Miracle-dz/UniFAR-FTUs huggingface dataset:
Disparities Among Blacks, Hispanics, and Whites in Time From Starting Dialysis to Kidney Transplant Waitlisting

Background Although a longer time on dialysis before kidney transplant waitlisting has been shown for Blacks versus non-Blacks, relatively few studies have compared this outcome between Hispanics and Whites. Methods A multivariable analysis of 1910 (684 Black, 452 Hispanic, and 774 White) consecutive patients waitlisted at our center for a primary kidney transplant between 2005 and mid-2010 was performed for time from starting dialysis to waitlisting (months), the percentage who were preemptively waitlisted (waitlisted before starting dialysis), and time from starting dialysis to waitlisting after excluding the preemptively waitlisted patients. Results The variables associated with significantly longer median times from starting dialysis to waitlisting and less preemptive waitlisting included Medicare insurance for patients ages <65 years (by far, the most significant variable in each analysis), Black race, higher percentage of households in the patient’s zip code living in poverty, being a non-U.S. citizen (for preemptive waitlisting), Medicaid insurance, waitlisted for kidney-alone (vs. kidney-pancreas) transplant, and higher body mass index (longer median times for the latter three variables). Although the effect of Black race was mostly explained by significant associations with lower socioeconomic status (Medicare insurance for patients ages <65 years and greater poverty in the patient’s zip code), an unexplained component still remained. The univariable differences showing poorer outcomes for Hispanics versus Whites were smaller and completely explained in multivariable analysis by significant associations with lower socioeconomic status and non-U.S. citizenship. Conclusion Black and Hispanic patients had significantly longer times from starting dialysis to waitlisting, in large part related to their lower socioeconomic status and less preemptive waitlisting. A greater focus on earlier nephrology care may help to erase much of these disparities.
Clinical relevance and genotypes of circulating noroviruses in northern Taiwan, 2006–2011

The incidence of noroviral gastroenteritis has increased dramatically in recent years, and norovirus (NoV) genogroup II.4 (GII.4) is associated with outbreaks worldwide. The NoV genotypes and their clinical relevance in children hospitalized with acute gastroenteritis between 2006 and 2011 in northern Taiwan were evaluated in this study. NoV sequences were amplified from 47 clinical specimens and phylogenetic analysis was performed. Based on noroviral capsid protein (VP1) and RNA dependent RNA polymerase (RdRp) phylogeny, circulating NoV could be divided into GII.2, GII.3, GII.12, and GII.4 and GII.16, GII.12, GII.g, and GII.4; respectively. The GII.4 subtype was predominant and could be divided further into the 2004 (Hunter), 2006b, and 2010 (New Orleans) subtypes. Regarding clinical manifestations, convulsive disorder occurred only in cases caused by NoV GII.4 2006b. Patients affected by NoV GII.4 2006b presented with a higher frequency of diarrhea (P = 0.0204), longer duration of diarrhea (P = 0.0215), more frequent hypoglycemia (P = 0.038), and electrolyte imbalance (P = 0.0487) than acute gastroenteritis caused by NoV GII.4 2010. Structural analysis showed that the amino acid changes in viral VP1 between GII.4 2006b and 2010 subtype were located mainly in the protruding domain 2 (P2 domain). In conclusion, the NoV GII.4 variants 2006b and 2010 were the main causes of acute gastroenteritis in hospitalized children in northern Taiwan during 2006–2011. The clinical presentations and structural changes in VP1 of the two NoV GII.4 variants should be evaluated in the future. J. Med. Virol. 86:335–346, 2014. © 2013 Wiley Periodicals, Inc.
Large scale study of HPV genotypes in cervical cancer and different cytological cervical specimens in Thailand

