bluuebunny/crossref_metadata_2025_split huggingface dataset:
Sex and age differences of major cardiovascular events in patients after percutaneous coronary intervention
Authors: Yang Ya-Ling , Chen Su-Chan , Wu Cheng-Hsueh , Huang Shao-Sung , Leong Chan Wan , Lin Shing-Jong , Chou Chia-Yu , Chen Jaw-Wen , Pan Ju-Pin , Charng Min-Ji , Chen Ying-Hwa , Wu Tao-Cheng , Lu Tse-Min , Hsu Pai-Feng , Huang Po-Hsun , Cheng Hao-Min , Huang Chin-Chou , Sung Shih-Hsien , Lin Yenn-Jiang , Leu Hsin-Bang 
Published: October 2023

Background:
Women usually have higher risk after receiving percutaneous coronary interventions (PCIs) than men with coronary artery disease (CAD). The aim of this study was to investigate the association of sex differences with future outcomes in CAD patients undergoing PCI, to assess the role of age, and to extend observed endpoints to stroke and congestive heart failure.

Methods:
Six thousand six hundred forty-seven patients with CAD who received successful PCIs. The associations between clinic outcomes and sex were analyzed. The primary outcome was major cardiovascular events (MACE), including cardiac death, nonfatal myocardial infraction, and nonfatal stroke. The secondary outcome was MACE and hospitalization for heart failure (total CV events).

Results:
During a mean of 52.7 months of follow-up, 4833 men and 1614 women received PCI. Univariate and multivariate analyses showed that women were independently associated with an increased risk of cardiac death (HR, 1.78; 95% CI, 1.32-2.41), hospitalization for heart failure (HR, 1.53; 95% CI, 1.23-1.89), MACE (HR, 1.34; 95% CI, 1.10-1.63), and total CV events (HR, 1.39; 95% CI, 1.20-1.62). In the subgroup analysis, women aged under 60 years had higher cardiovascular risks than men of the same age category.

Conclusion:
Women with CAD after successful PCI had poorer cardiovascular outcomes than men. Additionally, younger women (aged <60 years) were especially associated with a higher risk of developing future adverse cardiovascular outcomes.
Sexual Practices and Predisposition to PrEP Use Among Men Ages 50 Years and Older Who Have Sex With Men: A Cross-Sectional Study
Authors: Nunes Rômulo Veloso , de Araújo Telma Maria Evangelista , de Oliveira Layze Braz , Almeida Priscilla Dantas , Lima Shirley Veronica Melo Almeida , Magalhães Rosilane de Lima Brito , Valle Andréia Rodrigues Moura da Costa , Fronteira Inês , Mendes Isabel Amélia Costa , de Sousa Álvaro Francisco Lopes 
Published: October 2023

Abstract
This study aimed to evaluate the sexual practices of men ages 50 years or older who have sex with men (MSM) and factors influencing their predisposition to use preexposure prophylaxis (PrEP). An analytical cross-sectional study was conducted in Brazil and Portugal with 718 MSM. Of these, 278 (38.7%) were categorized as being at high risk for HIV based on the HIV Incidence Risk Index (HIRI), and 418 (58.2%) expressed a predisposition to use PrEP. Overall, sociodemographic factors and specific sexual practices increased the likelihood of being classified as high risk for HIV, particularly sexual position and sexual activity. However, factors that influenced the predisposition to use PrEP included age group, receptive anal sex, knowledge of postexposure prophylaxis, high HIRI score, and a history of syphilis. These findings underscore the urgent need for health services to provide comprehensive and adequate attention to the realities of this population, considering its complexities and specificities.
Physicians’ Turnover Intention During the “Post–COVID-19” Era
Authors: Margheritti Simona , Giorgi Ines , Magnone Stefano , Miglioretti Massimo , Fiabane Elena 
Published: October 2023

PurposeThis research investigates risk and protective factors affecting physicians’ turnover intention during the post–COVID-19 era.Design/Methodology/ApproachA cross-sectional online survey study of 958 physicians working in Lombardy (Northern Italy) hospitals was conducted.FindingsIn the post–COVID-19 era, burnout significantly increases physicians’ turnover intention. The same is true for fear of being infected by COVID-19 (FIC), which indirectly affects turnover intention via burnout. The higher FIC and burnout, the higher intention to leave the job or working unity. Self-efficacy significantly decreases turnover intention by reducing FIC and burnout.Originality/ValueImplementing turnover preventive programs in healthcare professionals is essential, mainly reducing BO and promoting physicians’ personal resources, such as self-efficacy.
Analyzing the Symptom Clusters Among Children With Acute Lymphoblastic Leukemia During Chemotherapy Based on Electronic Nursing Records
Authors: Wang Yuxin , Xie Hongxia , Jiang Hao , Chen Meijia , Ren Liya , Dong Chaoqun 
Published: October 2023

Background
Children with acute lymphoblastic leukemia often experience various physical and psychological symptoms during chemotherapy. Previous studies have used predetermined symptom inventories to analyze the complex relationships between these symptoms, which has certain limitations.

