Miracle-dz/UniFAR-FTUs huggingface dataset:
Nurses' Knowledge of Blood Culture Sampling Procedure

Background : False-positive blood culture results due to contaminated samples have shown to increase patients’ health costs, including the use of broad spectrum antibiotics and prolonged hospital length of stay. While previous research have suggested that increasing staff knowledge on proper specimen collection lowers contamination rates significantly, staff’s current knowledge of hospital-recommended sample collection procedure have yet to be assessed in Dr. Dr. Hasan Sadikin General Hospital, Bandung, Indonesia. Methods : This was a cross-sectional descriptive study on 81 Emergency Department nurses in Dr. Hasan Sadikin General Hospital, Indonesia. Subjects were asked to complete a questionnaire in order to measure their knowledge of blood culture sampling procedure in accordance with the hospital’s standard operating procedure. Results : Among 81 subjects enrolled, 51 managed to adequately describe the prerequisites in proper blood culture sampling procedure and their purpose as dictated by Dr. Hasan Sadikin General Hospital’s standard operating procedure. Conclusions : Up to 67% of nurses conducting blood sampling procedure in Dr. Hasan Sadikin General Hospital’s Emergency Department understood the prerequisites of hospital-recommended blood culture sampling procedure and their purpose.
Routine early coronary angioplasty versus ischaemia-guided angioplasty after thrombolysis in acute ST-elevation myocardial infarction: a meta-analysis.

AIMS Prompt coronary reperfusion following acute ST-segment elevation myocardial infarction is pivotal to survival. Primary angioplasty is the gold standard in restoring reperfusion, but thrombolysis needs consideration when optimal call to balloon time is not feasible. Following lysis and with evolving pharmacoinvasive therapies, the advantage of routine, early percutaneous coronary intervention (PCI) over standard ischaemia-guided PCI remains debatable. We meta-analysed studies comparing these two interventional strategies. METHODS AND RESULTS A MEDLINE search for randomized control studies was performed using the search terms 'coronary, thrombolysis, early or immediate stenting, and acute ST-elevation myocardial infarction'. Further, relevant studies were identified from global cardiovascular scientific sessions/congresses. Two interventional strategies were studied in 3195 patients in eight trials and meta-analysed using a random effects model. The combined endpoint of 30-day mortality, re-infarction, and ischaemia was reached in 106/1487 (7.3%) patients in the routine early PCI group and in 199/1470 (13.5%) patients in the ischaemia-guided PCI group following lysis with odds ratio (OR) 0.47 [95% confidence interval (CI), 0.32-0.68, P < 0.0001] favouring routine early PCI, driven by significant reduction in both re-infarction OR 0.62 (95% CI, 0.42-0.90, P < 0.011) and ischaemia OR 0.21 (95% CI, 0.10-0.47, P < 0.001). Thirty-day mortality or major bleeding rates between strategies were not significantly different. CONCLUSION Where primary PCI is not feasible, our meta-analysis favours routine early PCI within 24 h of thrombolysis for acute ST-elevation myocardial infarction-a strategy that is safe and a time-target that is easily achievable. Early PCI is associated with reduced recurrence of ischaemia and re-infarction, but at no increased risk of major haemorrhage.
Economics of malaria control in China: Cost, performance and effectiveness of Henan's consolidation programme

6 INTRODUCTION . 8 BACKGROUND . 10 METHODS . 12 Classifying costs . 13 Identifying costs for health authorities . 13 Data collection . 15 RESULTS Patient costs . 18 Government costs . 20 Performance analysis . 23 DISCUSSION AND CONCLUSIONS . 28 Health attainment . 29 Stewardship and responsiveness . 29 Equity and fair financing . 30 Case management . 30 Costs and benefits . 32 Limitations and sensitivity of findings . 34 Conclusions . 35 ACKNOWLEDGEMENTS . 38 REFERENCES . 39 APPENDIX A . 42 Types of economic evaluation . 42 Evaluation comparing two or more projects . 42 APPENDIX B . 44 APPENDIX C . 51 Table of contents So ci al , Ec on om ic a nd B eh av io ur al R es ea rc h • Re po rt N o. 1
Training and accreditation in cardiovascular magnetic resonance in Europe: a position statement of the working group on cardiovascular magnetic resonance of the European Society of Cardiology.

