bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nurses’ Scope of Practice and the Implication for Quality Nursing Care
Authors: Lubbe J.C. (Irene) , Roets Lizeth 
Published: December 2013

AbstractPurposeThis article provides an overview of the implications for patients’ health status and care needs when assessments are performed by nurses not licensed or competent to perform this task. The Waterlow™ scale (Judy Waterlow, The Nook, Stroke Road, Henlade, TAUNTON, TA3 5LX) scenario is used as a practice example to illustrate this case.Organizational ConstructThe international nursing regulatory bodies, in South Africa called the South African Nursing Council, set the scope of practice wherein nurses are allowed to practice. Different categories of nurses are allowed to practice according to specified competencies, in alignment with their scope of practice.MethodsA retrospective quantitative study was utilized. A checklist was used to perform an audit on a random sample of 157 out of an accessible population of 849 patient files. Data were gathered in May 2012, and the analysis was done using frequencies and percentages for categorical data. Reliability and validity were ensured, and all ethical principles were adhered to.FindingsEighty percent of risk assessments were performed by nurses not licensed or enrolled to perform this task unsupervised. Areas such as tissue malnutrition, neurological deficits, and medication were inaccurately scored, resulting in 50% of the Waterlow™ risk‐assessment scales, as an example, being incorrectly interpreted. This has implications for quality nursing care and might put the patient and the institution at risk.ConclusionsLower‐category nurses and student nurses should be allowed to perform only tasks within their scope of practice for which they are licensed or enrolled. Nurses with limited formal theoretical training are not adequately prepared to perform tasks unsupervised, even in the current global nursing shortage scenario.Clinical RelevanceTo optimize and ensure safe and quality patient care, risk assessments should be done by a registered professional nurse, who will then coordinate the nursing care of the patient with the assistance of the lower category of nurses.
Perceptions of intimate relationships in partners before and after a patient's myocardial infarction
Authors: Fransson Eleonor I , Arenhall Eva , Steinke Elaine E , Fridlund Bengt , Nilsson Ulrica G 
Published: December 2013

Aims and objectivesTo describe and explore how partners rate their intimate relationship before and after the patients' first myocardial infarction. A further aim was to investigate the association between partners' rating of their intimate relationship and self‐rated health.BackgroundTo date, information on how partners experience the intimate relationship before and after a patient's myocardial infarction is sparse.DesignA descriptive and exploratory design with longitudinal data collection.MethodsThe study comprised 127 partners, aged 34–87 years. Data collection included self‐reported information on socio‐demographic data, intimate relationship and self‐rated health one year before and one year after patients' first myocardial infarction. Intimate relationship was assessed by the Swedish version of the Relationship Assessment Scale. Self‐rated health was evaluated by the EuroQoL visual analogue scale.ResultsIn general, partners reported high satisfaction with their intimate relationship both before and after the patients' myocardial infarction. Women reported somewhat lower ratings in their intimate relationship than men before the myocardial infarction. Women increased their ratings after one year, while men on average decreased their ratings. Partners with higher education reported lower ratings for intimate relationship after one year. Those with children living at home rated intimate relationship lower than those without children living at home after one year. Partners' self‐rated health status was stable over time. No significant association between intimate relationship and self‐rated health was found.ConclusionsThis study provides important insights regarding couples' relationships from the perspective of the partner. Socio‐demographic factors such as sex, educational level, having children living at home and employment status may influence how the relationship, from the partners' perspective, is affected by a myocardial infarction event.Relevance to clinical practiceThis study provides insight into how partners rate their intimate relationship and self‐rated health over time before and after patients' myocardial infarction.
The Complete Nucleotide Sequence of the RNA 1 of a Chinese Isolate of Tomato chlorosis virus
Authors: Karwitha Miriam , Feng Zhike , Yao Min , Chen Xiaojiao , Zhang Wenna , Liu Xiaofan , Tao Xiarong 
Published: December 2013

