Miracle-dz/UniFAR-FTUs huggingface dataset:
Relationships between evidence-based practice, quality improvement and clinical error experience of nurses in Korean hospitals.

AIM This study investigated individual and work-related factors associated with nurses' perceptions of evidence-based practice (EBP) and quality improvement (QI), and the relationships between evidence-based practice, quality improvement and clinical errors. BACKGROUND Understanding the factors affecting evidence-based practice and quality improvement activities and their relationships with clinical errors is important for designing strategies to promote evidence-based practice, quality improvement and patient safety. METHOD A cross-sectional survey was conducted with 594 nurses in two Korean teaching hospitals using the evidence-based practice Questionnaire and quality improvement scale developed in this study. RESULT Four hundred and forty-three nurses (74.6%) returned the completed survey. Nurses' ages and educational levels were significantly associated with evidence-based practice scores whereas age and job position were associated with quality improvement scores. There were positive, moderate correlations between evidence-based practice and quality improvement scores. Nurses who had not made any clinical errors during the past 12 months had significantly higher quality improvement skills scores than those who had. CONCLUSION The findings indicated the necessity of educational support regarding evidence-based practice and quality improvement for younger staff nurses who have no master degrees. Enhancing quality improvement skills may reduce clinical errors. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers should consider the characteristics of their staff when implementing educational and clinical strategies for evidence-based practice and quality improvement.
Kinetics of Homeostatic Proliferation and Thymopoiesis after rATG Induction Therapy in Kidney Transplant Patients

Background Lymphocyte-depleting therapy is associated with long-lasting effects on repopulated T cells and subsequent increased rates of infections and malignancies. The mechanisms of T-cell repopulation and their posttransplantation kinetics are not fully understood. Methods We studied thymopoiesis by CD31+ naïve T cells (recent thymic emigrants) and homeostatic proliferation by Ki-67+ T cells in rabbit antithymocyte globulin (rATG)–treated patients the first 6 months after transplantation. Patients receiving basiliximab or no induction therapy served as controls. Results At 6 months after transplantation, T-cell numbers were lower than before transplantation in rATG-treated patients, whereas T-cell numbers remained stable in both control groups. In this time period, thymopoiesis was similar between the three treatment groups; CD8+ T cells showed the highest percentage of recent thymic emigrants. At month 1, percentages of Ki-67+ naïve and memory CD4+ and CD8+ T cells were the highest in rATG-treated patients, but these percentages declined in the months thereafter. When CD31 was used to distinguish between cytokine- and antigen-driven proliferation in naïve T cells, we found evidence for cytokine-dependent proliferation. Cytokine-dependent proliferation was also shown by in vivo increased percentages of phosphorylated STAT5 and high expression levels of the interleukin-7 receptor-&agr; and interleukin-15 receptor-&agr; by T cells. Conclusion These findings demonstrate that, in the first month after rATG therapy, cytokine-induced homeostatic proliferation is involved in T-cell repopulation of both naïve and memory T cells. At later time points, the contribution of homeostatic proliferation diminished, which explains the observed incomplete T-cell recovery.
Reliable detection of Human papillomavirus in recurrent laryngeal papillomatosis and associated carcinoma of archival tissue

Recurrent laryngeal papillomatosis (RLP) is, although benign, a challenging disease for both, the patient and the treating physician. Maximum disease control with minimum intervention is considered to be the gold standard. However, patients have to undergo repeating surgical interventions. Human papillomavirus (HPV), mainly so called low risk types, are thought to be responsible for the development of RLP. But, there is still some controversy over the true prevalence of HPV and the virus‐specific molecular diagnostic of choice. Therefore archival tissue samples from 44 patients with RLP at laryngeal site, out of which eight developed laryngeal cancer, was screened for presence of HPV through various molecular approaches. Results from these different methodologies were compared between each other and with patient's characteristics. The overall detection rates of HPV with the various methods used in this study were: HPV16 E6/E7 PCR: 0%; GP5+/6+ PCR: 4.5%; CDKN2A/p16 immunohistochemistry: 6.8%; in‐situ hybridization for low and high risk HPV types: 52.3%; HPV6/11 L1 PCR: 72.7% and HPV6/11 E6 PCR: 79.5%. Disease progression showed no apparent dependence of the detected HPV type or clinical variables like age at diagnosis, sex, or additional drug application (Cidofovir and Bevacizumab). In conclusion, the broad‐spectrum PCRs alone or in combination with immunohistochemistry of CDKN2A/p16 and in‐situ hybridization are unsuitable for HPV detection in RLP. Based on the findings presented in this study the type specific PCRs targeting the E6 open reading frame are clearly superior in detection of HPV in this tumor entity. J. Med. Virol. 87:860–870, 2015. © 2015 Wiley Periodicals, Inc.
Early career experiences and perceptions - a qualitative exploration of the turnover of young registered nurses and intention to leave the nursing profession in Finland.