Cardiovascular magnetic resonance (CMR) has become an established imaging modality which provides often unique information on a wide range of cardiovascular diseases. The European Society of Cardiology (ESC) training curriculum reflects the emerging role of CMR by recommending that all trainees obtain a minimum level of training in CMR and by defining criteria for subspecialty training in CMR.1 The wider use of CMR requires the definition of standards for data acquisition, reporting, and training in CMR across Europe. At the same time, training and accreditation in all cardiac imaging methods should be harmonized and integrated to promote the training of cardiac imaging specialists. The recommendations presented in this document are intended to inform the discussion about standards for accreditation and certification in CMR in Europe and the discussion on integrated imaging training. At present, the recommendations in this position statement are not to be interpreted as guidelines. Until such guidelines are available and nationally ratified, physicians will be able to train and practice CMR according to current national regulations. This document has been prepared by the working group (WG) on CMR of the ESC. It aims to make proposals for a European standard for competency and excellence in CMR acquisition and reporting. This is to be achieved by providing recommendations for training of individuals wishing to perform and report CMR studies as well as for the accreditation of centres performing CMR studies and wishing to offer CMR training. The document has been written in concordance with the ESC processes on accreditation and certification. However, it is emphasized that European certification of CMR competency or institutional accreditation in CMR as outlined in this document are not compulsory or regulatory certificates. An individual's right to report and sign clinical studies and an institution's right to provide a CMR service in individual …
The alignment of agricultural and nature conservation policies in the European Union

Europe is a region of relatively high population density and productive agriculture subject to substantial government intervention under the Common Agricultural Policy (CAP). Many habitats and species of high conservation interest have been created by the maintenance of agricultural practices over long periods. These practices are often no longer profitable, and nature conservation initiatives require government support to cover the cost for them to be continued. The CAP has been reformed both to reduce production of agricultural commodities at costs in excess of world prices and to establish incentives for landholders to adopt voluntary conservation measures. A separate nature conservation policy has established an extensive series of protected sites (Natura 2000) that has, as yet, failed to halt the loss of biodiversity. Additional broader scale approaches have been advocated for conservation in the wider landscape matrix, including the alignment of agricultural and nature conservation policies, which remains a challenge. Possibilities for alignment include further shifting of funds from general support for farmers toward targeted payments for biodiversity goals at larger scales and adoption of an ecosystem approach. The European response to the competing demands for land resources may offer lessons globally as demands on rural land increase.
Controversies in cardiovascular medicine Renovascular hypertension : screening and modern management

The diagnosis and management of patients with renovascular disease and hypertension continue to elude healthcare providers. The advent of novel imaging and interventional techniques, and increased understanding of the pathways leading to irreversible renal injury and renovascular hypertension, have ushered in commendable attempts to optimize and finetune strategies to preserve or restore renal function and control blood pressure. Large randomized clinical trials that compare different forms of therapy, and smaller trials that test novel experimental treatments, will hopefully help formulate innovative concepts and tools to manage the patient population with atherosclerotic renovascular disease.
Percutaneous pulmonary valve implantation: two-centre experience with more than 100 patients.

