Miracle-dz/UniFAR-FTUs huggingface dataset:
Nurses' Perceptions of Barriers and Facilitators Affecting the Shaken Baby Syndrome Education Initiative: An Exploratory Study of a Massachusetts Public Policy

The objective of this study was to assess nurses' perceptions of barriers to and facilitators of implementation of the shaken baby syndrome (SBS)/abusive head trauma (AHT) public policy. A legislative Act providing for the prevention of SBS/AHT was passed in Massachusetts in November 2006. A stipulation of this Act was the provision of a program to educate parents/guardians of newborns about SBS/AHT prevention. A quantitative, cross-sectional research design with a qualitative component was used for this study. Nurses in 13 Massachusetts birthing hospitals were surveyed using a Web-based questionnaire (hosted by Qualtrics, Provo, Utah). Hospital nurses' responses (N = ∼ 922; 155 responded) revealed barriers to and facilitators of SBS/AHT guideline implementation. The disadvantage of Web-based surveys as they relate to the challenges of enlisting cooperation and a lack of direct access to the nurses may have attributed to the low response rate (17%) for this study. The outcomes of logistic regression analyses and themes from the qualitative analysis revealed a lack of SBS/AHT brochures and an inability to provide SBS/AHT education for non-English-speaking parents/guardians as barriers to SBS/AHT education. An atmosphere of supportive leadership facilitated implementation of the SBS/AHT education guidelines by nurses. It is imperative that nurse leadership support be sustained so that nurses have SBS/AHT education resources, an understanding of the SBS/AHT education guidelines, and feedback about the impact of their SBS/AHT education interventions.
The Effects of Perceived Racial/Ethnic Discrimination on Substance Use Among Youths Living in the Cherokee Nation

ABSTRACT We examined frequency and intensity of racial/ethnic discrimination and the longitudinal relationship to substance use. The sample included (N = 1,421) American Indian, American Indian and White, and White adolescents. A high frequency of perceived racial discrimination was associated with an increased risk for heavy alcohol use, prescription drug misuse, and other illicit drug use. Experiences of perceived racial discrimination high in intensity were associated with further increased risk of prescription drug misuse and other illicit drug use. Race/ethnicity did not moderate the relationship between perceived racial discrimination and substance use. Interventions targeting the deleterious effects of racial discrimination may need to be designed to account for both the environment and the individual.
Neurodevelopmental follow-up results in very low birth weight premature infants and influential factors.

Objective: To investigate the frequency of long-term neurodevelopmental disorders and evaluate risk factors it was aimed for growth, and developmental retardation in very low birth weight infants who were discharged from Neonatal Intensive Care Unit. Methods: Sixty-one preterm infants with birth weights under 1500 grams hospitalized in Neonatal intensive Care Units at Izmir Tepecik Teaching and Research Hospital between January and December 2007 were retrospectively evaluated. Demographical features, complications encountered during hospitalization and clinical risk factors affecting growth retardation were recorded. Infants were examined for growth and neurological development corrected for 18 and 24 months of age and Denver Developmental Screening Test was used for determining neurological development. Results: The main findings were as follows: 45.9% of the cases was male, the mean gestational age was 29 ± 2.1 weeks and mean birth weight was 1205 ± 214 grams. Risk factors that influenced the neurodevelopmental prognosis were respiratory distress syndrome (80.3%), clinical sepsis (50.8%), monitorization with mechanical ventilation (39.3%) and need for surfactant (37.7%). Denver Developmental Screening test found smaller head circumference and height of infants with growth retardation at 18. , and 24. months of age relative to their peers with normal neurodevelopmental status.The rates of clinical sepsis, surfactant administration, mechanical ventilation, bronchopulmonary dysplasia and intraventricular hemorrhage were statistically significant height in very low birth weight infants with abnormal neurodevelopment corrected for 24 months of age (p<0,05). These infants also showed growth retardation both at 18 and 24 months of age (p<0,05). Conclusion: Clinical sepsis, surfactant need, monitorization with mechanical ventilation, bronchopulmonary dysplasia and severe intraventricular hemorrhage are risk factors that influence neurodevelopmental prognosis in very low birth weight preterm infants.
Markers and function of human NK cells in normal and pathological conditions