AIM To describe why young registered nurses (RNs) had previously left an organisation and why they intend to leave the profession. BACKGROUND Currently, many young registered nurses, including those in Finland, are considering leaving their job or have an intention to leave the profession. DESIGN An in-depth, descriptive approach was adopted. METHOD Data were collected in 2012 from interviews with 15 registered nurses (under the age of 30 years). The interviews were semi-structured and analysed using conventional content analysis. The main questions addressed were: 'Why had the young registered nurses left their previous organisation? ' and 'Why do young registered nurses have an intention to leave the profession? ' RESULTS The findings centre on three themes: poor nursing practice environments; lack of support, orientation and mentoring, and nursing as a 'second best' or serendipitous career choice. CONCLUSIONS The first years of nursing are particularly stressful for newly-graduated and inexperienced registered nurses. An in-depth, qualitative approach reveals more complex reasons behind the turnover of registered nurses and intention to leave the profession than questionnaire surveys. IMPLICATIONS FOR NURSING MANAGEMENT Young registered nurses need social support from nurse managers and experienced colleagues to successfully transition into nursing practice environments. Adequate orientation and mentoring programmes are needed to facilitate this transition.
Immunodiagnostic Tests’ Predictive Values for Progression to Tuberculosis in Transplant Recipients: A Prospective Cohort Study

Background Little is known about the predictive value for progression to tuberculosis (TB) of interferon-&ggr; release assays and how they compare with the tuberculin skin test (TST) in assessing the risk of TB infection in transplant recipients. Methods We screened 50 liver transplant (LT) and 26 hematopoietic stem cell transplant (HSCT) recipients with both QuantiFERON-TB Gold In-tube (QFT-GT) and TST and prospectively followed them for a median of 47 months without preventive chemoprophylaxis. Results In the LT cohort, 1 in 22 (4.5%) QFT-GT–positive patients developed posttransplant TB, compared with none of the QFT-GT–negative patients. In the HSCT cohort, none of the 7 QFT-GT–positive patients developed TB, whereas 1 case (5.3%) progressed to active TB among the 19 QFT-GT-negative patients. Comparable results were obtained with the TST: in the LT group, 1 of 23 TST-positive and none of the 27 TST-negative patients developed TB; and in the HSCT group, none of the 8 TST-positive and one of the 18 TST-negative patients progressed to active TB. Conclusions In this cohort of transplant recipients, the positive predictive value of QFT-GT for progression to active TB was low and comparable to that of TST. Although the risk of developing TB in patients with negative results at baseline is very low, some cases may still occur.
Lack of an association between apolipoprotein E ϵ4 and Alzheimer's disease in elderly nigerians

As part of a community‐based study of Alzheimer's Disease (AD) in a Nigerian population aged 65 years and over, we have determined apolipoprotein E (APOE) genotypes on 56 subjects (39 controls and 17 subjects with dementia, including 12 with AD). The ϵ4 allele of APOE was not associated with AD or dementia in this community‐based sample. The ϵ4 allele frequency was 17.6% in demented patients and 16.7% in AD patients compared with 20.5% in the control subjects. These findings are in marked contrast to the strong association between the ϵ4 allele and AD in our previously reported study with African Americans.
Conscientiousness, openness to experience and extraversion as predictors of nursing work performance: a facet-level analysis.

