The association between workplace physical environment and nurses' safety compliance: A serial mediation of psychological and behavioral factors.

Aim: This study describes Jordanian intensive care unit nurses' satisfaction with their physical environment and investigates the association between workplace physical environment and nurses' safety compliance. Additionally, the study offers serial mediation analyses of psychological and behavioral factors between satisfaction with the workplace physical environment and nurses' safety compliance. Introduction: Compliance with safety measures is a vital indicator of safety performance, as less compliance directly reflects undesirable safety outcomes among nurses, like occupational accidents, injuries, and fatalities. Social cognitive theory and the safety triad model contribute to understanding safety compliance behaviors to safety procedures. Thus, enhancing safety compliance in healthcare organizations remains a challenge and concern. Methods: A quantitative research method was used based on cross-sectional and descriptive data from eight governmental hospitals in Jordan. The population included all intensive care unit nurses in the Ministry of Health's hospitals (n = 1104). A cluster sampling technique selected 285 nurses to participate. Empirical results were obtained through structural equation modeling (i.e., Smart PLS-SEM), which has become popular in this kind of research. Results: The mean of Jordanian ICU nurses' satisfaction with the workplace physical environment was 3.36, which is moderate. Although the Smart PLS findings did not support the direct association between the workplace physical environment and nurses' safety compliance, serial mediation of safety participation in the workplace physical environment and nurses' safety compliance and perceived safety management commitment confirm the indirect association in the study model. Conclusion: This study fills a gap in available safety and nursing literature, especially when considering the scarce studies that investigated the physical elements in the workplace and both safety compliance and safety participation. The findings are valuable for academicians, health providers, and policymakers and may trigger creative ideas and interventional solutions to improve nurses' safety compliance in healthcare organizations.

The Effects of Various Teaching Methods on Chest X-ray Interpretation Skills Among Medical Students and Interns: A Systematic Review.

Chest X-ray (CXR) is a common tool used in medical practice. Medical students and interns should acquire knowledge of CXR interpretation, as it is an essential diagnostic tool for a large spectrum of diseases. This systematic review aimed to compare the effect of different intervention techniques on the competency of medical students and interns to demonstrate the level of confidence and competence in interpreting common presentations of CXRs. The population, intervention, comparison, and outcomes (PICO) framework was used to formulate the review question. All related articles in five databases (PubMed, Web of Science, Scopus, Medline, and Embase) were retrieved and the search was completed in March 2023 with no limiters on date and time. The number of relevant studies was 469. A multi-level approach through the Rayyan platform was used for the screening and exclusion processes. Eleven articles were included in the systematic review consisting of eight randomized controlled trials, one quasi-experimental study, one cross-sectional study, and one interventional cohort. Results showed significant effects of teaching methods utilizing deductive or inductive approach, clinical history, patient care comfort survey, and SAFMEDS (Say-All-Fast-Minute-Every-Day-Shuffled). Contrarily, no significant effect was shown by flipped classroom models and mixed and blocked practice, peer-assisted learning vs. expert-assisted learning, and Chester, an artificial intelligence tool. This review identified beneficial approaches that may enhance the learning outcomes of interpreting CXRs for medical students and interns, highlighting the remarkable impact of SAFMEDS on medical students' ability to identify CXR findings as well as the availability and practicality of online and e-learning resources for students.

Organizational and behavioral attributes' roles in adopting cloud services: An empirical study in the healthcare industry.

