Miracle-dz/UniFAR-FTUs huggingface dataset:
Quality of nursing diagnoses: evaluation of an educational intervention.

PURPOSE To investigate the effects on the quality of nursing diagnostic statements in patient records after education in the nursing process and implementation of new forms for recording. METHODS Quasi-experimental design. Randomly selected patient records reviewed before and after intervention from one experimental unit (n = 70) and three control units (n = 70). A scale with 14 characteristics pertaining to nursing diagnoses was developed and used together with the instrument (CAT-CH-ING) for record review. FINDINGS Quality of nursing diagnostic statements improved in the experimental unit, whereas no improvement was found in the control units. Serious flaws in the use of the etiology component were found. CONCLUSION. Nurses must be more concerned with the accuracy and quality of the nursing diagnoses and the etiology component needs to be given special attention. PRACTICE IMPLICATIONS Education of RNs in nursing diagnostic statements and peer review using standardized evaluation instruments can be means to further enhance RNs' documentation practice.
Time estimation and time production in depressive patients

ABSTRACT– Twenty‐three depressive inpatients and matched controls were studied three times at 2‐week intervals. Both patients and controls initially overestimated, and subsequently approximated to, the “short” time spans (5–240 sec) whilst both correctly estimated the “long” ones (15 and 30 min) over the three occasions (Time, Estimation Test, TED. There were no differences in the TET scores among the patients themselves, or between the patients and controls with the exception of one time span which the patients overestimated more than the controls. Among the depressive symptoms, only retardation was correlated with the TET scores. Similarly in the production of 30 sec (Time Production Test, TPT) there were no differences among the patients or between patients and controls. Again, only retardation was negatively correlated with the TPT score. Since the TET scores of the “short” time spans were negatively correlated with the TPT scores, it was speculated that both results derived from a single faculty, which was clinically manifested as retardation.
Effects of Soybean Tillage Systems on Imazaquin Persistence

Dissipation studies were conducted during 1988, 1989, and 1990 in Mississippi on a Marietta loam, and during 1988 and 1989 in Tennessee on a Statler loam, to determine the effects of soybean tillage systems on persistence of bioavailable imazaquin. Imazaquin concentration as determined by a corn shoot bioassay was generally not correlated with time after application. This was because of wide fluctuations in rainfall that occurred throughout the duration of the experiments in each of the years. Imazaquin half-life ranged from 30 to 75 days in Mississippi and from 24 to 50 days in Tennessee. Imazaquin dissipation was not affected by tillage systems. The only difference between years occurred in Tennessee, and could be attributed to difference in initial concentration between years and differences in rainfall the first 30 DAT. Differences in locations occurred in 1989, and were attributed to differences in initial concentration and the lack of rainfall 60 to 120 DAT in Mississippi.
Viral dynamics of hepatitis C early after orthotopic liver transplantation: Evidence for rapid turnover of serum virions

The pathogenesis of hepatitis C virus (HCV) infection is likely to be associated with viral replication in vivo, but little is known concerning the dynamics of HCV turnover. We performed serial measurements of serum HCV‐RNA levels following orthotopic liver transplantation (OLT) in nine patients with HCV‐positive cirrhosis. Serum HCV‐RNA levels were determined by quantitative polymerase chain reaction before, immediately after, and for up to 1 month after OLT. There was a rapid decline in HCV‐RNA levels from 3.1 ± 1.3 × 105 copies/ mL (mean ± SEM) preoperatively to 0.15 ± 0.6 × 105 copies/mL on the first and 0.16 ± 0.6 × 105 copies/mL on the second postoperative day (mean viral half‐life, 4.0 ± 0.5 h). Thereafter, HCV‐RNA levels increased in all but one patient, and by postoperative day 8 reached 3.6 ± 1.3 × 105 copies/mL, exceeding the preoperative levels irrespective of the use or not of rescue immunosuppressive therapy including steroid bolus administration. In most patients, serum virions continued to increase averaging 11.6 ± 2.8 × 105 copies/mL on the 30th postoperative day. These findings indicate that the half‐ life of HCV is quite short, and that extrahepatic viral replication contributes little to the total virus pool in serum. Furthermore, the marked HCV replication beginning as early as the third postoperative day strongly suggests that the liver graft is rapidly reinfected by HCV after OLT.
[Infertility in polycystic ovary syndrome treated with acupuncture and clomiphene: a randomized controlled trial].

