Miracle-dz/UniFAR-FTUs huggingface dataset:
An Exploratory Study of a Research Culture Development by Administrators, Lecturers and Clinical Specialists in Nursing

Context: Escalating healthcare demands combined with diminishing resources underline the importance of ensuring nurses in leading roles, having the capacity to conduct evidence-based research to inform practice. Aims: This study explored the perceptions of research knowledge and experiences of nurses in administrative, teaching and clinical specialist positions to highlight gaps in research provision within educational institutions and healthcare organisations in Singapore. Design/Methods: A mixed-method exploratory descriptive design, using a questionnaire with open and closed questions was employed to obtain the views of nurses on their capacity in conducting research. Convenience sampling was employed in 3 research seminars in Singapore between July-August 2011. Results: Forty seven nurses were recruited and they confirmed good research knowledge and skills but indicated the need for enhanced educational preparation and organisational support to fully embrace a research culture. Conclusions: Research in nursing requires prioritisation and support in educational training and healthcare settings. Otherwise, conducting research would continue to be a lesser priority for nurses, even if they were in teaching or clinical positions which provided significant opportunities to lead or facilitate research. Given that role modeling enhances research culture in nursing, within education and clinical settings, nurses in leadership positions require confidence in conducting research. However, without prioritising research, and filtering this down through the nursing hierarchical system to promote a research culture, new knowledge to improve practice will remain elusive.
Legacy of the chameleon: Edible wild plants in the Kindom of Swaziland, Southern Africa. A cultural, ecological, nutritional study. Part II ‐ demographics, species availability and dietary use, analysis by ecological zone

This paper, the second of four, presents demographic characteristics for 211 adults and 140 school children surveyed in four ecological zones in the Kingdom of Swaziland. It identifies edible species recognized and consumed, and concludes with an analysis of edible plant use by ecological zone. Swaziland is culturally homogeneous: 90 % of persons interviewed were ethnic Swazi; 46 % had no formal education; 60 % of adults were born or had lived for more than 13 years at their present homestead in a specific ecological zone. All respondents consumed wild plants; 11 % never purchased food. More older respondents occupied the Highveld; more younger Swazi Middleveld and Lowveld. Most land was cultivated at Middleveld sites. Food production varied significantly by ecological zone; most maize was produced in the Highveld. Adults reported a range of edible species (9–90) in each of four ecological zones; adults ate, on average, ten more species than school children. Most prominently consumed edible leaves were fr.
Mindfulness-based stress reduction for breast cancer-a systematic review and meta-analysis.

OBJECTIVE The aim of this systematic review and meta-analysis was to assess the effectiveness of mindfulness-based stress reduction (mbsr) and mindfulness-based cognitive therapy (mbct) in patients with breast cancer. METHODS The medline, Cochrane Library, embase, cambase, and PsycInfo databases were screened through November 2011. The search strategy combined keywords for mbsr and mbct with keywords for breast cancer. Randomized controlled trials (rcts) comparing mbsr or mbct with control conditions in patients with breast cancer were included. Two authors independently used the Cochrane risk of bias tool to assess risk of bias in the selected studies. Study characteristics and outcomes were extracted by two authors independently. Primary outcome measures were health-related quality of life and psychological health. If at least two studies assessing an outcome were available, standardized mean differences (smds) and 95% confidence intervals (cis) were calculated for that outcome. As a measure of heterogeneity, I(2) was calculated. RESULTS Three rcts with a total of 327 subjects were included. One rct compared mbsr with usual care, one rct compared mbsr with free-choice stress management, and a three-arm rct compared mbsr with usual care and with nutrition education. Compared with usual care, mbsr was superior in decreasing depression (smd: -0.37; 95% ci: -0.65 to -0.08; p = 0.01; I(2) = 0%) and anxiety (smd: -0.51; 95% ci: -0.80 to -0.21; p = 0.0009; I(2) = 0%), but not in increasing spirituality (smd: 0.27; 95% ci: -0.37 to 0.91; p = 0.41; I(2) = 79%). CONCLUSIONS There is some evidence for the effectiveness of mbsr in improving psychological health in breast cancer patients, but more rcts are needed to underpin those results.
Breast Cancer Neoantigens Can Induce CD8+ T-Cell Responses and Antitumor Immunity