Objective
The aim of this study was to explore the dynamic changes in symptom clusters among children with acute lymphoblastic leukemia during chemotherapy using electronic nursing records.

Methods
Electronic nursing records for 2021 (N = 14 490) were obtained from a pediatric hematology department. A natural language processing tool was used to identify the presence of 46 symptoms in 3 chemotherapy phases of induction, consolidation, and maintenance. Incidence of symptom documentation was calculated by notes and patients, and principal component analysis and cluster analysis were performed for symptoms with an incidence above 15%.

Results
The most common symptoms included bleeding, cough, and vomiting. The number of symptom clusters in each chemotherapy period was 7, 6, and 4, respectively. There were upper gastrointestinal, respiratory system, lower gastrointestinal, skin-related, psychological, self-image disorder, and other discomfort symptom clusters in the induction period. Notably, the upper gastrointestinal, respiratory system, lower gastrointestinal, and skin-related symptom clusters persisted through the consolidation and maintenance periods. Neurological and other discomfort symptom clusters were observed during the consolidation period.

Conclusion
Symptom clusters of children with acute lymphoblastic leukemia at various stages of chemotherapy showed a certain level of stability and dynamics, informing healthcare providers in developing continuous symptom management.

Implications for Practice
Medical staff should explore targeted intervention programs based on characteristics of symptom clusters at different chemotherapy stages, to improve the efficiency of symptom management and alleviate the symptom burden of children.
Implementation of a Modified Early Screening for Discharge Tool to Optimize Case Manager Efficiency and Impact Length of Stay
Authors: Grafton James , Bowen Brady Helene , Kelly Joanne , Kelly Margaret , Lang Kathleen , Wolski Paula , Ray Soumi , Loescher Cori , Pearson Madelyn , Mendu Mallika 
Published: October 2023

Purpose of Study:The postacute landscape has been challenged since the onset of the COVID-19 pandemic by staffing shortages and a decline in postacute bed availability. As a result, patients in acute care hospitals are experiencing longer lengths of stay (LOS) and case managers (CMs) are managing increasingly complex discharge plans. This project involved the design and implementation of a modified Early Screen for Discharge Planning (ESDP) tool to support prioritizing patients with complex discharge needs, with the primary outcome of decreasing LOS.Primary Practice Setting:The project took place in a community teaching hospital, part of a large academic health system in the Northeast, United States.Methodology and Participants:The project was designed as a prospective controlled study (between September 1 and November 30, 2021) with defined intervention and control cohorts, involving a modified ESDP electronic health record–based score including self-rated walking limitation, age, prior living status, and mobility level of assist. A modified ESDP score of 10 and greater indicated that patients would benefit from ongoing CM support, whereas those with an ESDP score of less than 10 were unlikely to have discharge planning needs. Participants were adult patients on medical and surgical inpatient units.Results:The project included 718 patients, 376 and 342 in the intervention and control cohorts, respectively. The modified ESDP performed comparably with the standard ESDP (14% discrepancy, with all patients appropriately identified for CM services). Implementation of the modified ESDP led to 53.5% of patients screening out of CM services, thereby increasing the time CMs were able to spend on complex discharge planning and was associated with a trend in LOS reduction (0.55 days).Implications for Case Management Practice:The findings of this project demonstrate that implementation of a modified ESDP can improve CM efficiency and improve hospital throughput. Given the unprecedented capacity challenges in both the acute and postacute settings, there is a need to implement CM workflow strategies that will optimize the effectiveness of critical resources, while ensuring that patients' complex discharge needs are met.
Palliative Care Nursing Case Management in Young Adults With Advanced Rare Cancer
Authors: Fusetti Viviana , Angi Martina , Caraceni Augusto T. , Di Guardo Lorenza , Regalia Enrico , Bosisio Marco , Lo Dico Silvia , Pigni Alessandra , Brunelli Cinzia , Lusignani Maura 
Published: October 2023

Purpose/Objectives:
This case aims to identify the elements of care continuity that are lacking in young adult patients with advanced rare cancer, suggesting ways to enhance continuity of care through nurse case manager/management (NCM) interventions and describing their impact on the emotional burden of patients and their families.

