759 research outputs found

    Factors Influencing the Development of Social Change Involvement

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    How to cultivate and encourage the motivation to become an agent of positive social change has not been studied to a great degree. For example, what kind of factors influence the development and growth in nurses toward a desire to be involved in changing society for the better? Knowledge of these factors could help educators and nurse leaders provide and encourage those growth opportunities. The purpose of this research was to interview nurses known to be deeply involved in various types of positive social change and discover what factors influenced this development. Three overall themes emerged as influencing factors for involvement in positive social change including emerging perspectives; experiences and encounters; and consideration of the successful effects of social change attempts

    18F-FDG PET-Derived Volume-Based Parameters to Predict Disease-Free Survival in Patients with Grade III Breast Cancer of Different Molecular Subtypes Candidates to Neoadjuvant Chemotherapy

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    We investigated whether baseline [F-18] Fluorodeoxyglucose (F-18-FDG) positron emission tomography (PET)-derived semiquantitative parameters could predict disease-free survival (DFS) in patients with grade III breast cancer (BC) of different molecular subtypes candidate to neoadjuvant chemotherapy (NAC). For each F-18-FDG-PET/CT scan, the following parameters were calculated in the primary tumor (SUVmax, SUVmean, MTV, TLG) and whole-body (WB_SUVmax, WB_MTV, and WB_TLG). Receiver operating characteristic (ROC) analysis was used to determine the capability to predict DFS and find the optimal threshold for each parameter. Ninety-five grade III breast cancer patients with different molecular types were retrieved from the databases of the University Hospital of Padua and the University Hospital of Ferrara (luminal A: 5; luminal B: 34; luminal B-HER2: 22; HER2-enriched: 7; triple-negative: 27). In luminal B patients, WB_MTV (AUC: 0.75; best cut-off: WB_MTV > 195.33; SS: 55.56%, SP: 100%; p = 0.002) and WB_TLG (AUC: 0.73; best cut-off: WB_TLG > 1066.21; SS: 55.56%, SP: 100%; p = 0.05) were the best predictors of DFS. In luminal B-HER2 patients, WB_SUVmax was the only predictor of DFS (AUC: 0.857; best cut-off: WB_SUVmax > 13.12; SS: 100%; SP: 71.43%; p < 0.001). No parameter significantly affected the prediction of DFS in patients with grade III triple-negative BC. Volume-based parameters, extracted from baseline F-18-FDG PET, seem promising in predicting recurrence in patients with grade III luminal B and luminal B- HER2 breast cancer undergoing NAC

    Bridging the Gap Rather Than Filling the Entire Valley-Anatomic Insights When Treating the Medial Infraorbital Region

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    Background: The treatment of the medial infraorbital region also termed the tear trough has become increasingly popular by the use of soft tissue fillers in a minimally invasive approach using a cannula. Methods: A total of 246 tear troughs were injected and investigated originating from 123 study participants. The clinical outcome was evaluated 6 months after the treatment by independent observers based on standardized frontal images and the procedure was documented by ultrasound imaging. Results: On average, 0.26 (0.1) cc [range: 0.08–0.32] of soft tissue filler material was injected per tear trough. Tear trough depth was before the treatment rated as 2.12 (0.4), whereas after the treatment it was 1.15 (0.4) (p &lt; 0.001). Hyperpigmentation score was 2.19 (0.4) before the treatment, whereas after the treatment it was 1.31 (0.5) (p &lt; 0.001). Intraorbital fat pseudo-prolapse severity was rated before the treatment 1.88 (0.7), whereas it was rated after the treatment 1.14 (0.3) (p &lt; 0.001). Wrinkle severity of the lower eyelid was rated before the treatment 1.51 (0.6), whereas it was rated after the treatment 1.12 (0.3) (p &lt; 0.001). Conclusion: The results of this retrospectively investigated case series revealed that the conducted injection technique for treating the tear trough for medial infraorbital hollowing with a cannula provided statistically significant clinical improvement with a limited adverse events profile. The technique utilized an injection approach which was perpendicularly oriented to the longitudinal axis of the tear trough thereby “bridging the gap instead of filling the entire valley.”.</p

    Progression of Renal Impairment and Chronic Kidney Disease in Chronic Heart Failure:An Analysis From GISSI-HF

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    AbstractBackgroundData on the natural change in renal function in patients with chronic heart failure (HF) are limited.Methods and ResultsEstimated glomerular filtration rate (eGFR) was assessed over 36 months in 6934 patients included in the GISSI-HF study. Associations from baseline, changes in renal function, and occurrence of cardiovascular death or HF hospitalization were assessed. Mean age was 67 years, mainly men (78%), and mean eGFR was 68 mL • min−1 • 1.73 m−2. Change in eGFR in the 1st year was −1.5 ± 16 mL • min−1 • 1.73 m−2, and over 36 months it was −3.7 ± 18 mL • min−1 • 1.73 m−2. Over the latter period, only 25% deteriorated ≥1 Kidney Disease Outcomes Quality Initiatives (KDOQI) class of chronic kidney disease (CKD). Fifteen percent of patients had >15 mL • min−1 • 1.73 m−2 decrease in eGFR in the 1st 12 months. Lower eGFR was associated with outcome: hazard ratio (HR) 1.10, 95% confidence interval (CI) 1.08–1.10 (P < .001) per 10 mL • min−1 • 1.73 m−2 decrease, as well as every 10 mL • min−1 • 1.73 m−2 decrease over the 1st year (HR 1.10, 95% CI 1.04–1.17; P < .001). A deterioration in eGFR >15 mL • min−1 • 1.73 m−2 in the 1st year showed the highest risk of events (HR 1.22, 95% CI 1.10–1.36; P < .001).ConclusionsMean decrease in renal function over time in patients with chronic HF was modest. Only 25% deteriorated ≥1 KDOQI class of CKD after 3 years. Any decrease in eGFR over time was associated with strongly increased event rates
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