Miracle-dz/UniFAR-FTUs huggingface dataset:
Identifying the core components of cultural competence: findings from a Delphi study.

AIM To identify the core components of cultural competence from a Swedish perspective. Background. The cultural diversity of Swedish society raises challenges for nursing practice. Nurses need to be culturally competent, i.e. demonstrate the effective application of knowledge, skills and attitudes to practice safely and effectively in a multicultural society. Existing frameworks of cultural competence reflect the socio-cultural, historical and political context they were developed in. To date, there has been no research examining cultural competence within a Swedish context. DESIGN A Delphi survey. METHODS A purposeful sample of 24 experts (eight nurses, eight researchers and eight lecturers) knowledgeable in multicultural issues was recruited. Interviews were undertaken to identify the knowledge, skills and attitudes that formed the components of cultural competence. Content analysis yielded statements which were developed into a questionnaire. Respondents scored questionnaire items in terms of perceived importance. Statements which reached consensus were removed from questionnaires used in subsequent rounds. Three rounds of questionnaires were distributed during 2006. RESULTS A total of 118 out of 137 components reached a consensus level of 75%. The components were categorised into five areas, cultural sensitivity, cultural understanding, cultural encounters, understanding of health, ill-health and healthcare and social and cultural contexts with 17 associated subcategories. CONCLUSIONS There are some similarities between the issues raised in the current study and existing frameworks of cultural competence from the USA and the UK. However, Swedish experts placed less emphasis on ethnohistory and on developing skills to challenge discrimination and racism. RELEVANCE TO CLINICAL PRACTICE This study identified the core components of cultural competence important to nurses practising within a multicultural society such as Sweden. Acquisition of the knowledge, skills and attitudes identified should enable nurses to meet the needs of patients from different cultural backgrounds. The components of cultural competence can form the basis of nursing curricula.
Alpha5 Nicotinic Acetylcholine Receptor Contributes to Nicotine-Induced Lung Cancer Development and Progression

Nicotine and nicotinic acetylcholine receptors (nAChRs) are considered to be involved in lung cancer risk, onset and progression, but their precise physiological roles in these contexts remain unclear. Our previous studies suggested that α5-nAChR mediates nicotine-induced lung cancer cell proliferation, migration, and invasion in vitro. In this study, we aimed to determine the role of α5-nAChR in the development and progression of non-small cell lung cancer (NSCLC). Our microarray results reveal that knockdown of the CHRNA5 gene encoding α5-nAChR significantly modulates key pathways including the cell cycle, DNA replication, pathway in cancer. α5-nAChR knockdown in cultured A549 cells affected cell cycle distribution, apoptosis, and cyclin expression. In vivo, α5-nAChR silencing inhibited the growth of lung tumors, especially in the context of nicotine exposure. Importantly, α5-nAChR expression in patient tumors correlated with the primary T stage, N stage, and reduced survival time. These results reveal that α5-nAChR silencing inhibits the progression of nicotine-related NSCLC, making this receptor a potential pharmacological target for the treatment of nicotine-related lung carcinogenesis.
Smad3-mediated Myocardin Silencing

Both TGF-β and myocardin (MYOCD) are important for smooth muscle cell (SMC) differentiation, but their precise role in regulating the initiation of SMC development is less clear. In TGF-β-induced SMC differentiation of pluripotent C3H10T1/2 progenitors, we found that TGF-β did not significantly induce Myocd mRNA expression until 18 h of stimulation. On the other hand, early SMC markers such as SM α-actin, SM22α, and SM calponin were detectable beginning 2 or 4 h after TGF-β treatment. These results suggest that Myocd expression is blocked during the initiation of TGF-β-induced SMC differentiation. Consistent with its endogenous expression, Myocd promoter activity was not elevated until 18 h following TGF-β stimulation. Surprisingly, Smad signaling was inhibitory to Myocd expression because blockade of Smad signaling enhanced Myocd promoter activity. Overexpression of Smad3, but not Smad2, inhibited Myocd promoter activity. Conversely, shRNA knockdown of Smad3 allowed TGF-β to activate the Myocd promoter in the initial phase of induction. Myocd was activated by PI3 kinase signaling and its downstream target Nkx2.5. Interestingly, Smad3 did not affect PI3 kinase activity. However, Smad3 physically interacted with Nkx2.5. This interaction blocked Nkx2.5 binding to the Myocd promoter in the early stage of TGF-β induction, leading to inhibition of Myocd mRNA expression. Moreover, Smad3 inhibited Nkx2.5-activated Myocd promoter activity in a dose-dependent manner. Taken together, our results reveal a novel mechanism for Smad3-mediated inhibition of Myocd in the initiation phase of SMC differentiation.
Digital Time-Optimal Phase Shedding in Multiphase Buck Converters