Primary Practice Setting(s):
Comprehensive cancer center.

Findings/Conclusions:
The dyadic care alliance with the NCM can alleviate disease burden, fostering trust in the team and adherence to care advice, thus reducing the patient's distress. The NCM can be an efficient option to advocate for patient needs on the multidisciplinary team, addressing practical issues and the unmet needs of patients and their caregivers, and facilitating referrals to other professionals. The study also shows that caring for young adults with advanced rare cancers should include mindful evaluation of their significant others.

Implications for Case Management Practice:
Predictive and Associated Factors of Burnout in Nursing Faculty
Authors: Dugger Jennifer 
Published: October 2023

Background:
Nurse educators are at high risk of experiencing burnout, resulting in high numbers of vacant faculty positions.

Purpose:
The aims of this integrative review were to review the prevalence of measurable dimensions of professional burnout and discuss the predictive and associated factors of burnout and intent to leave nursing academia.

Approach:
This review used the Whittemore and Knafl integrative review methodology to perform a structured search of 4 electronic databases (CINAHL, ERIC, EMBASE, and PubMed).

Outcomes:
Nine empirical research studies measured 5 identifiable features of burnout in nursing educators: emotional exhaustion, depersonalization, lack of accomplishment, compassion satisfaction, and secondary traumatic stress. Five predictors of intent to leave nursing academia were identified: demographics, health status, salary, workload, and work-life imbalance.

Conclusions:
The highest contributing factor to burnout and intent to leave nursing academia is high workload levels and lack of work-life balance. Nursing faculty report moderate to high levels of all dimensions of professional burnout.
Medication adherence to oral chemotherapeutic agents: a qualitative study of patients' and cancer care professionals' perspectives
Authors: Torres Essie , Richman Alice , Koutlas Judy B. , DeAntonio Phyllis A. , Liles Darla K. , Romero-Trejo Katherine , Tripp Molly Robinson 
Published: October 2023

Abstract

Background:
Adherence is increasingly understood as a complex concept and is affected by many factors. Among rural patients with cancer, adherence behavior can be affected by increased psychosocial and physical distress as well as economic burden. This study explored facilitators and barriers to medication adherence to oral chemotherapeutic agents (OCAs) from the perspective of both rural patients with cancer and their cancer care providers.

Methods:
This study was conducted in a regional Cancer Center in North Carolina. Data for the cancer care providers (N = 10) were collected (January-February 2016), and data for the patients with cancer (N = 25) were collected (March-June 2016). Qualitative interviews were conducted with patients with cancer currently taking OCAs, and interviews/focus groups were conducted with cancer care providers. Data analysis was conducted using the immersion crystallization approach.

Results:
The results of this qualitative study provide valuable insights into the attitudes of both cancer care providers and patients with cancer and their perceptions of adherence barriers and facilitators. The main barriers to adherence were costs associated with treatment, side effect management, comorbidities and concomitant treatments, limited health literacy, lack of social support, and patient-provider communication. Facilitators to adherence include education and follow-up, social support networks, and adherence strategies.

Conclusion:
Better communication, education/information, and social support were identified as facilitators of adherence in this study. It is critical to develop tailored strategies such as self-management behaviors, adherence strategies, and effective communication that can improve medication adherence and empower patients and their caregivers in their treatment management.
Helicobacter pylori Eradication Rate Using Stool Antigen Test in Vietnamese Children: A Prospective Multicenter Study
Authors: Nguyen Tu Cam , Robert Annie , Pham Thu Hien Anh , Vo Khoa Hoang , Le Loc Duc , Ma Ha Tu , Le My Huynh Thao , Che Thai Hoang , Nguyen Hiep Thanh , Truong Dinh Quang , Bontems Patrick , Nguyen Phuong Ngoc Van 
Published: October 2023

