Miracle-dz/UniFAR-FTUs huggingface dataset:
What Barriers and Facilitators Do School Nurses Experience When Implementing an Obesity Intervention?

A recent evaluation of a school nurse–led obesity intervention demonstrated a 5% implementation rate. The purpose of this study was to explore school nurses’ perceived barriers to and facilitators of the intervention in order to understand reasons for the low implementation rate. Methods included semi-structured individual interviews with school nurses. Data were analyzed using content analysis and heat mapping. Nineteen nurses participated and eight themes were identified. Parental and administrative gatekeeping, heavy nurse workload, obesogenic environments, and concerns about obesity stigma were barriers to implementation. Teamwork with parents and school staff was a key facilitator of implementation. Nurses also noted the importance of cultural considerations and highlighted the need to tailor the intervention to the unique needs of their school environment and student population. These findings suggest that for school nurses to play a key role in school-based obesity interventions, barriers must be identified and addressed prior to program implementation.
Sleep Habits and Nighttime Texting Among Adolescents

The aim of this study was to examine sleep habits (i.e., bedtimes and rising times) and their association with nighttime text messaging in 15- to 17-year-old adolescents. This cross-sectional study analyzed data from a web-based survey of adolescent students attending secondary schools in southern Sweden (N = 278, 50% female). Less than 8 hr of time in bed during school nights was significantly associated with more sleep difficulties, wake time variability on school days and weekends, daytime tiredness, and less enjoyment at school (all ps < .05). Sending and/or receiving text messages (Short Message Service [SMS]) at night was significantly associated with later bedtimes, shorter time in bed, daytime tiredness during school, and irregular sleep habits (p < .05). These findings highlight the importance of regular, consistent sleep habits and the problems associated with sleeping with a cell phone in the bedroom.
Repeated catastrophic valley infill following medieval earthquakes in the Nepal Himalaya

Nepal's quake-driven landslide hazards Large earthquakes can trigger dangerous landslides across a wide geographic region. The 2015 Mw 7.8 Gorhka earthquake near Kathmandu, Nepal, was no exception. Kargal et al. used remote observations to compile a massive catalog of triggered debris flows. The satellite-based observations came from a rapid response team assisting the disaster relief effort. Schwanghart et al. show that Kathmandu escaped the historically catastrophic landslides associated with earthquakes in 1100, 1255, and 1344 C.E. near Nepal's second largest city, Pokhara. These two studies underscore the importance of determining slope stability in mountainous, earthquake-prone regions. Science, this issue p. 10.1126/science.aac8353; see also p. 147 Sediment records are used to identify catastrophic debris flows from paleoquakes near Pokhara, Nepal. Geomorphic footprints of past large Himalayan earthquakes are elusive, although they are urgently needed for gauging and predicting recovery times of seismically perturbed mountain landscapes. We present evidence of catastrophic valley infill following at least three medieval earthquakes in the Nepal Himalaya. Radiocarbon dates from peat beds, plant macrofossils, and humic silts in fine-grained tributary sediments near Pokhara, Nepal’s second-largest city, match the timing of nearby M > 8 earthquakes in ~1100, 1255, and 1344 C.E. The upstream dip of tributary valley fills and x-ray fluorescence spectrometry of their provenance rule out local sources. Instead, geomorphic and sedimentary evidence is consistent with catastrophic fluvial aggradation and debris flows that had plugged several tributaries with tens of meters of calcareous sediment from a Higher Himalayan source >60 kilometers away.
Genomic islands of speciation separate cichlid ecomorphs in an East African crater lake

