated the role of religion in providing meaning or questioned whether religious decline prompts a crisis of meaninglessness. We use national survey data (2019, N = 1,326) to identify the overall patterns in what people find meaningful in general and how they spend time in activities understood as meaningful. We find five bundles of meaningful commitments: three focused on relationships, including one focused on a variety of family and friend relationships, one anchored by a relationship with a partner, and one anchored by a relationship with a child; one focused on ideals and lifestyle; and one that is less specialized but more prone to focus on religious commitment. We find three bundles of meaningful practices, the things people do in their daily lives that they understand as meaningful: one focused on relationships, one focused on ideals and lifestyle, and one that is less specialized but more prone to focus on religious commitments. We analyze how each bundle is associated with happiness and well-being, and how religious and nonreligious identification shape who embraces which bundle. In the conclusion, we discuss the benefits of our approach and suggest directions for future research.
Research on the navigational risk of liquefied natural gas carriers in an inland river based on entropy: A cloud evaluation model
Authors: Liu Chengyong , Li Shijie , Chen Shuzhe , Chen Qifan , Liu Kang
Published: April 2023

Due to the flammability and explosive nature of liquefied natural gas (LNG), an extremely strict process is followed for the transportation of LNG carriers in China. Particularly, no LNG carriers are operating in inland rivers within the country. Therefore, to ensure the future navigation safety of LNG carriers entering the Yangtze River, the risk sources of LNG carriers' navigation safety must be identified and evaluated. Based on the Delphi and expert experience method, this paper analyses and discusses the navigation risk factors of LNG carriers in the lower reaches of the Yangtze River from four aspects (human, ship, environment and management), identifies 12 risk indicators affecting the navigation of LNG carriers and establishes a risk evaluation index system. Further, an entropy weight fuzzy model is utilized to reduce the influence of subjective judgement on the index weight as well as to conduct a segmented and overall evaluation of LNG navigation risks in the Baimaosha Channel. Finally, the cloud model is applied to validate the consistent feasibility of the entropy weight fuzzy model. The research results indicate that the method provides effective technical support for further study on the navigation security of LNG carriers in inland rivers.
12th Japan-US Seminar in Plant Pathology Meeting Report
Authors: Sasaki Yumino , González-Tobón Juliana , Hino Yuta , Jin Chujia , Li Tianrun , Nguyen Tan Anh Nhi , Oakley Blake , Stevens Danielle
Published: April 2023

The 12th iteration of the Japan-US Seminar in Plant Pathology was held in Ithaca, New York at Cornell University in the fall of 2022. Presentations covered a range of topics under the theme “Remodeling of the Plant-Microbe Environment During Disease, Defense, and Mutualism,” and the meeting included a panel discussion of best practices in science communication. This report presents highlights of the meeting, from the perspective of early career participants of the seminar.

[Formula: see text] Copyright © 2023 The Author(s). This is an open access article distributed under the CC BY-NC-ND 4.0 International license .
Oligogenic Control of Quantitative Resistance Against Powdery Mildew Revealed in Portuguese Common Bean Germplasm
Authors: Leitão Susana T. , Mendes Francisco A. , Rubiales Diego , Vaz Patto Maria Carlota
Published: April 2023

Common bean (Phaseolus vulgaris L.) is one of the most important food legumes worldwide, and its production is severely affected by fungal diseases such as powdery mildew. Portugal has a diverse germplasm, with accessions of Andean, Mesoamerican, and admixed origin, making it a valuable resource for common bean genetic studies. In this work, we evaluated the response of a Portuguese collection of 146 common bean accessions to Erysiphe diffusa infection, observing a wide range of disease severity and different levels of compatible and incompatible reactions, revealing the presence of different resistance mechanisms. We identified 11 incompletely hypersensitive resistant and 80 partially resistant accessions. We performed a genome-wide association study to clarify its genetic control, resulting in the identification of eight disease severity-associated single-nucleotide polymorphisms, spread across chromosomes Pv03, Pv09, and Pv10. Two of the associations were unique to partial resistance and one to incomplete hypersensitive resistance. The proportion of variance explained by each association varied between 15 and 86%. The absence of a major locus, together with the relatively small number of loci controlling disease severity, suggested an oligogenic inheritance of both types of resistance. Seven candidate genes were proposed, including a disease resistance protein (toll interleukin 1 receptor-nucleotide binding site-leucine-rich repeat class), an NF-Y transcription factor complex component, and an ABC-2 type transporter family protein. This work contributes with new resistance sources and genomic targets valuable to develop selection molecular tools and support powdery mildew resistance precision breeding in common bean.
Molecular and Biological Characterization of a Novel Tobamovirus Infecting Sunn Hemp (Crotalaria juncea) in Hawaii
Authors: Kong Alexandra T. , Olmedo-Velarde Alejandro , Borth Wayne , Wang Koon-Hui , Hu John S. , Melzer Michael J.
Published: April 2023