The need for cloud services has been raised globally to provide a platform for healthcare providers to efficiently manage their citizens' health records and thus provide treatment remotely. In Iraq, the healthcare records of public hospitals are increasing progressively with poor digital management. While recent works indicate cloud computing as a platform for all sectors globally, a lack of empirical evidence demands a comprehensive investigation to identify the significant factors that influence the utilization of cloud health computing. Here we provide a cost-effective, modular, and computationally efficient model of utilizing cloud computing based on the organization theory and the theory of reasoned action perspectives. A total of 105 key informant data were further analyzed. The partial least square structural equation modeling was used for data analysis to explore the effect of organizational structure variables on healthcare information technicians' behaviors to utilize cloud services. Empirical results revealed that Internet networks, software modularity, hardware modularity, and training availability significantly influence information technicians' behavioral control and confirmation. Furthermore, these factors positively impacted their utilization of cloud systems, while behavioral control had no significant effect. The importance-performance map analysis further confirms that these factors exhibit high importance in shaping user utilization. Our findings can provide a comprehensive and unified guide to policymakers in the healthcare industry by focusing on the significant factors in organizational and behavioral contexts to engage health information technicians in the development and implementation phases.

Prevalence of Type 2 Diabetes Mellitus in the General Population of Saudi Arabia, 2000-2020: A Systematic Review and Meta-Analysis of Observational Studies.

Background: The prevalence of type 2 diabetes mellitus (T2DM) has increased worldwide, including in Saudi Arabia. Objective: To systematically review the available literature and assess the pooled prevalence of T2DM in Saudi Arabia between 2000 and 2020. Methods: Observational studies that reported quantitative estimates of the prevalence of T2DM as their main outcome, included the general population of Saudi Arabia, and were published between 2000-2020 and in English were retrieved using three electronic databases (namely, CINAHL, Medline via PubMed, and Web of Science). Retrieved studies were screened, and relevant data were extracted. The Joanna Briggs Institute Critical Appraisal guideline was used to assess the methodological quality of included studies. A random-effects model was used to estimate the prevalence of T2DM. Results: Twenty-three studies were included in the systematic review, of which 19 were included in the meta-analysis (total pooled population: 258,283). The overall pooled prevalence of T2DM in Saudi Arabia was 16.4% (95% CI: 11.6-17.5). However, there was heterogeneity in the results of the studies [I2 = 99.31%, P < 0.0001] and the summary values varied from 3.18% (95% CI: 1.46-5.95) to 94.34% (95% CI: 89.53-97.38). Although the prevalence of T2DM by age varied across studies, in most studies, it was higher among the older age groups. In addition, the prevalence of diabetes widely varied across the different geographical regions of Saudi Arabia. Conclusions: This is the first meta-analysis that determined the pooled prevalence of T2DM in Saudi Arabia, and it revealed a high prevalence over the past two decades. However, owing to data collection inconsistencies in the identified studies, neither the modifiable (such as obesity, educational status, emotional support, etc.) nor the non-modifiable (such as gender and age) risk factors of T2DM could be determined, thereby indicating the need for a nationally collective effort in determining these factors.

The Impact of the Working Hours Among Malaysian Nurses on Their Ill-Being, Intention to Leave, and the Perceived Quality of Care: A Cross-Sectional Study During the COVID-19 Pandemic.

Purpose: This study explores the effect of working duration on nurses and their ill-being (ie, anxiety, depression, fatigue, and sleepiness), intention to leave, and the quality of nursing care. Methods: A questionnaire survey was employed for a convenience sample of 400 nurses at Malacca General Hospital in Malaysia who voluntarily participated in this cross-sectional study. The Statistical Package for the Social Sciences (SPSS) was used to treat and analyze the data. Descriptive statistics were generated, and Post Hoc analyses and ANOVA tests were conducted. Results: Findings indicated that working hours duration was significantly associated with nurses' anxiety (F (4, 394) = 10.362, p <0.001), depression (F (4, 395) = 23.041, p< 0.001), fatigue (F (4, 395) = 24.232, p< 0.001), sleepiness (F (4, 395) = 4.324, p < 0.002), quality of nursing care (F (4, 395) = 16.21, p <0.001) and intention leave their job, (F (4, 395) = 50.29, p <0.001). The results also revealed that working more than 14 hours was negatively associated with their perceived quality of nursing care and positively associated with their perceived ill-being and intention to leave. Conclusion: Shift length is an important issue, and nursing managers must consider shift length as it can adversely correlate with the nurses' perceptions of work and life.