Neoantigens are valuable for immunotherapy, but human breast cancers offer fewer than other cancers. With next-generation sequencing and computerized epitope-prediction, neoantigens in breast cancer were identified. The immune system recognized these neoantigens and protected mice from tumor challenge. Next-generation sequencing technologies have provided insights into the biology and mutational landscape of cancer. Here, we evaluate the relevance of cancer neoantigens in human breast cancers. Using patient-derived xenografts from three patients with advanced breast cancer (xenografts were designated as WHIM30, WHIM35, and WHIM37), we sequenced exomes of tumor and patient-matched normal cells. We identified 2,091 (WHIM30), 354 (WHIM35), and 235 (WHIM37) nonsynonymous somatic mutations. A computational analysis identified and prioritized HLA class I–restricted candidate neoantigens expressed in the dominant tumor clone. Each candidate neoantigen was evaluated using peptide-binding assays, T-cell cultures that measure the ability of CD8+ T cells to recognize candidate neoantigens, and preclinical models in which we measured antitumor immunity. Our results demonstrate that breast cancer neoantigens can be recognized by the immune system, and that human CD8+ T cells enriched for prioritized breast cancer neoantigens were able to protect mice from tumor challenge with autologous patient-derived xenografts. We conclude that next-generation sequencing and epitope-prediction strategies can identify and prioritize candidate neoantigens for immune targeting in breast cancer. Cancer Immunol Res; 5(7); 516–23. ©2017 AACR.
Achievement of take-home dose privileges is associated with better-perceived sleep and with cognitive status among methadone maintenance treatment patients

Abstract Objectives. Methadone maintenance treatment (MMT) patients may achieve up to a 2-week privilege of methadone take-home doses (THD), which is associated with considerable responsibility. MMT patients are characterized as having poor sleep quality and low cognitive states. We studied sleep indices and cognitive status with respect to THD privileges. Methods. A sample of 123 MMT patients stratified by THD groups was studied. Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), and the cognitive Clock Drawing Test (CDT) were performed. Results. Thirty-one of 123 patients never had any THD and 92 did (25 had the maximum of 2 weeks). The never THD had history of longer duration of opiate usage and a shorter period in MMT. They had the highest rates of poor sleep (80.6%, PSQI > 5), daily sleepiness (“fall asleep while talking”) (41.9%), and impaired cognitive status (58.1%, CDT < 3), while those who had 2-week privileges had the lowest (56, 8, and 28%, respectively). Logistic regression characterized THD patients as no-benzodiazepine and no-cocaine, short opiate usage duration, low ADHD scores, and no cognitive impairment (CDT = 3) and its interaction with treatment duration. Conclusion. Privileges that reflect patients’ abstinence and rehabilitation were also expanded to be associated with better cognitive states. These finding confirm the THD dispensing performance. Including CDT as part of the decision for dispensing THD may be considered.
Look Beyond the Disease Activity Score of 28 Joints (DAS28): Tender Points Influence the DAS28 in Patients with Rheumatoid Arthritis

Objective. To explore the influence of tender points (TP) on the Disease Activity Score assessing 28 joints (DAS28) in patients with rheumatoid arthritis (RA). Methods. In 200 consecutive patients with RA from the outpatient clinic, DAS28 and its components, tender and swollen joint counts (TJC, SJC, respectively), visual analog scale (VAS) for patient’s general health (GH), and erythrocyte sedimentation rate (ESR), along with a tender point count (TPC) were assessed. Patients were categorized according to 4 TPC classes: zero, 1–5, 6–10, and ≥ 11 TP. The influence of TPC classes on DAS28 and its individual components was determined with Kruskal-Wallis tests and correlations between TP and DAS28 and its components were calculated. Results. In 196 eligible patients, 70% were female, mean age was 59 years, and median disease duration was 3.9 years; median DAS28 was 3.1; and 49% had active disease, defined as DAS28 > 3.2. In 15% of patients, the TPC was ≥ 11, in 12% 6–10, in 30% 1–5, and in 43% zero. TPC significantly influenced the DAS28 and its less objective components TJC and VAS-GH (i.e., based on patient’s report), but not the more objective DAS28 components SJC and ESR (i.e., observer- and laboratory-based). Conclusion. DAS28 is influenced by tender points, even in the non-fibromyalgia range, falsely suggesting higher disease activity and decreasing the sensitivity of the DAS28 criterion of low disease activity or remission. When applying DAS28-guided “tight control” or “treat-to-target” treatment strategies in RA, evaluation of not only the DAS28, but also its individual components along with a full joint and physical evaluation including assessment of TP is required to reliably estimate the individual’s disease activity, which guides therapeutic decisions.
The benefits of exercise for the health of older people