OBJECTIVE To explore the best therapy for infertility caused by polycystic ovary syndrome (PCOS). METHODS One hundred and twenty patients were randomized into three groups, a clomi-phene group (group A), an acupuncture-moxibustion + Chinese medicine group (group B) and a clomiphene + acupuncture-moxibustion+ Chinese medicine group (group C), 40 cases in each one. In the group A, since the 5th day of menstruation, clomiphene was prescribed for oral administration. In the group B, on the 5th day of menstruation, warm needling therapy was applied at Zhongji (CV 3), Guanyuan (CV 4), Guilai (ST 29), etc. Additionally, the Chinese herbal medication for tonifying the kidney and activating blood circulation was provided. In the group C, the therapy as the group B was combined on the basis of the treatment as the group A. The treatment lasted continuously for 3 menstrual cycles. The endometrial thickness, endometrial type and cervical mucus score on human chorionic gon adotropin (HCG) day, and ovulatory cycle rate, clinical pregnancy rate and abortion rate after treatment were observed in the patients of the three groups. RESULTS 1) HCG day cervical mucus score, endometrial thickness and endometrial morphology (A type rate): the results in the group C were better than those in the group A (all P<0.01); the results in the group B were better than those in the group A (all P<0.05). The difference in the endometrial thickness was not significant in comparison between the group C and the group B (P>0.05). The cervical mucus score and endometrial morphology (A type rate) in the group C were better than those in the group B (both P<0.05). 2) The ovulatory cycle rates in the group A and group (C were higher than that in the group B (both P<0.05), the pregnancy rate in the group C was higher than that in the other groups (both P<0.05), and the early abortion rate in the group C was lower than that in the group A and group B (both P<0.01). 3) Follicle diameter from 18 mm to 20 mm and endometrial thickness: the differences were not significant between the normal pregnancy patients and the early abortion patients (both P>0.05). The endometrial morphology A type rate in the normal pregnancy patients was higher than that in the early abortion patients (P<0.05). CONCLUSION The combined therapy of acupuncture, herbal medicine and clomiphene improves the pregnancy rate and reduces early abortion rate by effectively improving HCG day cervical mucus, endometrial thickness and morphology. The efficacy is apparently superior to the simple medication with clomiphene and the combined application of acupuncture and herbal medicine.
Use of N‐terminal pro‐brain natriuretic peptide to detect acute cardiac dysfunction during weaning failure in difficult‐to‐wean patients with chronic obstructive pulmonary disease*

Objective: To evaluate the utility of serial measurements of plasma N‐terminal pro‐brain natriuretic peptide (NT‐proBNP) to detect acute cardiac dysfunction during weaning failure in difficult to wean patients with chronic obstructive pulmonary disease. Design: Prospective observational cohort study. Setting: A 14‐bed general intensive care unit in a university hospital. Patients: Nineteen patients mechanically ventilated for chronic obstructive pulmonary disease exacerbation who were difficult to wean. Interventions: None. Measurements and Main Results: Cardiac and hemodynamic variables, arterial and central venous blood gas, breathing pattern, respiratory mechanics, indexes of oxygen cost of breathing, and plasma levels of NT‐proBNP were measured and analyzed immediately before (baseline) and at the end of a spontaneous breathing trial. Eight of 19 patients (42%) were identified with acute cardiac dysfunction at the end of the weaning trial. Baseline NT‐proBNP levels were significantly higher (median 5000, interquartile range 4218 pg/mL) in these patients than in patients without evidence of acute cardiac dysfunction (median 1705, interquartile range 3491 pg/mL). Plasma levels of NT‐proBNP increased significantly at the end of the spontaneous breathing trial only in patients with acute cardiac dysfunction (median 12,733, interquartile range 16,456 pg/mL, p < .05). The elevation in NT‐proBNP at the end of the weaning trial had a good diagnostic performance in detecting acute cardiac dysfunction, as estimated by area under the receiver operating characteristic curve analysis (area under the curve 0.909, se 0.077, 95% confidence interval 0.69–0.98; p < .0001, cutoff = 184.7 pg/mL). Conclusions: Serial measurements of NT‐proBNP plasma levels provided a noninvasive manner to detect acute cardiac dysfunction during an unsuccessful weaning trial in difficult to wean patients with chronic obstructive pulmonary disease. The utility of this test as a complement of the standard clinical monitoring of the weaning trial deserves further investigation.
Tumour-associated macrophages are related to progression in patients with metastatic melanoma following interleukin-2 based immunotherapy

