bluuebunny/crossref_metadata_2025_split huggingface dataset:
Myocardial infarction with nonobstructive coronary arteries: the need for precision medicine
Authors: Del Buono Marco Giuseppe , La Vecchia Giulia , Rinaldi Riccardo , Sanna Tommaso , Crea Filippo , Montone Rocco Antonio 
Published: September 2022

Purpose of review
Myocardial infarction with nonobstructive coronary arteries (MINOCA) represents about 6–8% of all patients with myocardial infarction (MI), and several pathophysiological mechanisms showed to be involved in this heterogeneous clinical condition. Of note, MINOCA proved to be associated with a significant risk of mortality, angina burden and socioeconomic costs.

Recent findings
Results from randomized clinical trials evaluating the clinical effectiveness of a comprehensive diagnostic algorithm, along with the acute and long-term management of patients with MINOCA, are pending.

Summary
In this review article, we aim at providing an overview of the clinical features, diagnostic work-up and the therapeutic management of patients presenting with MINOCA, highlighting the recent acquisition along with the remaining important knowledge gaps in this field.
Angiotensin II prompts heart cell apoptosis via AT1 receptor-augmented phosphatase and tensin homolog and miR-320-3p functions to enhance suppression of the IGF1R-PI3K-AKT survival pathway
Authors: Lu Shang-Yeh , Hong Wei-Zhi , Tsai Bruce Chi-Kang , Chang Yu-Chun , Kuo Chia-Hua , Mhone Thomas G. , Chen Ray-Jade , Kuo Wei-Wen , Huang Chih-Yang 
Published: September 2022

Background:
Hypertension is a severe public health risk factor worldwide. Elevated angiotensin II (Ang II) produced by the renin–angiotensin–aldosterone system can lead to hypertension and its complications.

Method:
In this study, we addressed the cardiac-injury effects of Ang II and investigated the signaling mechanism induced by Ang II. Both H9c2 cardiomyoblast cells and neonatal rat cardiomyocytes were exposed to Ang II to observe hypertension-related cardiac apoptosis.

Results:
The results of western blotting revealed that Ang II significantly attenuated the IGF1R-PI3K-AKT pathway via the Ang II-AT1 receptor axis and phosphatase and tensin homolog expression. Furthermore, real-time PCR showed that Ang II also activated miR-320-3p transcription to repress the PI3K-Akt pathway. In the heart tissue of spontaneously hypertensive rats, activation of the IGF1R survival pathway was also reduced compared with that in Wistar-Kyoto rats, especially in aged spontaneously hypertensive rats.

Conclusion:
Hence, we speculate that the Ang II-AT1 receptor axis induces both phosphatase and tensin homolog and miR-320-3p expression to downregulate the IGF1R-PI3K-AKT survival pathway and cause cell apoptosis in the heart.
Comparison of Postoperative Infection Rates After Office-based Oculoplastic Procedures Using Sterile and Clean Gloves
Authors: Wang Diane , Shinder Roman 
Published: September 2022

Purpose:
To compare postoperative infection (PI) rates using sterile and clean-boxed gloves in office-based oculoplastic procedures.

Methods:
Prospective, comparative study of patients undergoing oculoplastic procedures by a single surgeon (RS) in an office-based procedure room between October 2018 and September 2020. Participants included were 18 years or older. Excluded were patients on oral antibiotics within 2 weeks before the procedure, had a follow-up period of less than 1 week, had a contaminated wound, had complex reconstructions, or had multiple simultaneous procedures performed. Oculoplastic procedures were performed using either sterile or clean-boxed gloves. The main outcome measure was the frequency of postoperative infection.

Results:
Three thousand one hundred twenty-nine patients, 1,815 (58%) of whom were women, with a mean age of 60 (18–102) years were included. One thousand five hundred seventy procedures were performed with sterile gloves, while 1,559 were performed with clean-boxed gloves. The patients in the 2 groups were similar in age, gender, and number of high-risk individuals. One patient in the sterile glove group who underwent upper blepharoplasty (0.064%) and one patient (0.064%) in the clean-boxed glove group who had an external levator advancement blepharoptosis repair developed PI. Neither patient had risk factors for infection, and both infections resolved after 1 week of oral amoxicillin-clavulanate 875/125 mg twice daily.