AIMS Dysfunction of valved conduits in the right ventricular outflow tract (RVOT) limits durability and enforces repeated surgical interventions. We report on our combined two-centre experience with percutaneous pulmonary valve implantation (PPVI). METHODS AND RESULTS One hundred and two patients with RVOT dysfunction [median weight: 63 kg (54.2-75.9 kg), median age: 21.5 years (16.2-30.1 years), diagnoses: TOF/PA 61, TAC 14, TGA 9, other 10, AoS post-Ross-OP 8] were scheduled for PPVI since December 2006. Percutaneous pulmonary valve implantation was performed in all patients. Pre-stenting of the RVOT was done in 97 patients (95%). The median peak systolic RVOT gradient decreased from 37 mmHg (29-46 mmHg) to 14 mmHg (9-17 mmHg, P < 0.001) and the ratio RV pressure/AoP decreased from 62% (53-76%) to 36% (30-42%, P < 0.0001). The median end-diastolic RV-volume index (MRI) decreased from 106 mL/m(2) (93-133 mL/m(2)) to 90 mL/m(2) (71-108 mL/m(2), P = 0.001). Pulmonary regurgitation was significantly reduced in all patients. One patient died due to compression of the left coronary artery. The incidence of stent fractures was 5 of 102 (5%). During follow-up [median: 352 days (99-390 days)] one percutaneous valve had to be removed surgically 6 months after implantation due to bacterial endocarditis. In 8 of 102 patients, a repeated dilatation of the valve was done due to a significant residual systolic pressure gradient, which resulted in a valve-in-valve procedure in four. CONCLUSION This study shows that PPVI is feasible and it improves the haemodynamics in a selected patient collective. Apart from one coronary compression, the rate of complications at short-term follow-up was low. Percutaneous pulmonary valve implantation can be performed by experienced interventionalists with similar results as originally published. The intervention is technically challenging and longer clinical follow-up is needed.
Quantifying the relative irreplaceability of important bird and biodiversity areas

World governments have committed to increase the global protected areas coverage by 2020, but the effectiveness of this commitment for protecting biodiversity depends on where new protected areas are located. Threshold‐ and complementarity‐based approaches have been independently used to identify important sites for biodiversity. We brought together these approaches by performing a complementarity‐based analysis of irreplaceability in important bird and biodiversity areas (IBAs), which are sites identified using a threshold‐based approach. We determined whether irreplaceability values are higher inside than outside IBAs and whether any observed difference depends on known characteristics of the IBAs. We focused on 3 regions with comprehensive IBA inventories and bird distribution atlases: Australia, southern Africa, and Europe. Irreplaceability values were significantly higher inside than outside IBAs, although differences were much smaller in Europe than elsewhere. Higher irreplaceability values in IBAs were associated with the presence and number of restricted‐range species; number of criteria under which the site was identified; and mean geographic range size of the species for which the site was identified (trigger species). In addition, IBAs were characterized by higher irreplaceability values when using proportional species representation targets, rather than fixed targets. There were broadly comparable results when measuring irreplaceability for trigger species and when considering all bird species, which indicates a good surrogacy effect of the former. Recently, the International Union for Conservation of Nature has convened a consultation to consolidate global standards for the identification of key biodiversity areas (KBAs), building from existing approaches such as IBAs. Our results informed this consultation, and in particular a proposed irreplaceability criterion that will allow the new KBA standard to draw on the strengths of both threshold‐ and complementarity‐based approaches.
Non-evidence-based ICD implantations in the United States.

CONTEXT Practice guidelines do not recommend use of an implantable cardioverter-defibrillator (ICD) for primary prevention in patients recovering from a myocardial infarction or coronary artery bypass graft surgery and those with severe heart failure symptoms or a recent diagnosis of heart failure. OBJECTIVE To determine the number, characteristics, and in-hospital outcomes of patients who receive a non-evidence-based ICD and examine the distribution of these implants by site, physician specialty, and year of procedure. DESIGN, SETTING, AND PATIENTS Retrospective cohort study of cases submitted to the National Cardiovascular Data Registry-ICD Registry between January 1, 2006, and June 30, 2009. MAIN OUTCOME MEASURE In-hospital outcomes. RESULTS Of 111,707 patients, 25,145 received non-evidence-based ICD implants (22.5%). Patients who received a non-evidence-based ICD compared with those who received an evidence-based ICD had a significantly higher risk of in-hospital death (0.57% [95% confidence interval {CI}, 0.48%-0.66%] vs 0.18% [95% CI, 0.15%-0.20%]; P <.001) and any postprocedure complication (3.23% [95% CI, 3.01%-3.45%] vs 2.41% [95% CI, 2.31%-2.51%]; P <.001). There was substantial variation in non-evidence-based ICDs by site. The rate of non-evidence-based ICD implants was significantly lower for electrophysiologists (20.8%; 95% CI, 20.5%-21.1%) than nonelectrophysiologists (24.8% [95% CI, 24.2%-25.3%] for nonelectrophysiologist cardiologists; 36.1% [95% CI, 34.3%-38.0%] for thoracic surgeons; and 24.9% [95% CI, 23.8%-25.9%] for other specialties) (P<.001 for all comparisons). There was no clear decrease in the rate of non-evidence-based ICDs over time (24.5% [6908/28,233] in 2006, 21.8% [7395/33,965] in 2007, 22.0% [7245/32,960] in 2008, and 21.7% [3597/16,549] in 2009; P <.001 for trend from 2006-2009 and P = .94 for trend from 2007-2009). CONCLUSION Among patients with ICD implants in this registry, 22.5% did not meet evidence-based criteria for implantation.
A comparison of cat‐related risk perceptions and tolerance for outdoor cats in Florida and Hawaii

