Improving nurse staffing measures: Discharge day measurement in adjusted patient days of care

Previous research cannot account for the discrepancy between registered nurse (RN) reports of understaffing and studies showing slight improvement. One reason may be that adjusted patient days of care (APDC) underestimates patient load. Using data from all Pennsylvania acute care general hospitals for the years 1994 through 1997, we found that APDC is underestimated by two hours. After adjusting APDC, we examined the difference in nurse staffing over the period 1991-2000 before and after the adjustment. We found a significant difference between unadjusted and adjusted measures. However, when applied to the changes in nurse staffing between 1991 and 2000, the difference was not enough to account for the discrepancy between reports and data. Other measurement and conceptual problems may exist in terms of patients\u27 increasing acuity levels, patients\u27 declining lengths of stay and the associated greater proportion of nurse time devoted to admission and discharge, and lack of recent data in some empirical studies

Mapping Physical Formats to Logical Models to Extract Data and Metadata: The Defuddle Parsing Engine

Scientists, fueled by the desire for systems-level understanding of phenomena, increasingly need to share their results across multiple disciplines. Accomplishing this requires data to be annotated, contextualized, and readily searchable and translated into other formats. While these requirements can be addressed by custom programming or obviated by community standardization, neither approach has ‘solved’ the problem. In this paper, we describe a complementary approach – a general capability for articulating the format of arbitrary textual and binary data using a logical data model, expressed in XML-Schema, which can be used to provide annotation and context, extract metadata, and enable translation. This work is based on the draft specification for the Data Format Description Language and our open source “Defuddle” parser. We present an overview of the specification, detail the design of Defuddle, and discuss the benefits and challenges of this general approach to enabling discovery and sharing of diverse data sets

ARSENIC REMOVAL IN WATER TREATMENT FACILITIES: SURVEY OF GEOCHEMICAL FACTORS AND PILOT PLANT EXPERIMENTS

Midwest Technology Assistance Center for Small Community Water Supplies (MTAC)Ope

The role of the chemokine receptor CXCR4 in infection with feline immunodeficiency virus

Infection with feline immunodeficiency virus (FIV) leads to the development of a disease state similar to AIDS in man. Recent studies have identified the chemokine receptor CXCR4 as the major receptor for cell culture-adapted strains of FIV, suggesting that FIV and human immunodeficiency virus (HIV) share a common mechanism of infection involving an interaction between the virus and a member of the seven transmembrane domain superfamily of molecules. This article reviews the evidence for the involvement of chemokine receptors in FIV infection and contrasts these findings with similar studies on the primate lentiviruses HIV and SIV (simian immunodeficiency virus)

Potential health impacts of heavy metals on HIV-infected population in USA.

Noninfectious comorbidities such as cardiovascular diseases have become increasingly prevalent and occur earlier in life in persons with HIV infection. Despite the emerging body of literature linking environmental exposures to chronic disease outcomes in the general population, the impacts of environmental exposures have received little attention in HIV-infected population. The aim of this study is to investigate whether individuals living with HIV have elevated prevalence of heavy metals compared to non-HIV infected individuals in United States. We used the National Health and Nutrition Examination Survey (NHANES) 2003-2010 to compare exposures to heavy metals including cadmium, lead, and total mercury in HIV infected and non-HIV infected subjects. In this cross-sectional study, we found that HIV-infected individuals had higher concentrations of all heavy metals than the non-HIV infected group. In a multivariate linear regression model, HIV status was significantly associated with increased blood cadmium (p=0.03) after adjusting for age, sex, race, education, poverty income ratio, and smoking. However, HIV status was not statistically associated with lead or mercury levels after adjusting for the same covariates. Our findings suggest that HIV-infected patients might be significantly more exposed to cadmium compared to non-HIV infected individuals which could contribute to higher prevalence of chronic diseases among HIV-infected subjects. Further research is warranted to identify sources of exposure and to understand more about specific health outcomes

Metabolomics Reveals Reduction of Metabolic Oxidation in Women with Polycystic Ovary Syndrome after Pioglitazone-Flutamide-Metformin Polytherapy

Polycystic ovary syndrome (PCOS) is a variable disorder characterized by a broad spectrum of anomalies, including hyperandrogenemia, insulin resistance, dyslipidemia, body adiposity, low-grade inflammation and increased cardiovascular disease risks. Recently, a new polytherapy consisting of low-dose flutamide, metformin and pioglitazone in combination with an estro-progestagen resulted in the regulation of endocrine clinical markers in young and non-obese PCOS women. However, the metabolic processes involved in this phenotypic amelioration remain unidentified. In this work, we used NMR and MS-based untargeted metabolomics to study serum samples of young non-obese PCOS women prior to and at the end of a 30 months polytherapy receiving low-dose flutamide, metformin and pioglitazone in combination with an estro-progestagen. Our results reveal that the treatment decreased the levels of oxidized LDL particles in serum, as well as downstream metabolic oxidation products of LDL particles such as 9- and 13-HODE, azelaic acid and glutaric acid. In contrast, the radiuses of small dense LDL and large HDL particles were substantially increased after the treatment. Clinical and endocrine-metabolic markers were also monitored, showing that the level of HDL cholesterol was increased after the treatment, whereas the level of androgens and the carotid intima-media thickness were reduced. Significantly, the abundance of azelaic acid and the carotid intima-media thickness resulted in a high degree of correlation. Altogether, our results reveal that this new polytherapy markedly reverts the oxidant status of untreated PCOS women, and potentially improves the pro-atherosclerosis condition in these patients