Sunn hemp (Crotalaria juncea L.) cultivar Tropic Sun plants, stunted and displaying mottle and mosaic symptoms on foliage, were observed at a seed farm in Maui County, Hawaii. Lateral flow assays indicated the presence of either tobacco mosaic virus or a serologically related virus. High-throughput sequencing results coupled with real-time PCR experiments recovered the 6,455-nucleotide genome of a virus with an organization typical of tobamoviruses. Nucleotide and amino acid sequence comparisons and phylogenetic analyses indicated that this virus was most closely related to sunn-hemp mosaic virus but represents a distinct species. Sunn-hemp mottle virus (SHMoV) is being proposed as the common name of this virus. Transmission electron microscopy of virus extracts purified from symptomatic leaves revealed rod-shaped particles approximately 320 by 22 nm in size. In inoculation studies, the experimental host range of SHMoV appeared limited to members of the plant families Fabaceae and Solanaceae. Greenhouse experiments demonstrated plant-to-plant transmission of SHMoV that increased with ambient wind speed. Seeds from SHMoV-infected Tropic Sun were collected and were either surface disinfested or directly planted. A total of 924 seedlings germinated; 2 were positive for the virus, resulting in a seed transmission rate of 0.2%. Both infected plants came from the surface disinfestation treatment, suggesting that the virus might be unaffected by the treatment.
Real-World Data for Interdisciplinary Health Care Research
Authors: Nahm Eun-Shim , Zhu Shijun , Seidl Kristin , Chen Lynn , Day Jenni , Seong Hohyun
Published: April 2023

Real-word data (RWD) refer to data relating to patient health status and/or the delivery of health care routinely collected from a variety of sources, including electronic health records, medical claims data, and patient-generated data. Data sets that combine personal health data stored in different sources can provide a more complete picture of an individual's health and can be used to improve population health through research and practice. The 2-tiered aim of this article is to provide a brief introduction to using RWD in health care research and to present a case study that demonstrates data curation and data merge from different sources while highlighting the benefits and limitations of using RWD. The current digital health ecosystem and value-based care approach highlight the need to use RWD to catalyze the advancement of health care research and practice. This is an excellent field that nurse researchers can lead, as they have an innate understanding of such data and data sources.
The Onset and Development of Patella Alta in Children With Patellar Instability
Authors: Patel Nikhil B. , Oak Sameer R. , Rogers Kelly , Crawford Eileen A.
Published: April 2023

Background:

Patella alta is an anatomic risk factor for patellar instability in adolescents that is also linked to the risk factor of trochlear dysplasia. This study aims to determine the age of onset and age-related incidence of patella alta in a pediatric population of patients with patellar instability. We hypothesized that patellar height ratios would not increase with age, suggesting a congenital rather than the developmental origin of patella alta.

Methods:

A retrospective cross-sectional cohort of patients was collected with the following inclusion criteria: patients aged 5 to 18 who had a knee magnetic resonance imaging performed from 2000 to 2022 and the International Classification of Diseases code for patellar dislocation. Demographic information and details of the patellar instability episode(s) were collected with a chart review. Sagittal magnetic resonance imaging was used to measure Caton-Deschamps Index (CDI) and the Insall-Salvati Ratio (ISR) by 2 observers. Data were analyzed to assess for associations between patellar height ratios and age of the first dislocation and to assess if the proportion of patients categorized as having patella alta changed with age.

Results:

The 140 knees included in the cohort had an average age of 13.9 years (SD=2.40; range: 8–18) and were 55% female. Patella alta was present in 78 knees (55.7%) using CDI>=1.2 and in 59 knees (42.1%) using ISR>=1.3. The earliest age patella alta was observed was at age 8 using CDI>=1.2 and age 10 using ISR>=1.3. There were no statistically significant associations between CDI and age without adjustment (P=0.14) nor after adjustment for sex and body mass index (P=0.17). The proportion of knees above the CDI threshold for patella alta to the knees below the cutoff did not show a significant change with age (P=0.09).

Conclusions:

Patella alta, as defined by CDI, is seen in patients as young as 8 years old. Patellar height ratios do not change with age in patients with patellar dislocation, suggesting that patella alta is established at a young age rather than developing during the adolescent years.

Level of Evidence:

Level III–diagnostic, cross-sectional.
Antegrade Fixation of Distal Metaphyseal Ulnar Shortening Osteotomy
Authors: Zhou Joanne Y. , Frey Christopher S. , Shah Kalpit N. , Ostergaard Peter J. , Yao Jeffrey
Published: April 2023

The ulnar shortening osteotomy (USO) is a common procedure used to treat ulnar impaction syndrome secondary to static or dynamic ulnar-positive variance. There are many described techniques for the USO. The distal metaphyseal ulnar shortening osteotomy (DMUSO) with retrograde cannulated screw fixation was described to reduce complications seen with other techniques. Biomechanical analysis of fixation constructs demonstrates 2-screw constructs are significantly stiffer than 1 screw and antegrade constructs have similar or greater stiffness when compared with retrograde constructs. Here, we describe a technique of antegrade cannulated screw fixation for DMUSO that obviates the need for the disruption of the distal radioulnar joint for intra-articular exposure of the ulnar head. Similar to the traditional retrograde DMUSO technique, this construct may also decrease the risk of delayed union, symptomatic implants associated with diaphyseal osteotomies, and disruption of triangular fibrocartilaginous complex in wafer procedures.
CLIC1-mediated autophagy confers resistance to DDP in gastric cancer
Authors: Nong Zhen-Liang , Zhao Kun , Wang Ye , Yu Zhu , Wang Cong-jun , Chen Jun-Qiang
Published: April 2023

