Miracle-dz/UniFAR-FTUs huggingface dataset:
Nurse absenteeism and workload: negative effect on restraint use, incident reports and mortality.

AIM This paper is a report of a study to assess the impact of nurse absenteeism on the quality of patient care. BACKGROUND Nurse absenteeism is a growing management concern. It can contribute to understaffed units, staffing instability, and other factors that could have a negative impact on patient care. The impacts of absenteeism on the quality of nursing care have rarely been studied. METHOD Retrospective monthly data from incident reports and staffing records in six inpatient units for 2004 were analysed. Dependent variables were the numbers of restraints, alternatives to restraints, incident reports, deaths, and length of stay. Explanatory variables were nurse absenteeism hours, patient days per nursing staff, and interaction between these variables. Controls were patient acuity and unit characteristics. Fixed effects regressions were analysed as regular or negative binomial models. FINDINGS Neither high Registered Nurse absenteeism nor high patient load was related to restraint use when taken separately. However, high Registered Nurse absenteeism was related to restraint use when patient load was high. Registered Nurse absenteeism was related to a lower use of alternatives to restraints. Incident reports were increased by high patient load, but not absenteeism, or absenteeism given patient load. When both patient load and absenteeism were high, deaths were higher also. CONCLUSION Absenteeism alone may not be a strong factor in lowering quality, but the combination of high Registered Nurse absenteeism and high patient load could be a factor. Staffing and absenteeism may be part of a vicious cycle in which low staffing contributes to unit absenteeism, which contributes to low staffing, and so on.
Large registry analysis to accurately define second malignancy rates and risks in a well-characterized cohort of 744 consecutive multiple myeloma patients followed-up for 25 years

Additional malignancies in multiple myeloma patients after first-line and maintenance treatment have been observed, questioning whether specific risks exist. Second primary malignancies have also gained attention since randomized data showed associations to newer drugs. We have conducted this large registry analysis in 744 consecutive patients and analyzed: 1) frequency and onset of additional malignancies; and 2) second primary malignancy- and myeloma-specific risks. We assessed the frequency of additional malignancies in terms of host-, myeloma- and treatment-specific characteristics. To compare these risks, we estimated cumulative incidence rates for second malignancies and myeloma with Fine and Gray regression models taking into account competing risks. Additional malignancies were found in 118 patients: prior or synchronous malignancies in 63% and subsequent in 37%. Cumulative incidence rates for second malignancies were increased in IgG-myeloma and decreased in bortezomib-treated patients (P<0.05). Cumulative incidence rates for myeloma death were increased with higher stage and age, but decreased in IgG-subtypes and due to anti-myeloma treatment (P<0.05). Cytogenetics in patients acquiring second primary malignancies were predominantly favorable, suggesting that indolent myeloma and long disease latency may allow the manifestation of additional malignancies. An assessment of the Surveillance, Epidemiology, and End Result Program of the National Cancer Institute and our data with long-term follow up of 25 years confirmed a prevalence of second malignancy of 10% at 25 years, whereas death from myeloma decreased from 90% to 83%, respectively. Our important findings widen our knowledge of second malignancies and show that they are of increasing relevance as the prognosis in myeloma improves and mortality rates decrease.
Violence Reported by the Immigrant Population Is High as Compared With the Native Population in Southeast Spain