This letter proposes a time-optimal digital controller for the phase shedding (PS) in multiphase buck converters. PS is an established technique to improve the efficiency of multiphase converters at light load by changing the active number of phases depending on the load-current level. In order to minimize the output-voltage deviation and the transient time during PS, a minimum time algorithm is investigated. The proposed technique is insensitive to the power stage parameters, as its operation relies only on a feedforward action, depending on the steady-state duty cycle and the number of phases to be turned on or turned off. The proposed approach is validated through experimental tests on a synchronous buck converter.
The effect of exercise on motor performance tasks used in the neurological assessment of sports-related concussion

Sports-related concussion is assessed using both cognitive and motor performance tasks. There is limited understanding of how exercise affects these measures. The purpose of this study was to investigate the effect of moderate-intensity exercise on three selected measures of motor performance. A repeated measures design was used to compare baseline motor performance scores with post-exercise scores with an exercise intervention modelled on the physiological demands of a team sport. 30 physically active subjects performed timed motor performance tasks: Finger-to-Nose (FTN), Tandem Gait (TG) and Single Leg Stance (SLS). The tasks were administered twice pre-exercise and twice post-exercise. FTN, TG and SLS demonstrated high test–retest reliability (ICC values >0.8). 15 minutes of moderate-intensity exercise caused a significant improvement in FTN (T2 = 2.66 (SD 0.38), T3 = 2.49 (0.32); p<0.001) and TG (T2 = 13.08 (2.84), T3 = 12.23 (2.22); p = 0.001), but not in SLS (T2 = 5.94 (4.99), T3 = 5.91 (5.54); p = 0.507). Improvement in the performance of motor tasks after exercise has implications for the immediate assessment of sports-related concussion, given that measures of motor performance are utilised in concussion assessment instruments.
A Hypomorphic Mutation in Lpin1 Induces Progressively Improving Neuropathy and Lipodystrophy in the Rat*

The Lpin1 gene encodes the phosphatidate phosphatase (PAP1) enzyme Lipin 1, which plays a critical role in lipid metabolism. In this study we describe the identification and characterization of a rat model with a mutated Lpin1 gene (Lpin11Hubr), generated by N-ethyl-N-nitrosourea mutagenesis. Lpin11Hubr rats are characterized by hindlimb paralysis and mild lipodystrophy that are detectable from the second postnatal week. Sequencing of Lpin1 identified a point mutation in the 5′-end splice site of intron 18 resulting in mis-splicing, a reading frameshift, and a premature stop codon. As this mutation does not induce nonsense-mediated decay, it allows the production of a truncated Lipin 1 protein lacking PAP1 activity. Lpin11Hubr rats developed hypomyelination and mild lipodystrophy rather than the pronounced demyelination and adipocyte defects characteristic of Lpin1fld/fld mice, which carry a null allele for Lpin1. Furthermore, biochemical, histological, and molecular analyses revealed that these lesions improve in older Lpin11Hubr rats as compared with young Lpin11Hubr rats and Lpin1fld/fld mice. We observed activation of compensatory biochemical pathways substituting for missing PAP1 activity that, in combination with a possible non-enzymatic Lipin 1 function residing outside of its PAP1 domain, may contribute to the less severe phenotypes observed in Lpin11Hubr rats as compared with Lpin1fld/fld mice. Although we are cautious in making a direct parallel between the presented rodent model and human disease, our data may provide new insight into the pathogenicity of recently identified human LPIN1 mutations.
Expressions of BAFF/BAFF receptors and their correlation with disease activity in Chinese SLE patients