Hospital Work Conditions and the Mediation Role of Burnout: Residents and Practicing Physicians Reporting Adverse Events.

Background: "Patient Safety" in everyday practices is a target of healthcare leaders, and adverse events reported by healthcare providers directly reflect patient safety in the health system. Recognising how residents and practising physicians rate adverse events concerning their work conditions and burnout must be explored. Objective: This study aims to explore the mediation effect of burnout dimensions (emotional exhaustion and burnout-interpersonal disengagement) between the effects of work conditions on perceived patient safety by exploring the adverse events that residents and practising physicians reported. Methods: A quantitative and cross-sectional study collected data from 249 residents and practising physicians in a huge teaching hospital and primary health care centre (PHC) in the Eastern Province of Saudi Arabia. Hayes Macro regression analysis was employed to evaluate the multiple mediation effect of burnout dimensions, with 5000 bootstrapping and a confidence interval (CI) of 95% for statistical inference and p≤0.05 for the significance level. Results: Leadership support (B= 0.39, t= 6.24, p<0.001) and physician engagement (B=0.43, t=6.50, p<0.001) were associated with a decreased rate of adverse events to patient safety, whereas workload (B=-0.23, t=-3.73, p<0.001) was negatively associated with an increased rate of adverse events. Burnout was shown to mediate the relationship between the effects of physician's leadership support (R2=0.26, F=27.50, p<0.001), work engagement (R2=0.25, F=27.07, p<0.001) and workload (R2=0.23, F=24.23, p<0.001) on the rate of adverse events. Conclusion: This study provides insights into burnout dimensions and their consequences on patient safety indicators (ie, adverse events). Work conditions (ie, leadership support, physician engagement, and workload) directly affect the rate of adverse events and indirectly through mediators like burnout-emotional exhaustion and burnout-interpersonal disengagement.

Knowledge sharing behaviour among head nurses in online health communities: The moderating role of knowledge self-efficacy.

BACKGROUND: Head nurses are vital in understanding and encouraging knowledge sharing among their followers. However, few empirical studies have highlighted their contribution to knowledge-sharing behaviour in Online Health Communities (OHCs). In addition, scant literature has examined the moderating role of knowledge self-efficacy in this regard. PURPOSES: This study examines the moderating role of self-efficacy between the association of four selected individual factors of head nurses (i.e., Trust, Reciprocity, Reputation, and Ability to Share) and their knowledge-sharing behaviour in OHCs in Jordan. METHOD: The data were obtained by using a self-reported survey from 283 head nurses in 22 private hospitals in Jordan. A moderation regression analysis using a structural equation modelling approach (i.e. Smart PLS-SEM, Version 3) was utilised to evaluate the study's measurement and structural model. RESULTS: Knowledge self-efficacy moderates the relationship between the three individual factors (i.e., Trust, Reciprocity, and Reputation) and knowledge-sharing behaviours. However, self-efficacy did not moderate the relationship between the ability to share and knowledge-sharing behaviours. IMPLICATIONS: This study contributes to understanding the moderating role of knowledge self-efficacy among head nurses in online healthcare communities. Moreover, this study provides guidelines for head nurses to become active members in knowledge sharing in OHCs. The findings of this study offer a basis for further research on knowledge sharing in the healthcare sector.

The Registered Nurses amid COVID-19 in Saudi Arabia: A descriptive phenomenological study.