Immigrants constitute a population vulnerable to the problem of violence. This study sought to ascertain the prevalence of violence reported by the immigrant population in the Murcian Region of Spain and characterize the related factors, taking the country population as reference. A cross-sectional study was carried out based on a representative population sample of Latin American (n = 672; 48% women), Moroccan (n = 361; 25% women), and Spanish origin (n = 1,303; 66% women), aged 16 to 64 years. Using a specific questionnaire, the prevalence of violence in the preceding year was assessed. The results were compared with the Spaniards using the 2006 National Health Survey (NHS). Multivariate logistic regression models were used to study the factors associated with violence having been reported in each group, both separately and in immigrants versus Spaniards. Finally, the cause and place of last aggression were studied. The prevalence of violence was 6.5% in Latin Americans, 12.0% in Moroccans, and 2.7% in Spaniards. Discrimination was the principal violence-related factor in all three groups. Among Latin Americans, low educational level was also associated with violence. Among Moroccans, those who had perceived discrimination showed the greatest differences in prevalence of violence compared with natives. Intimate partner violence (IPV) registered a prevalence of below 2%. As a conclusion, in this study, violence was little reported and higher among immigrants. The principal violence-related factor was discrimination. More studies of this type are called for to characterize the problem in other population-representative samples.
World Health Organization disability assessment schedule 2.0: An international systematic review

Abstract Purpose: This systematic review examines research and practical applications of the World Health Organization Disability Assessment Schedule (WHODAS 2.0) as a basis for establishing specific criteria for evaluating relevant international scientific literature. The aims were to establish the extent of international dissemination and use of WHODAS 2.0 and analyze psychometric research on its various translations and adaptations. In particular, we wanted to highlight which psychometric features have been investigated, focusing on the factor structure, reliability, and validity of this instrument. Method: Following Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology, we conducted a search for publications focused on “whodas” using the ProQuest, PubMed, and Google Scholar electronic databases. Results: We identified 810 studies from 94 countries published between 1999 and 2015. WHODAS 2.0 has been translated into 47 languages and dialects and used in 27 areas of research (40% in psychiatry). Conclusions: The growing number of studies indicates increasing interest in the WHODAS 2.0 for assessing individual functioning and disability in different settings and individual health conditions. The WHODAS 2.0 shows strong correlations with several other measures of activity limitations; probably due to the fact that it shares the same disability latent variable with them. Implications for Rehabilitation WHODAS 2.0 seems to be a valid, reliable self-report instrument for the assessment of disability. The increasing interest in use of the WHODAS 2.0 extends to rehabilitation and life sciences rather than being limited to psychiatry. WHODAS 2.0 is suitable for assessing health status and disability in a variety of settings and populations. A critical issue for rehabilitation is that a single “minimal clinically important . difference” score for the WHODAS 2.0 has not yet been established.
Some haematological parameters in Malawian neonates.

Studies of haematological parameters were performed on 366 (177 male and 189 female) normal Malawian neonates with mean +/- s.d. birthweight of 2.99 +/- 0.37 (range 2.1-4.0) kg using a Nova Cell Track, Model Nova CT11. Cord anaemia (Cord Hb < 13.5g dl-1) was detected in 100 (27.3%) of the neonates. It was also shown that although the male babies had a significantly higher erythrocyte protoporphyrin level (p < 0.001) than the females, there were no significant differences (p > 0.05) in the red cell, white cell and platelet indices between the two sexes. When the haematological parameters of the 266 (72.7%) non-anaemic (Cord Hb > 13.5g dl-1) neonates were analysed, the mean +/- s.d. values which may serve as local reference standards were: Hb 16.0 +/- 1.7 (range 13.5-21.3) g dl-1, Hct 47.0 +/- 6.0 (range 36.5-67.5) percent, MCV 112.6 +/- 8.9 (range 72.2-131.0) fl, MCH 31.9 +/- 5.5 (range 24.4-48.5) pg, MCHC 33.5 +/- 2.8 (range 29.1-48.9) g dl-1 reticulocyte count 6.9 +/- 3.6 (range 1.2-25.0) percent, free erythrocyte protoporphyrin 3.3 +/- 0.9 (range 1.9-7.7) mgs ZPP gm-1 Hb, platelet count 269.9 +/- 57.7 (range 134.0-454.0) x 10(9) l-1 and total leucocyte count 12.3 +/- 4.8 (range 5.5-35.3) x 10(9) l-1. Further analysis of the differential wbc count disclosed normal levels of eosinophils and neutrophils similar to those given in standard haematology textbooks for Caucasian neonates; thus strengthening the belief that eosinophilia and relative neutropenia previously reported in adult Africans is not of genetic origin, but rather an acquired phenomena.
Short-time xylem relaxation results in reliable quantification of embolism in grapevine petioles and sheds new light on their hydraulic strategy.