Active lifestyles are associated with better health and lower rates of mortality from all causes. Increasing activity levels also have positive effects on many of the risk factors for developing chronic disease and on mortality rates (see Figure 1). Evidence to support these claims, at least for middle-aged men, has accumulated steadily over the last 20 years. This review presents evidence that physical activity can contribute to health and wellbeing in old age.
Severe head injury and amyotrophic lateral sclerosis

Abstract Our objective was to examine whether severe head injury, subtypes of head injury, or repeated head injuries are associated with ALS risk based on the Swedish population and health registers. We conducted a case-control study, nested within a cohort of 5,764,522 individuals who were born in Sweden during 1901–1970 and followed between 1991 and 2007. The study included 4004 ALS patients identified from the Swedish Patient Register during follow-up and 20,020 randomly selected controls matched by gender and birth year. We evaluated hospitalization for severe head injury that was recorded in the inpatient register before ALS diagnosis. Conditional logistic regression was used to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results showed that there was an association of ALS risk with severe head injury ≤ 1 year before diagnosis (OR: 3.9, 95% CI 2.6–6.1). No association was observed for severe head injury > 3 years before ALS diagnosis, nor was ALS associated with subtypes of head injury or repeated injuries occurring > 3 years before diagnosis. In conclusion, our findings from the Swedish registers provide no strong support for an etiological relationship between severe head injury in adulthood and ALS risk.
A randomized controlled trial of nurse-led care for symptomatic moderate-severe obstructive sleep apnea.

RATIONALE Obstructive sleep apnea (OSA) is a prevalent disease. Often limited clinical resources result in long patient waiting lists. Simpler validated methods of care are needed. OBJECTIVES To demonstrate that a nurse-led model of care can produce health outcomes in symptomatic moderate-severe OSA not inferior to physician-led care. METHODS A randomized controlled multicenter noninferiority clinical trial was performed. Of 1,427 potentially eligible patients at 3 centers, 882 consented to the trial. Of these, 263 were excluded on the basis of clinical criteria. Of the remaining 619, 195 met home oximetry criteria for high-probability moderate-severe OSA and were randomized to 2 models of care: model A, the simplified model, using home autoadjusting positive airway pressure to set therapeutic continuous positive airway pressure (CPAP), with all care supervised by an experienced nurse; and model B, involving two laboratory polysomnograms to diagnose and treat OSA, with clinical care supervised by a sleep physician. The primary end point was change in Epworth Sleepiness Scale (ESS) score after 3 months of CPAP. Other outcome measures were collected. MEASUREMENTS AND MAIN RESULTS For the primary outcome change in ESS score, nurse-led management was no worse than physician-led management (4.02 vs. 4.15; difference, -0.13; 95% confidence interval: -1.52, 1.25) given a prespecified noninferiority margin of -2 for the lower 95% confidence interval. There were also no differences between both groups in CPAP adherence at 3 months or other outcome measures. Within-trial costs were significantly less in model A. CONCLUSIONS A simplified nurse-led model of care has demonstrated noninferior results to physician-directed care in the management of symptomatic moderate-severe OSA, while being less costly. Clinical trial registered with http://www.anzctr. org.au (ACTRN012605000064606).
Usefulness of Triple Test Score for Breast Lesions