Identification of high‐risk HPV genotypes in patients is essential for vaccination and prevention programs while the geographic distribution of cervical cancer varies widely. HPV 16 is the major cause of cervical cancer followed by HPV 18, HPV 31, HPV 52, or HPV 58 depending on geographic area. In this study, the distribution of HPV genotypes in cervical specimens from women living in Thailand was analyzed by HPV testing with electrochemical DNA chip and PCR direct sequencing. The 716 specimens were grouped according to their cytological grades; 100 normal, 100 low‐grade squamous intraepithelial lesions, 100 high grade squamous intraepithelial lesions, and 416 specimens of cervical cancer. The results showed that HPV 16, HPV 18, HPV 52, and HPV 58 are the most common HPV genotypes in Thailand, respectively. With respect to age, women below the age of 26 years were almost negative for high‐risk HPV DNA exclusively. Conversely, high prevalence of high‐risk HPV DNA and abnormal cytology were usually found in women between 26 and 45 years while cervical cancer was detected mainly in women above the age of 45 years. To increase protection efficiency, a vaccine including HPV 52 and HPV 58 should be offered to Asian women, and primary HPV screening should start at 26–30 years of age. J. Med. Virol. 86:601–607, 2014. © 2013 Wiley Periodicals, Inc.
Correlation between hepatitis B virus surface antigen level and alpha‐fetoprotein in patients free of hepatocellular carcinoma or severe hepatitis

Alfa‐fetoprotein (AFP) is used as a marker of early hepatocarcinogenesis. However, the impact of hepatitis B virus surface antigen (HBsAg) on this relationship in patients with HBV infection is not clear. The present study evaluated the relation between HBsAg and AFP levels at the initial visit in 1,610 untreated HBV patients, free of hepatocellular carcinoma (HCC) or severe hepatitis. The cumulative rate of HCC was significantly lower in patients with a low AFP level (≤10 µg/L; below the upper limit of normal) than in those with a high AFP level (≥11 µg/L) at the initial visit. In patients with HBsAg levels more than 500 IU/ml, HBsAg levels correlated significantly and negatively with AFP levels, and significantly with platelet count. Multivariate analysis of data of patients with HBsAg more than 500 IU/ml identified HBsAg (<7,000 IU/ml), albumin (<3.9 g/dl), platelet count (<20.0 × 104/mm3), gamma‐glutamyl transpeptidase (≥50 IU/L), aspartate aminotransferase (≥34 IU/L), HBeAg (positive), and HBV core‐related antigen (≥3.0 log U/ml) as determinants of a high AFP. Especially, in patients with HBsAg more than 500 IU/ml and low transaminase levels (below the upper limit of normal), HBsAg was identified as significant determinant of a high AFP. On the other hand, in patients with HBsAg less than 500 IU/ml, multivariate analysis identified albumin, gamma‐glutamyl transpeptidase, and HBV core‐related antigen as determinants of a high AFP. The results indicated that HBsAg level seems to affect, at least in part, the AFP levels, and that it can be used as a surrogate marker of early hepatocarcinogenesis. J. Med. Virol. 86:131–138, 2014. © 2013 Wiley Periodicals, Inc.
Prevalence of alcohol consumption among secondary school students in Port Harcourt, Southern Nigeria

Background : Consumption of alcohol by secondary school students is a major public health concern globally, but its prevalence is not known in secondary schools in Port Harcourt. Objective : To determine the prevalence and factors associated with alcohol use among secondary school students in Port Harcourt. Methods : This was a cross sectional school based study conducted in Port Harcourt in March 2014. A 20 itemed structured, self -administered questionnaire was distributed to 1080 senior secondary 1 to 3 students from 10 public secondary schools selected through Multistage Sampling technique. Questions asked covered drinking of alcohol, frequency of drinking and being drunk in the past 30 days before the survey. Other behaviours sought were smoking of cigarette, use of cocaine and going out in the evening for fun. Sociodemographic was also sought. Data was analyzed using SPSS version 20. Results : 1080 students participated in the study, mean age 16.09±6SD and male to female ratio of 0.9: 1. Prevalence of current drinking of alcohol was 30.6% and 38.1% of current drinkers were also drunk in the past 30 days, with 17.2 % being very frequently drunk. The behaviour which showed a strong association with drinking of alcohol, being drunk and the frequency of being drunk was going out in the evening for fun and recreation. Gender showed a positive association with drinking of alcohol, as more males drank alcohol with in the past 30 days compared to the females (p=0.000). Smoking of cigarette in the past 30 days and truancy were positively associated with being drunk, while academic grades showed an inverse relationship with consumption of alcohol. Majority of those who drank alcohol (42.6%) were experimenting with alcohol, though 5.4% drank due to addiction. Majority (39.3%) bought their drinks from stores and supermarkets. The most Common problems experienced by the drinkers were fatigue, alcohol made them behave in ways they later regretted and it hurt their relationships. Conclusion : Alcoholism is a serious problem with secondaryschool students in Port Harcourt. It is linked with truancy, poor academic achievement and other substances use. The most serious health and social problem experienced by the drinkers is addiction. Keywords : Prevalence, Alcohol, Secondary school, Consumption,
Awareness of Legislation Moderates the Effect of Opt-Out Consent on Organ Donation Intentions