In recent years, the validity of embolism quantification methods has been questioned, especially for long-vesseled plants. Some studies have suggested that cutting xylem while under tension, even under water, might generate artificial cavitation. Accordingly, a rehydration procedure prior to hydraulic measurements has been recommended to avoid this artefact. On the other hand, concerns have been raised that xylem refilling might occur when samples are rehydrated. Here, we explore the potential biases affecting embolism quantification for grapevine (Vitis vinifera L.) petioles harvested under tension or after xylem relaxation. We employ direct visualization of embolism through X-ray micro-computed tomography (microCT) to test for the occurrence of fast refilling (artifactually low per cent loss of conductivity (PLC) due to rehydration prior to sample harvest) as well as excision-induced embolism (artifactually high embolism due to air introduction during harvest). Additionally, we compared the response functions of both stomatal regulation and xylem embolism to xylem pressure (Ψx). Short-time (20 min) xylem tension relaxation prior to the hydraulic measurement resulted in a lower degree of embolism than found in samples harvested under native tensions, and yielded xylem vulnerability curves similar to the ones obtained using direct microCT visualization. Much longer periods of hydration (overnight) were required before xylem refilling was observed to occur. In field-grown vines, over 85% of stomatal closure occurred at less negative Ψx than that required to induce 12% PLC. Our results demonstrate that relaxation of xylem tension prior to hydraulic measurement allows for the reliable quantification of native embolism in grapevine petioles. Furthermore, we find that stomatal regulation is sufficiently conservative to avoid transpiration-induced cavitation. These results suggest that grapevines have evolved a strategy of cavitation resistance, rather than one of cavitation tolerance (diurnal cycles of embolism and repair).
Overview of Power Management Strategies of Hybrid AC/DC Microgrid

Today, conventional power systems are evolving to modern smart grids, where interconnected microgrids may dominate the distribution system with high penetration of renewable energy and energy storage systems. The hybrid ac/dc systems with dc and ac sources/loads are considered to be the most possible future distribution or even transmission structures. For such hybrid ac/dc microgrids, power management strategies are one of the most critical operation aspects. This paper presents an overview of power management strategies for a hybrid ac/dc microgrid system, which includes different system structures (ac-coupled, dc-coupled, and ac-dc-coupled hybrid microgrids), different operation modes, a thorough study of various power management and control schemes in both steady state and transient conditions, and examples of power management and control strategies. Finally, discussion and recommendations of power management strategies for the further research are presented.
Cardiovascular Toxicity of Local Anesthetics: An Alternative Hypothesis

The current study examined the possibility that high local anesthetic concentrations within the central nervous system could contribute to the toxic cardiovascular effects observed clinically after an accidental intravenous injection. Equal numbers of molecules of lidocaine (1.6 μl of a 2% solution) and bupivacaine (1.0 μl of a 4% solution) were injected at three vasomotor and cardioactive areas in the rat medulla by means of a 28-gauge hypodermic needle and a micro-syringe. These areas were the C1 region, the intermedialateral column (IML), and the nucleus tractus solitarius (NTS). Both lidocaine and bupivacaine at C1 significantly decreased mean arterial pressure and, at IML, resulted in significant bradycardia and hypotension. At NTS, both lidocaine and bupivacaine caused significant bradycardia and hypotension, which were accompanied by ventricular arrhythmias in 55% of the animals. In all animals in whom ventricular arrhythmias were associated with lidocaine, the arrhythmias spontaneously reverted to normal sinus rhythm. In 50% of animals developing ventricular arrhythmias after bupivacaine, the arrhythmias resulted in death. Using an equal number of molecules of lidocaine and bupivacaine, all three regions studied demonstrated that bupivacaine was 2–4 times more potent than lidocaine in producing cardiovascular effects. These data demonstrate that direct application of local anesthetics within the medullary region of the central nervous system can result in hypotension, bradycardia, and ventricular arrhythmias similar to what may be seen in humans after accidental intravenous injections of local anesthetics. Moreover, the sites and mechanisms of action appear to be identical for bupivacaine and lidocaine. Thus bupivacaine does not appear to be an aberrant local anesthetic, as some have suggested, but rather produces more profound effects related to its potency and physico-chemical properties.
Factors associated with delay in diagnosis of childhood amblyopia.