Cichlids diverge within a crater lake It is not clear how populations diversify and new species form at the genomic level, especially when they coexist in the same location. Malinsky et al. investigated how two ecomorphs of cichlid fish in a small lake in Tanzania are diversifying relative to each other. Although there is gene flow between the two forms, major regions of genetic divergence, known as genomic islands, separate the populations. Within these islands, the authors found genes likely to be associated with mate choice, supporting the idea that genetic changes related to breeding preferences are the first to diverge during speciation. Science, this issue p. 1493 Incipient species of African cichlid fish have divergent genomic islands associated with mate choice. The genomic causes and effects of divergent ecological selection during speciation are still poorly understood. Here we report the discovery and detailed characterization of early-stage adaptive divergence of two cichlid fish ecomorphs in a small (700 meters in diameter) isolated crater lake in Tanzania. The ecomorphs differ in depth preference, male breeding color, body shape, diet, and trophic morphology. With whole-genome sequences of 146 fish, we identified 98 clearly demarcated genomic “islands” of high differentiation and demonstrated the association of genotypes across these islands with divergent mate preferences. The islands contain candidate adaptive genes enriched for functions in sensory perception (including rhodopsin and other twilight-vision–associated genes), hormone signaling, and morphogenesis. Our study suggests mechanisms and genomic regions that may play a role in the closely related mega-radiation of Lake Malawi.
How can higher-yield farming help to spare nature?

Mechanisms to link yield increases with conservation Expansion of land area used for agriculture is a leading cause of biodiversity loss and greenhouse gas emissions, particularly in the tropics. One potential way to reduce these impacts is to increase food production per unit area (yield) on existing farmland, so as to minimize farmland area and to spare land for habitat conservation or restoration. There is now widespread evidence that such a strategy could benefit a large proportion of wild species, provided that spared land is conserved as natural habitat (1). However, the scope for yield growth to spare land by lowering food prices and, hence, incentives for clearance (“passive” land sparing) can be undermined if lower prices stimulate demand and if higher yields raise profits, encouraging agricultural expansion and increasing the opportunity cost of conservation (2, 3). We offer a first description of four categories of “active” land-sparing mechanisms that could overcome these rebound effects by linking yield increases with habitat protection or restoration (table S1). The effectiveness, limitations, and potential for unintended consequences of these mechanisms have yet to be systematically tested, but in each case, we describe real-world interventions that illustrate how intentional links between yield increases and land sparing might be developed.
Effects of Non-Identical Rayleigh Fading on Differential Unitary Space-Time Modulation

Non-identical fading distribution in a multiple-input multiple-output (MIMO) channel, including unequal average channel gains and fade rates, often occurs when antennas are not co-located. In this paper, we present an analytical study of the effects of non-identical Rayleigh fading on the error performance of differential unitary space-time modulation (DUSTM). The fading processes for different transmit-receive antenna pairs are assumed to be independent and time-variant. We find that the maximum-likelihood (ML) differential detector of DUSTM over such channels is involved except for differential cyclic group codes. The conventional detector is proved to be asymptotically optimal in the limit of high signal-to-noise ratio (SNR) over static fading channels. Applying the distribution of quadratic forms of Gaussian vectors, we then derive closed-form expressions for the exact error probabilities of two specific unitary classes, namely, cyclic group codes and orthogonal codes. Simple and useful asymptotic bounds on error probabilities are also obtained. Our analysis leads to the following general findings: (1) equal power allocation is asymptotically optimal, and (2) non-identical channel gain distribution degrades the error performance. Finally, we also introduce a water-filling based power allocation to exploit the transmit non-identical fading statistics.
Treatment of epilepsy in postmenopausal women

Menopausal women represent a rapidly growing proportion of the population. Epidemiologic evidence for the increased incidence of epilepsy in elderly patients suggests that with global aging of the population, there is likely to be a growing need for healthcare workers to manage seizures in older women. Unfortunately, there has been relatively little scientific investigation into the unique concerns of postmenopausal woman with epilepsy. There is some evidence that women may experience increased seizure activity during the menopausal transition owing to the effects of estrogen and progesterone on neuronal excitability. During perimenopause and menopause, use of hormone-replacement therapy can also worsen seizure control. Menopausal women are particularly vulnerable to osteoporosis and fragility fractures, both of which demonstrate increased risk following exposure to antiepileptic drugs. Optimization of epilepsy therapy to avoid both seizures and falls caused by antiepileptic drug-induced imbalance is cruc.
The Role of School Nurses, Challenges, and Reactions to Delegation Legislation: A Qualitative Approach