Risk perceptions and attitudes toward animals often explain tolerance for wildlife and management preferences. However, little is understood about how these relationships vary across different geographic regions and stakeholder groups. To address this gap in knowledge, we compared differences in acceptance capacity, risk perceptions, perceived enjoyment from outdoor cats, and experiences with outdoor cats among 3 groups (general public, conservation community, and animal‐welfare community) in Hawaii and Florida, two states with large conservation challenges. We combined independently collected data from Florida and Hawaii, to determine how perception of the risks presented by outdoor cats, group membership, and state of residence influenced people's tolerance for outdoor cats. Florida respondents were significantly more tolerant of outdoor cats and less concerned about cat‐related risks than Hawaii respondents (p < 0.05). In both states, animal‐welfare group members reported greater enjoyment seeing cats and perceived a smaller increase in the cat population and lower levels of risk than other groups (p < 0.05). All groups exhibited similar relationships between acceptance capacity and enjoyment and the perceived increase in the cat population. Our results suggest public tolerance for cats varied due to the influence of local or geographical concerns, but that strongly held beliefs, risk perceptions, and feelings about cats explained more of the variance in stakeholder tolerance.
Combining Medication and Psychosocial Treatments for Addictions: The BRENDA Approach

Recent studies have shown a combination of psychosocial support and medications to lead to better addiction treatment outcomes than talk therapy alone. This practical manual provides an empirically supported framework for managing biopsychosocial treatment of alcohol and drug dependence. Fully compatible with cognitive-behavioral and 12-step models, BRENDA is a collaborative, case-management approach to treatment. It incorporates the use of newly developed medications that target the biological underpinnings of addiction, and maximizes treatment compliance through working with patients in a nonjudgmental manner and enhancing their motivation to change. Illustrated with extended case examples, the book describes how to conduct a thorough assessment, make recommendations for a variety of individualized interventions, and coordinate service delivery with other providers as needed. The approach has been demonstrated effective in more than 80% of alcohol-dependent referrals to the authors' treatment program
Flash pulmonary oedema and bilateral renal artery stenosis: the Pickering syndrome.

In 1988 Pickering et al . reported in the Lancet a series of 11 hypertensive patients with bilateral atheromatous renovascular disease who presented with a history of multiple episodes of pulmonary oedema.1 Seven of these patients had stenosis of both renal arteries and in a subsequent series of 90 patients, pulmonary oedema was significantly more common in patients with bilateral than in those with unilateral renal artery stenosis (RAS). 2 Successful revascularization of one or both renal arteries eliminated pulmonary oedema in 77% of patients with bilateral RAS.2 The authors concluded that ‘bilateral RAS may be a specific and treatable predisposing factor to pulmonary oedema in azotemic hypertensive patients'. 1 Since the initial observation of this clinical entity 29 case reports,3–31 9 case series,1,32–39 and 10 clinical studies1–2,40–47 of flash pulmonary oedema (FPO) and RAS (both unilateral and bilateral) have been published of which 16 case reports, 2 case series, and 7 clinical studies comprising a total of 87 patients relate to bilateral RAS and FPO. The underlying pathophysiological mechanisms responsible for triggering FPO in patients with bilateral RAS have been delineated in several clinical and experimental studies. Since FPO and bilateral RAS seem to be a unique entity with distinct pathophysiological, clinical, and therapeutic features, we propose to name it Pickering Syndrome. In the following, we review incidence, pathophysiology, clinical findings, and treatment of the Pickering Syndrome. Flash pulmonary oedema is a general term used to describe a particularly dramatic form of acute decompensated heart failure. Regardless of its aetiology, an acute increase of left ventricular (LV) end diastolic pressure is the conditio sine qua non for the development of FPO and remains the common denominator of all clinical situations associated with …
The complex relationship between personal sense of connection to animals and self‐reported proenvironmental behaviors by zoo visitors