The prevention of permanent visual impairment from amblyopia is an important goal of pediatric vision screening. Unfortunately, many cases of amblyopia are not diagnosed until the child is too old to benefit maximally from treatment. A review of patient records from the practice of a private pediatric ophthalmologist confirmed that late detection is a frequent occurrence among children with amblyopia who have had good access to health care. A case-control study was then used to identify factors associated with delayed diagnosis, in which children with an adverse outcome (diagnosed at or after 5 years of age) were compared with those with an optimal outcome (diagnosed before 5 years of age). The chart review identified 161 children with amblyopia who participated in this study; 75 had late diagnoses (case patients) and 86 served as control patients. Children with early diagnoses more often had the following characteristics: a positive family history of strabismus, greater degrees of strabismus (when strabismus was present), higher maternal educational level, greater parental suspicion that an eye problem existed, and an increased chance that the parents requested the eye examination that led to the diagnosis. The parents of children with late diagnoses expressed less concern over the seriousness of amblyopia but were more likely to report that their children had suffered adverse consequences of amblyopia. When diagnosed early, amblyopia was more often detected by the child's primary health care provider. Physicians of the children with early diagnoses more often reported compliance with both the American Academy of Pediatrics guidelines for vision screening in infancy and referral for vision problems. (ABSTRACT TRUNCATED AT 250 WORDS)
Fratricide Is Essential for Efficient Gene Transfer between Pneumococci in Biofilms

ABSTRACT Streptococcus pneumoniae and a number of commensal streptococcal species are competent for natural genetic transformation. The natural habitat of these bacteria is multispecies biofilms in the human oral cavity and nasopharynx. Studies investigating lateral transfer of virulence and antibiotic resistance determinants among streptococci have shown that interspecies as well as intraspecies gene exchange takes place in these environments. We have previously shown that the action of a competence-specific murein hydrolase termed CbpD strongly increases the rate of gene transfer between pneumococci grown in liquid cultures. CbpD is the key component of a bacteriolytic mechanism termed the fratricide mechanism. It is secreted by competent pneumococci and mediates the release of donor DNA from sensitive streptococci present in the same environment. However, in nature, gene exchange between streptococci takes place in biofilms and not in liquid cultures. In the present study, we therefore investigated whether CbpD affects the rate of gene transfer in laboratory-grown biofilms. Our results show that the fratricide mechanism has a strong positive impact on intrabiofilm gene exchange, indicating that it is important for active acquisition of homologous donor DNA under natural conditions. Furthermore, we found that competent biofilm cells of S. pneumoniae acquire a Novr marker much more efficiently from neighboring cells than from the growth medium. Efficient lysis of target cells requires that CbpD act in conjunction with the murein hydrolase LytC. In contrast, the major autolysin LytA does not seem to be important for fratricide-mediated gene exchange in a biofilm environment.
Casein kinase 2 specifically binds to and phosphorylates the carboxy termini of ENaC subunits.