Passage of new laws, national standards regarding delegation, and the recommendation for at least one full-time nurse in every school have provided more visibility to the role of school nurses. Recent legislative amendments in Kentucky presented an opportunity to examine how the role of the school nurse is changing. Aims were to describe the (1) role of school nurses in Kentucky, (2) impact of school nurses, (3) challenges faced by school nurses, and (4) impact of budget cuts and legislation. Three focus groups were conducted. School nurses faced challenges of limited time and resources, communication barriers, and multiple documentation requirements. Nurses’ greatest impacts were their availability, recognition of psychosocial problems and health concerns, and connection with resources. Nurses had not yet encountered many changes due to new legislation that expanded delegation of diabetes-related tasks to unlicensed school personnel, but some had concerns about possible negative effects while others expressed support.
Cotranslational protein folding on the ribosome monitored in real time

Proteins shape up in the ribosome Proteins consist of linear chains of amino acids. These chains must fold into complex three-dimensional shapes to become functional. Holtkamp et al. “watched” how a small helical protein folds as it is being synthesized by the ribosome. The lengthening polypeptide passes out through the ribosome exit tunnel where folding starts. The initially compact structure quickly rearranges into a native three-dimensional structure as the polypeptide emerges from the tunnel. Science, this issue p. 1104 A small protein folds into a non-native form as it is synthesized on the ribosome before adopting its native shape. Protein domains can fold into stable tertiary structures while they are synthesized on the ribosome. We used a high-performance, reconstituted in vitro translation system to investigate the folding of a small five-helix protein domain—the N-terminal domain of Escherichia coli N5-glutamine methyltransferase HemK—in real time. Our observations show that cotranslational folding of the protein, which folds autonomously and rapidly in solution, proceeds through a compact, non-native conformation that forms within the peptide tunnel of the ribosome. The compact state rearranges into a native-like structure immediately after the full domain sequence has emerged from the ribosome. Both folding transitions are rate-limited by translation, allowing for quasi-equilibrium sampling of the conformational space restricted by the ribosome. Cotranslational folding may be typical of small, intrinsically rapidly folding protein domains.
Optimum and suboptimum memoryless nonlinearities for the detection of ultrashort light pulses in Gaussian noise

Detection of ultrashort light pulses with conventional bandlimited photodetectors can lead to substantial performance degradation in digital lightwave communication systems. All-optical nonlinear processing of the received field prior to the optical to electrical conversion can greatly overcome this problem. In this letter, through a decision-theoretic framework and using a basic invariance property of the photodetector, we obtain the optimal zero-memory nonlinear element and evaluate its performance. Possible suboptimum nonlinearities are also investigated and their performance is examined. The results in this letter strongly justify the intuitive use of power-law devices, such as those implemented via two photon absorption (TPA) or second harmonic generation (SHG), in the detection of ultrashort light pulses and show how by using them almost optimal performance can be achieved.
Fathers' perspectives on breastfeeding: ideas for intervention

This article presents the findings of a small-scale qualitative study with fathers which was part of a larger social marketing project focusing on increasing rates of exclusive breastfeeding in Brighton and Hove. In-depth semi-structured interviews were used to explore fathers' experiences during the pregnancy, birth and up to the first year. Findings revealed a number of potential areas which may be of use to midwives, health visitors, and other health professionals to increase the initiation and continuance of breastfeeding. In addressing these possibilities, we also discuss a number of practical ways forward and suggest areas for future research.
Impact of Pharmacists’ Interventions and Simvastatin Dose Restrictions