Objectives:This study assessed the diagnostic value of a monoclonal immunoassay stool antigen test (HpSA) forHelicobacter pylori (H. pylori) infection and the eradication outcomes.Methods:Children undergoing digestive endoscopy at 2 Children’s Hospitals in Ho Chi Minh City were recruited. Treatment was offered toH. pylori-infected children. Stool samples were collected on the same day as the endoscopy procedure and after 6 weeks post-treatment for HpSA. Diagnostic value and optimal cutoff of HpSA were assessed using biopsy-based tests as the gold standard. Eradication was defined as a negative HpSA post-treatment. Ethical approval was obtained, and informed consent was signed by the participants.Results:In total, 394 patients participated in the study. The most common symptoms were epigastric pain (74.6%) and vomiting (37.3%).H. pyloristatus was positive in 78% of patients (306/394), doubtful in 10.1%, and negative in 12.2%. HpSA was positive in 73.2% (142/194). Excluding doubtful infections, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of HpSA were 87.4%, 95.2%, 99.2%, 51.3%, and 88.4%, respectively. The optimal cutoff value of 0.148 provided similar accuracy to the recommended cutoff. The eradication rate was 56.1% in per-protocol analysis and 27.9% in intention-to-treat analysis. Treatment success was higher in boys, but lower among malnourished children and those infected withcagA+strains.Conclusions:The HpSA is reliable for identifyingH. pyloriinfection in epidemiological studies and assessing eradication outcomes. The low eradication rate highlights the need for an appropriate intervention strategy in Vietnamese children.
Further Insight in Selecting the Ideal Vein for Lymphaticovenous Anastomosis: Utilizing the Venturi Effect
Authors: Cho Jeongmok , Yoon Johyun , Suh Hyunsuk Peter , Pak Changsik John , Hong Joon Pio 
Published: October 2023

Background:
The functional and dilated lymphatic vessel and veins with minimal backflow and pressure are considered ideal for lymphaticovenous anastomosis (LVA). How to select the ideal vein remains to be determined. This study aimed to provide further insight into selecting the ideal vein.

Methods:
This is a retrospective study evaluating 166 limbs with lymphedema with a minimal follow-up period of 12 months. The surgical approach included side-to-end LVA, including 1 group with a non-Venturi LVA and another with a small branch draining into a major vein (Venturi LVA). Preoperative and 1, 3, 6, and 12 months postoperative limb volume, circumference, reduction volume, and ratio were evaluated.

Results:
The postoperative volume reduction was significant for both groups when compared with their respective preoperative volume. When compared between the 2 groups, the Venturi LVA had a significantly higher reduction volume and ratio at postoperative 1 month (240.82 ± 260.73 cm³ versus 364.27 ± 364.08 cm³, 6.13 ± 5.62% versus 8.77 ± 6.64%; P < 0.05) and 3 months (289.19 ± 291.42 cm³ versus 432.50 ± 395.04 cm³, 7.31 ± 6.39% versus 10.55 ± 6.88%; P < 0.05) However, the reduction volume and ratio was not significant by months 6 and 12.

Conclusions:
This study provides further insight into selecting the ideal vein for LVA. By using a small vein draining into the main vein, valves play a role in reducing backflow. Furthermore, the Venturi effect allows significantly enhanced drainage, especially in the initial period after surgery. The effect slowly plateaus after few months, ultimately having a similar outcome of reduction at 12 months.
Nasal Tip Flexibility and Stability: Comparison of Septal Extension Grafts and Columellar Strut Grafts in a Prospective Trial
Authors: Kucukguven Arda , Çelik Murat , Altunal Sinan K. , Kocer Ugur 
Published: October 2023

Background:
The stability of nasal tip rotation and projection, and providing a flexible nasal tip, are important elements in rhinoplasty. Two common options to provide these requirements are the septal extension graft (SEG) and the columellar strut graft (CSG). This study aims to compare nasal tip stability and flexibility between the 2 graft options.

Methods:
A prospective randomized study was carried out in 60 patients operated on with either the CSG or the SEG. Tip rotation and projection stability were analyzed with photographic evaluation at the immediate postoperative period, the first month, and the first year. Nasal tip flexibility was evaluated with a newton meter at the preoperative period and postoperative first, third, and sixth months and the first year.

Results:
The CSG showed a significant loss of projection and rotation, whereas the SEG showed better preservation of projection and rotation. However, both options showed a greater loss of projection and rotation in the first month and then a slight decrease in the following months. Although the SEG had lesser flexibility compared with the CSG anteroposteriorly, there was no flexibility difference between them in the lateral direction in the long term.

