Miracle-dz/UniFAR-FTUs huggingface dataset:
Post‐traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the Yushu earthquake: a cross‐sectional survey in China

AIMS AND OBJECTIVES To examine the prevalence of post-traumatic stress disorder symptoms and to explore the predictive factors of post-traumatic stress disorder symptoms among bereaved adolescents four years after the Yushu earthquake. BACKGROUND On 14 April 2010, the 7·1-magnitude Yushu earthquake occurred in the high-altitude, hypoxia-prone regions primarily inhabited by ethnic minorities. Many adolescents lost their parents during the earthquake. This study examined post-traumatic stress disorder and its predictors among bereaved Tibetan adolescents four years after the trauma in China. DESIGN This was a cross-sectional descriptive study. METHODS This study used a cross-sectional design with 830 bereaved adolescents. Participant demographic data included gender, age and grade, and the earthquake exposure variables included the deceased relatives, whether they were buried, injured or amputated (non-life-threatening) and whether they witnessed a burial, injury or death. The post-traumatic stress disorder Checklist-Civilian version was used to assess the symptoms and prevalence of post-traumatic stress disorder, and the Coping Style Scale assessed coping styles. RESULTS The results indicated that the prevalence of post-traumatic stress disorder was 19·3%. Individuals who were buried, injured or amputated (non-life-threatening), who witnessed a burial, injury or death, who suffered severe property loss during the earthquake and who had negative coping skills were the most likely individuals to have post-traumatic stress disorder symptoms. CONCLUSIONS The presence of post-traumatic stress disorder was very prevalent among adolescents four years after the Yushu earthquake. Effective mental health services should be developed to facilitate postdisaster recovery for bereaved adolescents at high risk for post-traumatic stress disorder. RELEVANCE TO CLINICAL PRACTICE The findings in this study improve our understanding of post-traumatic stress disorder and related risk factors in bereaved adolescents in non-Western communities, providing useful information for rebuilding and relief work.
Gender impacts mortality after traumatic brain injury in teenagers

BACKGROUND Gender may influence outcomes following traumatic brain injury (TBI) although the mechanism is unknown. Animal TBI studies suggest that gender differences in endogenous hormone production may be the source. Limited retrospective clinical studies on gender present varied conclusions. Pediatric patients represent a unique population as pubescent children experience up-regulation of endogenous hormones that varies dramatically by gender. Younger children do not have these hormonal differences. The aim of this study was to compare pubescent and prepubescent females with males after isolated TBI to identify independent predictors of mortality. METHODS We performed a retrospective review of the National Trauma Data Bank Research Data Sets from 2007 and 2008 looking at all blunt trauma patients 18 years or younger who required hospital admission after isolated, moderate-to-severe TBI, defined as head Abbreviated Injury Scale (AIS) score 3 or greater. We excluded all individuals with AIS score of 3 or greater for any other region to limit the confounding effect of comorbidities. Based on the median age of menarche, we defined two age groups as follows: prepubescent (0–12 years) and pubescent (>12 years). Analysis was performed to compare trauma profiles and outcomes between groups. Our primary outcome measure was in-hospital mortality. RESULTS A total of 20,280 patients met inclusion criteria; 10,135 were prepubescent, and 10,145 were pubescent. Overall mortality was 6.9%, and lower mortality was noted among prepubescent patients compared with pubescent (5.2% vs. 8.6%, p < 0.0001). Although female gender did not predict reduced mortality in the prepubescent cohort (adjusted odds ratio, 1.05; 95% confidence interval, 0.85–1.30; p = 0.63), female gender was associated with reduced mortality in the pubescent (adjusted odds ratio, 0.78; 95% confidence interval, 0.65–0.93; p = 0.007). CONCLUSION In contrast to prepubescent female gender, pubescent female gender predicts reduced mortality following isolated, moderate-to-severe TBI. Endogenous hormonal differences may be a contributing factor and require further investigation. LEVEL OF EVIDENCE Prognostic study, level III.
Left ventricular twist and shear in patients with primary mitral regurgitation