The global biodiversity crisis requires an engaged citizenry that provides collective support for public policies and recognizes the consequences of personal consumption decisions. Understanding the factors that affect personal engagement in proenvironmental behaviors is essential for the development of actionable conservation solutions. Zoos and aquariums may be some of the only places where many people can explore their relations with wild animals and proenvironmental behaviors. Using a moderated‐mediation analysis of a survey of U.S. zoo and aquarium visitors (n = 3588), we explored the relationship between the sense of connection to animals and self‐reported engagement in proenvironmental behaviors related to climate change and how this relationship is affected by certainty that climate change is happening, level of concern about climate change, and perceptions of effectiveness in personally addressing climate change. We found a significant, directional relationship between sense of connection to animals and self‐reported proenvironmental behaviors. Political inclination within the conservative to liberal spectrum did not affect the relationship. We conclude that a personal sense of connection to animals may provide a foundation for educational and communication strategies to enhance involvement in proenvironmental actions.
Contribution of γ glutamyl transpeptidase to oxidative damage of ischemic rat kidney

Contribution of γ glutamyl transpeptidase to oxidative damage of ischemic rat kidney. Background A variety of mechanisms have been considered in the pathogenesis of the cell damage occurring in the kidney that is undergoing transient ischemia. However, little information is available about the role of oxidative stress in building up the tissue injury in the hypoxic organ during short-term ischemia. Methods After a standard brief period (25 min) of unilateral kidney ischemia in rats, pretreated or not with acivicin (60 μmol/L/kg i.v.), tissue samples from both ischemic and not ischemic kidneys were obtained to measure malondialdehyde (MDA) and glutathione (GSH) content, γ glutamyl transpeptidase (GGT) activity by spectrophotometry, localization and intensity of enzyme activity, and tissue damage by histochemistry. Results GGT activity was found to be increased in both cortical and medullar zones of the ischemic kidneys, where the GSH level was only slightly decreased and the MDA level, in contrast, was markedly increased; in parallel, the cytosolic volume of the proximal tubular (PT) cells showed a significant increment. The animal pretreatment with acivicin, a specific inhibitor of GGT, besides preventing the up-regulation of the enzyme during ischemia, afforded good protection against the observed changes of MDA and GSH tissue levels, as well as of tubular cell volume. Conclusions Ex vivo data supporting a net pro-oxidant effect of up-regulated GGT during short-term ischemia of rat kidney have been obtained. The enzyme stimulation appears to contribute to the renal morphological damage exerted by a brief hypoxic condition at the level of PT cells. The actual impact on kidney function by GGT-dependent oxidative damage during transient ischemia and the potential protective action of GGT inhibitors require subsequent investigation.
Access to Care, Provider Choice and Racial Disparities

This paper explores whether choice of provider explains any of the observed infant health gradients, and if so, why poor women choose different providers than their richer neighbors. We exploit an exogenous change in policy that occurred in California in the early 1990s that suddenly increased Medicaid payments to hospitals and which lead to a sharp change in where women with Medicaid delivered. To characterize the extent to which poor women responded to the increase in provider access, we calculate hospital segregation indices (which measure the extent to which Medicaid mothers delivered in separate hospitals than privately insured mothers residing in the same geographic area) both before and after the policy change for each market in California and show that it fell sharply after the policy change. Even though black mothers responded least to the increase in provider choice afforded by the policy change, they benefited the most from hospital desegregation in terms of reduced neonatal mortality and decreased incidence of very low birth weight. In contrast, other groups with lower initial neonatal mortality moved more and gained less in terms of improvements in birth outcomes.