Background: On June 8, 2011, the United States Food and Drug Administration (FDA) reported safety concerns regarding statin-related myopathies and advised further restrictions on simvastatin dosing. These restrictions reduced the maximum dose for specific patient characteristics, primarily certain concomitant medications. Objective: The purpose of this study was to compare the effectiveness of 2 different pharmacist-conducted educational interventions on appropriate simvastatin use in the primary care setting. Methods: This retrospective cohort analysis was conducted in 2 academic medical center clinics. Patients prescribed simvastatin before June 8, 2011, requiring dosage adjustment based on labeling changes were evaluated for study inclusion. The pharmacists’ interventions included: 30-minute didactic session for prescribers or patient-specific recommendation communicated with the physician during the patient’s follow-up visit. Primary outcomes were the number of patients prescribed FDA-recommended simvastatin doses after pharmacist intervention and the intervention’s impact on low-density lipoprotein (LDL). Results: Medical record review identified 1173 patients prescribed simvastatin prior to June 8, 2011; 126 patients qualified for study inclusion. After controlling for baseline characteristics, the likelihood of patients being prescribed an appropriate dose postintervention increased if they were in the patient-specific recommendation group (odds ratio [OR] = 10.59; 95% CI = 3.43-32.69; P < .0001). LDL change occurred at a similar rate between intervention groups (P = .652). Conclusion: Following FDA labeling changes for simvastatin, patient-specific recommendations made by pharmacists correlated with a greater likelihood of appropriate simvastatin dosing compared with a one-time didactic education session. Patient-specific recommendations positively affect prescribing habits and making steps to improve patient safety.
Extended multilevel prime codes for optical CDMA

In this paper, a new family of "multilevel" wavelength-time codes with expanded code cardinality, flexible code length, zero autocorrelation sidelobes, and the maximum cross-correlation function of any arbitrary positive integer n is constructed and analyzed. Besides having asymptotically optimal cardinality, the new codes can be partitioned into n levels, such that the cross-correlation function between any two code matrices in level l is at most l, where 1 ¿ l ¿ n. The hardlimiting performance of these multilevel codes is analyzed algebraically. Our results show that the unique partitioning property of these multilevel codes supports a trade-off between code cardinality and performance for meeting different system requirements, such as user capacity and throughput.
Comparison of the efficacy and safety of a new recombinant human follicle‐stimulating hormone (DA‐3801) with follitropin‐α (Gonal‐F®) in women undergoing controlled ovarian hyperstimulation for assisted reproductive technology

Aim: To compare the efficacy and safety of a new recombinant human follicle‐stimulating hormone (FSH; DA‐3801) with follitropin‐α (Gonal‐F®) in women undergoing controlled ovarian hyperstimulation (COH) for assisted reproductive technology (ART).
Recovering Cooperative Multiplexing Gain in Wireless Relay Networks

We consider an uplink communication in a wireless network where each source-user is assisted by M half-duplex relays. The source users and relays are equipped with single-antenna whereas the destination has N antennas. We show that the degree of freedom (d.o.f.) of this network is limited by the links from the source to the collection of relays and destination. This phenomenon is referred to as a "d.o. f. bottleneck problem" which compromise the cooperative multiplexing gain (CMG) and the achievable rate of the system. To improve the CMG, we propose an auxiliary frequency bands (AFBs)-based approach to tackle the d.o. f. bottleneck problem. Information theoretic analysis and numerical results show that the proposed scheme can achieve a CMG of min(M+1,N) when the number of AFBs is sufficiently large. As compared with conventional cooperative communications, the improved multiplexing gain of the proposed scheme is translated into tremendously increased achievable rate at a relatively high SNR.
Characteristics of HIV/AIDS Patients Presenting Late at a Teaching Hospital in Nigeria