AIM: To investigate the experiences of registered nurses' lived experiences in the Coronavirus Disease 2019 (COVID-19) pandemic crisis in a government hospital in the Eastern Region of Saudi Arabia. DESIGN: Qualitative descriptive phenomenology. METHODS: Utilizing in-depth interviews with twenty registered nurses with the use of purposive sampling from September to December 2020. Data was analyzed using Colaizzi methods, and a COREQ checklist was utilized to report the study's results. RESULTS: The participants' narratives generated three major themes, namely: 'one foot below the ground', 'the nightingale pledge'; and 'hope beyond COVID-19'. The lived experiences of Registered Nurses throughout the pandemic brought by the COVID-19 virus increase a person's understanding of the phenomenon under investigation and plan collective actions to improve the nurses' welfare. The unique challenges faced by Registered Nurses as they carry out their duties in a variety of healthcare settings can be better appreciated if their experiences are taken into account. Nursing administrations all around the world can use the findings of this research to create safeguards for their staff.

Compliance of non-pharmacological preventive practice of venous thromboembolism among Jordanian nurses.

Many practices, such as non-pharmacological preventive practices, have demonstrated significant improvement and reduced the venous thromboembolism incidence. This study aims at investigating the compliance with non-pharmacological preventive practice of venous thromboembolism guidelines among Jordanian intensive care and medical and surgical nurses. Descriptive and cross-sectional with the non-participant observational design was used. This study recruited 271 registered nurses in adult medical-surgical units and intensive care units of 12 different government hospitals in Jordan's middle and north regions. The observational checklist included 10 preventive practices based on the non-pharmacological preventive of venous thromboembolism guidelines. In the observational checklist, the highest score was 20, and the lowest was 0. If the nurse received equal to or higher than (>14) score were classified as sufficient compliance, while insufficient compliance was (≤14) score. The observations period started from September 2019 until March 2020. The participants' overall mean venous thromboembolism compliance score was insufficient compliance (10.6 ±â€…1.6). The majority of nurses were classified as insufficient compliance 67%. "Doing foot exercise and early ambulation 2 times per day 50.3%" and "checked the integrity of the patient's skin at regular intervals 50.0%" were the highest practices done rightly and completely by half of the participants. The participants who had a bachelor of nursing degree, staff nurse, and works in the intensive care unit, are less experienced and have no previous venous thromboembolism education reported low venous thromboembolism compliance. This study presents expanded compliance regarding venous thromboembolism preventive practices among Jordanian intensive care and medical & surgical nurses, so the policymakers need to develop an initiative to improve nurses' compliance.

Effectiveness of game-based virtual reality phone application and online education on knowledge, attitude and compliance of standard precautions among nursing students.

Game-based virtual reality phone applications can create a realistic environment to prepare for clinical applications and improve students' knowledge of and compliance with standard precautions. An experimental study was performed among 126 nursing students' from the third and fourth nursing levels to determine the effect of online education and game-based virtual reality phone applications related to standard precautions. Students were divided randomly into two groups; the experimental group used online education and game-based virtual reality phone applications, while the control group used traditional education. The study was performed between July and August 2019 to prevent clashes with lectures and midterm and final examinations. A tool package including knowledge, attitude, and compliance with standard precautions was used in pre-and post-tests among nursing students. The results showed that the knowledge of, attitudes towards, and compliance with standard precautions differed between the two groups. The performance of the experimental group of nursing students significantly improved with online instruction and game-based virtual reality phone applications. This study demonstrated the effectiveness of online education and game-based virtual reality phone application among nursing students.

Knowledge, Practice, Compliance, and Barriers toward Ventilator-Associated Pneumonia among Critical Care Nurses in Eastern Mediterranean Region: A Systematic Review.