Conclusions:
In minimally complex in-office oculoplastic procedures, using sterile versus clean-boxed gloves resulted in similar low infection rates in this large cohort. The healthcare benefits may not outweigh the costs of using sterile gloves universally for office-based oculoplastic procedures.
Impact of Child Passenger Safety Education for Pediatric Nurses
Authors: Ramsey Gia C. , Grippi Christine 
Published: September 2022

BACKGROUND:
Hospital-based child passenger safety education is effective in decreasing car seat misuse. Although child passenger safety training has been studied with pediatricians, emergency physicians, and emergency nurses, there is a lack of literature regarding child passenger safety training performed by pediatric nurses.

OBJECTIVE:
The purpose of this study was to determine the effect of a 30-min child passenger safety education session on pediatric nurses' child passenger safety knowledge and confidence.

METHODS:
This was a pre- and posttest comparison study of pediatric nurses' knowledge and confidence levels following child passenger safety training in a pediatric trauma center in New York State conducted from September 2018 to March 2019. Registered nurses from the neonatal intensive care unit, pediatric intensive care unit, general pediatric unit, and mother–baby unit participated in the study. The intervention was a single 30-min child passenger safety training session provided by a certified child passenger safety technician. A demographic questionnaire and 11-question pre- and posttest surveys were used. Data were compared using the t test, the chi-square test, and Fisher's exact tests.

RESULTS:
A total of 133 nurses participated, of which 97% were female and 50% were White. Posttest scores significantly increased (3.83; 95% CI [3.1, 3.7], t = 22.54, p≤ .001) in nurses' child passenger safety knowledge and confidence after a 30-min modular educational session.

CONCLUSION:
Passenger safety training increased pediatric nurses' knowledge and confidence to provide child passenger safety education to families and caregivers. Child passenger safety education is recommended for all nurses who are expected to provide child passenger safety education regardless of unit location.
Lower paraoxonase 1 paraoxonase activity is associated with a worse prognosis in patients with non-ST-segment elevation myocardial infarction in long-term follow-up
Authors: Leocádio Paola Caroline Lacerda , Goulart Alessandra Carvalho , Santos Itamar Souza , Lotufo Paulo Andrade , Bensenor Isabela Martins , Alvarez-Leite Jacqueline Isaura 
Published: September 2022

Background
Acute coronary syndrome (ACS) is one of the main manifestations of coronary artery disease, with a higher prevalence and worst prognosis. Oxidative stress is important in atherosclerosis and ACS, and paraoxonase 1 (PON1) is directly related to reducing the effects of oxidative stress on lipoproteins. The present study evaluated the prognostic value of PON1 activity in patients with non-ST-segment elevation ACS [non-ST-segment elevation myocardial infarction (NSTEMI) and unstable angina (UA)], included in the ERICO study.

Methods
PON1 paraoxonase activity was determined in serum samples from 485 patients collected on admission. The prognostic value in the follow-up of up to 5 years was evaluated according to cutoff points established by tertiles. Kaplan–Meier curves and Cox regression were used for the analysis of all-cause mortality and cardiovascular mortality.

Results
The sample consisted mainly of elderly patients with a high frequency of cardiovascular risk factors. At follow-up of up to 5 years, there were 126 deaths from all causes (80 deaths from CVD). The lowest tertile of PON1 paraoxonase activity was associated with a higher risk of death in patients with NSTEMI, but not in patients with UA.

Conclusion
PON1 paraoxonase activity has potential prognostic value in patients with NSTEMI.
Effectiveness of Nonpharmacologic Interventions for Chemotherapy-Related Cognitive Impairment in Breast Cancer Patients
Authors: Liu Yu , Liu Jun-E , Chen Shaohua , Zhao Fuyun , Chen Lu , Li Ruolin 
Published: September 2022

Background
Neurotoxicity is a major adverse effect of chemotherapy in breast cancer (BC) patients. A number of nonpharmacologic interventions are used to alleviate chemotherapy-related cognitive impairment (CRCI), but no studies have compared their effectiveness.