AbstractInterveinal leaf chlorosis, brittleness, limited necrotic flecking or bronzing developed on greenhouse‐grown tobacco and tomato plants at Nanjing Agricultural University from 2010 to 2013. A positive RT‐PCR using a pair of degenerate primers for Crinivirus confirmed the diseased plants were infected with Tomato chlorosis virus (ToCV). The complete RNA 1 genomic sequence of this ToCV isolate was determined; it comprises of 8596 nucleotides with four open reading frames. Phylogenetic analysis of ToCV isolates from diverse geographical regions categorized the ToCV isolates into two main groups. Group one consisted of Chinese, American‐Florida, Greek and Brazilian isolates, while Group two contained only the Spanish isolate. The first group had two subgroups, one of Chinese and American‐Florida isolates, while the other subgroup had Greek and Brazilian isolates. This is the first study of the complete nucleotide sequence of the RNA 1 of ToCV isolated from China.
Detection and Molecular Variability of Fig Fleck‐Associated Virus and Fig Cryptic Virus in Iran
Authors: Ale‐Agha Ghaffar Nouri , Rakhshandehroo Farshad 
Published: December 2013

AbstractForty‐eight fig orchards were surveyed to determine the presence and incidence of Fig cryptic virus (FCV), Fig fleck‐associated virus (FFkaV), Fig leaf mottle‐associated virus 1 (FLMaV‐1), Fig leaf mottle‐associated virus 2 (FLMaV‐2) andFig mosaic virus(FMV) in four provinces of northeast, northwest and central regions of Iran. A total of 197 leaf samples from commercial and outdoor fig gardens were collected in April and September 2012 and tested by reverse‐transcription polymerase chain reaction (RT‐PCR). Approximately 14.7% of the tested fig trees were infected byFCV,FFkaV andFMVwith a peak of 18% in Tehran province. None of samples was found to be infected withFLMaV‐1 orFLMaV‐2.FFkaV was found in fig trees collected in all the four provinces, but noFCVinfection was found inSemnan province, andFMVwas just occurred inMarkai andTehran. Mixed infections ofFCVwithFFkaV andFMVwere detected in 2.5% of the samples. The sequence of theCPfragment of sixIranianFCVisolates showed 97–99% nucleotide (nt) identity with the referenceFCVisolate, while that of a RdRp and Gp fragments of nineFFkaV and twoFMVIranian isolates showed 87–91% nt and 89–90% identity with the reference isolates, respectively. Phylogenetic analysis grouped theFCVandFFkaV isolates in two distinct clusters, with the Iranian isolates included in both clusters. Results showed genetic diversity among Iranian viruses. Structure and diversity ofFCVandFFkaV populations are discussed.
First Report of Botrytis cinerea Pers. on Salicornia bigelovii Torr. in North‐West México
Authors: Rueda Puente Edgar O. , Hernandez Montiel Luis G. , Holguin Peña Jaime , Murillo Amador Bernardo , Rivas Santoyo Francisco J. 
Published: December 2013

AbstractGrey mould has been detected on Salicornia bigelovii Torr plants in nursery and in the wild in north‐west Mexico. Sampling of the grey mould was performed in the state of Sonora, Mexico, of wild as well as cultivated S. bigelovii plants. The samples were isolated, and based on morphology, the species was identified as Botrytis cinerea Pers. Koch's postulates were fulfilled by pathogenicity tests carried out in plated petri dishes on branches from the 3‐month‐old potted S. bigelovii plants. To our knowledge, this is the first report of the isolation and identification of the fungal pathogen B. cinerea from S. bigelovii in the north‐west Mexico.
Evidence of Alternaria alternata Causing Leaf Spot of Aloe vera in Iran
Authors: Abkhoo Javad , Sabbagh Seyed Kazem 
Published: December 2013

AbstractA leaf spot and leaf blight disease was observed on Aloe vera plants as small, circular to oval dark brown necrotic sunken spots on leaves. Infected tissues collected from different sites in diseased fields were cultured on potato carrot agar medium, and the pathogen was identified as Alternaria alternata on the basis of morphological and cultural characteristics. The conidiophores were branched, straight, golden brown, smooth‐walled, measuring up to μm long by 3 μm wide with one conidial scar. The conidia were golden brown in colour and produced in long branched chains, obclavate in shape and in short conical flask. Pathogenicity tests conducted on healthy potted aloe plants in a glasshouse showed typical leaf spot symptoms after 4–7 days. The optimal temperature for the growth of A. alternata was 25°C.
Diversification in the South American Pampas: the genetic and morphological variation of the widespread Petunia axillaris complex (Solanaceae)
Authors: Turchetto Caroline , Fagundes Nelson J. R. , Segatto Ana L. A. , Kuhlemeier Cris , Solís Neffa Viviana G. , Speranza Pablo R. , Bonatto Sandro L. , Freitas Loreta B. 
Published: December 2013

