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PubMedDate not supplied

New graduate RN internship program: a collaborative approach for system-wide integration.

Population growth and aging increase the demand for skilled nurses. Hospitals face the challenge of supplying experienced and qualified caregivers. The cost of training new nurses remains significant. Nursing educators are pivotal in developing the nursing workforce, especially under tightening constraints. This article examines the development of a nursing internship program aimed at attracting and retaining newly graduated nurses and its effect on retention to the institution.

Cooperative Behavior↗
PubMed2006

The new enzyme-linked immunosorbent digoxin assay on the ADVIA Integrated Modular System is virtually free from oleander interference.

Despite known toxicity of oleander, this product is used in herbal preparations. Oleander interferes with various digoxin immunoassays. It is possible that a person taking digoxin also may take oleander-containing herbal products, and digoxin immunoassays interfering with oleander cannot be used for therapeutic monitoring of digoxin. Recently, Bayer Diagnostics introduced a new enzyme-linked chemiluminescent immunosorbent digoxin assay for application on the ADVIA IMS System (ECLIA-digoxin). We studied potential interference of oleander with this new digoxin assay and found that this assay is virtually free from oleander interference. When aliquots of drug-free serum pools were supplemented with ethyl alcohol extract of oleander leaf or pure oleandrin standard, we observed significant apparent digoxin concentration when measured by the fluorescence polarization immunoassay (FPIA) but minimal digoxin-like immunoreactivity using the ECLIA digoxin assay. Because cross-reactivity should be studied in the presence of primary analyte, we prepared 2 serum pools using sera from patients receiving digoxin. Then aliquots of first digoxin pool were supplemented with oleandrin standard and aliquots of second digoxin pool with oleander extract. We observed significant increases in apparent digoxin concentration in the presence of both oleandrin and oleander extract using the FPIA. However, we observed no statistically significant change in digoxin concentration when ECLIA digoxin assay was used, indicating that this assay is virtually free from oleander interference.

Cardenolides↗
PubMed2003

Validation of an integrated staging system toward improved prognostication of patients with localized renal cell carcinoma in an international population.

PURPOSE: Outcome prediction for patients with renal cell carcinoma is based on a combination of factors. In this study a previously published clinical outcome algorithm based on 1997 T stage, Fuhrman grade and performance score is validated using an international database. MATERIALS AND METHODS: A total of 1,060 patients from Nijmegen, the Netherlands (NN), MD Anderson (MDA) and University of California, Los Angeles (UCLA) who had localized renal cell carcinoma were evaluated for outcome prediction using a clinical outcome algorithm previously shown to stratify patients into low, intermediate and high risk groups. Validation was performed by comparing the 3 risk groups separately within the 3 centers as well as by comparing hazard ratios and concordance indices among the 3 centers. RESULTS: Estimated disease specific survival rates at 5 years for the low risk groups were 94% (NN), 92% (MDA) and 93% (UCLA). The 5-year disease specific survival rates for the intermediate risk groups were 65% (NN), 73% (MDA) and 78% (UCLA), while the rates for the high risk groups were 40% (NN), 30% (MDA) and 48% (UCLA). The concordance indices for each of the databases were 79% (NN), 86% (MDA) and 84% (UCLA). CONCLUSIONS: A clinical algorithm that uses only 3 prognostic variables (1997 T stage, Fuhrman grade and performance status) to stratify patients with localized renal cell carcinoma into 3 risk groups has been shown to be applicable to external databases. This algorithm may be useful for patient counseling, surveillance and identification of high risk patients for enrollment in clinical trials.

Algorithms↗
PubMed2003

Two-soliton collisions in a near-integrable lattice system.

We examine collisions between identical solitons in a weakly perturbed Ablowitz-Ladik (AL) model, augmented by either onsite cubic nonlinearity (which corresponds to the Salerno model, and may be realized as an array of strongly overlapping nonlinear optical waveguides) or a quintic perturbation, or both. Complex dependences of the outcomes of the collisions on the initial phase difference between the solitons and location of the collision point are observed. Large changes of amplitudes and velocities of the colliding solitons are generated by weak perturbations, showing that the elasticity of soliton collisions in the AL model is fragile (for instance, the Salerno's perturbation with the relative strength of 0.08 can give rise to a change of the solitons' amplitudes by a factor exceeding 2). Exact and approximate conservation laws in the perturbed system are examined, with a conclusion that the small perturbations very weakly affect the norm and energy conservation, but completely destroy the conservation of the lattice momentum, which is explained by the absence of the translational symmetry in generic nonintegrable lattice models. Data collected for a very large number of collisions correlate with this conclusion. Asymmetry of the collisions (which is explained by the dependence on the location of the central point of the collision relative to the lattice, and on the phase difference between the solitons) is investigated too, showing that the nonintegrability-induced effects grow almost linearly with the perturbation strength. Different perturbations (cubic and quintic ones) produce virtually identical collision-induced effects, which makes it possible to compensate them, thus finding a special perturbed system with almost elastic soliton collisions.

Journal Article↗