B-cell activating factor belonging to tumour necrosis factor family (BAFF) is essential for B-cell survival and function through interaction with its receptors BAFF receptor 3 (BR3), B-cell maturation antigen (BCMA) and/or transmembrane activator and calcium modulator and cyclophilin ligand interactor (TACI), though BCMA and/or TACI can also bind to a proliferation-inducing ligand (APRIL). We evaluate the correlation of the expressions of these ligands/receptors with different clinical manifestations of systemic lupus erythematosus (SLE). Levels of BAFF and APRIL in plasma from 73 SLE patients were determined by enzyme-linked immunosorbent assay. Expressions of BR3, TACI and BCMA on CD19+ B cells were detected by flow cytometry. Clinical data were collected and disease activity was evaluated using SLEDAI-2000. SLE patients had elevated BAFF and APRIL levels in their plasma. BAFF levels correlated positively with SLEDAI while negatively with the BR3 protein expression on CD19+ B cells (p < .05). The detected BR3 protein expression in SLE patients was reduced on CD19+IgD+CD27—, CD19+IgD+CD27+ as well as CD19+IgD—CD27+ B cells compared to the counterparts of healthy controls (p < .001), whereas SLE patients did not differ from healthy controls in BR3 mRNA levels. In untreated new-onset patients, the expression rate of BR3 on CD19+ B cells correlated negatively with SLEDAI (p < .05). Elevation of BAFF and reduction of BR3 on CD19+ B cells were more obvious in those with lupus nephritis (LN, p < .05). TACI expression on CD19+ B cells was up-regulated only in those subjects with LN (p < .05). Elevated plasma BAFF and reduced BR3 protein expression on peripheral B cells could act as biomarkers for active disease in SLE patients. High expression of TACI may indicate the occurrence of LN.
Perceived Insider Status and Job Design Predict Job Attitudes and Work Performance of Restaurant Employees

In this article, the role of perceived insider status (PIS) as a predictor of attitudinal and behavioral work outcomes and the role of core job characteristics as moderators of this relationship has been investigated. Data from 203 employees of a casual restaurant chain in Singapore provide support for the central hypotheses. The results suggest that objective employment characteristics (full-time vs. part-time and permanent vs. seasonal) predict PIS even when controlling for organizational tenure. Moreover, PIS predicts job satisfaction, turnover intention, in-role job performance, as well as voice behavior and personal initiative. In addition to having significant main effects, enriched core job characteristics also moderate most of the relationships between PIS and the various outcomes. The article concludes with a discussion of some important implications of these findings for research and for managerial practice in the hospitality industry.
Geographic Neighbourhood and Cluster Formation: Evidence from Indian Agriculture

Abstract We study an empirical occurrence largely overlooked in studies on income clusters: (i) most clusters include geographic neighbours and non-neighbours; and (ii) not all geographic neighbours are cluster-co-members. Using agricultural income across Indian states, we find a similar pattern in income-clusters over the last 45 years. Logistic regressions that consider state-pairs as the unit of analysis show that cluster membership is not driven by geographic variables but rather by non-geographic factors like weather shock, resource constraints, technology/input usage, extent of crop diversification, infrastructure, policy and institutions
A Context Dependent Interpretation of Inconsistencies in 2D:4D Findings: The Moderating Role of Status Relevance

Whereas direct relationships between 2D:4D and dominance related attitudes or behavior often turn out to be weak, some literature suggests that the relation between 2D:4D and dominance is context-specific. That is, especially in status-challenging situations 2D:4D may be related to dominant behavior and its correlates. Based on this perspective, we interpret inconsistencies in the literature on the relation between 2D:4D and risk taking, aggression and dominance related outcomes and investigate in our empirical study how attitudes in low 2D:4D men may change as a function of the status relevance of the context. We provide evidence for the idea that status relevance of the particular situation at hand influences the attitude towards performance-enhancing means for low 2D:4D men, but not for high 2D:4D men. We argue that 2D:4D may be related to any behavior that is functional to attain status in a specific context. Implications for (economic) decision making are discussed.
Sobriety checkpoint and open container laws in the United States: Associations with reported drinking-driving