Natural killer (NK) cells, the most important effectors of the innate lymphoid cells (ILCs), play a fundamental role in tumor immune‐surveillance, defense against viruses and, in general, in innate immune responses. NK cell activation is mediated by several activating receptors and co‐receptors able to recognize ligands on virus‐infected or tumor cells. To prevent healthy cells from auto‐aggression, NK cells are provided with strong inhibitory receptors (KIRs and NKG2A) which recognize HLA class I molecules on target cells and, sensing their level of expression, allow killing of targets underexpressing HLA‐class I. In vivo, NK cell‐mediated anti‐tumor function may be suppressed by tumor or tumor‐associated cells via inhibitory soluble factors/cytokines or the engagement of the so called immune‐check point molecules (e.g., PD1‐PDL1). The study of these immune check‐points is now offering new important opportunities for the therapy of cancer. In haemopoietic stem cell transplantation, alloreactive NK cells (i.e., those that express KIRs, which do not recognize HLA class I molecules on patient cells), derived from HSC of haploidentical donors, are able to kill leukemia blasts and patient's DC, thus preventing both tumor relapses and graft‐versus‐host disease. A clear correlation exists between size of the alloreactive NK cell population and clinical outcome. Thus, in view of the recent major advances in cancer therapy based on immuno‐mediated mechanisms, the phenotypic analysis of cells and molecules involved in these mechanisms plays an increasingly major role. © 2017 International Clinical Cytometry Society
Medication Alert Fatigue: The Potential for Compromised Patient Safety

Isaac et al conducted a ret-rospective of 3,570,378 prescrip-tions written by 2,872 prescribersin 3 states over 9 months in 2006.All the prescribers used an electron-ic prescribing software programmade by the same vendor. Thesoftware generated 233,537 med-ication safety alerts during thisperiod related to 6.6% of allattempted electronic prescriptions.The prescribers overrode 90.8% ofthe drug interaction alerts and 77%of the drug allergy alerts. The ac -ceptance rates of drug interactionalerts varied a little based on thelevel of severity; the acceptance ratefor high-severity alerts was 10.4%,whereas the acceptance rates formoderate-severity (7.3%) and low-severity (7.1%) alerts were slightlylower.A smaller study conducted in2007 over 1 month found that am -bulatory prescribers overrode al -lergy alerts 97% of the time.
Affective Imagery and Acceptance of Replacing Nuclear Power Plants

This study examined the relationship between the content of spontaneous associations with nuclear power plants and the acceptance of using new‐generation nuclear power plants to replace old ones. The study also considered gender as a variable. A representative sample of the German‐ and French‐speaking population of Switzerland (N= 1,221) was used. Log‐linear models revealed significant two‐way interactions between the association content and acceptance, association content and gender, and gender and acceptance. Correspondence analysis revealed that participants who were opposed to nuclear power plants mainly associated nuclear power plants with risk, negative feelings, accidents, radioactivity, waste disposal, military use, and negative consequences for health and environment; whereas participants favoring nuclear power plants mainly associated them with energy, appearance descriptions of nuclear power plants, and necessity. Thus, individuals opposing nuclear power plants had both more concrete and more diverse associations with them than people who were in favor of nuclear power plants. In addition, participants who were undecided often mentioned similar associations to those participants who were in favor. Males more often expressed associations with energy, waste disposal, and negative health effects. Females more often made associations with appearance descriptions, negative feelings, and negative environmental effects. The results further suggest that acceptance of replacing nuclear power plants was higher in the German‐speaking part of the country, where all of the Swiss nuclear power plants are physically located. Practical implications for risk communication are discussed.
Changes in Tonsil B Cell Phenotypes and EBV Receptor Expression in Children Under 5‐Years‐Old