Gastric cancer has been a constant concern to researchers as one of the most common malignant tumors worldwide. The treatment options for gastric cancer include surgery, chemotherapy and traditional Chinese medicine. Chemotherapy is an effective treatment for patients with advanced gastric cancer. Cisplatin (DDP) has been approved as a critical chemotherapy drug to treat various kinds of solid tumors. Although DDP is an effective chemotherapeutic agent, many patients develop drug resistance during treatment, which has become a severe problem in clinical chemotherapy. This study aims to investigate the mechanism of DDP resistance in gastric cancer. The results show that intracellular chloride channel 1 (CLIC1) expression was increased in AGS/DDP and MKN28/DDP, and as compared to the parental cells, autophagy was activated. In addition, the sensitivity of gastric cancer cells to DDP was decreased compared to the control group, and autophagy increased after overexpression of CLIC1. On the contrary, gastric cancer cells were more sensitive to cisplatin after transfection of CLIC1siRNA or treatment with autophagy inhibitors. These experiments suggest that CLIC1 could alter the sensitivity of gastric cancer cells to DDP by activating autophagy. Overall, the results of this study recommend a novel mechanism of DDP resistance in gastric cancer.
Real-world Outcomes of Ipilimumab Plus Nivolumab Combination Therapy in a Nation-wide Cohort of Advanced Melanoma Patients in the Netherlands
Authors: van Zeijl Michiel C.T. , van Breeschoten Jesper , de Wreede Liesbeth C. , Wouters Michel W.J.M. , Hilarius Doranne L. , Blank Christian U. , Aarts Maureen J.B. , van den Berkmortel Franchette W.P.J. , de Groot Jan Willem B. , Hospers Geke A.P. , Kapiteijn Ellen , Piersma Djura , van Rijn Rozemarijn S. , Stevense-den Boer Marion A. , van der Veldt Astrid A.M. , Vreugdenhil Gerard , Boers-Sonderen Marye J. , Suijkerbuijk Karijn P.M. , Haanen John B.A.G. , van den Eertwegh Alfons J.M.
Published: April 2023

In phase III trials, ipilimumab plus nivolumab combination therapy is highly efficacious for advanced melanoma, despite many treatment-related grades 3–4 adverse events. Here, we report real-world safety and survival outcomes of ipilimumab plus nivolumab for advanced melanoma. Patients with advanced melanoma who received first-line ipilimumab plus nivolumab between January 1, 2015 and June 30, 2021 were selected from the Dutch Melanoma Treatment Registry. We evaluated response status at 3, 6, 12, 18, and 24 months. OS and PFS were estimated with the Kaplan-Meier method. Separate analyses were performed for patients with or without brain metastases and for patients who met the inclusion criteria of the Checkmate-067 trial. In total, 709 patients received first-line ipilimumab plus nivolumab. Three hundred sixty (50.7%) patients experienced grade 3–4 adverse events, with 211 of the (58.6%) patients requiring hospital admission. The median treatment duration was 42 days (IQR = 31–139). At 24 months, disease control was achieved in 37% of patients. Median PFS since the start of treatment was 6.6 months (95% CI: 5.3–8.7), and median OS was 28.7 months (95% CI: 20.7–42.2). CheckMate-067 trial-like patients had a 4-year OS of 50% (95% CI: 43–59). Among patients with no asymptomatic or symptomatic brain metastases, the 4-year OS probabilities were 48% (95% CI: 41–55), 45% (95% CI: 35–57), and 32% (95% CI: 23–46). Ipilimumab plus nivolumab can achieve long-term survival in advanced melanoma patients in a real-world setting, including patients not represented in the CheckMate-067 trial. However, the proportion of patients with disease control in the real world is lower compared with clinical trials.
Accuracy of baseline low-dose computed tomography lung cancer screening: a systematic review and meta-analysis
Authors: Guo Lanwei , Yu Yue , Yang Funa , Gao Wendong , Wang Yu , Xiao Yao , Du Jia , Tian Jinhui , Yang Haiyan
Published: April 2023

Background:

Screening using low-dose computed tomography (LDCT) is a more effective approach and has the potential to detect lung cancer more accurately. We aimed to conduct a meta-analysis to estimate the accuracy of population-based screening studies primarily assessing baseline LDCT screening for lung cancer.

Methods:

MEDLINE, Excerpta Medica Database, and Web of Science were searched for articles published up to April 10, 2022. According to the inclusion and exclusion criteria, the data of true positives, false-positives, false negatives, and true negatives in the screening test were extracted. Quality Assessment of Diagnostic Accuracy Studies-2 was used to evaluate the quality of the literature. A bivariate random effects model was used to estimate pooled sensitivity and specificity. The area under the curve (AUC) was calculated by using hierarchical summary receiver-operating characteristics analysis. Heterogeneity between studies was measured using the Higgins I
2 statistic, and publication bias was evaluated using a Deeks’ funnel plot and linear regression test.