Background: The introduction of highly active antiretroviral therapy (HAART) has significantly reduced the morbidity and mortality associated with HIV/AIDS. This benefit that HAART confers can only be maximized if patients present early. This study was embarked upon to describe the characteristics of patients presenting late at a teaching hospital in north central Nigeria. Methodology: This was a cross sectional study of patients who presented late with HIV/AIDS admitted into the medical wards of the Jos University Teaching Hospital over a one year period. Late presentation was defined as patients presenting in CDC class B or C Results: 56.7% of patients who were admitted with HIV /AIDS presented late with the majority (79%) being in CDC class C. The median CD4+ cell count was 88 cells/mm3 with a range of 12 -552 cells/mm3. Reasons for late presentation included fear of stigma 35 (46.7%), financial constraints 23 (30.7%), faith in herbal / spiritual healing 8 (10.7%) and not believing in HIV treatment 5 (6.7%). No one came to hospital in late stage because of distance from hospital. Similarly HCT services were not accessed early because of fear of stigma 37 (50.7 %), not wanting to know about status 29 (39.2 %), absence of symptoms 51(68%) and seeing partner as faithful 28 (38.9%). Tuberculosis was the commonest reason for hospitalization Conclusions: Stigma was the major reason for delayed HIV testing and late presentation. Public education and enlightenment on the need for routine HCT and early presentation for care and treatment is advocated. Original Article
Evaluation of Adjunctive Ketamine to Benzodiazepines for Management of Alcohol Withdrawal Syndrome

Background: Adjunctive medications to manage alcohol withdrawal syndrome (AWS) in patients not adequately responding to escalating doses of benzodiazepines (BZDs) are limited. The use of the N-methyl-d-aspartate antagonist ketamine, may serve as an effective adjunct agent; however, no published data currently exist for this practice. Objective: To determine the safety and efficacy of adjunct ketamine for management of AWS. Methods: The study was a retrospective review of adult patients from April 2011 to March 2014 who were administered ketamine specifically for management of AWS. Outcomes included changes in BZD requirements and ketamine-related adverse reactions. Results: Of 235 patients screened, 23 patients met study eligibility. Ketamine was initiated primarily with toxicology consultation for significant BZD requirements or delirium tremens. The mean time to initiation of ketamine from first treatment of AWS, and total duration of therapy were 33.6 and 55.8 hours, respectively. Mean initial infusion dose and median total infusion rate during therapy were 0.21 and 0.20 mg/kg/h, respectively. There was no change in sedation or alcohol withdrawal scores in patients within 6 hours of ketamine initiation. The median change in BZD requirements at 12 and 24 hours post–ketamine initiation were −40.0 and −13.3 mg, respectively. The mean time to AWS resolution was 5.6 days. There was one documented adverse reaction of oversedation, requiring dose reduction. Conclusions: Ketamine appears to reduce BZD requirements and is well tolerated at low doses. Prospective dose range evaluations in the management of AWS would be helpful in determining its place as an adjunctive agent.
How surface composition and meteoroid impacts mediate sodium and potassium in the lunar exosphere

The Moon's time-variable exosphere Earth's Moon does not have a conventional gaseous atmosphere, but instead an “exosphere” of particles ejected from the surface. Colaprete et al. have used NASA's LADEE orbiter to investigate how the exosphere varies over time, by using the glow from sodium and potassium atoms as a probe (see the Perspective by Dukes and Hurley). The exosphere composition varies by a factor of 2 to 3 over the course of a month, as different parts of the Moon are exposed to sunlight. There are also increases shortly after the Moon passes through streams of meteoroids. Science, this issue p. 249; see also p. 230 The Moon’s tenuous atmosphere varies over each month and after meteoroid streams. [Also see Perspective by Dukes and Hurley] Despite being trace constituents of the lunar exosphere, sodium and potassium are the most readily observed species due to their bright line emission. Measurements of these species by the Ultraviolet and Visible Spectrometer (UVS) on the Lunar Atmosphere and Dust Environment Explorer (LADEE) have revealed unambiguous temporal and spatial variations indicative of a strong role for meteoroid bombardment and surface composition in determining the composition and local time dependence of the Moon’s exosphere. Observations show distinct lunar day (monthly) cycles for both species as well as an annual cycle for sodium. The first continuous measurements for potassium show a more repeatable variation across lunations and an enhancement over KREEP (Potassium Rare Earth Elements and Phosphorus) surface regions, revealing a strong dependence on surface composition.