Palatine tonsils are principally B cell organs that are the initial line of defense against many oral pathogens, as well as the site of infection for others. While the size of palatine tonsils changes greatly in the first five years of life, the cellular changes during this period are not well studied. Epstein Barr virus (EBV) is a common orally transmitted virus that infects tonsillar B cells. Naïve B cells are thought to be the target of primary infection with EBV in vivo, suggesting that they are targeted by the virus. EBV enters B cells through CD21, but studies of older children and adults have not shown differences in surface CD21 between naïve B cells and other tonsil B cell populations.
Facial emotion recognition and alexithymia in adults with somatoform disorders

Objective: The primary aim of this study was to investigate facial emotion recognition in patients with somatoform disorders (SFD). Also of interest was the extent to which concurrent alexithymia contributed to any changes in emotion recognition accuracy. Methods: Twenty patients with SFD and twenty healthy, age, sex and education matched, controls were assessed with the Facially Expressed Emotion Labelling Test of facial emotion recognition and the 26‐item Toronto Alexithymia Scale (TAS‐26). Results: Patients with SFD exhibited elevated alexithymia symptoms relative to healthy controls. Patients with SFD also recognized significantly fewer emotional expressions than did the healthy controls. However, the group difference in emotion recognition accuracy became nonsignificant once the influence of alexithymia was controlled for statistically. Conclusions: This suggests that the deficit in facial emotion recognition observed in the patients with SFD was most likely a consequence of concurrent alexithymia. Impaired facial emotion recognition observed in the patients with SFD could plausibly have a negative influence on these individuals' social functioning. Depression and Anxiety, 2009. © 2008 Wiley‐Liss, Inc.
Biomarkers and Receptor Targeted Therapies Reduce Clinical Trial Risk in Non–Small-Cell Lung Cancer

Introduction: This study analyzed the risk of clinical trial failure during non–small-cell lung cancer (NSCLC) drug development between 1998 and January 2012. We also looked for factors that impacted clinical trial risk in NSCLC. Methods: NSCLC drug development was investigated using trial disclosures from http://www.clinicaltrials. gov and other publically available resources. Compounds were excluded from the analysis if they had begun phase I clinical testing before 1998, did not use treatment-relevant endpoints, or if they did not have a completed phase I trial in NSCLC. Analysis was conducted in regard to treatment indication, compound classification, and mechanism of action. Results: Six hundred seventy-six clinical trials that included 199 unique compounds met our inclusion criteria. The likelihood, or cumulative clinical trial success rate, that a new drug would pass all phases of clinical testing and be approved was found to be 11%, which is less than industry aggregate rates. Over half of the biomarkers used in NSCLC have not yet been approved by the Food and Drug Administration in any indication. Biomarker targeted therapies (62%) and receptor targeted therapies (31%) were found to have the highest success rates. The risk-adjusted cost for NSCLC clinical drug development was calculated to be U.S. $1.89 billion. Conclusion: Biomarker use alone in this indication resulted in a sixfold increase in clinical trial success whereas receptor targeted therapies did so by almost threefold. Physicians who enroll patients in NSCLC trials should prioritize their participation in clinical trial programs that use biomarkers and receptor targeted therapies.
Computer‐assisted delivery of cognitive behavioral therapy for anxiety disorders in primary‐care settings

Objectives: This article describes a computer‐assisted cognitive behavioral therapy (CBT) program designed to support the delivery of evidenced‐based CBT for the four most commonly occurring anxiety disorders (panic disorder, posttraumatic stress disorder, generalized anxiety disorder, and social anxiety disorder) in primary‐care settings. The purpose of the current report is to (1) present the structure and format of the computer‐assisted CBT program, and (2) to present evidence for acceptance of the program by clinicians and the effectiveness of the program for patients. Methods: Thirteen clinicians using the computer‐assisted CBT program with patients in our ongoing Coordinated Anxiety Learning and Management study provided Likert‐scale ratings and open‐ended responses about the program. Rating scale data from 261 patients who completed at least one CBT session were also collected Results: Overall, the program was highly rated and modally described as very helpful. Results indicate that the patients fully participated (i.e., attendance and homework compliance), understood the program material, and acquired CBT skills. In addition, significant and substantial improvements occurred to the same degree in randomly audited subsets of each of the four primary anxiety disorders (N=74), in terms of self ratings of anxiety, depression, and expectations for improvement. Conclusions: Computer‐assisted CBT programs provide a practice‐based system for disseminating evidence‐based mental health treatment in primary‐care settings while maintaining treatment fidelity, even in the hands of novice clinicians. Depression and Anxiety, 2009. Published 2009 Wiley‐Liss, Inc.
Epidermal Growth Factor Receptor Mutations in 510 Finnish Non–Small-Cell Lung Cancer Patients