AbstractUnderstanding the spatiotemporal distribution of genetic variation and the ways in which this distribution is connected to the ecological context of natural populations is fundamental for understanding the nature and mode of intraspecific and, ultimately, interspecific differentiation. The Petunia axillaris complex is endemic to the grasslands of southern South America and includes three subspecies: P. a. axillaris, P. a. parodii and P. a. subandina. These subspecies are traditionally delimited based on both geography and floral morphology, although the latter is highly variable. Here, we determined the patterns of genetic (nuclear and cpDNA), morphological and ecological (bioclimatic) variation of a large number of P. axillaris populations and found that they are mostly coincident with subspecies delimitation. The nuclear data suggest that the subspecies are likely independent evolutionary units, and their morphological differences may be associated with local adaptations to diverse climatic and/or edaphic conditions and population isolation. The demographic dynamics over time estimated by skyline plot analyses showed different patterns for each subspecies in the last 100 000 years, which is compatible with a divergence time between 35 000 and 107 000 years ago between P. a. axillaris and P. a. parodii, as estimated with the IMa program. Coalescent simulation tests using Approximate Bayesian Computation do not support previous suggestions of extensive gene flow between P. a. axillaris and P. a. parodii in their contact zone.
Global distribution, diversity hot spots and niche transitions of an astaxanthin‐producing eukaryotic microbe
Authors: David‐Palma Márcia , Libkind Diego , Sampaio José Paulo 
Published: December 2013

AbstractMicrobes establish very diverse but still poorly understood associations with other microscopic or macroscopic organisms that do not follow the more conventional modes of competition or mutualism.Phaffia rhodozyma, an orange‐coloured yeast that produces the biotechnologically relevant carotenoid astaxanthin, exhibits a Holarctic association with birch trees in temperate forests that contrasts with the more recent finding of aSouthAmerican population associated withNothofagus(southern beech) and with stromata of its biotrophic fungal parasiteCyttariaspp. We investigated whether the association ofPhaffiawithNothofagus–Cyttariacould be expanded to Australasia, the other region of the world whereNothofagusare endemic, studied the genetic structure of populations representing the known worldwide distribution ofPhaffiaand analysed the evolution of the association with tree hosts. The phylogenetic analysis revealed thatPhaffiadiversity inAustralasia is much higher than in other regions of the globe and that two endemic and markedly divergent lineages seem to represent new species. The observed genetic diversity correlates with host tree genera rather than with geography, which suggests that adaptation to the different niches is driving population structure in this yeast. The high genetic diversity and endemism inAustralasia indicate that the genus evolved in this region and that the association withNothofagusis the ancestral tree association. Estimates of the divergence times ofPhaffialineages point to splits that are much more recent than the break‐up of Gondwana, supporting that long‐distance dispersal rather than vicariance is responsible for observed distribution ofP. rhodozyma.
Cardiac Implantable Electronic Device Reutilization: Battery Life of Explanted Devices at a Tertiary Care Center
Authors: GAKENHEIMER LINDSEY , ROMERO JOSHUA , BAMAN TIMIR S. , MONTGOMERY DAN , SMITH CYDNI A. , ORAL HAKAN , EAGLE KIM A. , CRAWFORD THOMAS 
Published: December 2013