Background With the worldwide shortage of organs to meet the demand for transplants, many countries are considering whether introducing opt-out consent would increase the availability of donor organs. This research assessed whether people’s willingness to donate their organs for transplant purposes was greater in opt-out than opt-in countries and whether such effects were moderated by people’s awareness of their nation’s legislative system. Methods Using secondary data from the 2010 Eurobarometer (n=29,288), this study compared people’s willingness to donate their organs in a representative sample from 19 opt-out and 10 opt-in consent countries from across Europe. Results The majority of participants (66.04%) stated that they were willing to donate their organs for transplant purposes. The proportion of people who were willing to donate their organs did not differ between opt-in (65.97%) and opt-out (66.37%) countries. However, the effect of consent on willingness to donate was moderated by people’s awareness of their nation’s organ donation legislation. When people were aware of their nation’s legislation, the proportion of people who were willing to donate their organs was greater in opt-out (85.26%) than opt-in (80.72%) countries. By contrast, when people were not aware of their nation’s legislation, there was no difference in people’s willingness to donate their organs in opt-in (58.63%) and opt-out (59.23%) countries. Conclusions Opt-out consent countries should increase people’s awareness of their legislation to improve donor rates. Further research is needed to understand the factors that moderate the effect of opt-out consent legislation on organ donation.
Design and application of a real‐time polymerase chain for the detection and subsequent characterization of respiratory adenoviral infections

Human adenoviruses (HADVs) comprise at least 54 types and cause a wide spectrum of respiratory tract infections; early diagnosis and epidemiological monitoring of HADV infections requires a rapid and sensitive assay. The use of a real‐time polymerase chain reaction (PCR) assay was evaluated with one set of in‐house designed primers for respiratory adenoviral infections. The assay was first validated by detecting successfully 6 representative types and 100 clinical isolates. A concomitant prospective surveillance of viral aetiology using conventional cultures and PCR assays in 160 febrile children with acute respiratory tract symptoms was conducted between May 2010 and July 2011. Viral aetiologies were confirmed in 72 (45%) cases using conventional cultures, including 51 adenoviral infections. The concordance between the real‐time PCR and culture was good (Kappa = 0.94), and two additional culture‐negative adenovirus infections were identified. During the study period (January 2011), an adenoviral community epidemic occurred. Adenovirus B3 was the predominant type in this epidemic (69.8%), followed by C2 (5.7%), C1 (5.7%), C5 (1.9%), E4 (1.9%), C6 (1.9%), F41 (1.9%), and 4 unclassified species C (7.5%). Significantly prolonged duration of fever (>5 days), higher leukocyte counts, higher neutrophil counts, and higher C‐reactive protein levels were in the adenoviral infected group (n = 53, P < 0.001), compared with the non‐adenoviral infected group (n = 107). In conclusion, this in‐house real‐time PCR is capable of detecting adenoviral respiratory infections of various types in children; and patients with adenoviral aetiology suffered from more severe clinical manifestations. J. Med. Virol. 86:2128–2133, 2014. © 2014 Wiley Periodicals, Inc.
Letter. Early amniocentesis versus chorionic villus sampling