Introduction: Among the driver gene mutations in non–small-cell lung cancer, mutations in epidermal growth factor receptor (EGFR) are the most important because of their predictive role in selecting patients eligible for targeted therapy. Our aim was to study EGFR mutations in a Finnish non–small-cell lung cancer cohort of 528 patients. Methods: Mutation testing was conducted on DNA extracted from paraffin-embedded, formalin-fixed tumor material using the following real-time polymerase chain reaction-based kits: Therascreen EGFR PCR Kit and cobas EGFR Mutation Test. Results: EGFR mutation frequency was 11.4% and all positive cases were adenocarcinomas, of which a majority had an acinar predominant pattern. Mutations were seen significantly more often in females and never-smokers than in males and smokers. The most frequent mutations were L858R in exon 21 and deletions in exon 19. Overall survival of the patients, not treated with EGFR inhibitor, did not differ between EGFR mutation-positive and EGFR mutation-negative patients. Conclusion: EGFR mutation profile in this Finnish non–small-cell lung cancer cohort resembles in many respect with that of other Western European cohorts, even though the overall frequency of mutations is slightly higher. We show the occurrence of EGFR mutations in patients with occupational asbestos exposure and also in those diagnosed with chronic obstructive pulmonary disease who have not been often investigated before.
National Patterns of Care and Outcomes After Combined Modality Therapy for Stage IIIA Non–Small-Cell Lung Cancer

Introduction: The role of surgery in addition to chemotherapy and radiation for stage IIIA non–small-cell lung cancer (NSCLC) remains controversial. Because there are limited data on the benefit from surgery in this setting, we evaluated the use of combined modality therapy nationally and explored the outcomes with and without the addition of surgery. Methods: Patient variables and treatment-related outcomes were abstracted for patients with clinical stage IIIA NSCLC from the National Cancer Database. Patients receiving chemotherapy and radiation were compared with those undergoing chemotherapy, radiation, and surgery (CRS) in any sequence. Results: Between 1998 and 2010, 61,339 patients underwent combined modality treatment for clinical stage IIIA NSCLC. Of these, 51,979 (84.7%) received chemotherapy and radiation while 9360 (15.3%) underwent CRS. Patients in the CRS group were younger, more likely female patients and Caucasians, and had smaller tumors and lower Charlson comorbidity scores. The 30-day surgical mortality was 200 of 8993 (2.2%). The median overall survival favored the CRS group in both unmatched (32.4 months versus 15.7 months, p < 0.001) and matched analysis based on patient characteristics (34.3 versus 18.4 months, p < 0.001). Conclusions: There is significant heterogeneity in the treatment of stage IIIA NSCLC in the United States. Patients selected for surgery in addition to chemoradiation therapy seem to have better long-term survival.
Supplementary Prognostic Variables for Pleural Mesothelioma