IntroductionPrior studies have suggested that pacemaker reuse may be a reasonable alternative to provide device therapy in the low‐ and middle‐income countries. We studied explant indications and remaining battery life of cardiac implantable electronic devices (CIEDs) at a tertiary medical center.Methods and ResultsWe conducted a retrospective review of all CIEDs extracted at the University of Michigan between 2007 and 2011. Devices were considered reusable if battery longevity was ≥48 months or >75% battery life was remaining; there was no evidence of electrical malfunction, and they were not under advisory or recall. Eight hundred and one CIEDs were explanted: Medtronic (MDT [Medtronic Inc., Minneapolis, MN, USA]; 454), Boston Scientific (BS [Boston Scientific Corp., Natick, MA, USA])/Guidant (GDT; 255 [Guidant Corp., St. Paul, MN, USA]), St. Jude Medical (SJM; 73 [St. Paul, MN, USA]), and Biotronik (BTK; 15 [Biotronik GmBH, Berlin, Germany]). After eliminating devices explanted for elective replacement indicator (ERI, 541), 51.9% of pacemakers (41/79), 54.2% of implantable cardioverter‐defibrillators (ICDs) (64/118), and 47.6% of cardiac resynchronization therapy and defibrillation (CRT‐D) devices (30/63) had sufficient battery life and no evidence of electrical malfunction to be considered for reuse. A logistic regression analysis found that the indications for device removal independently predicted reusability: upgrade to an ICD (odds ratio [OR] 162.8, P < 0.001) or CRT‐D (OR 63.8, P < 0.001), infection (OR 110.7, P < 0.001), heart transplantation or left ventricular assist device placement (OR 56.6, P < 0.001), and device removal at patient's request (OR 115.4, P < 0.001).ConclusionThe majority of explanted CIEDs for reasons other than ERI have an adequate battery life and, if proven safe, may conceivably be reutilized for basic pacing in underserved nations where access to this life‐saving therapy is limited.
Discrepancy between Electrical and Mechanical Dyssynchrony in Patients with Heart Failure and an Electrical Disturbance
Authors: FUJIWARA RYUDO , YOSHIDA AKIHIRO , FUKUZAWA KOJI , TAKEI ASUMI , KIUCHI KUNIHIKO , ITOH MITSUAKI , IMAMURA KIMITAKE , SUZUKI ATSUSHI , NAKANISHI TOMOYUKI , YAMASHITA SOICHIRO , MATSUMOTO AKINORI , TANAKA HIDEKAZU , HIRATA KEN‐ICHI 
Published: December 2013

BackgroundCardiac resynchronization therapy (CRT) improves the survival rates of patients with heart failure, but 30–40% of them do not respond to CRT, partially because of the position of the left ventricular (LV) lead. The relationship between the electrical and mechanical activation of the left ventricle is unknown. The aim of this study was to compare the electrical and mechanical dyssynchrony.MethodsWe inserted electrode catheters into the coronary sinus (CS) and venous branches of the CS during CRT implantations and constructed electroanatomical contact maps in 16 patients using the EnSite NavX™ system. Mechanical activation was evaluated by speckle‐tracking echocardiography and the latest mechanical and electrical sites were compared. The degrees of the electrical and mechanical delays of the implanted LV lead were also compared.ResultsThe electroanatomical maps revealed that the latest electrical sites were anterior in one, anterolateral in five, lateral in eight, and posterolateral in two. Echocardiographic imaging revealed that the latest mechanical sites were anteroseptal in two, anterior in four, lateral in five, posterior in two, and inferior in three. The latest electrical and mechanical sites matched in only three patients. The degree of the local mechanical delay for the LV lead was significantly larger in the responders than nonresponders, whereas the local electrical delay did not differ.ConclusionA discrepancy between the electrical and mechanical dyssynchrony might affect an adequate LV lead positioning.
RV‐Only Pacing Can Produce a Q Wave in Lead 1 and an R Wave in V1: Implications for Biventricular Pacing
Authors: COOPER JOSHUA M. , PATEL RUTUKE K. , EMMI ANTHONY , WANG YAN , KIRKPATRICK JAMES N. 
Published: December 2013

BackgroundBiventricular (bi‐v) pacing improves congestive heart failure and mortality in patients with left ventricular (LV) dysfunction and electrical dyssynchrony. Effective resynchronization must include an LV pacing contribution to the QRS. Leads 1 and V1 are often exclusively used to verify proper biventricular pacing.MethodsIn 40 patients referred to our cardiac resynchronization therapy (CRT) optimization clinic, 12‐lead electrocardiograms (ECGs) were obtained during bi‐v pacing, right ventricular (RV)‐only pacing, LV‐only pacing, and a range of atrio‐ventricular and ventriculo‐ventricular intervals. The presenting bi‐v QRS morphology was compared to RV and LV pacing, and RV‐only pacing was evaluated for the presence of a Q wave in lead 1 and an R wave in V1.ResultsIn 22 patients (55%), RV pacing produced an initial Q wave in lead 1 and/or R wave in V1, mimicking bi‐v pacing. In three patients, the presenting bi‐v paced ECG looked identical to RV‐only pacing. In 28 patients (70%), LV pacing was advanced by a mean of 30 ms after CRT optimization. Using all 12 ECG leads, especially the precordial leads, was necessary to appreciate the QRS changes that occurred when LV pacing meaningfully contributed to electrical activation.ConclusionsBecause of LV pacing latency, some patients require an earlier LV offset to achieve proper resynchronization pacing. Commonly used ECG criteria cannot verify meaningful LV pacing contribution during biventricular pacing because RV‐only pacing often creates a Q wave in lead 1 and/or R wave in V1. The full 12‐lead ECG during biventricular pacing should be compared with isolated RV and LV pacing to verify that LV pacing is properly contributing to the QRS.
The Effect of Open‐Irrigated Radiofrequency Catheter Ablation of Atrial Fibrillation on Left Atrial Pressure and B‐Type Natriuretic Peptide
Authors: SEILER JENS , STEVEN DANIEL , ROBERTS‐THOMSON KURT C. , INADA KEIICHI , TEDROW USHA B. , MICHAUD GREGORY F. , STEVENSON WILLIAM G. 
Published: December 2013