Conclusions:
The SEG provides better nasal tip stability compared with the CSG. The greatest downside of the SEG is decreased flexibility compared with the CSG. Surgeons should be aware of the loss of projection and rotation with both graft options and adjust their operation plan according to these points.

CLINICAL QUESTION/LEVEL OF EVIDENCE:
Therapeutic, II.
Cone Beam Computed Tomographic Evaluation of Schneiderian Membrane Thickness
Authors: Al-Bahrani Zainab M. , Al-Ghurabi Zainab H. 
Published: October 2023

Objective:
This study aimed to determine the measurements and classification of Schneider membrane thickness correlated to age and sex factors using cone beam computed tomography (CBCT).

Methods:
The study included CBCT images for 100 maxillary sinuses of 50 consecutive patients, and the thickness of the maxillary sinus membrane (Schneiderian membrane) was measured in coronal view from the lowest point in the floor of the maxillary sinus to the highest point. The thickness of the Schneiderian membrane was classified into 4 types.

Results:
The study result revealed that out of the total cases, 45% of sinus membranes were classified as type 2, while only 10% were classified as type 4. The most frequent type of membrane thickness diagnosed in the age group 20 to 30 as type 1, whereas in age groups 31 to 40 and 41 to 50, regarding sex, type 4 was more obvious in males with membrane thickening >6 mm.

Conclusions:
Measurement and classification of sinus membrane thickness can be performed accurately with CBCT, and it is affected by age and sex factors.
Radiocarbon signatures of carbon phases exported by Swiss rivers in the Anthropocene
Authors: Rhyner Timo M. Y. , Bröder Lisa , White Margot E. , Mittelbach Benedict V. A. , Brunmayr Alexander , Hagedorn Frank , Storck Florian R. , Passera Lucas , Haghipour Negar , Zobrist Juerg , Eglinton Timothy I. 
Published: October 2023

Lateral carbon transport through the land-to-ocean-aquatic-continuum (LOAC) represents a key component of the global carbon cycle. This LOAC involves complex processes, many of which are prone to anthropogenic perturbation, yet the influence of natural and human-induced drivers remains poorly constrained. This study examines the radiocarbon (
14
C) signatures of particulate and dissolved organic carbon (POC, DOC) and dissolved inorganic carbon (DIC) transported by Swiss rivers to assess controls on sources and cycling of carbon within their watersheds. Twenty-one rivers were selected and sampled during high-flow conditions in summer 2021, a year of exceptionally high rainfall. Δ
14
C values of POC range from −446‰ to −158‰, while corresponding ranges of Δ
14
C values for DOC and DIC are −377‰ to −43‰ and −301‰ to −40‰, respectively, indicating the prevalence of pre-aged carbon. Region-specific agricultural practices seem to have an influential effect on all three carbon phases in rivers draining the Swiss Plateau. Based on Multivariate Regression Analysis, mean basin elevation correlated negatively with Δ
14
C values of all three carbon phases. These contrasts between alpine terrain and the lowlands reflect the importance of overriding ecoregional controls on riverine carbon dynamics within Switzerland, despite high spatial variability in catchment properties.

This article is part of the Theo Murphy meeting issue 'Radiocarbon in the Anthropocene'.
Warming and altered precipitation independently and interactively suppress alpine soil microbial growth in a decadal-long experiment
Authors: Ruan Yang , Ling Ning , Jiang Shengjing , Jing Xin , He Jin-Sheng , Shen Qirong , Nan Zhibiao 
Published: October 2023

AbstractWarming and precipitation anomalies affect terrestrial carbon balance partly through altering microbial eco-physiological processes (e.g., growth and death) in soil. However, little is known about how such processes responds to simultaneous regime shifts in temperature and precipitation. We used the18O-water quantitative stable isotope probing approach to estimate bacterial growth in alpine meadow soils of the Tibetan Plateau after a decade of warming and altered precipitation manipulation. Our results showed that the growth of major taxa was suppressed by the single and combined effects of temperature and precipitation, eliciting 40-90% of growth reduction of whole community. The antagonistic interactions of warming and altered precipitation on population growth were common (~70% taxa), represented by the weak antagonistic interactions of warming and drought, and the neutralizing effects of warming and wet. The members inSolirubrobacterandPseudonocardiagenera had high growth rates under changed climate regimes. These results are important to understand and predict the soil microbial dynamics in alpine meadow ecosystems suffering from multiple climate change factors.