AIM This study examined the relationships between the personality traits of conscientiousness, openness and extraversion at trait and facet-levels and three indicators of work role performance; proficiency, 'adaptivity' and proactivity measured at individual, team and organisational levels. BACKGROUND This is one of the first studies to explore the relationship between personality, measured at trait and facet-level and performance using a comprehensive range of performance indicators. METHOD An online survey of 393 nurses from health-care organisations across Australia was conducted to test hypothesised relationships. RESULTS Path analyses revealed numerous relationships between personality, measured at both trait and facet-levels, and work role performance. Conscientiousness was highlighted as the strongest driver of work role performance across all the indicators, with extraversion also strongly associated with work role performance. Openness to experience, previously considered a week predictor of performance, was, when examined at the facet-level, related to all of the work role performance indicators. CONCLUSIONS Results suggests a bandwidth effect, where the personality traits drive global performance while the facets drive specific performance. IMPLICATIONS FOR NURSING MANAGEMENT Better understanding of the relationship between personality and work role performance will help nurse managers to foster the fit between individual and organisation, improving job satisfaction, engagement, retention and performance in role.
Tolerance to the Nonbronchodilator Effects of Inhaled β2-Agonists in Asthma

Abstract Background. Tolerance to the direct bronchodilator effects of β2-agonists does not appear to occur in asthma. However, it is not known whether this is true for the nonbronchodilator effects of these agents, which protect the airways against bronchoconstrictive stimuli. Methods. We investigated whether tolerance develops to the protective effect of inhaled terbutaline on airway responsiveness to the bronchoconstrictors methacholine (which acts directly on airway smooth muscle) and AMP (which acts indirectly by stimulating the release of mediators from mast cells) during sustained treatment with terbutaline. In a randomized, double-blind, crossover study, 12 patients with mild asthma each inhaled a single dose of terbutaline (500 μg) or placebo before a challenge with a series of doubling doses of inhaled methacholine or AMP, before and after treatment for seven days with 500 μg of terbutaline four times daily or placebo. Results. Before the seven days of treatment with terbutaline, a single dose o.
Applying the 2003 Beers update to Medicaid/Medicare enrollees

Purpose – The purpose of this paper is to examine rates of potentially inappropriate prescribing in a population dually eligible for Medicare and Medicaid using the new 2003 Fick update, which revises the previous 1997 Beers list.Design/methodology/approach – Cross sectional retrospective review of 2003 Centers for Medicare and Medicaid Service (CMS) Medicaid Pharmacy claims data. Claims data submitted for outpatient and nursing home residents for elderly enrollees dually eligible for Medicare and Medicaid were analyzed. Potentially inappropriate drug use was assessed using the 2003 Fick update to the previous 1997 Beers list. Inappropriate use was identified based on these criteria for drugs independent of diagnosis.Findings – Of enrollees with drug use, 34 percent received an inappropriate drug per the 1997 Beers list; 47 percent per the 2003 Fick update. Hispanics had the highest percentage of drug recipients receiving an inappropriate drug in the Northeast region per the 2003 Fick update. Within thera.
Seroprevalence of hepatitis E in HIV infected patients in Greece

HEV infection is an emerging public health problem worldwide Data concerning HEV infection in HIV+ patients in Greece is scare. The aim of the study was to determine HEV seroprevalence in patients with HIV infection in Greece. We studied 243 HIV(+) patients 214 men (88%) and 29 women (12%) with a median age of 45 years (range 19–83) who attended the HIV unit of Pathophysiology Department of Laikon General Hospital in Athens for the presence of anti‐HEV IgG antibodies with (EIA) (EIA HEV IgG, Adaltis, Rome, Italy Eighteen/243 patients (7.3%) were positive for HEV IgG antibodies, a seroprevalence that was not different from that described for the blood donors group from Greece There was no difference of the presence of HbsAg, hepatitis C and hepatitis A between the HEV(+) and HEV(−) patients. There was no statistically significant difference between the HEV(+) and HEV(−) group in terms of HIV acquisition, sexual orientation, median duration of HIV infection, ART treatment, or duration of ART. Only the median age of HEV(+) was 52years (35–78) while that of HEV(−) was 44years (19–83)(P = 0.03). Only 2/18(11.1%) HEV(+) HIV(+) patients had abnormal ALT and AST values. The seroprevalence of hepatitis E in HIV(+) patients in Greece seems to be the same with that of the general population thus implying that HIV infection is not a risk factor for HEV infection and only age shows a positive correlation with seropositivity. J. Med. Virol. 87:1517–1520, 2015. © 2015 Wiley Periodicals, Inc.
Vitamin D‐related gene polymorphisms do not influence the outcome and serum vitamin D level in pegylated interferon/ribavirin therapy combined with protease inhibitor for patients with genotype 1b chronic hepatitis C

