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Background . The phenomenon of theory‐practice gap has endured within the field of nursing from the era of Florence Nightingale until today, persistently manifesting negative consequences within the profession by accentuating the dichotomy between theoretical understanding and the practical dimensions of nursing. This prevalent issue necessitates comprehensive examination to unveil all the circumstances and variables that fuel the gap, along with exploring viable resolutions to bridge these divides. Objective . To identify, summarize, and synthesize literature on the causes leading to theory‐practice gaps and solutions in nursing profession. Methods . MEDLINE, PubMed, Scopus, CINAHL, EMCARE, ERIC, and Ovid were searched from 2012 to December 2022. Eligible reviews addressed causes of the theory to practice gap in nursing. Extracted data from included reviews were synthesized using guidelines for meta‐synthesis along with the JBI Critical Appraisal Checklist for qualitative research. Result . The analysis of studies yielded 22 significant findings, subsequently categorized into six thematic areas based on their contextual similarity. Following this, a meta‐aggregation process combined these categories, generating two synthesized findings: (1) barriers for the gap and (2) facilitators for the gap. Barriers for the gap had three subcategories: “clinical life challenges,” “misconception of clinical nursing,” and “lack of collaboration between universities and clinical settings.” The second synthesis was “Facilitators for the gap” which had two subcategories: “create clinically culture‐based content” and “develop clinically based curriculum.” Conclusion . This review provides a comprehensive summary of the current understanding of barriers and facilitators influencing the theory‐practice gap in the field of nursing. To effectively reduce this gap in nursing care, stakeholders such as regulatory bodies, healthcare professionals, and academic institutions must take into account various contextual factors while recognizing the ever‐evolving nature of the healthcare environment.

Background Severe acute respiratory tract infection (SARI) is a major global health threat. This study aimed to examine risk factors associated with poor outcomes in patients with SARI. Methods All patients who met World Health Organization's (WHO) SARI case definition and were admitted to Salmaniya Medical Complex from January 2018 to December 2021 were included. Epidemiological and virological data were obtained and analyzed. Results Of 1159 patients with SARI included, 731 (63.1%) patients were below 50 years, and 357 (30.8%) tested positive for viral pathogens. The most prevalent virus was Flu‐A (n = 134, 37.5%), SARS‐CoV2 (n = 118, 33%), RSV (n = 51, 14.3%), Flu B (n = 49,13.7%), other viruses (n = 3, 0.8%), and combined infection (n = 2, 0.6%). Six hundred fifty‐eight (56.8%) patients had comorbidities, mainly diabetes (n = 284, 43%) and heart disease (n = 217, 33%). 183 (16%) patients were admitted to ICU, 110 (9%) needed mechanical ventilation, and 80 (7%) patients died. The odds of ICU admission were higher for patients with hematological (OR 5.9, 95% CI 3.1–11.1) and lung diseases (OR 2.7, 95% CI 1.6–4.6). The odds of mechanical ventilation were higher among patients with lung disease (OR 3.1, 95% 1.7–5.5). The mortality odds were higher among patients above 50 (OR 2.4, 95% CI 1.4–4.1) and chronic kidney disease (OR 2.5, 95% CI 1.1–5.2). Conclusions Being 50 years or above or having kidney, lung, or heart diseases was associated with worse SARI outcomes. Efforts and actions in developing better strategies to vaccinate individuals at high risk and early diagnosis and treatment should help in reducing the burden of SARI.

PurposeCardiac resynchronization therapy (CRT) with multipoint left ventricular (LV) pacing (MultiPoint™ Pacing, MPP) has been shown to improve CRT response, although MPP response using automated pacing vector programming has not been demonstrated in the Middle East. The purpose of this study was to compare the impact of MPP to conventional biventricular pacing (BiV) using echocardiographic and clinical changes at 6-month post-implant.MethodsThis prospective, randomized study was conducted at 13 Middle Eastern centers. After de novo CRT-D implant (Abbott Unify Quadra MP™ or Quadra Assura MP™) with quadripolar LV lead (Abbott Quartet™), patients were randomized to either BiV or MPP therapy. In BiV patients, the LV pacing vector was selected per standard practice; in MPP patients, the two LV pacing vectors were selected automatically using VectSelect. CRT response was defined at 6-month post-implant by a reduction in LV end-systolic volume (ESV) ≥ 15%.ResultsOne hundred and forty-two patients (61 years old, 68% male, NYHA class II/III/IV 19%/75%/6%, 33% ischemic, 57% hypertension, 52% diabetes, 158 ms QRS, 25.8% ejection fraction [EF]) were randomized to either BiV (N = 69) or MPP (N = 73). After 6 months, MPP vs. BiV patients experienced greater ESV reduction (25.0% vs. 15.3%, P = 0.08), greater EF improvement (11.9% vs. 8.6%, P = 0.36), significantly greater ESV response rate (68.5% vs. 50.7%, P = 0.04), and significantly greater NYHA class improvement rate (80.8% vs. 60.3%, P = 0.01).ConclusionsWith MPP and automatic LV vector selection, more CRT patients in the Middle East experienced reverse remodeling and clinical improvement relative to conventional BiV pacing.

Liver cancer is the fifth most common cancer in men and the seventh in women. Hepatocellular carcinoma (HCC) is responsible for significant morbidity and mortality in patients with liver cirrhosis and accounts for 90% of primary liver cancer. Synovial sarcoma X chromosome (SSX) genes belong to cancer testis antigens (CTA) family; expressed only in germ cell tumors. There have been some studies about the SSX genes expression in the HCC. To the best of our knowledge no reports included these genes expression in the Egyptian patients with HCC. This study aims to evaluate the SSX-1 and SSX-5 mRNA expression in tumor cells circulating in the peripheral blood (PB) of a cohort of Egyptian patients with HCC and to find out any possible associations between these genes expression and different clinical/laboratory parameters. This study included 100 subjects; 52 HCC cases, 25 with post viral hepatitis liver cirrhosis and 23 apparently healthy controls. Expression of SSX-1 and SSX-5 mRNA in PB was tested by reverse transcription polymerase chain reaction (RT-PCR). SSX-1 and SSX-5 mRNA were expressed in 40.4% and 36.5% of the HCC patients, respectively. SSX-1 and/or SSX-5 were not detected in healthy controls or cirrhotic patients. Neither SSX-1 nor SSX-5 expression showed an association with Alfa-Fetoprotein (AFP) levels, tumor size, tumor differentiation, hepatitis B infection and Bilharziasis (P>0.05). SSX-1 and SSX-5 mRNA are specifically expressed in tumor cells circulating in PB of HCC patients and thus could be used as easy access, simple method molecular markers for early diagnosis of HCC patients in Egypt.