ABSTRACT Objective: The objective of this study was to assess how 2 types of drinking-driving laws—permitting sobriety checkpoints and prohibiting open containers of alcohol in motor vehicles—are associated with drinking-driving and how enforcement efforts may affect these associations. Methods: We obtained 2010 data on state-level drinking-driving laws and individual-level self-reported drinking-driving from archival sources (Alcohol Policy Information System, NHTSA, and Behavioral Risk Factor Surveillance System). We measured enforcement of the laws via a 2009 survey of state patrol agencies. We computed multilevel regression models (separate models for each type of law) that first examined how having the state law predicted drinking-driving, controlling for various state- and individual-level covariates; we then added the corresponding enforcement measure as another potential predictor. Results: We found that states with a sobriety checkpoint law, compared with those without a law, had 18.2% lower drinking-driving; states that conducted sobriety checks at least monthly (vs. not conducting checks) had 40.6% lower drinking-driving (the state law variable was not significant when enforcement was added). We found no significant association between having an open container law and drinking-driving, but states that conducted open container enforcement, regardless of having a law, had 17.6% less drinking-driving. Conclusion: Our results suggest that having a sobriety checkpoint law and conducting checkpoints as well as enforcement of open containers laws may be effective strategies for addressing drinking-driving.
The effect of hospital infection control policy on the prevalence of surgical site infection in a tertiary hospital in South-South Nigeria

Background: Surgical site infections (SSIs) are a significant cause of morbidity, emotional stress and financial cost to the affected patients and health care institutions; and infection control policy has been shown to reduce the burden of SSIs in several health care institutions. This study assessed the effects of the implementation of the policy on the prevalence of SSI in the University of Port Harcourt Teaching Hospital, Nigeria. Patients and Methods: A review of the records of all Caesarean sections carried out in the hospital, before and 2 years after the implementation of the infection control policy was conducted. Data collected include the number and characteristics of the patients that had Caesarean section in the hospital during the period and those that developed SSI while on admission. Results: The proportion of patients with SSI decreased from 13.33% to 10.34%, 2 years after the implementation of the policy (P-value = 0.18). The implementation of the policy did not also result in any statistically significant change in the nature of the wound infection (P-value = 0.230), in the schedule of the operations (P-value = 0.93) and in the other predisposing factors of the infections (P-value = 0.72); except for the significant decrease in the infection rate among the un-booked patients (P-value = 0.032). Conclusion: The implementation of the policy led to a small decrease in SSI, due to the non-implementation of some important aspects of the WHO policy. The introduction of surveillance activities, continuous practice reinforcing communications and environmental sanitation are recommended to further decrease the prevalence of SSI in the hospital.
Hepatic epithelioid haemangioendothelioma: is transplantation the only treatment option?

BACKGROUND Hepatic epithelioid haemangioendothelioma (HEH) is a rare vascular neoplasm with unpredictable clinical behaviour. AIM To compare overall survival (OS) and disease-free survival (DFS) between liver resection (LR) and orthotopic liver transplantation (OLT) for the treatment of HEH. METHODS Retrospective review of 30 patients with HEH treated at Mayo Clinic during 1984 and 2007. RESULTS Median age was 46 years with a female predominance of 2:1. Treatment included LR (n= 11), OLT (n= 11), chemotherapy (n= 5) and no treatment (n= 3). LR was associated with a 1-, 3- and 5-year OS of 100%, 86% and 86% and a DFS of 78%, 62% and 62%, respectively. OLT was associated with a 1-, 3- and 5-year OS of 91%, 73% and 73% and a DFS 64%, 46% and 46%, respectively. Metastases were present in 37% of patients but did not significantly affect OS. Important predictors of a favourable OS and DFS were largest tumour ≤ 10 cm and multifocal disease with ≤ 10 nodules. CONCLUSION LR and OLT achieve comparable results in the treatment of HEH. LR is appropriate for patients with resectable disease and favourable prognostic factors. OLT is appropriate for patients with unresectable disease and possibly those with unfavourable prognostic factors. Metastases may not be a contraindication to surgical treatment.
Role of real-time reverse transcription polymerase chain reaction for detection of respiratory viruses in critically ill children with respiratory disease: Is it time for a change in algorithm?