BACKGROUND: Ventilator-associated pneumonia (VAP) has been identified as a serious complication among hospitalized patients and is associated with prolonged hospitalizations and increased costs. The purpose of this study was to examine the knowledge, practices, compliance, and barriers related to ventilator-associated pneumonia among critical care nurses in the eastern Mediterranean region. METHODS: The PRISMA guidelines guided this systematic review. Four electronic databases (EMBASE, MEDLINE (via PubMed), SCOPUS, and Web of Science) were used to find studies that were published from 2000 to October 2021. RESULTS: Knowledge of ventilator-associated pneumonia was the highest outcome measure used in 14 of the 23 studies. The review results confirmed that nurses demonstrated low levels of knowledge of ventilator-associated pneumonia, with 11 studies assessing critical care nurses' compliance with and practice with respect to ventilator-associated pneumonia. Overall, the results showed that most sampled nurses had insufficient levels of compliance with and practices related to ventilator-associated pneumonia. The main barriers reported across the reviewed studies were a lack of education (N = 6), shortage of nursing staff (N = 5), lack of policies and protocols (N = 4), and lack of time (N = 4). CONCLUSIONS: The review confirmed the need for comprehensive interventions to improve critical care nurses' knowledge, compliance, and practice toward ventilator-associated pneumonia. Nurse managers must address barriers that impact nurses' levels of knowledge, compliance with, and practices related to ventilator-associated pneumonia.

Intrapartum cardiotocography trace pattern pre-processing, features extraction and fetal health condition diagnoses based on RCOG guideline.

Context: The computerization of both fetal heart rate (FHR) and intelligent classification modeling of the cardiotocograph (CTG) is one of the approaches that are utilized in assisting obstetricians in conducting initial interpretation based on (CTG) analysis. CTG tracing interpretation is crucial for the monitoring of the fetal status during weeks into the pregnancy and childbirth. Most contemporary studies rely on computer-assisted fetal heart rate (FHR) feature extraction and CTG categorization to determine the best precise diagnosis for tracking fetal health during pregnancy. Furthermore, through the utilization of a computer-assisted fetal monitoring system, the FHR patterns can be precisely detected and categorized. Objective: The goal of this project is to create a reliable feature extraction algorithm for the FHR as well as a systematic and viable classifier for the CTG through the utilization of the MATLAB platform, all the while adhering to the recognized Royal College of Obstetricians and Gynecologists (RCOG) recommendations. Method: The compiled CTG data from spiky artifacts were cleaned by a specifically created application and compensated for missing data using the guidelines provided by RCOG and the MATLAB toolbox after the implemented data has been processed and the FHR fundamental features have been extracted, for example, the baseline, acceleration, deceleration, and baseline variability. This is followed by the classification phase based on the MATLAB environment. Next, using the guideline provided by the RCOG, the signals patterns of CTG were classified into three categories specifically as normal, abnormal (suspicious), or pathological. Furthermore, to ensure the effectiveness of the created computerized procedure and confirm the robustness of the method, the visual interpretation performed by five obstetricians is compared with the results utilizing the computerized version for the 150 CTG signals. Results: The attained CTG signal categorization results revealed that there is variability, particularly a trivial dissimilarity of approximately (+/-4 and 6) beats per minute (b.p.m.). It was demonstrated that obstetricians' observations coincide with algorithms based on deceleration type and number, except for acceleration values that differ by up to (+/-4). Discussion: The results obtained based on CTG interpretation showed that the utilization of the computerized approach employed in infirmaries and home care services for pregnant women is indeed suitable. Conclusions: The classification based on CTG that was used for the interpretation of the FHR attribute as discussed in this study is based on the RCOG guidelines. The system is evaluated and validated by experts based on their expert opinions and was compared with the CTG feature extraction and classification algorithms developed using MATLAB.

Students' Perception of Quality of Learning Experience (Structure, Process and Outcome): Discipline Versus Problem Based Medical Curriculum and the Mediation Role of Process Quality.