d with interest the article entitled ‘A safety of EAC because it is impossib mparative study on transabdominal us sampling and amniocentesis EAC at week 11 directly from the beginning without getting into difficulties. performed at 10–13 weeks’ gestation’ (Cederholm and Axelsson, 1997). The authors reported on a higher risk for fetal loss and repeated testing in early amniocentesis (EAC) than in chorionic villus sampling (CVS). In our opinion, the main problem of the cited article is the very small number of EACs (147) performed and probably the poor experience of the operators. As we know from early CVS studies, the operator’s experience is the most important factor for the safety of a certain method. So, despite the important attempt of the authors to set up a randomized study, we have to assume that the number of performed cases is much too small. No information is given about the EAC experience before starting the prospective study. In 6·8 per cent of procedures they were unable to obtain enough amniotic fluid using the EAC technique. Even the laboratory problems with EAC are unsolved in the laboratory of the Swedish colleagues if we take a look at the high rate of failed cytogenetic analyses (12·2 per cent). In our opinion, Cederholm and Axelsson seem to be in the learning phase! So, basic preliminaries, which would allow the two methods to be compared are not given. The data of this study are so sparse that such a fundamental conclusion can not be drawn. In our hospital, we have done one of the largest studies on early amniocentesis worldwide (Eiben et al., 1997). More than 6000 EACs have been performed. Between 1990 and 1995, 3277 EACs have performed from week 10+3 to week 13+6 of gestation for advanced maternal age and maternal anxiety (Eiben et al., 1997). When we started EAC in 1990, nearly 500 EACs were done in week 14 before we performed our first cases at earlier gestational weeks. After 2000 EACs at weeks 14 and 13, the first cases were done at weeks 11 and 12. In our opinion, this strategy is essential for the
Contribution of Interferon-&ggr; Release Assays (IGRAs) to the Diagnosis of Latent Tuberculosis Infection After Renal Transplantation

Background Renal transplant recipients (RTRs), as all immunosuppressed patients, are at increased risk of reactivating latent tuberculosis infection (LTBI). Detecting LTBI in this population is therefore important to prevent active TB. The tuberculin skin test (TST) has a poor sensitivity in this setting. Methods The aim of this prospective study was to compare the diagnostic performance of the TST and two interferon-&ggr; release assays (IGRAs): T-SPOT.TB (Oxford Immunotec, Oxford, UK) and QuantiFERON Gold In-Tube (QGIT; Cellestis, Australia), performed simultaneously, for the detection of patients with risk factors for LTBI or a definite history of TB among RTRs under stable immunosuppression. Results Two hundred five patients (ages 59±13 years, tested 10.4±7.1 years after transplantation) were studied. Positivity rate was 4.5% for TST, 20.5% for T-SPOT.TB, and 23.5% for QGIT. Agreement between IGRAs was fair (&kgr;=0.71). Sensitivity of T-SPOT.TB and QGIT for detection of prior active TB was 55.6% (95% confidence interval [CI], 21.2–86.3) and 44.4 (95% CI, 13.7–78.8), respectively. Sensitivity of both IGRAs for detection of risk factors for LTBI was 33.3% (95% CI, 19.6–49.5). Specificity was 85.5% (95% CI, 78.9–90.7) for T-SPOT.TB and 80.1% (95% CI, 72.9–86.2) for QGIT. Combining IGRAs did not significantly improve sensitivity. Conclusions Because their sensitivity for detecting prior active TB and probable LTBI in RTRs is very low, IGRAs cannot be used to exclude LTBI. These results emphasize the limitations of IGRAs in the setting of chronic immunosuppressive therapy.
Incivility, retention and new graduate nurses: an integrated review of the literature.

AIM To evaluate the influence of incivility on the new graduate nurse transition experience. BACKGROUND Incivility in the work environment is a major source of dissatisfaction and new graduate nurses are especially vulnerable. Incivility contributes to the high levels of turnover associated within the first 2 years of new graduate nurse employment. EVALUATION An integrated review of the literature was conducted using MEDLINE-EBSCOhost, PsycInfo and CINAHL databases. Relevant articles were reviewed for appropriateness related to inclusion/exclusion criteria and for quality using established criteria. Sixteen studies were included in the final analysis. KEY ISSUES Themes that emerged included workplace incivility, nurse residency programmes, mentoring through preceptors and empowerment/work environment. Findings indicated that incivility in the workplace was a significant predictor of low job satisfaction in new graduate nurses transitioning into practice. CONCLUSIONS While graduate nurse transition programmes are associated with improved satisfaction and retention, they appear to address incivility by acculturating new graduate nurses to the experience of incivility. There is little evidence that the culture of incivility has been addressed. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers have the responsibility to be aware of the prevalence of incivility, assess for its occurrence, and implement strategies which eliminate workplace incivility and tolerance for uncivil behaviours.
Early Versus Late Acute Antibody-Mediated Rejection in Renal Transplant Recipients