A number of findings have suggested the involvement of protein phosphorylation in the regulation of the epithelial Na+ channel (ENaC). A recent study has demonstrated that the C tails of the beta and gamma subunits of ENaC are subject to phosphorylation by at least three protein kinases [Shi, H. , Asher, C. , Chigaev, A. , Yung, Y. , Reuveny, E. , Seger, R. & Garty, H. (2002) J. Biol. Chem. 277, 13539-13547]. One of them was identified as ERK which phosphorylates betaT613 and gammaT623 and affects the channel interaction with Nedd4. The current study identifies a second protein kinase as casein kinase 2 (CK2), or CK-2-like kinase. It phosphorylates betaS631, a well-conserved serine on the beta subunit. Such phosphorylation is observed both in vitro using glutathione-S-transferase-ENaC fusion proteins and in vivo in ENaC-expressing Xenopus oocytes. The gamma subunit is weakly phosphorylated by this protein kinase on another residue (gammaT599), and the C tail of alpha is not significantly phosphorylated by this kinase. Thus, CK2 may be involved in the regulation of the epithelial Na+ channel.
Safety of an intravenous (i.v.) dose of ibandronate followed by daily oral dosing in metastatic bone disease: Results of an open-label study.

735 Background: Ibandronate is a highly-potent aminobisphosphonate for the prevention of skeletal events from metastatic bone disease. A 3-month trial has assessed the safety and effects on bone turnover of a single rapid infusion of i.v. ibandronate, followed by daily oral dosing. This abstract reports the safety results. METHODS In a multicenter, open-label study of patients with metastatic bone disease from breast cancer or multiple myeloma, a single i.v. dose of ibandronate (6mg infused over 15 minutes) on Day 1 was followed by oral ibandronate 50mg/day for 12 weeks. The combination of an initial i.v. dose with subsequent daily dosing was adopted to promote rapid onset of the effects on bone turnover. Adverse events (AEs) were recorded during the course of the study and safety laboratory assessments included the monitoring of serum creatinine levels. RESULTS Thirty-nine patients were included in the safety analysis. On Day 1, 3 patients reported non-serious AEs that were considered possibly or probably related to ibandronate infusion (flu-like syndrome, asthenia, headache and cervical pain). During the 12-week treatment period, 25 patients experienced at least one AE. The most common AEs reported, but not necessarily related to ibandronate, were nausea (n=6), asthenia (n=5), raised temperature (n=3) and bone pain (n=3). Four patients were withdrawn due to AEs prior to completion of the 12-week study. Two patients experienced serious AEs, of which only one was considered related to ibandronate (stomach ulcer, in a patient with a medical history of gastritis). No renal AEs were reported, and calculated creatinine clearance levels were similar at baseline and week 12 (mean 77.9 ± 22.4μmol/L vs 79.4 ± 25.8μmol/L). CONCLUSIONS A single dose of i.v. ibandronate 6mg, followed by oral ibandronate 50mg/day for 12 weeks, was well tolerated in metastatic bone disease from breast cancer or multiple myeloma, with no significant changes in renal functioning. The 15-minute infusion schedule in this study was well tolerated and had no negative impact on renal safety. [Table: see text].
Effects of Perceived Risk and Strength of Affiliation on Decisions to Help Others: Toward a Convergence of Evolutionary and Social Psychology

In this study, the influence of perceived affiliation with a target and perceived risk on decisions to act altruistically were investigated. These are variables which have been suggested by the social and evolutionary psychology literatures, respectively. 12 participants responded to automobile accident scenarios that combined risk and affiliation with a target in descriptions of opportunities to render aid. Participants reported a lower likelihood to help when perceived risk was high, but only if their perceived affiliation with the targets was low or moderate; tendency to help highly affiliated targets was uniformly high throughout all risk conditions. Participants' ratings of certainty in their decisions to render aid were directly related to both perceived risk and perceived affiliation with a target. Decisions were arrived at more slowly when perceived risk and perceived affiliation were both moderate. Therefore, both risk and affiliation were considered by participants when deciding whether to act altruistically. This illustrates a convergence of predictions from social and evolutionary psychology.