Problem-based learning (PBL) is now incorporated into the curricula of most medical schools around the world. In comparison to the traditional curriculum, less is known about the influence of the adoption and implementation of a problem-based curriculum on the perceived structures, processes, and outcomes of learning experiences reported by students. The purpose of this study was twofold: (1) to compare the quality of learning experience of students enrolled in traditional discipline-based and problem-based medical curricula and (2) to explore the mediation effect of the process quality between the relationship of the structural quality and students' perception of learning experience outcomes. Through the distribution of an electronic survey, all 3rd and 4th year medical students enrolled in the discipline-based curriculum and the problem-based curriculum were invited to participate in the study. The students from both curricula completed the Student Experience Survey (SES), which was developed by the National Center for Academic Accreditation and Evaluation. Descriptive statistics, independent sample t-test and Hayes Macro regression analysis were used. Students enrolled in the problem-based curriculum had higher perceived support and sufficient advice with higher perceived quality of learning experiences compared with students enrolled in the traditional curriculum, however they reported less enjoyment of their university life. The structural factors (t = 19.83, p ≤ 0.001) and process factors (t = 9.21, p ≤ 0.001) were associated with an increase in students' reported outcomes by 0.67 and 0.49, respectively. These findings explain the mechanism by which the structural factors, such as maintaining adequate facilities and support, may help in enhancing the process quality (e.g., learner-centered learning), which in turn can enhance learning experience outcomes.

ICU nurses' safety performance related to respect for safety and management commitment: A cross-sectional study.

BACKGROUND: Healthcare work is one of the most accident-prone occupations globally. Nurses, especially those who work in Intensive Care Units (ICU), are very likely to experience mishaps on the job due to the complicated duties they perform. Safety performance through compliance and participation in safety is a proactive approach and a critical tool to measure the protection of employees, like these, in the workplace. Although interest in this tool has increased among hospital administrators and managers, scientific research has been limited in this area. AIMS: The study's purposes were twofold: (1) to explore the effect of perceived respect safety on the safety performance of ICU nurses and (2) to explore the mediation effect of Management Commitment to Safety (MCS) between the relationship of perceived respect safety and safety performance. METHODS: Eight public hospitals from the Jordanian Ministry of Health (JMoH) were selected randomly using cluster sampling, and their ICU nurses were surveyed. A total of 285 nurses completed questionnaires. The SmartPLS3 bootstrapping technique was used to analyse data. RESULTS: The results established that the perceived respect for the safety of nurses has a significant and positive effect on their safety compliance (ß = .39, p < .01) and safety participation (ß = .34, p < .01), and that MCS mediated these associations. CONCLUSION: The findings support the importance of developing and maintaining a culture of respect between management and employees, especially in terms of perceived respect for safety issues, and that culture will improve safety performance. The study explains the role of an active MCS, which contributes to understanding the research model fully. Practical implications for improving workplace safety also are added. IMPACT STATEMENT: Recognition of the study's findings by healthcare organisation managers would improve ICU nurses' safety and ultimately decrease undesirable outcomes.

The Relationship between Emotional Intelligence and Pain Management Awareness among Nurses.

Background: Pain management, a crucial part of nursing care, is considered one of the most basic patient rights. To properly treat patients' pain, nurses need a high degree of pain management awareness (PMA). The researchers hypothesized that nurses' pain management awareness is affected by their emotional intelligence (EI). Purpose: Because there is a dearth of studies on this topic, the purpose of this study was to describe the relationship between emotional intelligence and pain management awareness in a sample of nurses. Methods: The study employed a descriptive design with a quantitative approach to analyze data from a survey designed with the simple random sample technique. The questionnaires were completed by 330 nurses working at six governmental hospitals in Saudi Arabia. The Statistical Package for the Social Sciences (V23) and Analysis of Moment Structures (V23) were used to determine the reliability and validity of the questionnaires and analyze the causal relationships among the variables. Results: The results revealed a significant positive relationship between nurses' emotional intelligence and their pain management awareness. Conclusions: These findings suggest that having emotional intelligence is an important nurse characteristic for effective pain management awareness and possibly the provision of pain management care. Clinical Implications: Hospital and nurse managers as well as administration should consider using the emotional intelligence variables utilized in this study to develop ways to improve pain management awareness among nurses. Such efforts may help improve hospital and patient outcomes related to pain management.