Introduction: The staging system for malignant pleural mesothelioma is controversial. To revise this system, the International Association for the Study of Lung Cancer Staging Committee developed an international database. This report analyzes prognostic variables in a surgical population, which are supplementary to previously published CORE variables (stage, histology, sex, age, and type of procedure). Methods: Supplementary prognostic variables were studied in three scenarios: (1) all data available, that is, patient pathologically staged and other CORE variables available (2) only clinical staging available along with CORE variables, and (3) only age, sex, histology, and laboratory parameters are known. Survival was analyzed by Kaplan–Meier, prognostic factors by log rank and stepwise Cox regression modeling after elimination of nonsignificant variables. p value less than 0.05 was significant. Results: A total of 2141 patients with best tumor, node, metastasis (TNM) stages (pathologic with/without clinical staging) had nonmissing age, sex, histology, and type of surgical procedure. Three prognostic models were defined. Scenario A (all parameters): best pathologic stage, histology, sex, age, type of surgery, adjuvant treatment, white blood cell count (WBC) (≥15.5 or not), and platelets (≥400 k or not) (n = 550). Scenario B (no surgical staging): clinical stage, histology, sex, age, type of surgery, adjuvant treatment, WBC, hemoglobin (<14.6 or not), and platelets (n = 627). Scenario C (limited data): histology, sex, age, WBC, hemoglobin, and platelets (n = 906). Conclusion: Refinement of these models could define not only the appropriate patient preoperatively for best outcomes after cytoreductive surgery but also stratify surgically treated patients after clinical and pathologic staging who do or do not receive adjuvant therapy.
Are obsessive–compulsive symptom dimensions familial in nonclinical individuals?

Background: Obsessive–compulsive disorder (OCD) is a heterogeneous condition, which can be expressed as various potentially overlapping symptom dimensions. In clinical samples, some of these dimensions are associated with increased familial risk for OCD and appear to be familial (intercorrelated within pairs of affected family members), whereas others are not. The goal of this study was to determine whether obsessive–compulsive (OC) symptom dimensions are familial in a nonclinical sample. Methods: OC symptom dimensions and negative affect were assessed in 184 female undergraduate students and their parents using the Obsessive–Compulsive Inventory—Revised (OCI‐R) and the Positive and Negative Affect Scales, respectively. Bivariate correlations and multiple regression models controlling for age and negative affect were employed to examine the familiarity of OC symptom dimensions. Results: The OCI‐R total scores were significantly correlated in both mother–daughter and father–daughter dyads but the magnitude of these correlations tended to be greater for the mother–daughter dyads. Multiple regression models showed that the Ordering and Hoarding subscales of the OCI‐R breed true in mother–daughter dyads. Ordering scores in mothers were also predictive of other symptoms in the daughters (Washing and Checking). Conclusions: These results are broadly consistent with the findings in clinical samples and suggest that Ordering and Hoarding are more strongly familial than other symptom dimensions and that high Ordering scores in mothers are associated with increased levels of symptoms in daughters in a less specific manner. Depression and Anxiety, 2009. © 2009 Wiley‐Liss, Inc.
Impact of Non–Small-Cell Lung Cancer-Not Otherwise Specified Immunophenotyping on Treatment Outcome

Introduction: The vast majority of non–small-cell lung cancers (NSCLCs) presents as advanced disease, and histological diagnosis is widely based on small samples. The differential activity and toxicity profile of new cytotoxic and molecular-targeted therapies according to histotypes requires a precise subtyping of NSCLC. Immunohistochemistry (IHC) contributes to define the most probable histotype; however, the real impact of IHC characterization of NSCLC-not otherwise specified (NOS) in terms of outcome is not well established. Methods: A large series of 224 advanced “nonsquamous” NSCLC diagnosed on small biopsy or cytological samples and homogeneously treated was retrospectively selected, all having adequate follow-up data available. Reviewed diagnoses resulted into two groups: adenocarcinoma (ADC) and NSCLC-NOS. The latter was further characterized by IHC (TTF-1, Napsin-A, p40, and Desmocollin-3) –identify a possible, most probable differentiation lineage. Results: Sixty-seven percentage of cases were classified as ADC based on morphological examination only (“morphological ADC”) and 33% as NSCLC-NOS. IHC profiling of NSCLC-NOS identified 43.2% of cases with an ADC immunophenotype (“NSCLC favor ADC”), 10.8% with a phenotype favoring squamous lineage, and 46% lacking differentiation features. Survival curves confirmed no difference in terms of outcome between the morphological ADC and the NSCLC favor ADC groups, while a significantly poorer outcome was found in the “null” group in terms of best response, progression-free survival or overall survival (OS). Conclusion: Tumors with an IHC profile ADC-like had an OS comparable with that of morphological ADCs. These findings support the use of IHC to optimize lung cancer histological typing and therapy.