bluuebunny/crossref_metadata_2025_split huggingface dataset:
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.
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.

Summary
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.
Development and Implementation of an Interdisciplinary Model for the Management of Breastfeeding in Women With HIV in the United States: Experience From the Children's Hospital Colorado Immunodeficiency Program
Authors: Abuogi Lisa , Smith Christiana , Kinzie Kay , Barr Emily , Bonham Adrianne , Johnson R.L. , Dinnebeil Megan , McFarland Elizabeth , Weinberg Adriana 
Published: April 2023

Background:
Women with HIV in high-income settings have increasingly expressed a desire to breastfeed their infants. Although national guidelines now acknowledge this choice, detailed recommendations are not available. We describe the approach to managing care for breastfeeding women with HIV at a single large-volume site in the United States.

Methods:
We convened an interdisciplinary group of providers to establish a protocol intended to minimize the risk of vertical transmission during breastfeeding. Programmatic experience and challenges are described. A retrospective chart review was conducted to report the characteristics of women who desired to or who did breastfeed between 2015 and 2022 and their infants.

Results:
Our approach stresses the importance of early conversations about infant feeding, documentation of feeding decisions and management plans, and communication among the health care team. Mothers are encouraged to maintain excellent adherence to antiretroviral treatment, maintain an undetectable viral load, and breastfeed exclusively. Infants receive continuous single-drug antiretroviral prophylaxis until 4 weeks after cessation of breastfeeding. From 2015 to 2022, we counseled 21 women interested in breastfeeding, of whom 10 women breastfed 13 infants for a median of 62 days (range, 1–309). Challenges included mastitis (N = 3), need for supplementation (N = 4), maternal plasma viral load elevation of 50–70 copies/mL (N = 2), and difficulty weaning (N = 3). Six infants experienced at least 1 adverse event, most of which were attributed to antiretroviral prophylaxis.

Discussion:
Many knowledge gaps remain in the management of breastfeeding among women with HIV in high-income settings, including approaches to infant prophylaxis. An interdisciplinary approach to minimizing risk is needed.
Clinical decision support in promoting evidence-based nursing in primary healthcare: a cross-sectional study in Finland
Authors: Hamari Lotta , Parisod Heidi , Siltanen Hannele , Heikkilä Kristiina , Kortteisto Tiina , Kunnamo Ilkka , Pukkila Heidi , Holopainen Arja 
Published: April 2023

ABSTRACT

Introduction and aims:
The aim was to explore clinical decision support (CDS) use in the practice of primary healthcare nurses. The objectives were to recognize to what extent nurses (registered nurses, public health nurses, and practical nurses) use CDS, what factors were associated with the CDS used, what kind of organizational support nurses need, and what were nurses’ views about CDS development needs.

Methods:
The study was conducted with a cross-sectional study design, using an electronic questionnaire developed for this purpose. The questionnaire contained 14 structured questions and nine open-ended questions. The sample consisted of randomly selected primary healthcare organizations (N = 19) in Finland. Quantitative data were analyzed using cross-tabulation and Pearson's chi-squared test, and qualitative data with quantification.

Results:
A total of 267 healthcare professionals (age range 22–63 years) volunteered to participate. Participants were mainly registered nurses, public health nurses, and practical nurses (46.8, 24, and 22.9%, respectively). Overall, 59% of the participants had never used CDS. The majority (92%) found it necessary to develop nursing-specific content for CDS. The most commonly used features were medication recommendations and warnings (74%), reminders (56%), and calculators (42%). Half of the participants (51%) had not received training on the use of CDS. The older age of participants was associated with the feeling of not having enough training to use CDS (P = 0.039104). Nurses felt that CDS was helpful in their clinical work and decision-making, promoting evidence-based practice, and narrowing the research-into-practice gap, improving patient safety and the quality of care, and helping those who are new in their work.