Exposure Detection Applications Acceptance: The Case of COVID-19.

The pandemic's context is rife with numerous dangerous threats and high fear levels, influencing human decision-making. Such characteristics are identified by investigating the acceptance of exposure detection apps from the technology acceptance model (TAM) perspective. This study purposed a model to investigate protection technology acceptance, specifically exposure detection apps in the context of COVID-19. Quantitative study approach and a cross-section design targeted 586 participants from Saudi Arabia. As the study model is complex, the study hypotheses were analysed using the structural equation modelling-partial least squares (SEM-PLS3) approach. The findings support the entire model hypothesis except the link between social media awareness and exposure detection apps' intention. Mediation of COVID-19 anxiety and influence was confirmed as well. The current paper contributes to the technologies acceptance domain by developing a context-driven model comprising the major pandemic characteristics that lead to various patterns of technology acceptance. This study also fills the literature gap regarding mediating effects of social influence and COVID-19 anxiety in the relationship between trust in government and exposure detection apps implementation, and between COVID-19 anxiety and exposure detection apps implementation, respectively. The results may assist government agencies, health policymakers, and health organisations in the wide world and specifically Saudi Arabia, in their attempts to contain the COVID-19 pandemic spread.

Prognostic Epstein-Barr Virus (EBV) miRNA biomarkers for survival outcome in EBV-associated epithelial malignancies: Systematic review and meta-analysis.

BACKGROUND: The EBV-associated epithelial tumours consist 80% of all EBV-associated cancer, where the nasopharyngeal cancer (NPC) and EBV-associated gastric carcinoma (EBVaGC) are considered as the most frequent EBV-associated epithelial tumours. It has been shown that the BART-encoded miRNAs are abundantly expressed in EBV-associated epithelial tumours, hence, these miRNAs may serve as diagnostic and prognostic biomarkers for EBV-associated epithelial tumours. Therefore, the purpose of this systematic review and meta-analysis is to assess these EBV miRNAs as prognostic biomarkers for NPC and GC. METHOD: This systematic review was developed based on PRISMA guidelines and utilizing PubMed, Web of Science, Scopus, Cochrane, and Google scholar databases. The retrieved articles were thoroughly screened in accordance with the selection criteria. The hazard ratio (HR) and 95% confidence interval (CI) for patient survival outcomes were used to evaluate EBV miRNA expression levels. To assess the risk of bias, funnel plot symmetry and Egger's bias test were employed. RESULT: Eleven studies met the selection criteria for inclusion, and four were included in the meta-analysis. Most of the articles considered in this study were from China, with one study from South Korea. The overall pooled effect size estimation (HR) for upregulated EBV miRNAs was 3.168 (95% CI: 2.020-4.969), demonstrating that upregulated EBV miRNA expression enhanced the mortality risk in NPC and GC patients by three times. CONCLUSION: To the best of our knowledge, this is the first meta-analysis that investigates the significance of EBV miRNAs as prognostic biomarkers in NPC and GC patients. The pooled effect estimates of HR of the various studies revealed that higher EBV miRNA expression in NPC and GC may result in a worse survival outcome. To assess the clinical significance of EBV miRNAs as prognostic biomarkers, larger-scale prospective studies are needed.

Patient Safety Attitudes among Doctors and Nurses: Associations with Workload, Adverse Events, Experience.

Patient safety concept has achieved more attention from healthcare organizations to improve the safety culture. This study aimed to investigate patient safety attitudes among doctors and nurses and explore associations between workload, adverse events, and experience with patient safety attitudes. The study used a descriptive cross-sectional design and the Turkish version of the Safety Attitudes Questionnaire. Participants included 73 doctors and 246 nurses working in two private hospitals in Northern Cyprus. The participants had negative perceptions in all patient safety domains. The work conditions domain received the highest positive perception rate, and the safety climate domain received the lowest perception rate among the participants. Nurses showed a higher positive perception than doctors regarding job satisfaction, stress recognition, and perceptions of management domains. There were statistically significant differences between experiences, workloads, adverse events, and total mean scores of patient safety attitudes. Policymakers and directors can improve the quality of care of patients and patient safety by boosting the decision-making of health care providers on several domains of safety attitudes. Patient safety needs to be improved in hospitals through in-service education, management support, and institutional regulations.

