6,046 research outputs found
Endemic Methicillin-Resistant Staphylococcus Aureus: Nurses' Risk Perceptions and Attitudes
Dissemination of methicillin-resistant Staphylococcus aureus (MRSA) remains one of the most difficult challenges for prevention, control, and treatment of health care-associated infections. A survey and interviews were conducted on nurses from a hospital center. We found that most nurses' perceived risk of acquiring MRSA related to themselves (72%), other nurses (88.5%), and patients (97.8%). This perception influences attitudes, leading to compliance with the existing recommendations
The PML-RAR alpha transcript in long-term follow-up of acute promyelocytic leukemia patients
Background and Objectives. Detection of PML-RAR alpha transcripts by RT-PCR is now established as a rapid and sensitive method for diagnosis of acute promyelocytic leukemia (APL), Although the majority of patients in longterm clinical remission are negative by consecutive reverse transcription polymerase chain reaction (RT-PCR) assays, negative tests are still observed in patients who ultimately relapse. Conversion from negative to positive PCR has been observed after consolidation and found to be a much stronger predictor of relapse. This study reports on 47 APL patients to determine the correlation between minimal residual disease (MRD) status and clinical outcome in our cohort of patients. Design and Methods. The presence of PML-RAR alpha t transcripts was investigated in 47 APL patients (37 adults and 10 children) using a semi-nested reverse transcriptase-polymerase chain reaction to evaluate the prognostic value of RT-PCR tests. Results. All patients achieved complete clinical remission (CCR) following induction treatment with all-trans retinoic acid (ATRA) and chemotherapy (CHT) or ATRA alone. Patients were followed up between 2 and 117.6 months (median: 37 months). Relapses occurred in 11 patients (9 adults and 2 children) between 11.4 and 19 months after diagnosis (median: 15.1 months) while 36 patients (28 adults and 8 children) remained in CCR, Seventy-five percent of patients carried the PML-RARa long isoform (bcr 1/2) which also predominated among the relapsed cases (9 of 11) but did not associate with any adverse outcome (p = 0.37), For the purpose of this analysis, minimal residual disease tests were clustered into four time-intervals: 0-2 months, 3-5 months, 5-9 months and 10-24 months. Interpretation and Conclusions. Children showed persisting disease for longer than adults during the first 2 months of treatment, At 2 months, 10 (50%) of 20 patients who remained in CCR and 4 (80%) of 5 patients who subsequently relapsed were positive. Patients who remained in CCR had repeatedly negative results beyond 5.5 months from diagnosis. A positive MRD test preceded relapse in 3 of 4 tested patients. The ability of a negative test to predict CCR (predictive negative value, PNV) was greater after 6 months (> 83%), while the ability of a positive test to predict relapse (predictive positive value, PPV) was most valuable only beyond 10 months (100%). This study (i) highlights the prognostic value of RT-PCR monitoring after treatment of APL patients but only from the end of treatment, (ii) shows an association between conversion to a positive test and relapse and (iii) suggests that PCR assessments should be carried out at 3-month intervals to provide a more accurate prediction of hematologic relapses but only after the end of treatment, (C) 2001, Ferrata Storti Foundatio
The impacts of geopolitical risks on the energy sector: Micro-level operative analysis in the European Union
Energy prices play a crucial role in combating geopolitical risks, especially for the major suppliers of energy resources. However, energy prices display a bilateral relationship with geopolitical risks in any economy. Any hike in the price of energy stimulates geopolitical risk factors and visa-versa. The consequences adversely impact economies and bring forth international tensions. This paper bridges a gap between the influence of geopolitical risks relating to energy and international tensions by analyzing micro-level operational measures. We deploy an empirical model to predict the energy sector and possible risk factors incorporating Eurostat data on twenty-seven states, from 2011 to 2020. This study collected a different energy variable to support the multiple regression model constructed by the āblocksā (hierarchical linear regression) method. The results suggest that geopolitical risks cause adverse effects on both the energy and other corporate sectors. The future direction of this research is to estimate how statistical model relationships may assist the corporate sector, and investors, in adopting mitigating measures to control upcoming geopolitical risks due to energy risks caused by geopolitical unrest.info:eu-repo/semantics/publishedVersio
Urotensin II-Induced Increase in Myocardial Distensibility Is Modulated by Angiotensin II and Endothelin-1
Endogenous regulators, such as angiotensin-II (AngII), endothelin-1 (ET-1) and urotensin-II (U-II) are released from various cell types and their plasma levels are elevated in several cardiovascular diseases. The present study evaluated a potential crosstalk between these systems by investigating if the myocardial effects of U-II are modulated by AngII or ET-1. Effects of U-II (10(-8), 10(-7), 10(-6) M) were tested in rabbit papillary muscles in the absence and in the presence of losartan (selective AT, receptor antagonist), PD-145065 (nonselective ET-1 receptors antagonist), losartan plus PD-145065, AngII or ET-1. U-II promoted concentration-dependent negative inotropic and lusitropic effects that were abolished in all experimental conditions. Also, U-II increased resting muscle length up to 1.008 +/- 0.002 L/L(max). Correcting it to its initial value resulted in a 19.5 +/- 3.5 % decrease of resting tension, indicating increased muscle distensibility. This effect on muscle length was completely abolished in the presence of losartan and significantly attenuated by PD-145065 or losartan plus PD-145065. This effect was increased in the presence of AngII, resulting in a 27.5 +/- 3.9 % decrease of resting tension, but was unaffected by the presence of ET-1. This study demonstrated an interaction of the U-II system with the AngII and ET-1 systems in terms of regulation of systolic and diastolic function
Fecal occult blood and fecal calprotectin as point-of-care markers of intestinal morbidity in Ugandan children with Schistosoma mansoni infection.