Results:

A total of 49 studies with 157,762 individuals were identified for the final qualitative synthesis; most of them were from Europe and America (38 studies), ten were from Asia, and one was from Oceania. The recruitment period was 1992 to 2018, and most of the subjects were 40 to 75 years old. The analysis showed that the AUC of lung cancer screening by LDCT was 0.98 (95% CI: 0.96–0.99), and the overall sensitivity and specificity were 0.97 (95% CI: 0.94–0.98) and 0.87 (95% CI: 0.82–0.91), respectively. The funnel plot and test results showed that there was no significant publication bias among the included studies.

Conclusions:

Baseline LDCT has high sensitivity and specificity as a screening technique for lung cancer. However, long-term follow-up of the whole study population (including those with a negative baseline screening result) should be performed to enhance the accuracy of LDCT screening.
Smartphone Dynamic Infrared Thermography for Harvesting AICAP Flap in a Large Breast-conservative Surgery
Authors: Vaccari Stefano , Lorenzano Valerio , Lisa Andrea , Di Giuli Riccardo , Klinger Marco , Klinger Francesco , Vinci Valeriano
Published: April 2023

Flaps based on perforators of the intercostal arteries have been described for the reconstruction of defects resulting from partial mastectomies. Dynamic infrared thermography (DIRT) identifies hot spots that accurately correspond to and evaluate perforator vessels toward the skin. The new generation of portable thermal cameras has become smaller, less expensive, more sensitive, and compatible with common smartphones. One option is the FLIR ONE system (FLIR Systems, Inc., Wilsonville, OR), a smartphone-compatible thermal camera. Despite its lower resolution, compared with the larger infrared camera models, it represents a viable option for thermal skin mapping, and its compact nature allows for easy portable use. The purpose of this article is to report a case of a preoperative study with smartphone DIRT used in the preparation of an anterior intercostal artery perforator–based flap for breast reconstruction after a wide resection at the level of the right infer-internal breast region, including a skin excision. Our study documents how smartphone DIRT is a rapid, sensitive, easily accessible and cost-effective diagnostic method for the topographical identification of intercostal artery perforators. It can be used as a rescue method at any stage of the intervention if it differs from the preoperative planning. It also confirms the proven usefulness of this flap for the reconstruction of partial defects in the breast and thoracic region.
Efficacy and Safety of Microsurgical Pharyngolaryngeal and Pharyngoesophageal Reconstruction: A Systematic Review of the Literature
Authors: Gasteratos Konstantinos , Vlachopoulos Nikolaos , Kokosis George , Goverman Jeremy
Published: April 2023

Background:

Restoration of function and complication management after pharyngolaryngectomy remains a challenging task. The aim of our study was to compare the functional and clinical outcomes of pharyngolaryngeal and pharyngoesophageal reconstruction using free flaps, namely jejunal (FJF), anterolateral thigh, and radial forearm, and describe a reconstructive approach for these defects following tumor resection.

Methods:

We performed a systematic literature review on PubMed (Medline), Embase and Cochrane Library over the last two decades for articles reporting the surgical reconstructive modalities available after total or partial pharyngeal and/or laryngeal resection using a structured search strategy and strict inclusion and elimination criteria.

Results:

Our search identified a total of 677 articles, 112 full texts were fully reviewed for eligibility, and 39 met the inclusion criteria. The use of both FJF and fasciocutaneous flaps is safe. The FJF has optimal swallowing outcomes and a low incidence of major recipient-site complications. Nevertheless, free fasciocutaneous flaps exhibit comparable functional results, while they seem linked with fewer cases of perioperative mortality and flap failure. However, none of the currently available techniques can combine all potential benefits.

Conclusions:

Despite these procedures being mainly palliative in nature, the advent of microvascular techniques and utilization of fasciocutaneous free flaps has allowed optimal restoration of function combined with a reduced rate of perioperative and longterm complications. Both FJF and fasciocutaneous flaps can be viable treatment options, depending on the expertise of the surgeon and patient selection, to ensure the best outcomes.
Immune signatures in variant syndromes of primary biliary cholangitis and autoimmune hepatitis
Authors: Schultheiß Christoph , Steinmann Silja , Willscher Edith , Paschold Lisa , Lohse Ansgar W. , Binder Mascha
Published: April 2023

Background:

Variant syndromes of autoimmune hepatitis (AIH) and primary biliary cholangitis (PBC) share diagnostic features of both entities, but their immunological underpinnings remain largely unexplored.

Methods:

We performed blood profiling of 23 soluble immune markers and immunogenetics in a cohort of 88 patients with autoimmune liver diseases (29 typical AIH, 31 typical PBC and 28 with clinically PBC/AIH variant syndromes). The association with demographical, serological and clinical features was analyzed.

Results:

While T and B cell receptor repertoires were highly skewed in variant syndromes compared to healthy controls, these biases were not sufficiently discriminated within the spectrum of autoimmune liver diseases. High circulating checkpoint molecules sCD25, sLAG-3, sCD86 and sTim-3 discriminated AIH from PBC on top of classical parameters such as transaminases and immunoglobulin levels. In addition, a second cluster of correlated soluble immune factors encompassing essentially TNF, IFNγ, IL12p70, sCTLA-4, sPD-1 and sPD-L1 appeared characteristic of AIH. Cases with complete biochemical responses to treatment generally showed a lower level of dysregulation. Unsupervised hierarchical clustering of classical and variant syndromes identified two pathological immunotypes consisting predominantly of either AIH or PBC cases. Variant syndromes did not form a separate group, but clustered together with either classical AIH or PBC. Clinically, patient with AIH-like variant syndromes were less likely to be able discontinue immunosuppressive treatment.