Nucleic Acid-Based COVID-19 Therapy Targeting Cytokine Storms: Strategies to Quell the Storm.

Coronavirus disease 2019 (COVID-19) has shaken the world and triggered drastic changes in our lifestyle to control it. Despite the non-typical efforts, COVID-19 still thrives and plagues humanity worldwide. The unparalleled degree of infection has been met with an exceptional degree of research to counteract it. Many drugs and therapeutic technologies have been repurposed and discovered, but no groundbreaking antiviral agent has been introduced yet to eradicate COVID-19 and restore normalcy. As lethality is directly correlated with the severity of disease, hospitalized severe cases are of the greatest importance to reduce, especially the cytokine storm phenomenon. This severe inflammatory phenomenon characterized by elevated levels of inflammatory mediators can be targeted to relieve symptoms and save the infected patients. One of the promising therapeutic strategies to combat COVID-19 is nucleic acid-based therapeutic approaches, including microRNAs (miRNAs). This work is an up-to-date review aimed to comprehensively discuss the current nucleic acid-based therapeutics against COVID-19 and their mechanisms of action, taking into consideration the emerging SARS-CoV-2 variants of concern, as well as providing potential future directions. miRNAs can be used to run interference with the expression of viral proteins, while endogenous miRNAs can be targeted as well, offering a versatile platform to control SARS-CoV-2 infection. By targeting these miRNAs, the COVID-19-induced cytokine storm can be suppressed. Therefore, nucleic acid-based therapeutics (miRNAs included) have a latent ability to break the COVID-19 infection in general and quell the cytokine storm in particular.

Efficacy and Safety of Remdesivir in COVID-19 Positive Dialysis Patients.

(1) Background: Immune compromised hemodialysis patients are more likely to develop COVID-19 infections, which increase the risk of mortality. The benefits of Remdesivir, despite less literature support on its effectiveness in dialysis patients due to renal toxicity, can outweigh the risks if prescribed early. The aim of this study was to evaluate the efficacy of Remdesivir on the 30-day in-hospital clinical outcome of hemodialysis population with COVID-19 infection and safety endpoints of adverse events. (2) Study design: A prospective quasi-experimental study design was used in the study. (3) Methods: The sample population consisted of 83 dialysis patients with COVID-19 who were administered Remdesivir at a dose of 100 mg before hemodialysis, as per hospital protocol. After the treatment with Remdesivir, we assessed the outcomes across two endpoints, namely primary (surviving vs. dying) as well as clinical and biochemical changes (ferritin, liver function test, C-reactive protein, oxygen requirements, and lactate dehydrogenase levels) and secondary (adverse effects, such as diarrhea, rise in ALT). In Kaplan-Meier analysis, the survival probabilities were compared between patients who received Remdesivir within 48 h of diagnosis and those who received it after 48 h. Cox regression analysis was employed to determine the predictors of outcome. (4) Results: Of the 83 patients, 91.5% survived and 8.4% died. Remdesivir administration did not reduce the death rate overall. Hospital stays were shorter (p = 0.03) and a nasopharyngeal swab for COVID-19 was negative earlier (p = 0.001) in survivors who had received Remdesivir within 48 h of diagnosis compared to those who had received Remdesivir after 48 h. The only variables linked to the 30-day mortality were serum CRP (p = 0.028) and TLC (p = 0.013). No major adverse consequences were observed with Remdesivir. (5) Conclusions: Remdesivir has the potential to shorten the recovery time for dialysis patients if taken within 48 h of onset of symptoms, without any adverse effects.