Abstract Objective : Evaluating the usefulness of the Triple Test Score (TTS) in breast lesions. Materials and Methods : Medical records of 100 cases were evaluated and TTS was calculated based on of physical examination, mammography and fine-needle aspiration cytology findings. The diagnostic value of TTS was assessed according to histopathology results. Results : Of the 23 lesions with score of 5, which considered as suspicious, 7 were benign and 16 were malignant. TTS less than or equal to 4 has a specificity of 100% and TTS greater than or equal to 6 has a sensitivity of 100%. Conclusion : The TTS reliably guides evaluation and treatment of breast lesions. TTS 3 or 4 are always benign and breast lesions with scores greater than or equal to 6 are malignant and should be treated accordingly. Keywords : Triple test score; Breast; Lesion Please cite this article as: Mokri M, Guity M, Shariat Torbaghan S, Arab Kheradmand A, Arbabai E, Bagherzade M, et al. Usefulness of Triple Test Score for Breast Lesions. Iran J Cancer Prev. 2008; 1(1): 23-25. References 1. Cochrane RA. Evaluation of general practitioner referrals to a specialist breast clinic according to the UK national guidelines. Eur J Surg Oneol.23 (3):198,1997. 2. Leis HP Jr. Clinical diagnosis of breast cancer. J Report Meet.1975; 14:231-232. 3. Sleltzer MH. The significance of breast complaints as correlated with age and breast cancer. Am Surg. 1992; 58: 413-7. 4. Seltzer MH. Preoperative prediction of open breast biopsy results, Cancer. 1997; 79:1822-1827. 5. Johansen C. A clinical study with special reference to diagnostic procedures, Acta clin Scand. 1975; 451(suppl):1-70,. 6. Vetto JT. Use of the Triple Test for palpable breast lesion yields high diagnostic accuracy and cost savings. Am J Surg. 1995; 169:519-522. 7. Morris A. Accurate evaluation of palpable breast masses by the triple test score. Arch Surg. 1998;133:93I. 8. Terminology in this table is reflective of the American College of Radiology (ACR). ACR-BI-RADS - Mammography. 4th Edition. In: ACR Breast Imaging Reporting and Data System, Breast Imaging Atlas. Reston VA. American College of Radiology, 2003 For more information, see (www.acr.org) 9. Katherine T Morris. Usefulness of the Triple Test Score for Palpable Breast Masses, Arch Surg. 2001; 136:11010.
Response to letter regarding article, "physical activity and heart rate variability in older adults: the cardiovascular health study".

We are pleased to address the suggestion of Monfredi and colleagues that further consideration of resting heart rate (HR) might provide insight into the relationship between physical activity and heart rate variability (HRV) reported in our article.1 As we have previously discussed,2 influences on HRV are complex and multifactorial. Although HR influences HRV, HRV indices are not merely linear nor nonlinear surrogates of HR, but independent measures influenced by numerous other physiological pathways. Although we agree that HRV indices such as 24-hour standard-deviation-of-all-normal-to-normal-intervals (SDNN) cannot directly characterize vagal activity, HRV indices can provide insights into autonomic influences on and responsiveness of the heart. We also note that we made no statements about the physiological determinants of resting bradycardia, which was not an outcome in our analysis. Previous studies have also demonstrated that associations of HRV with outcomes such as mortality …
Magnetic Resonance Imaging in the Prognostic Evaluation of Patients with Pulmonary Arterial Hypertension

&NA; Rationale: Prognostication is important when counseling patients and defining treatment strategies in pulmonary arterial hypertension (PAH). Objectives: To determine the value of magnetic resonance imaging (MRI) metrics for prediction of mortality in PAH. Methods: Consecutive patients with PAH undergoing MRI were identified from the ASPIRE (Assessing the Spectrum of Pulmonary Hypertension Identified at a Referral Centre) pulmonary hypertension registry. Measurements and Main Results: During the follow‐up period of 42 (range, 17‐142) months 576 patients were studied and 221 (38%) died. A derivation cohort (n = 288; 115 deaths) and validation cohort (n = 288; 106 deaths) were identified. We used multivariate Cox regression and found two independent MRI predictors of death (P < 0.01): right ventricular end‐systolic volume index adjusted for age and sex, and the relative area change of the pulmonary artery. A model of MRI and clinical data constructed from the derivation cohort predicted mortality in the validation cohort at 1 year (sensitivity, 70 [95% confidence interval (CI), 53‐83]; specificity, 62 [95% CI, 62‐68]; positive predictive value [PPV], 24 [95% CI, 16‐32]; negative predictive value [NPV], 92 [95% CI, 87‐96]) and at 3 years (sensitivity, 77 [95% CI, 67‐85]; specificity, 73 [95% CI, 66‐85]; PPV, 56 [95% CI, 47‐65]; and NPV, 87 [95% CI, 81‐92]). The model was more accurate in patients with idiopathic PAH at 3 years (sensitivity, 89 [95% CI, 65‐84]; specificity, 76 [95% CI, 65‐84]; PPV, 60 [95% CI, 46‐74]; and NPV, 94 [95% CI, 85‐98]). Conclusions: MRI measurements reflecting right ventricular structure and stiffness of the proximal pulmonary vasculature are independent predictors of outcome in PAH. In combination with clinical data MRI has moderate prognostic accuracy in the evaluation of patients with PAH.
White matter integrity and cognitive impairment in first-episode psychosis.