Although several vitamin D‐related gene polymorphisms were reported to affect the outcome of pegylated interferon/ribavirin (PR) therapy in chronic hepatitis C patients, there are no reports on the impact of the vitamin D‐related gene polymorphisms in PR therapy combined with protease inhibitor (PI). Vitamin D‐related gene polymorphisms were determined in 177 genotype 1b‐infected chronic hepatitis C patients who received 12 weeks of PR therapy with telaprevir, a first‐generation PI, followed by 12 weeks of PR therapy. The sustained virologic response (SVR) rate was 83.1% (147 of 177 patients). The frequencies of vitamin D‐related gene polymorphisms were: 83 non‐TT and 94 TT genotypes for GC, 97 non‐AA and 80 AA genotypes for DHCR7, 151 non‐AA and 26 AA genotypes for CYP2R1, 162 non‐GG and 15 GG genotypes for CYP27B1, and 105 non‐GG and 72 GG genotypes for VDR gene. Multivariate analysis extracted IL28B TT genotype (P = 2.05×10−6) and serum 25(OH) D3 level (P = 0.024) as independent factors contributing to the achieving of SVR. The SVR rate in IL28B TT genotype patients with serum 25(OH) D3 level of <25 ng/ml was significantly low compared to other patients. None of the vitamin D‐related gene polymorphisms affected the treatment outcome and serum 25(OH) D3 level. In conclusions, the IL28B polymorphism and serum 25(OH) D3 level contributed significantly and independently to SVR in PR combined with PI for genotype 1b‐infected chronic hepatitis C patients. However, none of vitamin D‐related gene polymorphisms had an impact on the treatment outcome and serum 25(OH) D3 level. J. Med. Virol. 87:1904–1912, 2015. © 2015 Wiley Periodicals, Inc.
pH and blood—gas analysis

During the past ten years there have been considerable advances in the design of apparatus used for pH and blood gas-measurements. Many hospitals have been equipped with suitable instruments and the value of these measurements in clinical practice has become widely recognised. Unfortunately all such instruments are subject to error. The errors vary widely in magnitude; some are obvious, others difficult to detect. During the past eight years one of the authors (MKS) has noted errors of up to 0.3 units in pH, 15mm Hg in Pc02 and 20mm Hg in Po2 during the use of electrode systems which were apparently functioning perfectly when checked with buffer solutions or reference gases. Such gross errors, if unsuspected, may lead to serious mistakes in diagnosis and treatment. In this article the authors discuss thr. main sources of these errors and indicate methods by which they may be prevented, detected and eliminated. These errors are discussed under the headings of blood sampling and storage and analytical errors.
Genetic Comparison of Symptomatic and Asymptomatic Persons With Alzheimer Disease Neuropathology

Objective: The objective was to determine whether symptomatic and asymptomatic persons with Alzheimer disease (AD) neuropathology have different allele counts for single-nucleotide polymorphisms that have been associated with clinical late-onset AD. Methods: Data came from the National Alzheimer’s Coordinating Center Uniform Data Set and Neuropathology Data Set, and the Alzheimer’s Disease Genetics Consortium (ADGC). Participants had low to high AD neuropathologic change. The 22 known/suspected genes associated with late-onset AD were considered. “Symptomatic” was defined as Clinical Dementia Rating global score >0. Results: Sixty-eight asymptomatic and 521 symptomatic participants met inclusion criteria. Single-nucleotide polymorphisms associated with ABCA7 [odds ratio (OR)=1.66; 95% confidence interval (CI), 1.03-2.85] and MAPT (OR=2.18; CI, 1.26-3.77) were associated with symptomatic status. In stratified analyses, loci containing CD2AP (OR=0.35; 95% CI, 0.16-0.74), ZCWPW1 (OR=2.98; 95% CI, 1.34-6.86), and MAPT (OR=3.73, 95% CI, 1.30-11.76) were associated with symptomatic status in APOE e4 carriers. Conclusions: These findings potentially explain some of the variation in whether a person with AD neuropathology expresses symptoms. Understanding why some people remain cognitively normal despite having AD neuropathology could identify pathways to disease heterogeneity and guide treatment trials.
Change in Health-related Quality of Life After Referral to Memory Assessment Services

