Revisiting factors associated with blood culture positivity: Critical factors after the introduction of automated continuous monitoring blood culture systems.

Blood culture is the main tool used to identify causative pathogens. Adequate volume and number of culture sets are considered key to blood culture positivity rate. It is not known whether these factors remain critical to the positivity rate after the introduction of automated continuous blood culture system monitoring. We measured blood volume per bottle and described the distribution of blood volume and number of culture sets. Multivariate logistic regression was performed to determine the independent association of blood volume, number of culture sets, diagnosis of sepsis in a patient, and other covariates with blood culture results. Only 6.9% of the blood culture bottle volumes complied with the guidance (8-10 mL), with the highest culture positivity rate (18%). Of the culture events, only one set of blood was cultured in 60.9% of events. In the multivariate analysis, blood culture volume per event (odds ratio [OR], 1.09 [95% confidence interval [CI], 1.06-1.11]), patients with a diagnosis of sepsis (OR, 2.86 [95% CI, 2.06-3.98]), and samples from the emergency department (OR, 2.29 [95% CI, 1.72-3.04]), but not the number of culture sets (OR, 0.74 [95% CI, 0.50-1.12]), were observed to be statistically significant with respect to blood culture positivity rate. Our results revealed that the total blood culture volume and the diagnosis of sepsis were critical factors affecting blood culture positivity rate. However, the proportion of blood culture bottles with the optimal blood volume was very low, and optimizing blood volume would be key to increasing blood culture positivity rate.

[Testing the Reliability and Validity of the Taiwan Health-Related Quality of Life for Nausea and Vomiting During Pregnancy Scale].

BACKGROUND: Symptom distress related to pregnancy-related nausea and vomiting is known to impact quality of life in pregnant women. However, few reliable and valid assessment tools are available for research use. PURPOSE: To test the reliability and validity of the Taiwan health-related quality of life for nausea and vomiting during pregnancy (NVPQOL) scale. METHODS: A cross-sectional study design was conducted. A convenience sample of 416 pregnant women in their first and second trimesters were recruited from the prenatal clinics of one medical center and one regional teaching hospital in southern Taiwan. Chi-square tests, item analysis, and principal axis factor analysis were used to examine construct validity. Pearson's correlation coefficient was then conducted to compare the concurrent validity of the scale against the Chinese-language version of the World Health Organization Quality of Life Assessment [WHOQOL-BREF (TW)]. RESULTS: Four factors were extracted using factor analysis: "limitations" (10 items), "physical symptoms/aggravating factors" (9 items), "emotions" (6 items), and "fatigue" (4 items), which together accounted for 67.45% of the total variance. The NVPQOL showed good convergent (r = .78 ~ .85, p < .01), discriminate (r = .48 - .68, p < .01), and concurrent validities, with a -0.37 correlation coefficient between the WHOQOL-BREF (TW) and the NVPQOL (p < .01). The Cronbach's α of the NVPQOL was .95. The intraclass correlation coefficient for test-retest reliability of two weeks was .92 (n = 37, p < .001). CONCLUSIONS / IMPLICATIONS FOR PRACTICE: The NVPQOL may be used in future research and clinical assessment to measure quality of life in women who experience nausea and vomiting during pregnancy in order to provide appropriate nursing interventions in a timely manner to improve quality of life.

Influence of residential environment and lifestyle on multiple primary malignancies in Taiwan.

BACKGROUND: Multiple primary malignancies (MPM) have become increasingly prevalent worldwide. This investigation was aimed at establishing the clinicopathological characteristics of MPM patients and evaluating the impact of the living environment on MPM in the Taiwanese population. MATERIALS AND METHODS: From January 2009 to December 2013, a total of 8,268 cancer patients were identified in our institutional center. Of these, 125 were diagnosed as MPM and thus enrolled. Data for clinicopathological features and treatment approaches for these MPM patients living in urban or suburb zone were obtained. Findings for the air pollution status in Taiwan were also collected. RESULTS: The most common cancer match of MPM was esophageal cancer with hypopharyngeal cancer (12.8%), followed by colorectal cancer with gastric cancer (6.4%) and colorectal cancer with breast cancer (5.6%). The air quality was significantly worse in the urban than in the suburban zone and there was a remarkably higher portion of MPM patients in the urban zone suffering from grade III and IV post-chemotherapeutic neutropenia (30.8% vs 15.1%, P=0.036). CONCLUSIONS: The tumor frequency and site distribution should be taken into the clinical evaluation because there is a relatively high risk of developing MPM. This study also highlighted the potential influence of environmental factors on post-chemotherapeutic neutropenia for patients with MPM.

Reaction mechanisms and kinetics of the iminovinylidene radical with NO: ab initio study.

The nitric oxide (NO) is a notorious compound for polluting environment. Recent year, removing nitric oxide from the atmosphere becomes a focus of the investigation. In our work, we study the iminovinylidene (HNCC) radical reacted with NO molecule. The mechanism and kinetic for reaction of the HNCC radical with the NO molecule is investigated via considering the possible channels of the N and O atoms of NO attacking the N and C atoms of the HNCC based on the high level ab initio molecular orbital calculations in conjunction with variational TST and RRKM calculations. The species involved have been optimized at the B3LYP/6-311++G(3df,2p) level and their single-point energies are refined by the CCSD(T)/aug-cc-PVQZ//B3LYP/6-311++G(3df,2p) method. The calculated potential energy surfaces indicated that energetically the most favorable channel for the HNCC + NO reaction was predicted to be the formation of HNC+CNO (P8) product via the addition reaction of the C atom of HNCC radical and the N atom of NO with the head to head orientation. To rationalize the scenario of the calculated results, we also employ the Fukui functions and HSAB theory to seek for a possible explanation. In addition, the reaction rate constants were calculated using VariFlex code, and the results show that the total rate coefficient, ktotal, at Ar pressure 760 Torr can be represented with an equation: ktotal = 6.433 × 10(-11) T (0.100) exp(0.275 kcal mol(-1)/RT) at T = 298-3000 K, in units of cm(3) molecule(-1) s(-1).