Objectives: To identify the respiratory viral pathogens associated with acute lower respiratory tract infection in critically ill pediatric patients by using real-time reverse transcription-polymerase chain reaction, and compare results with those of direct fluorescence antibody assay testing. Design: Observational cohort study. Setting: Pediatric intensive care unit at a tertiary care academic hospital. Patients: Pediatric patients admitted to the pediatric intensive care unit with severe respiratory symptoms consistent with viral lower respiratory tract infection. Interventions: None. Measurements: Respiratory samples of pediatric patients admitted to the pediatric intensive care unit with severe respiratory symptoms between January 2008 and July 2009 were tested with direct fluorescence antibody assay and real-time reverse transcription-polymerase chain reaction. Main Results: At least one viral agent was detected in 70.5% of specimens by real-time reverse transcription-polymerase chain reaction and in 16.5% by direct fluorescence antibody assay (p < .001). Real-time reverse transcription-polymerase chain reaction increased the total viral yield five-fold compared to direct fluorescence antibody assay. Rhinovirus was the most commonly identified virus (41.6%). For viruses included in the direct fluorescence antibody assay panel, direct fluorescence antibody assay had a sensitivity of 0.42 (95% confidence interval 0.25–0.61) and a specificity of 1 (95% confidence interval 0.86–1.00) compared with real-time reverse transcription-polymerase chain reaction. Coinfections were not uncommon, in particular with rhinovirus, and these patients tended to have higher mortality. Conclusions: Direct fluorescence antibody assay testing is a suboptimal method for the detection of respiratory viruses in critically ill children with lower respiratory tract infection. Given the importance of a prompt and accurate viral diagnosis for this group of patients, we suggest that real-time reverse transcription-polymerase chain reaction becomes part of the routine diagnostic algorithm in critically ill children when a viral etiology is suspected, even if conventional tests yield a negative result.
Older Adults and Functional Decline: A Cross-Cultural Comparison

Background: The study was conducted to examine the relationships between functional decline, health risk factors, lifestyle practices, and demographic variables in two culturally diverse, community-based samples of White and Japanese American older adults. Design: The study was an analysis of data from two ongoing studies of aging and dementia in King County, Washington. Functional status at baseline was evaluated, and factors associated with functional decline over a 4-year follow-up period were identified. The sample included 1,083 Japanese American and 1,011 White cognitively intact, community-dwelling adults aged 65 and older, who had no functional limitations at baseline and participated in at least one follow-up examination. Results: In 4 years of follow-up, 70% of the subjects reported no increase in functional limitation, and fewer than 5% of subjects declined in five or more activities. Risk factors associated with functional decline included increased age, female gender, medical comorbidity (particularly cerebrovascular disease, arthritis, and hypertension), elevated body mass index, poorer self-perceived health, and smoking. Depression and diabetes were also significant for persons with the greatest functional decline over the 4-year follow-up. Japanese speakers were significantly less likely to decline over the follow-up period than White or English-speaking Japanese American subjects. However, Japanese speakers were more likely to discontinue participation during the follow-up period, and may also have been more likely to underreport symptoms of functional decline. Conclusions: The present study provides further support that healthy lifestyle practices and prevention of chronic disease are important for maintaining functional independence in older adults. Japanese-speaking subjects were less likely to decline over time, although this could be due in part to differential dropout and reporting bias. These findings have important implications for the design and interpretation of longitudinal studies of older adults. Researchers interested in the effects of ethnicity on health and aging should be cognizant of differences in recruitment and enrollment strategies among studies, and the ways in which these affect study findings. This study also demonstrates the importance of devoting adequate resources to minimize dropouts, and of including measures of health and functioning that are culturally equivalent and less reliant on self-report data.