Despite strong support for the provision of memory assessment services (MASs) in England and other countries, their effectiveness in improving patient outcomes is uncertain. We aimed to describe change in patients’ health-related quality of life (HRQL) 6 months after referral to MASs and to examine associations with patient characteristics and use of postdiagnostic interventions. Data from 883 patients referred to 69 MASs and their informal caregivers (n=569) were collected at referral and 6 months later. Multivariable linear regression was used to examine associations of change in HRQL (DEMQOL, DEMQOL-Proxy) with patient characteristics (age, sex, ethnicity, socioeconomic deprivation, and comorbidity) and use of postdiagnostic interventions (antidementia medications and nonpharmacological therapies). Mean HRQL improved, irrespective of diagnosis: self-reported HRQL increased 3.4 points (95% CI, 2.7-4.1) and proxy-reported HRQL 1.3 points (95% CI, 0.5-2.1). HRQL change was not associated with any of the patient characteristics studied. Patients with dementia (54%) receiving antidementia drugs reported greater improvement in their HRQL but those using nonpharmacological therapies reported less improvement compared with those note receiving therapy. HRQL improved in the first 6 months after referral to MASs. Research is needed to determine longer term sustainability of the benefits and the cost-effectiveness of MASs.
The Nature and Natural History of Posterior Cortical Atrophy Syndrome: A Variant of Early-onset Alzheimer Disease

A prospective longitudinal evaluation of 12 patients over a 16-year interval using clinical neurological and imaging data to determine whether posterior cortical atrophy syndrome (PCA) related to early-onset Alzheimer disease (AD) and to examine its natural history. Our 12 patients had a median age of onset of 56 years (range, 48 to 63 y) and were followed for a median of 6 years (range, 3 to 9 y). Patients either presented with complex visual phenomena or developed them with time. Six patients underwent flurodeoxyglucose and Pittsburgh investigational compound B imaging which showed a mismatch between metabolic activity and amyloid deposition with reduced metabolism in parieto-occipital regions on flurodeoxyglucose positron emission tomography and diffuse neocortical uptake of amyloid without occipital predominance. All patients progressively deteriorated using a quality of life and total functional capacity assessments and this change is similar to the natural history of other early-onset AD variants (typical amnestic presentation, logopenic, and frontal). Two patients had neuropathologic assessments and were shown to have AD using standard pathologic criteria. Of interest, 5 of our 12 patients had occupations strongly dependent on visuospatial functioning. PCA is a syndrome that is most likely a variant of early-onset AD and our correlative clinical, structural, functional, and amyloid imaging data, along with neuropathologic studies in 2 patients, support this concept. The natural history of PCA shows progression with time and this trajectory seems to reflect that of other variants of early-onset AD.
Comparison of genotypic and virtual phenotypic drug resistance interpretations with laboratory‐based phenotypes among CRF01_AE and subtype B HIV‐infected individuals

HIV drug resistance assessments and interpretations can be obtained from genotyping (GT), virtual phenotyping (VP) and laboratory‐based phenotyping (PT). We compared resistance calls obtained from GT and VP with those from PT (GT‐PT and VP‐PT) among CRF01_AE and subtype B HIV‐1 infected patients. GT predictions were obtained from the Stanford HIV database. VP and PT were obtained from Janssen Diagnostics BVBA's vircoTypeTM HIV‐1 and Antivirogram®, respectively. With PT assumed as the “gold standard,” the area under the curve (AUC) and the Bland–Altman plot were used to assess the level of agreement in resistance interpretations. A total of 80 CRF01_AE samples from Asia and 100 subtype B from Janssen Diagnostics BVBA's database were analysed. CRF01_AE showed discordances ranging from 3 to 27 samples for GT‐PT and 1 to 20 samples for VP‐PT. The GT‐PT and VP‐PT AUCs were 0.76–0.97 and 0.81–0.99, respectively. Subtype B showed 3–61 discordances for GT‐PT and 2–75 discordances for VP‐PT. The AUCs ranged from 0.55 to 0.95 for GT‐PT and 0.55 to 0.97 for VP‐PT. Didanosine had the highest proportion of discordances and/or AUC in all comparisons. The patient with the largest didanosine FC difference in each subtype harboured Q151M mutation. Overall, GT and VP predictions for CRF01_AE performed significantly better than subtype B for three NRTIs. Although discrepancies exist, GT and VP resistance interpretations in HIV‐1 CRF01_AE strains were highly robust in comparison with the gold‐standard PT. J. Med. Virol. 88:234–243, 2016. © 2015 Wiley Periodicals, Inc.