Background Over the last decade, the diagnostic precision for acute antibody-mediated rejection (aABMR) in kidney transplant recipients has improved significantly. The phenotypes of early and late aABMR may differ. We assessed the characteristics and outcomes of early versus late aABMR. Methods Between January 1, 2005 and December 31, 2010, aABMR was diagnosed in 67 grafts in 65 kidney recipients, with a median follow-up of 3.6 years (range, 61 days–7.3 years). Recipients were stratified by early aABMR (<3 months after transplantation; n=40) and late aABMR (>3 months after transplantation; n=27). The main outcome was kidney allograft loss. Outcome of aABMR was compared with recipients with acute early (n=276) or late (n=100) non-ABMR during the same period. Results Recipients with late aABMR had significantly reduced graft survival compared with recipients with early aABMR (P<0.001, log-rank test; 40% vs. 75% at 4 years; hazard ratio, 3.72; 95% confidence interval, 1.65–8.42). Graft survival in late aABMR was also inferior to late non-ABMR acute rejections (P=0.008). At transplantation, more patients were presensitized to human leukocyte antigens (22 [55%] vs. 4 [15%] in the early vs. late aABMR group). The late aABMR group was characterized by younger recipient age (37.9±12.9 vs. 50.9±11.6 years; P<0.001), increased occurrence of de novo donor-specific antibodies (52% vs. 13%; P=0.001), and nonadherence/suboptimal immunosuppression (56% vs. 0%; P<0.001). Conclusion Compared with early aABMR, late aABMR had inferior graft survival and was characterized by young age, frequent nonadherence, or suboptimal immunosuppression and de novo donor-specific antibodies.
Incidence of Tuberculosis in Deceased-Organ Donors and Transmission Risk to Recipients in Spain

Background Globalization and migration patterns have increased the number of donors from countries with high incidence rates of tuberculosis (TB) in low incidence countries, with the subsequent increase in risk of TB transmission to the recipients. Methods Retrospective cohort study, including all actual deceased donors in Spanish hospitals between January 1998 and June 2011 and all the recipients who had received an organ from donors identified as TB cases. Results Six actual donors were identified as TB cases, representing an annual incidence of 30.6 cases/100,000 donors (95% CI, 4–58). Two cases did not become utilized donors, because TB was detected in the organ recovery and were therefore excluded. Annual incidence in utilized donors was 23 cases/100,000 donors (95% CI, 6–59). Annual incidence of the Spanish population in the same period was 17.5 cases/100,000 inhabitants (95% CI, 17–18). Annual incidence in actual donors belonging to the Romanian immigrant community was 2353 cases/100,000 donors (95% CI, 286–8242). Variations in the prophylactic strategy utilized in recipients were observed. TB was transmitted to three recipients (27.3% transmission), two of whom developed active TB. Conclusions Incidence of TB in actual donors is greater than that of the general population (P<0.001). The risk of immigrant communities should be grouped according to the real incidence in donors. Transmissibility of TB is high; therefore, transplant teams should be immediately informed when TB donor transmission is suspected to prevent TB in the recipient.
Organisational change stressors and nursing job satisfaction: the mediating effect of coping strategies.

AIM To examine the mediating effect of coping strategies on the consequences of nursing and non-nursing (administrative) stressors on the job satisfaction of nurses during change management. BACKGROUND Organisational change can result in an increase in nursing and non-nursing-related stressors, which can have a negative impact on the job satisfaction of nurses employed in health-care organisations. METHOD Matched data were collected in 2009 via an online survey at two time-points (six months apart). RESULTS Partial least squares path analysis revealed a significant causal relationship between Time 1 administrative and role stressors and an increase in nursing-specific stressors in Time 2. A significant relationship was also identified between job-specific nursing stressors and the adoption of effective coping strategies to deal with increased levels of change-induced stress and strain and the likelihood of reporting higher levels of job satisfaction in Time 2. CONCLUSIONS The effectiveness of coping strategies is critical in helping nurses to deal with the negative consequences of organisational change. IMPLICATIONS FOR NURSING MANAGEMENT This study shows that there is a causal relationship between change, non-nursing stressors and job satisfaction. Senior management should implement strategies aimed at reducing nursing and non-nursing stress during change in order to enhance the job satisfaction of nurses.