OBJECTIVE Impaired cognitive function has been identified as a core feature of schizophrenia. However, a significant proportion of patients do not show any cognitive deficits. The aim of this study was to assess if there were differences in white matter integrity between patients with and without cognitive impairment. METHOD A diffusion tensor imaging study and neurocognitive assessment were conducted in 49 patients with first-episode psychosis and 41 healthy comparison subjects. Subjects were assessed using the Continuous Performance Test, the Grooved Pegboard Test, the Rey Auditory Verbal Learning Test, and the Trail Making Test Part B. For each test, the patient sample was subdivided according to performance, with those scoring more than one standard deviation below the normative mean categorized as impaired. For each cognitive domain, white matter fractional anisotropy in deficit and nondeficit subgroups was compared using a voxel-based analysis. A nonparametric statistical method, controlling for multiple comparisons, was applied. RESULTS Impairment on the Trail Making Test Part B was associated with reduced fractional anisotropy in the right/left anterior thalamic radiation and inferior fronto-occipital fasciculus, forceps minor, and left superior and inferior longitudinal fasciculi. Patients exhibiting Grooved Pegboard Test impairment showed reduced fractional anisotropy in the forceps minor, inferior fronto-occipital fasciculus, anterior thalamic radiation, and corticospinal and corticopontine tracts. Impaired performance on the Rey Auditory Verbal Learning Test and Continuous Performance Test was not associated with significant differences in fractional anisotropy. CONCLUSION Deficits in executive and motor functioning in patients with first-episode psychosis are associated with reductions in white matter integrity in the major fasciculi that connect the frontal and temporal cortices as well as in pathways connecting cortical and subcortical regions. Their presence at the onset of illness, in minimally medicated patients, indicates that these findings are not attributable to effects of chronic illness or its treatment.
Word list and story recall elicit different patterns of memory deficit in patients with Alzheimer's disease, frontotemporal dementia, subcortical ischemic vascular disease, and Lewy body dementia.

BACKGROUND Different roles have been attributed to mesio-temporal areas and frontal lobes in declarative memory functioning, and qualitative differences have been observed in the amnesic symptoms due to pathological damage of these two portions of the central nervous system. OBJECTIVE The aim of the present study was to look for memory profiles related to pathological involvement in the temporal and frontal structures in patients with different dementia syndromes on word-list and prose memory tasks. METHODS 20 patients with Alzheimer's disease (AD), 20 with frontal variant of FTD (fvFTD), 20 with subcortical ischemic vascular dementia (SIVD), and 20 with Lewy body dementia (LBD) and 34 healthy subjects (NCs) were submitted to word-list and prose memory tasks. RESULTS All groups performed similarly on both the immediate and delayed recall of the word-list. Conversely, AD patients performed worse than all the other dementia groups on the immediate prose recall. On delayed prose recall, AD patients performed worse than fvFTD and SIVD patients but similar to LBD patients. Differential scores between word-list and prose tests were minimal in the AD group and very pronounced in fvFTD and SIVD groups. CONCLUSION The combined use of the prose and word-list tasks evidenced a "mesio-temporal" memory profile in AD patients as opposed to a "frontal" one in fvFTD and SIVD patients and a mixed profile in the LBD patients. In particular, a differential score between the two tests can be useful in differentiating AD patients from patients with other forms of dementia.