Objectives
The aim of this study was to identify and compare the effectiveness of different nonpharmacologic interventions for CRCI in BC patients.

Methods
A systematic review and network meta-analysis was conducted following the Cochrane guidelines. All randomized controlled trials were searched in the Cochrane Library, PubMed, MEDLINE (via OVID), Web of Science, EMBASE, and CINAHL databases from inception to September 2021. Studies using nonpharmacologic interventions to manage CRCI symptoms were included. A network meta-analysis and a comparative effects ranking were completed by STATA v14.0.

Results
Twelve studies with 8 nonpharmacologic interventions were included. For subjective outcomes on CRCI, there was no significant difference between nonpharmacologic interventions. For objective outcomes, qigong and exercise were more effective than the psychotherapy. Qigong and exercise were also more effective than music therapy. The top 3 interventions were psychotherapy (83.4%), music therapy (60.8%), and electroacupuncture (52.5%) for subjective outcomes and qigong (87.7%), exercise (82.1%), and electroacupuncture (70.3%) for objective outcomes.

Conclusion
In the subjective evaluation, it was difficult to judge which interventions are best, but psychotherapy had the greatest probability. For objective evaluation, qigong and exercise may be the best nonpharmacologic interventions.

Implications for Practice
This study provides evidence for the effectiveness of nonpharmacologic interventions for CRCI in BC patients and facilitates support for future clinical trials and work.
Jordanian Nurses’ Perspectives of Spirituality and Spiritual Care
Authors: Ibdah Rufaida , Zeilani Ruqayya , Atout Maha 
Published: September 2022

Background
Spirituality is considered one of the main aspects of wholesome care for human beings. Spirituality is a multidimensional concept and has several definitions in the literature. Most of the studies concerning spirituality were conducted in Western cultures and the Middle East; however, there are a limited number of studies regarding spirituality in Jordan.

Objective
The aim of this study was to explore Jordanian nurses’ perspectives on spirituality and spiritual care in a palliative care unit in 1 cancer center in Jordan.

Methods
A descriptive qualitative design with 20 semistructured interviews was used to access Jordanian nurses’ perspectives on spirituality. This study was conducted in the major specialist center for the treatment of cancer in Jordan. A purposive sample of 20 registered nurses who had worked at least 6 months in the palliative care unit was recruited.

Results
Nurses’ perceptions of spirituality were represented by 2 themes: spirituality means connectedness to “Allah,” and spirituality evokes enjoyment in life. Two themes emerged in terms of nurses’ perceptions of spiritual care: ensuring patients’ comfort and relaxation, and sharing patients’ religious rituals.

Conclusion
These findings underscore the importance of the nurses’ perspectives on spirituality in the context of Islamic and Arabic culture, and the need for training in spirituality.

Implications for Practice
The concept of spirituality is recognized as a fundamental aspect of the nurse’s role, making it essential to improve nurses’ capabilities to integrate spirituality courses into the nursing curriculum.
Patient Perception of Fall Risk and Fall Risk Screening Scores
Authors: Solares Nicole P. , Calero Patricia , Connelly Cynthia D. 
Published: September 2022

Background:
Falls are the most prevalent adverse event among hospitalized patients. Multilevel risk factors are associated with falls, yet falls continue.

Purpose:
To evaluate the relationship between the Johns Hopkins Fall Risk instrument, patient characteristics, and perception of fall risk.

Methods:
The Johns Hopkins Fall Risk score, patient perception of fall risk, and patient characteristics were analyzed among inpatient adults (n = 201) from 5 acute care units in a large southern California medical center.

Results:
Bivariate analyses revealed that fall risk was inversely associated with participants' confidence in their ability to perform high fall risk behaviors without help and without falling (P = .018).

Conclusions:
Perception of fall risk is a promising new indicator in preventing falls. Patient perception of fall risk may elicit a behavior change to help prevent falls. Increased health care provider awareness of patient perception of fall risk may improve fall risk interventions and prevention programs.
Nurse Leader Preparation for Disasters
Authors: Reedy James C. , Zedreck Judith F. , Ren Dianxu , Warburton Cindi M. , Fennimore Laura 
Published: September 2022

OBJECTIVE
The aim of this study was to evaluate nurse leader confidence in emergency management and disaster preparedness.