BACKGROUND: Calprotectin is a calcium-binding cytoplasmic protein found in neutrophils and increasingly used as a marker of bowel inflammation. Fecal occult blood (FOB) is also a dependable indicator of bowel morbidity. The objective of our study was to determine the applicability of these tests as surrogate markers of Schistosoma mansoni intestinal morbidity before and after treatment with praziquantel (PZQ).
METHODS: 216 children (ages 3-9 years old) from Buliisa District in Lake Albert, Uganda were examined and treated with PZQ at baseline in October 2012 with 211 of them re-examined 24 days later for S. mansoni and other soil transmitted helminths (STH). POC calprotectin and FOB assays were performed at both time points on a subset of children. Associations between the test results and infection were analysed by logistic regression.
RESULTS: Fecal calprotectin concentrations of 150-300 Āµg/g were associated with S. mansoni egg patent infection both at baseline and follow up (OR: 12.5 P = 0.05; OR: 6.8 P = 0.02). FOB had a very strong association with baseline anemia (OR: 9.2 P = 0.03) and medium and high egg intensity schistosomiasis at follow up (OR: 6.6 P = 0.03; OR: 51.3 P = 0.003). Both tests were strongly associated with heavy intensity S. mansoni infections. There was a significant decrease in FOB and calprotectin test positivity after PZQ treatment in those children who had egg patent schistosomiasis at baseline.
CONCLUSIONS: Both FOB and calprotectin rapid assays were found to correlate positively and strongly with egg patent S. mansoni infection with a positive ameloriation response after PZQ treatment indicative of short term reversion of morbidity. Both tests were appropriate for use in the field with excellent operational performance and reliability. Due to its lower-cost which makes its scale-up of use affordable, FOB could be immediately adopted as a monitoring tool for PC campaigns for efficacy evaluation before and after treatment
Elastic properties of graphyne-based nanotubes
Graphyne nanotubes (GNTs) are nanostructures obtained from rolled up graphyne
sheets, in the same way carbon nanotubes (CNTs) are obtained from graphene
ones. Graphynes are 2D carbon-allotropes composed of atoms in sp and sp2
hybridized states. Similarly to conventional CNTs, GNTs can present different
chiralities and electronic properties. Because of the acetylenic groups (triple
bonds), GNTs exhibit large sidewall pores that influence their mechanical
properties. In this work, we studied the mechanical response of GNTs under
tensile stress using fully atomistic molecular dynamics simulations and density
functional theory (DFT) calculations. Our results show that GNTs mechanical
failure (fracture) occurs at larger strain values in comparison to
corresponding CNTs, but paradoxically with smaller ultimate strength and
Young's modulus values. This is a consequence of the combined effects of the
existence of triple bonds and increased porosity/flexibility due to the
presence of acetylenic groups
Contributions to the Portuguese National Plan for Patient Safety 2021ā2026: A Robust Methodology Based on the Mixed-Method Approach
Introduction: Several countries prioritize patient safety in
their health policies. In Portugal, following the implementation of the National Plan for Patient Safety (NPPS) 2015ā
2020, the research team of the National School of Public
Health (NSPH) carried out extensive work to continue improving aspects of the previous Plan. This work was focused
on identifying the strengths and weaknesses of NPPS 2015ā
2020 and aspects related to its applicability and main challenges and opportunities for the implementation of the
NPPS 2021ā2026. Methods: Methodological dynamic process was based on the most relevant international and national guidelines and the feedback from key patient safety
stakeholders. We developed a cross-sectional mixed-methods study from January to August 2021. We used documentation and periodical reports from National Health Service
(NHS) healthcare institutions as secondary sources of information. For primary data collection, we used an online survey (applied to elements in the different quality and safety
structures of hospitals and primary care units), interviews, and focus groups to collect information from patient safety
experts. Results and Discussion: Strengthening safety culture, patient safety training, communication, leadership involvement, patient and family engagement, and monitorization process is considered essential. We also identified local
limitations such as the lack of resources and protected time
for the healthcare professionals and lack of leadership involvement on patient safety strategies for dedicating to patient safety actions. Most of the patient safety stakeholders
agreed that the safety and health of clinical teams and new
modalities of healthcare (such as telemedicine, home hospitalization, home care) should be a priority for patient safety
strategies. Conclusions: In our study, we used a robust methodology with a participatory process involving different
stakeholders. An alignment between local, regional, and national levels in terms of measuring indicators, the definition
of priorities, and actions and activities to improve patient
safety is recommended. Reinforced partnerships and alignment between the institutionās mission, and safety priorities
will be crucial to enhance patient safety. Additionally, this
work highlights the added value for health systems achieved
through strong partnerships between public administration
and academic institutions to improve healthcare quality and
patient safetyinfo:eu-repo/semantics/publishedVersio
Introducing social sustainability aspects in supplier selection : the role of governmental intervention
This paper aims to understand how governmental intervention can drive organisations to adopt social sustainability aspects in their supplier selection process. The successful case study of the recent introduction of the In-Country-Value program at the Oil and Gas sector of Oman is examined. A survey and interviews with supply chain, contracting and procurement managers were conducted and the primary data was analysed. Governmental intervention was found capable of driving organisations to adopt social sustainability aspects in their supplier selection process, but leads to a 'cap' bounded by governmental requirements if the motivation does not come from within the organisations
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