The aim of the present study was to analyze whether leukocyte subsets in peripheral blood and tumour biopsies obtained before treatment were able to predict response or survival in patients with metastatic melanoma following Interleukin-2 (IL-2) based immunotherapy. Flow cytometry was performed on peripheral blood for CD4+ T cells, CD8+ T cells and CD56+ natural killer (NK) cells. Immunohistochemical analyses were used to identify CD4+ T cells, CD8+ T cells, CD57+ NK cells and CD64+ (macrophages) cells in tumour biopsies. High numbers of tumour-associated CD64+ macrophages in tumour biopsies were statistically significantly associated with poor response to treatment. Our data suggest that tumour-associated macrophages may correlate negatively with response, which may be of biological importance for IL-2 based immunotherapy of malignant melanoma.
Dynamic gadolinium‐enhanced three‐dimensional abdominal MR arteriography

The abdominal aorta and renal, visceral, and iliac arteries were evaluated in 16 patients with three‐dimensional Fourier transform imaging enhanced with gadopentetate dimeglumine. By imaging dynamically during the arterial phase of a 5‐minute injection (0.2 mmol/kg), highly significant (P < .0001) preferential arterial enhancement (signal‐to‐noise ratio ± standard deviation, 10 ± 0.9), with minimal enhancement of the inferior vena cava (5.1 ± 1.4) or background tissues (fat, 4.3 ± 0.7; muscle, 2.4 ± 0.5), was achieved in every patient. In six patients with angiographic and/or surgical correlation, 10 of 10 stenoses and two of two occlusions were correctly identified. No inplane saturation or pulsatility artifact was identified in any of the 16 patients. In conclusion, dynamic imaging during the injection of gadopentetate dimeglumine is a promising technique for evaluation of the abdominal aorta and branch vessels.
Finite-dimensional observer-based control of linear distributed parameter systems using cascaded output observers

The synthesis of compensators for linear distributed-parameter systems on the basis of a finite-dimensional approximation is a classical technique. This so-called early-lumping approach suffers from the occurrence of spillover which means that the closed-loop dynamics is deteriorated by the neglected dynamics. In this contribution, an early-lumping compensator design is presented that overcomes the spillover problem by using certain fictitious outputs which can be reconstructed without spillover and that suppress the contributions of the unmodelled dynamics. When the new outputs are used for the compensator instead of the available measurements, the perturbation of the closed-loop spectrum, caused by spillover, can be reduced to an arbitrary extent. It is shown that the worst-case eigenvalue perturbation decreases exponentially with respect to the compensator order so that the spillover can be reduced systematically. In addition, an a priori estimate for the compensator order, that guarantees a prescribed maximal eigenvalue perturbation, is presented. The proposed design procedure is demonstrated for the control of an Euler–Bernoulli beam with Kelvin–Voigt damping.
Results of a BFM-based protocol for the treatment of childhood B-non-Hodgkin's lymphoma and B-acute lymphoblastic leukemia in Argentina.