Conclusions:

Our analyses suggest that variants of immune mediated liver diseases may represent an immunological spectrum from PBC to AIH-like disease reflected by their pattern of soluble immune checkpoint molecules rather than separate entities.
Wide variation in pre-procedural blood product transfusion practices in cirrhosis: a national multidisciplinary survey
Authors: Janko Natasha , Majeed Ammar , Clements Warren , Fink Michael A. , Lubel John , Goodwin Mark , Nicoll Amanda , Strasser Simone I. , Sood Siddharth , Bollipo Steven , Bate John , Bowers Kaye A , George Jacob , Kemp William , Roberts Stuart K.
Published: April 2023

Background and Aims:

Recent guidelines recognize the limitations of standard coagulation tests in predicting bleeding and guiding pre-procedural blood component prophylaxis in cirrhosis. It is unclear whether these recommendations are reflected in clinical practice. We performed a nationwide survey to investigate pre-procedural transfusion practices and opinions of key health care stakeholders involved in managing cirrhosis.

Methods:

We designed a 36-item multiple-choice questionnaire to investigate the international normalized ratio and platelet cutoffs utilized to guide pre-procedural transfusion of fresh frozen plasma and platelets in patients with cirrhosis undergoing a range of low and high-risk invasive procedures. Eighty medical colleagues from all mainland States involved in managing patients with cirrhosis were invited by email to participate.

Results:

Overall, 48 specialists across Australia completed the questionnaire: 21 gastroenterologists, 22 radiologists, and 5 hepatobiliary surgeons. 50% of respondents reported that their main workplace did not have written guidelines relating to pre-procedural blood component prophylaxis in patients with cirrhosis. There was marked variation in routine prophylactic transfusion practices across institutions for the different procedures and international normalized ratio and platelet cutoffs. This variation was present both within and between specialty groups and held for both low and high-risk procedures. For scenarios where the platelet count was ≤ 50 × 109/L, 61% of respondents stated that prophylactic platelet transfusions would be given before low-risk and 62% before high-risk procedures at their center. For scenarios where the international normalized ratio was ≥2, 46% of respondents stated that prophylactic fresh frozen plasma would be routinely given before low-risk procedures and 74% before high-risk procedures.

Conclusion:

Our survey reveals significant heterogeneity of pre-procedural prophylactic transfusion practices in patients with cirrhosis and discrepancies between guidelines and clinical practice.
Adipose tissue metabolic changes in chronic kidney disease
Authors: Serrano Eurico , Shenoy Prashamsa , Martinez Cantarin Maria Paula
Published: April 2023

Adipose tissue is a complex organ whose functions go beyond being an energy reservoir to sustain proper body energy homeostasis. Functioning as an endocrine organ, the adipose tissue has an active role in the body’s metabolic balance regulation through several secreted factors generally termed as adipokines. Thus, adipose tissue dysregulation in chronic kidney disease (CKD) can have a deep impact in the pathophysiology of diseases associated with metabolic dysregulation including metabolic syndrome, insulin resistance (IR), atherosclerosis, and even cachexia. CKD is a progressive disorder linked to increased morbidity and mortality. Despite being characterized by renal function loss, CKD is accompanied by metabolic disturbances such as dyslipidemia, protein energy wasting, chronic low-grade inflammation, IR, and lipid redistribution. Thus far, the mechanisms by which these changes occur and the role of adipose tissue in CKD development and progression are unclear. Further understanding of how these factors develop could have implications for the management of CKD by helping identify pharmacological targets to improve CKD outcomes.
“Suddenly Feeling Dark”: A Qualitative Study on the Experiences of Nurses Facing Coworker Death During the COVID-19 Pandemic
Authors: SIGA TAGE Petrus Kanisius , AZI DJOGO Herliana Monika , LETOR Yulia M. K. , BINA Maria Yoanita
Published: April 2023

Background

The coworkers of nurses who died because of COVID-19 infection generally experience a highly emotional grieving process. Nurses grieving the loss of a coworker during the COVID-19 pandemic experience higher psychological stress because of their high workload and the grueling shifts required to manage health emergencies during the pandemic and cope with long-standing staffing shortages. The limited number of studies discussing this issue has resulted in insufficient evidence necessary to develop effective counseling strategies and psychological support for nurses in Indonesia dealing with the massive waves of COVID-19 cases.

Purpose

This study was designed to elucidate the experiences of nurses across four provinces in Indonesia who had experienced the loss of a colleague during the COVID-19 pandemic.

Methods

A qualitative research design and phenomenological approach were used in this study. Sampling was done in Jakarta, Bali, East Java, and East Nusa Tenggara using purposive sampling for the first eight participants and snowball sampling for the subsequent 34 participants. Semistructured, in-depth interviews were used to collect data from 30 participants using appropriate ethical principles. Data saturation was achieved after interviewing 23 participants, and their data were analyzed using thematic analysis.