BACKGROUND
There is a dearth of evidence in the literature regarding the preparation of nurse leaders to manage emergencies and disasters. Research suggests significant gaps in nurse leader confidence across roles and in structured education that prepares nurse leaders across the spectrum of experience to manage in a crisis.

METHODS
An exploratory, cross-sectional survey included a sample of 432 RNs who are members of the Northwest Organization for Nurse Leaders.

RESULTS
Results indicate significant variance in nurse leader confidence across roles, experience, and previous disaster-related education. Positive associations regarding nurse leaders' confidence in managing disasters exist with more advanced positions, advanced education, and structured training.

CONCLUSIONS
Nursing leaders lack consistent education that prepares them for emergency and disaster management. Nurse leaders across all levels would benefit from formal education in these areas.
The Nurse Empowerment Program for Nurses in Direct Care Positions
Authors: Bard Kristin , Cornell Julie A. , Cunningham Shayna D. , Madigan Elizabeth A. , Solomon Julie 
Published: September 2022

OBJECTIVE
An educational program including online generic and nursing-specific content was evaluated for self-assessed leadership skill outcomes.

BACKGROUND
Leadership development for nurses in direct care positions has not received the same support as for nurses in formal leadership positions. Pandemic and workforce changes make it critical that leadership skills be built at all levels of nursing.

METHODS
Early-career nurses (≤10 years of experience) were recruited to participate in an online leadership development program offering 9 LinkedIn Learning courses, 3 leadership courses from Sigma, an e-book, and a discussion board.

RESULTS
Most participants who responded to both immediate postsurvey and 3-month follow-up survey (98.6% of n = 69) reported having applied new or improved abilities in their nursing practice to at least a small degree, and the majority reported having done so to a moderate or great degree.

CONCLUSION
This online leadership development program was valued and was associated with improved self-assessed leadership.
Enhancing the Content Validity of Self-Reported Physical Activity Self-Efficacy in Adolescents: A Qualitative Study
Authors: Algheryafi Reem A. , Bevans Katherine B. , Hiremath Shivayogi V. , Lai Jin-Shei , Tucker Carole A. 
Published: September 2022

Purpose:
This study's primary purpose was to enhance the content validity of a self-reported measure of self-efficacy for physical activity (PA) in adolescents. This was addressed through assessment of younger and older adolescents' understanding of the construct of self-efficacy for PA, coupled with assessment of the content coverage and comprehensibility of items derived from existing measures.

Methods:
Participants completed individual semistructured and cognitive debriefing interviews as well as 3 PA self-efficacy questionnaires.

Results:
Thematic analysis identified personal and environmental facilitators and barriers to PA self-efficacy. The major categories were physical; psychological; interaction with surroundings; support and relationships; attitudes; and services, systems, and natural environments. Cognitive interviews resulted in the retention of 52 final items: 24 for self-efficacy with perceived facilitators and 28 for self-efficacy to overcome barriers.

Conclusions:
This study provides a PA self-efficacy instrument with expanded content coverage that is relevant to adolescents as young as 11 years. With further validation testing in future studies, this instrument will enable pediatric physical therapists and researchers to assess PA self-efficacy and design effective intervention strategies to improve PA.
The Effect of Pretreatment Potential Resistance to NNRTIs on Antiviral Therapy in Patients With HIV/AIDS
Authors: Li Cui-Lin , Liang Hong-Yuan , Xiao Jing , Li Rui , Yu Feng-Ting , Zeng Yong-Qin , Pang Xiao-Li , Wang Di , Liu Ying , Li Bei , Han Jun-Yan , Zhao Hong-Xin 
Published: September 2022

Background:
With the increasing coverage of antiretroviral therapy, concerns for the emergence and transmission of HIV drug resistance (HIVDR) are arising. HIVDR was divided into 5 levels: sensitive, potentially resistant, low resistant, intermediate resistant, and high resistant. Most of the articles on HIVDR involved low-level, intermediate-level, and high-level drug resistance to antiretroviral drug, and few articles deal with potential drug resistance. Treatment failure associated with the level of low-level, intermediate-level, and high-level resistance to antiretroviral drug has been reported. However, whether virological failure (VF) is related to potential resistance remains unclear. In this study, we aimed to describe the situation of potential resistance to antiretroviral drug and whether it is related to VF.