PURPOSE To report the feasibility and results of a study based on the BFM-ALL. NHL/86 protocol for B-non-Hodgin's Lymphoma (NHL) and B-Acute Lymphoblastic Leukemia (B-ALL) in Argentina. Design. Prospective, single arm, non-randomized trial. PATIENTS AND METHODS From August 1988 to December 1993, 87 consecutive patients with B-NHL/B-ALL were admitted and 82 were eligible. The therapy was stratified according to stage. All patients received a cytoreductive prephase with cyclophosphamide and prednisone. Those with stage I-II were treated with three 5-day blocks of combined intense chemotherapy including dexamethasone, cyclophosphamidie, ifosfamide, cytarabine, teniposide, doxorabicin, and 500 mg/m2 of methotrexate as a 24 hour continuous infusion. Stage III received 6 blocks and those with stage IV/B-ALL received 6 intensified blocks in which 2 g/m2 of 24 hour continuous infusion methotrexate and vincristine were added. Triple intrathecal therapy was given for CNS prevention. After the first two blocks the response was assessed and those with a partial response were offered optionallya second look surgery or local radiotherapy. RESULTS With a median follow-up of 38 (range 16-71) months, the event-free survival (pEFS) for the whole group was 0.69 (Stage I-II n = 16 pEFS = 0.94, stage III n = 50 pEFS = 0.66, Stage IV n = 7 pEFS = 0.43, B-ALL n = 9 pEFS = 0.66). Patients with stage III abdominal tumors who achieved a partial response by imaging studies after induction had a significantly higher risk of relapse than those with a complete response (p = 0.02). Relapse was the most frequent event Toxicity was mainly hematological. CONCLUSIONS The application of this protocol was feasible in our setting and its results comparable to the German study. Patients with stage I-II had an excellent outcome. Those with stage III and B-ALL achieved an encouraging event-free survival, however those with abdominal tumors and partial response to induction chemotherapy fared less favourably. This strategy was less effective for patients with initial CNS disease.
Hospital resource utilization in the treatment of cerebral aneurysms.

The authors reviewed clinical and financial data for all patients treated for nontraumatic subarachnoid hemorrhage (SAH) and unruptured cerebral aneurysms at their institution between June 1993 and December 1994. This study sought to identify specific areas of high resource utilization that may be amenable to reduction of expenditures without compromising quality of care. Detailed hospital financial data were correlated with clinical grade and course. Areas of high resource use were identified based on patient charges and category-specific loaded hospital cost. Patients were divided into four groups: Group 1, surgically treated unruptured aneurysms (28 patients); Group 2, acute SAH (42 patients); Group 3, SAH with vasospasm (32 patients); and Group 4, SAH with negative angiogram (10 patients). Total cost per patient (mean +/- standard deviation in thousands of U.S. dollars) was highest for Group 3 (38.4 +/- 21.3; vs. Group 1, 12.7 +/- 8.8; Group 2, 22.6 +/- 20.9; and Group 4, 25.0 +/- 33.5) and correlated with hospital length of stay, Hunt and Hess grade, and Fisher grade. Areas of highest hospital cost were not always reflected in patient charges. The three areas of highest cost accounted for 48.5% of the total cost and were: 1) intensive care unit (ICU) room (Group 1, 2.5 +/- 3.5; Group 2, 7.0 +/- 9.2; Group 3, 11.0 +/- 7.8; and Group 4, 7.9 +/- 14.1); 2) arteriography (Group 1, 1.7 +/- 1.2; Group 2, 2.1 +/- 1.5; Group 3, 4.1 +/- 2.1; and Group 4, 2.2 +/- 0.7); and 3) ICU medicosurgical supplies (Group 1, 1.7 +/- 0.8; Group 2, 2.0 +/- 1.5; Group 3, 3.7 +/- 1.7; and Group 4, 2.0 +/- 3.0). It is concluded that cost containment strategies should be based on cost rather than charge and novel approaches will be required to reduce the cost of treating patients with SAH. Such approaches might include preventing vasospasm, reducing ICU stay, selective use of arteriography, and reducing the cost of supplies.
When does low oxygen become hypoxia? Implications for nitrite reduction.

To the Editor: Webb and Milsom et al1 present the intriguing finding that endothelial nitric oxide synthase (eNOS) in human umbilical vein endothelial cells (HUVECs) and potentially RBCs is responsible under hypoxic conditions for nitrite (NO2•) reduction to nitric oxide (NO). Based on several practical and theoretical points of view, the conclusions that the authors draw regarding their data are flawed. It is important that these are considered by the wider Circulation Research readership. The authors conclude that lack of oxygen (O2) availability to eNOS promotes NO2• reduction to NO. Whereas the RBC experiments involve measurement of NO produced by RBC under nitrogen and acidic conditions, the HUVEC experiments were carried out at 5% O2 and 5% CO2 (refer to online data supplement that accompanies the article for details). Although there is no question 5% …
A randomised multicentre trial of modified CHOP versus MCOP in patients aged 65 years and over with aggressive non-Hodgkin's lymphoma.