Results

Three main themes related to nurses' responses to the death of a colleague, distinguished into several stages, were identified. Stages in the first theme were as follows: (a) shocked to hear of colleague's death, (b) self-blame for failing to save a life, and (c) afraid to experience the same situation. Stages in the second theme were as follows: (a) make efforts to avoid the same thing from happening again, (b) develop strategies to avoid thoughts of loss, and (c) expect to have a psychological support system. Stages in the third theme were as follows: (a) seek new reasons, goals, directions, and meanings in life and (b) improve the physical and social health of individuals.

Conclusions/Implications for Practice

The range of responses from nurses to the death of a colleague during the COVID-19 pandemic identified in this study may be referenced by service providers to better provide psychological assistance and support to nursing staff. In addition, the coping strategies described by the participants provide detailed information that healthcare providers may use to deal with nurses facing death more comprehensively. This study emphasizes the importance of developing strategies to help nurses cope positively with their grief from a holistic perspective, which may be expected to impact positively the performance of nurses.
Benefits of an Integrated Nurse Residency Program in the Neonatal Intensive Care Unit
Authors: Waggoner Jacquelin K. , Waskosky Aksana
Published: April 2023

Background:

The neonatal intensive care unit is a specialized unit where nurses, physicians, and other providers take care of the smallest patients in healthcare. Because neonatal intensive care units are highly specialized, many nursing students graduate from undergraduate programs with little experience or knowledge related to the care of neonatal patients.

Results:

Nursing residency programs with hands-on simulation training have been shown to provide significant benefits to new and novice nurses as they enter the workforce, particularly in areas where the patient population requires highly specialized treatment. The myriad of benefits provided by nurse residency programs and simulation training exercises have been shown to result in improved nurse retention, job satisfaction, nursing skill, and patient outcomes.

Conclusion:

Because of the proven benefits, integrated nurse residency programs and simulation training should be the standard for training new and novice nurses in the neonatal intensive care unit environment.
Teaching Professional Peer Review With the Use of Simulation
Authors: Cole Linda J. , Andrighetti Tia P. , Thrower Eileen J. B. , Engstrom Janet L.
Published: April 2023

Background:

Quality improvement practices such as peer review and just culture are important components of patient safety initiatives, and health professions students should be introduced to these practices during their education.

Purpose:

The purpose of this study was to evaluate a peer-review simulation learning experience using just culture principles in a graduate-level, online nursing education program.

Methods:

The students rated their learning experience with high, positive scores in all 7 domains on the Simulation Learning Experience Inventory. Responses to the open-ended question indicated that the students thought the experience provided opportunities for deep learning, increased confidence, and enhanced critical thinking skills.

Conclusion:

A peer-review simulation program using just culture principles provided a meaningful learning experience for graduate-level students in an online nursing education program.
Low Volume, High Risk
Authors: Bassitt Sarah
Published: April 2023

Background:

Neonaticide is the leading cause of death for infants younger than 24 hours. Since Safe Haven laws have been in place, a large reduction in infant deaths has occurred. A literature review concluded that many healthcare staff members are unknowledgeable regarding Safe Haven infants, laws, and surrendering events. This lack of knowledge could lead to delayed care and poor patient outcomes.

Methods:

The researcher used Lewin's change theory to conduct a quasi-experimental study using a pre/posttest design.

Results:

Data revealed a statistically significant increase in staff knowledge of Safe Haven events, roles and teamwork after a new policy, an educational intervention, and a simulation intervention occurred.

Conclusion:

Safe Haven laws have assisted in saving thousands of infants' lives since 1999 by allowing mothers to legally surrender their infant to any place deemed safe by the state's law. Because of this, healthcare staff should be knowledgeable of their roles and responsibilities during a relinquishment. Safe Haven policies, annual education, and annual simulations can assist healthcare staff in their preparedness and confidence of such events and increase patient outcomes.
Healthcare Simulations' Contributions to Improving Perinatal and Neonatal Practice
Authors: Battista Alexis
Published: April 2023

This commentary examines evidence demonstrating how simulations have been used in the clinical setting to improve perinatal and neonatal clinical care, including simulations implemented to address select patient presentations, novel patient presentations, and those employed to test new clinical environments or renovated patient units. The underlying reasons these interventions support interprofessional collaboration, organizational learning, and problem solving are also discussed alongside common challenges associated with implementation.
Evaluating Risk Factors for Biceps Tendon Injuries in Softball Players: A Systematic Review
Authors: Stamm Michaela A. , Brahmbhatt Purav S. , Brown Symone M. , Miskimin L. Cadence , Mulcahey Mary K.
Published: April 2023

Objective:

Softball players commonly suffer overuse injuries due to the demands of repetitive throwing. The biceps tendon plays an important role in stabilizing the shoulder during the windmill pitch. The purpose of this study was to evaluate the measures used to identify and study biceps tendon pathology in softball players.

Design:

This was a systematic review.

Setting:

PubMed MEDLINE, Ovid MEDLINE, and EMBASE were searched.

Participants:

Studies that investigated biceps tendon injuries in softball players.

Interventions:

None.

Main Outcome Measures:

Range of motion (ROM), strength, and visual analog scale data were collected.