BackgroundOpen‐irrigated radiofrequency catheter ablation (oiRFA) of atrial fibrillation (AF) imposes a volume load and risk of pulmonary edema. We sought to assess the effect of volume administration during ablation on left atrial (LA) pressure and B‐type natriuretic peptide (BNP).MethodsLA pressure was measured via transseptal sheath at the beginning and end of 44 LA ablation procedures in 42 patients. BNP plasma levels were measured before and after 10 procedures.ResultsA median of 3,255 (interquartile range [IQR], 2,014)‐mL saline was administered during the procedure. During LA ablation, the median fluid balance was +1,438 (IQR, 1,109) mL and LA pressure increased by median 3.7 (IQR, 5.9) mm Hg (P < 0.001). LA pressure did not change in the 19 procedures with furosemide administration (median ΔP = −0.3 [IQR, 7.1] mm Hg, P = 0.334). The correlation of LA pressure and fluid balance was weak (rs = 0.383, P = 0.021). BNP decreased in all four procedures starting in AF or atrial tachycardia and then converting to sinus rhythm (P = 0.068), and increased in all six procedures starting and finishing in sinus rhythm (P = 0.028). After ablation, symptomatic volume overload responding to diuresis occurred in three patients.ConclusionsA substantial intravascular volume load during oiRFA can be absorbed with little change in LA pressure, such that LA pressure is not a reliable indicator of the fluid balance. Subsequent redistribution of the volume load imposes a risk after the procedure. Conversion to sinus rhythm may improve ability to acutely accommodate the volume load.
Proximity of Pacemaker and Implantable Cardioverter‐Defibrillator Leads to Coronary Arteries as Assessed by Cardiac Computed Tomography
Authors: PANG BENJAMIN J. , JOSHI SUBODH B. , LUI ELAINE H. , TACEY MARK A. , ALISON JEFF , SENEVIRATNE SUJITH K. , CAMERON JAMES D. , MOND HARRY G. 
Published: December 2013

IntroductionThere have been rare case reports of damage to adjacent coronary arteries by screw‐in pacemaker and implantable cardioverter‐defibrillator (ICD) leads. Our aim was to assess the proximity of pacemaker and ICD leads to the major coronary anatomy using cardiac computed tomography (CT).MethodsCardiac CT images were retrospectively analyzed to assess the spatial relationship of device lead tips to the major coronary anatomy.ResultsFifty‐two right ventricular (RV) leads (17 apical, 35 nonapical) and 35 right atrial (RA) leads were assessed. Leads on the RV antero‐septal junction (20 of 52) were close (median 4.7 mm) to, and orientated toward, the left anterior descending (LAD) coronary artery. RA leads in the anterior (26 of 35) and lateral (seven of 35) walls of the RA appendage were not close to (16.9 ± 7.7 mm and 18.9 ± 12.4 mm, respectively) and directed away from the right coronary artery. However, an RA lead adjacent to the superior border of the tricuspid valve was 4.3 mm from the right coronary artery and an RA lead on the medial wall of the RA appendage was 1.6 mm away from the aorta. An RV pacemaker lead in the lateral wall of the RV inlet was 3.4 mm from the right coronary artery.ConclusionsIn our cohort, a majority of RV leads were on the antero‐septal junction and close to the overlying LAD coronary artery. RA leads adjacent to the tricuspid valve or on the medial RA appendage were in close proximity to the right coronary artery and aorta, respectively.