BACKGROUND The aim of this study was to determine in a randomised trial whether there is any significant difference in toxicity between modified CHOP and MCOP chemotherapy in elderly patients with aggressive non-Hodgkin's lymphoma (NHL) and to determine whether this reduced dose chemotherapy can be administered with full dose intensity, low toxicity and produce acceptable survival. PATIENTS AND METHODS Between 1993 and 2000, 155 eligible patients were randomised into this trial mainly from three centres (Nottingham, Birmingham and Leeds, UK). The patients were newly diagnosed with aggressive NHL and had a median age of 74 years (range 65-91 years). Ninety-six patients (62%) had bulky stage I or II disease; 59 patients (38%) had either stage III or IV disease; 77% had one or more extranodal sites involved at presentation; and 31% showed B symptoms. Seventy-seven patients were randomised to receive six cycles of modified CHOP (cyclophosphamide 600 mg/m(2) i.v. , doxorubicin 30 mg/m(2) i.v. , vincristine 1 mg i.v. all on day 1 with prednisolone 20 mg bd for days 1-5) every 21 days and 78 patients to MCOP (mitozantrone 10 mg/m(2) i.v. substituted for doxorubicin). Growth factors were not used routinely. After completion of chemotherapy, 39 patients received involved field radiotherapy (35-40 Gy) in 20 fractions. RESULTS One hundred and one patients (65%) completed all six cycles of chemotherapy. The median course dose intensity was 97%. The median follow-up for 53 surviving patients was 51 months. The median survival was 19 months (95% confidence interval 10-36 months) with an actuarial survival of 47% at 2 years and 42% at 3 years (CHOP versus MCOP, P = 0.79). There was no significant difference in any of the toxicities experienced with either CHOP or MCOP, except for white cell count (46 patients on MCOP and 27 patients on CHOP had grade 3 or 4 toxicity, P = 0.002) and red cell transfusion (37 patients, MCOP; 17 patients, CHOP; P = 0.001). Grade 3 or 4 neutropenia was documented in 75 patients (50%). One patient died from toxicity whilst in remission and seven patients died with septicaemia and persistent NHL. CONCLUSION This multicentre randomised trial provides further information on the dose intensity achievable with CHOP or MCOP regimens in elderly patients (median age 74 years) with aggressive NHL. These dose-reduced regimens can be given with nearly 100% dose intensity with 65% of patients completing all the treatment. Survival is comparable to that observed with the more intensive regimens given in this age group.
Validation and Utilization of a Clinical Next-Generation Sequencing Panel for Selected Cardiovascular Disorders

The development of high-throughput technologies such as next-generation sequencing (NGS) has allowed for thousands of DNA loci to be interrogated simultaneously in a fast and economical method for the detection of clinically deleterious variants. Whenever a clinical diagnosis is known, a targeted NGS approach involving the use of disease-specific gene panels can be employed. This approach is often valuable as it allows for a more specific and clinically relevant interpretation of results. Here, we describe the customization, validation, and utilization of a commercially available targeted enrichment platform for the scalability of clinical diagnostic cardiovascular genetic tests, including the design of the gene panels, the technical parameters for the quality assurance and quality control, the customization of the bioinformatics pipeline, and the post-bioinformatics analysis procedures. Regions of poor base coverage were detected and targeted by Sanger sequencing as needed. All panels were successfully validated using genotype-known DNA samples either commercially available or from research subjects previously tested in outside clinical laboratories. In our experience, utilizing several of the sub-panels in a clinical setting with 33 real-life cardiovascular patients, we found that 20% of tests requested were reported to have at least one pathogenic or likely pathogenic variant that could explain the patient phenotype. For each of these patients, the positive results may aid the clinical team and the patients in best developing a disease management plan and in identifying relatives at risk.