Results:

Of 152 search results, 18 were included. A total of 536 of 705 athletes (76%) were softball players (average age 14-25 years). Five of 18 articles (27.7%) studied changes in external rotation with the shoulder at 90 degrees of abduction, and 4 of 18 (22.2%) studied internal rotation. Two of 18 studies (11.1%) examined ROM or strength changes in forward flexion.

Conclusions:

While researchers agree that the windmill pitch places significant stress on the biceps tendon, our study finds that the metrics used to evaluate shoulder pathology in these players primarily evaluate the rotator cuff without isolating the biceps tendon. Future studies should include clinical tests and biomechanical metrics more specific to identifying biceps and labral pathology (eg, strength, fatigue, and ROM in glenohumeral forward flexion, elbow flexion, and forearm supination) and attempt to clarify differences in pathology between pitchers and position players to better characterize the frequency and severity of biceps tendon pathology in softball players.
Assessing Factors That May Impact Physician-based Decisions for Placing Indwelling Pleural Catheters
Authors: Alexander Matthew , Ishisaka Yoshiko , Miyakawa Lina , Rothman Adam
Published: April 2023

Introduction:

Malignant pleural effusion is a common finding in patients with advanced cancer and is a frequent cause of dyspnea. Current guidelines indicate thoracentesis for symptomatic patients, while indwelling pleural catheters (IPC) are recommended for patients who develop pleural fluid re-accumulation. IPC maintenance, however, requires a significant level of financial and social support. This study aims to analyze potential influencing factors that may play a role in the decision for placing IPCs in patients with recurrent malignant pleural effusions.

Methods:

This study retrospectively collected baseline sociodemographic and laboratory data in patients who underwent thoracentesis for malignant pleural effusion from August 2016 to October 2021, and selected patients who presented with re-accumulation of pleural fluid within 30 days or had a pulmonary physician’s note documenting that IPC is a potential management option. Of these selected patients (IPC candidates), we stratified patients who underwent IPC placement and those who did not, and performed statistical analysis between these 2 groups.

Results:

One hundred seventy-six patients who underwent thoracentesis were regarded as IPC candidates. Almost all baseline sociodemographic characteristics, including ethnicity (P=0.637), sex (P=0.655), and marital status (P=0.773) were similar between the 2 groups, but significantly higher ECOG scores (P=0.049) were noted in the IPC group. No statistically significant differences were noted in age, body mass index, platelet, PTT, international normalized ratio, creatinine, white blood cell, red blood cells, fluid protein, or fluid lactate dehydrogenase. Fluid albumin (P=0.057) and serum neutrophil:lymphocyte ratio (P=0.003) were significantly higher in patients without IPC placement.

Conclusion:

This study did not recognize any baseline sociodemographic factors that may contribute to the decision to place IPCs.
Application of systemic inflammation indices and lipid metabolism-related factors in coronary artery disease
Authors: Zhao Zhuoyan , Lian Huan , Liu Yixiang , Sun Lixian , Zhang Ying
Published: April 2023

Objective

We aimed to investigate the relationship between coronary artery disease (CAD) and systemic inflammation indices and lipid metabolism-related factors and subsequently, discuss the clinical application of these factors in CAD.

Methods

We enrolled 284 consecutive inpatients with suspected CAD and divided them into a CAD group and a non-CAD group according to coronary angiography results. Serum levels of angiopoietin-like protein 3 (ANGPTL3), angiopoietin-like protein 4 (ANGPTL4), fatty acid-binding protein 4 (FABP4), and tumor necrosis factor-α (TNF-α) levels were assessed using the ELISA and the systemic inflammation indices were calculated. Multivariate logistic regression was used to assess the risk factors of CAD. The receiver operating characteristic curve was used to determine the cutoff and diagnostic values.

Results

The neutrophil-to-high density lipoprotein cholesterol ratio (5.04 vs. 3.47), neutrophil-to-lymphocyte ratio (3.25 vs. 2.45), monocyte-to-high density lipoprotein cholesterol ratio (MHR) (0.46 vs. 0.36), monocyte-to-lymphocyte ratio (0.31 vs. 0.26), systemic immune-inflammation index (SII) (696.00 vs. 544.82), serum TNF-α (398.15 ng/l vs. 350.65 ng/l), FABP4 (1644.00 ng/l vs. 1553.00 ng/l), ANGPTL3 (57.60 ng/ml vs. 52.85 ng/ml), and ANGPTL4 (37.35 ng/ml vs. 35.20 ng/ml) values showed a significant difference between the CAD and non-CAD groups (P < 0.05). After adjusting for confounding factors, the following values were obtained: ANGPTL3 > 67.53 ng/ml [odds ratio (OR) = 8.108, 95% confidence interval (CI) (1.022–65.620)]; ANGPTL4 > 29.95 ng/ml [OR = 5.599, 95% CI (1.809–17.334)]; MHR > 0.47 [OR = 4.872, 95% CI (1.715–13.835)]; SII > 589.12 [OR = 5.131, 95% CI (1.995–13.200)]. These factors were found to be independently associated with CAD (P < 0.05). Diabetes combined with MHR > 0.47, SII > 589.12, TNF-α >285.60 ng/l, ANGPTL3 > 67.53 ng/ml, and ANGPTL4 > 29.95 ng/l had the highest diagnostic value for CAD [area under the curve: 0.921, 95% CI, (0.881–0.960), Sensitivity: 88.9%, Specificity: 82.2%, P < 0.001].