Methods:
We analyzed the demographic, behavioral information, medical history, and drug resistance–associated mutation data from subjects. Drug resistance mutations at baseline and time of failure in patients suffering VF were detected by using the Vela automated next-generation sequencing platform. The χ2 test or Fisher exact test and logistic regression were used to assess the risk factors that contribute to VF in the potential drug-resistant people.

Results:
The prevalence of overall pretreatment drug resistance was 7.06% (233/3300), and the prevalence of pretreatment potential resistance was 8.79% (290/3300). All these patients with pretreatment potential first-line drugs resistance showed potential resistance to nonnucleoside reverse transcriptase inhibitors (NNRTIs), and some of them had potential drug resistance to NNRTIs and NRTIs or NNRTIs and PIs; among these patients, 94.71% (179/189) had V179 D/E mutations. The VF rate of first-line treatment for potentially resistant people is 17.99%. CD4+ T-cell count ≤200 cells/L at antiretroviral therapy initiation are risk factors for the failure of first-line treatment.

Conclusions:
The prevalence of potential drug resistance among individuals with HIV and the VF rate of first-line treatment for potential drug-resistant people were high. To better optimize clinical management, prevention, and control of HIV, attention should be devoted to the potential resistance of nonnucleoside drugs.
Effectiveness and Safety of Dolutegravir Versus Efavirenz-Based Antiviral Regimen in People Living With HIV-1 in Sichuan Province of China: A Real-World Study
Authors: Tongtong Yang , Shenghua He , Yin Wang , Lin Cai , Huanxia Liu , Chunrong Lv , Ruifeng Zhou , Xiaojing Yang , Yuan Yao , Yuanhong He , Ke Yin 
Published: September 2022

Background:
The application time of dolutegravir (DTG) is relatively short, and the treatment experience is insufficient. Therefore, evidence is required to shed more light on the effectiveness and safety issues of DTG in China.

Objectives:
To assess the effectiveness and safety of a DTG vs. efavirenz (EFV) antiviral regimens (the current mainstream regimen).

Methods:
This was a retrospective cohort study. Data of people with HIV (PWH), who started initial DTG-based or EFV-based antiretroviral therapy at the Chengdu Public Health Clinical Medical Center from January 2018 to October 2020, were collected. Effectiveness indicators such as CD4+ T-cell recovery and HIV viral suppression, and safety indicators, including blood routine, liver and kidney function, and occurrence of abnormal blood lipids after DTG vs. EFV-based antiviral regimen treatments, were analyzed.

Results:
A total of 656 patients were eligible, of which 611 patients were included in the study. Most of the PWHs in our center were young men (86.25%). Nearly one-third of the participants were coinfected with syphilis. The median baseline HIV viral load was 4.70 log10 copies/mL. The median CD4+ T-cell count was 254 cells/mm3. More participants started on EFV-based regimens than DTG-based regimens (82.32% vs. 17.67%). The time to reach the target value (CD4 > 350 cells/mm3) in the DTG group was shorter than that in the EFV group (408 days vs. 522 days), and the percentage of reaching the CD4 target value of the DTG group was higher than that of the EFV group (41.04% vs. 33.76%) in 1 year. The effect of virologic suppression (<50 copies/mL) in the DTG group was superior to that in the EFV group. The use of DTG-containing treatment regimens was significantly related to a quicker virologic suppression (hazard ratio, 1.76; 95% confidence interval of 1.40–2.21, P < 0.0001). The safety data analysis of laboratory indicators showed that there was no significant difference in the incidence of adverse events between the 2 groups.

Conclusions:
A DTG-based regimen may be more conducive to the CD4 recovery than the EFV-based regimen. The virologic suppression of the DTG group may be superior to that of the EFV group. DTG-based regimens might be the preferred treatment option for people with HIV for initial HIV treatment.