Conclusion:
CDS and its support structures should be developed from a nursing perspective to achieve the full potential of CDS in nursing practice.
Planning an implementation science training program for advanced practice registered nurses
Authors: Hebert Sharisse , Gaines Chloe , Benjamin-Garner Ruby , Moore Jerrel 
Published: April 2023

ABSTRACT

Background:
A gap exists between scientific discovery and implementation and adoption of research findings in healthcare and public health practice. This gap is due to the fact that research on treatment efficacy and safety in clinical trials ends prematurely with the publication of results, leaving a lack of knowledge of treatment effectiveness in real-world clinical and community settings. Comparative effectiveness research (CER) can facilitate the translation of research findings, reducing the gap between discovery and adoption into practice. Getting CER findings to patients and healthcare providers requires efforts to disseminate and train providers to successfully implement and sustain change in the healthcare setting. Advanced practice registered nurses (APRNs) are instrumental in the implementation of evidence-based research in primary care settings and an important group to target for the dissemination of research findings. There are numerous implementation training programs, but none focus specifically on APRNs.

Objective:
The objective of this article is to describe the infrastructure established to develop a 3-day implementation training program for APRNs and an implementation support system.

Method:
A description of the processes and strategies is provided, including stakeholder engagement through focus groups and the formation of a multistakeholder program planning advisory team, which includes APRNs, organization leaders, and patients. The program also includes curriculum development and program planning as well as the development of an implementation toolkit.

Results:
Stakeholders were instrumental in shaping the implementation training program, including the content of the curriculum and the program agenda. In addition, the unique perspective of each stakeholder group contributed to the selection of the CER findings disseminated through the intensive training program.

Conclusion:
It is important that strategies to address the lack of implementation training opportunities for APRNs be discussed and disseminated within the healthcare community. This article discusses the plan to address implementation training for APRNs through the development of an implementation curriculum and toolkit for APRNs.
The impact of long-term conditions and comorbidity patterns on COVID-19 infection and hospitalisation: a cohort study
Authors: Huang Yun-Ting , Steptoe Andrew , Patel Riyaz S. , Thomson Esme Fuller , Cadar Dorina 
Published: April 2023

AbstractIntroductionOlder adults are usually more vulnerable to COVID-19 infections; however, little is known about which comorbidity patterns are related to a higher probability of COVID-19 infection. This study investigated the role of long-term conditions or comorbidity patterns on COVID-19 infection and related hospitalisations.MethodsThis study included 4,428 individuals from Waves 8 (2016−2017) and 9 (2018−2019) of the English Longitudinal Study of Ageing (ELSA), who also participated in the ELSA COVID-19 Substudy in 2020. Comorbidity patterns of chronic conditions were identified using an agglomerative hierarchical clustering method. The relationships between comorbidity patterns or long-term conditions and COVID-19 related outcomes were examined using multivariable logistic regression.ResultsAmong a representative sample of community-dwelling older adults in England, those with cardiovascular disease (CVD) and complex comorbidities had an almost double risk of COVID-19 infection (OR=1.87, 95% CI=1.42−2.46) but not of COVID-19 related hospitalisation. A similar pattern was observed for the heterogeneous comorbidities cluster (OR=1.56, 95% CI=1.24−1.96). The individual investigations of long-term conditions with COVID-19 infection highlighted primary associations with CVD (OR=1.46, 95% CI=1.23−1.74), lung diseases (OR=1.40, 95% CI=1.17−1.69), psychiatric conditions (OR=1.40, 95% CI=1.16−1.68), retinopathy/eye diseases (OR=1.39, 95% CI=1.18−1.64), and arthritis (OR=1.27, 95% CI=1.09−1.48). In contrast, metabolic disorders and diagnosed diabetes were not associated with any COVID-19 outcomes.Discussion/ConclusionThis study provides novel insights into the comorbidity patterns that are more vulnerable to COVID-19 infections and highlights the importance of CVD and complex comorbidities.These findings facilitate crucial new evidence for appropriate screening measures and tailored interventions for older adults in the ongoing global outbreak.