Conclusion

MHR > 0.47, SII > 589.12, TNF-α >285.60 ng/l, ANGPTL3 > 67.53 ng/ml, and ANGPTL4 > 29.95 ng/l were identified as independent CAD risk factors and have valuable clinical implications in the diagnosis and treatment of CAD.
Effect of β1-adrenergic receptor gene polymorphism on ventricular arrhythmia and prognosis after myocardial infarction
Authors: Ran Tao , Xiaojuan Zong , Yang Pang , Qingxing Chen , Ye Xu , Lu Han , Yanling Su , Wei Hu , Wenqing Zhu
Published: April 2023

Background

Ventricular arrhythmia is a common complication of acute myocardial infarction (AMI). The Arg389Gly polymorphism of the β1-adrenergic receptor genotype may affect AMI patients.

Method

Patients diagnosed with AMI were included in this study. Clinical data were obtained from the patient’s medical history, and genotypes were retrieved from laboratory test reports. ECG data were recorded daily. Data analysis was performed using SPSS 20.0, and differences were deemed statistically significant at P < 0.05.

Result

In the final study, 213 patients were included. The proportions of the Arg389Arg, Arg389Gly, and Gly389Gly genotypes were 65.7%, 21.6%, and 12.7%, respectively. Patients with the Arg389Arg genotype exhibited significantly elevated cardiac troponin T (cTnT) and pro-BNP levels compared to the Arg389Gly and Gly389Gly genotypes [cTnT: 4.00 ± 2.43 ng/ml versus 2.82 ± 1.82 ng/ml, P = 0.012; pro-BNP: 1942.37 (1223.194, 206.59) pg/ml versus 1604.57 (798.05, 1884.79) pg/ml, P = 0.005]. Patients with the Arg389Arg genotype exhibited a lower ejection fraction than those with the Gly389Gly genotype (54.13 ± 4.94% vs. 57.11 ± 2.87%, P < 0.001). Patients homozygous for Arg389Arg exhibited a higher incidence of ventricular tachycardia and a greater proportion of premature ventricular contraction (PVC) compared to patients homozygous for Gly389Gly (ventricular tachycardia: 19.29% vs. 0.00%, P = 0.009; PVC: 70.00% vs. 40.74%, P = 0.003).

Conclusion

The Arg389Arg genotype is associated with greater myocardial damage, impaired cardiac function, and an increased probability of ventricular arrhythmia in AMI patients.
An update on bronchopleural fistulae following cancer-related surgery
Authors: Bashour Sami I. , Ost David E.
Published: April 2023

Purpose of Review

Bronchopleural fistulae (BPF) are rare complications in cancer-related surgery but impart significant morbidity and mortality. BPF may be difficult to identify, with a broad differential diagnosis at presentation, so it is critical to be aware of newer diagnostic and therapeutic approaches for this disease entity.

Recent Findings

Multiple novel diagnostic and therapeutic interventions are featured in this review. Reports of newer bronchoscopic techniques to localize BPF, as well as approaches for bronchoscopic management, like stent deployment, endobronchial valve placement, or alternative interventions when indicated are discussed, paying particular attention to factors that influence procedure selection.

Management of BPF remains highly variable, but several novel approaches have shown improved identification and outcomes. Although a multidisciplinary approach is imperative, an understanding of these newer techniques is important to provide optimal care for patients.
Pain and Functional Outcomes Following Targeted Muscle Re-innervation: A Systematic Review
Authors: ElAbd Rawan , Dow Todd , Jabori Sinan , Alhallabi Becher , Lin Samuel J. , Dowlatshahi Sammy
Published: April 2023

Introduction:

It is estimated that by 2050, a total of 3.6 million patients will be living with an amputation in the United States. The objective of this systematic review is to evaluate the effect of Targeted Muscle Reinnervation (TMR) on pain and physical functioning in amputees.

Methods:

A literature search was performed on Pubmed, EMBASE, and Medline up to the 28 th of November 2021. Clinical studies assessing the outcomes of TMR (pain, prosthesis control, life quality, limb function, and disability) were included.

Results:

Thirty-nine articles were included. Total patients that underwent TMR were 449 while 716 were controls. Mean follow-up was 25 months. A total of 309 (66%) lower limb and 159 (34%) upper limb amputations took place in the TMR group; the most common being below-knee (39%). The control group included a total of 557 (84%) lower limb and 108 (16%) upper limb amputations; the greatest proportion being below knee amputations in this group as well (54%). Trauma was the most common indication for amputation. Phantom Limb Pain scores were lower cases by 10.2 points for intensity (p value .01), 4.67 points for behavior (p value 0.01), and 8.9 points for interference (p value .09). Similarly, Residual Limb Pain measures were lower for cases for intensity, behavior, and interference but failed to reach significance. Neuroma symptoms occurred less frequently and functional and prosthesis control outcomes improved following TMR.

Conclusion:

The literature evidence suggests that TMR is a promising therapy for improving pain, prosthesis use, and functional outcomes after limb amputation.