To evaluate the relationship between left ventricular (LV) twist, shear, and twist‐per‐volume and the severity of mitral regurgitation (MR). Primary MR is a valvular disorder that induces LV dysfunction. There exist several measures of LV rotational mechanics, but it remains unclear which measure of LV dysfunction best accords with the severity of MR. We hypothesized that LV systolic twist‐per‐volume slope would decrease with increasing severity of MR because of both decreases in rotational mechanics and increases in stroke volumes.
BMP-2 and ALP gene expression induced by a BMP-2 gene–fibronectin–apatite composite layer

The bone morphogenetic protein 2 (BMP-2) gene delivery system with a gene–fibronectin (Fn)–apatite composite layer was fabricated on the surface of a hydroxyapatite ceramic scaffold. The BMP-2 gene–Fn–apatite composite layer was coated on the scaffold using a supersaturated calcium phosphate solution supplemented with BMP-2 DNA and Fn. The scaffolds were ectopically implanted into the dorsal subcutaneous tissue of rats. Four weeks after the implantation, the hydroxyapatite scaffold coated with the BMP-2 gene–Fn–apatite composite layer showed improved gene expressions of BMP-2 and alkaline phosphatase as compared with the scaffold coated with the apatite layer. Although these results suggest the possibility of ectopic bone formation induced by the present gene delivery system, further study is necessary to prove this.
Multicultural Food Perspectives

Dietary patterns are strongly influenced by cultural background and perspectives. Levels of dietary acculturation need to be considered when talking with immigrants about healthy eating. Lower levels of dietary acculturation are associated with positive health outcomes. Encouraging healthy traditional foods is a positive approach to use with individuals who are at lower levels of dietary acculturation. Questions about languages spoken in different settings and foods most often consumed can help health care practitioners assess levels of dietary acculturation. General intake recommendations of lower saturated fat, more whole grains, more fruits, more vegetables, leaner proteins, and smaller portion sizes (for caloric balance) are general recommendations that can be applied within most cultural food patterns to optimize health outcomes.
A combined intervention of art therapy and clown visits to reduce preoperative anxiety in children

AIMS AND OBJECTIVES To test whether a combined intervention of art therapy and clown visits could enhance the efficacy of oral medication in reducing children's anxiety at parental separation prior to induction of anaesthesia. BACKGROUND Approximately 50% of children undergoing surgery report high anxiety at anaesthesia induction. Complementary therapies have been used to decrease children's anxiety, but no study has evaluated the efficacy of a combination of such therapies. DESIGN This is an observational study, which involved allocating different interventions to two groups and measuring their anxiety at two time points. METHODS This study assigned 78 children (aged 3-11 years) undergoing general anaesthesia for surgery to two conditions. The control group underwent general anaesthesia following standard practice, and the intervention group received an intervention of integrated art therapy and clown visits upon their arrival at the hospital and throughout their time in the preoperating room. Each child in both groups received 0·5 mg/kg oral midazolam 30 minutes before surgery and had a parent present throughout their time in the preoperating room. Each child's anxiety was evaluated twice using the Modified Yale Preoperative Anxiety Scale: at baseline and at separation from parents. Repeated measures anova was used to test for differences between the time points and the two groups. RESULTS Children in the intervention group showed a significant (p < 0·001) reduction in Modified Yale Preoperative Anxiety Scale scores at parental separation compared to those in the control group. Additionally, the majority of parents and nurses evaluated the intervention to be effective for reducing children's anxiety. CONCLUSIONS This study found that an intervention based on art therapy and clown visits enhanced the effect of midazolam in reducing children's anxiety at preoperative separation from parents. RELEVANCE TO CLINICAL PRACTICE Paediatric staffs may consider using such a combination of strategies in preparing children for anaesthesia induction.
The epidemiology of horse-related injuries for different horse exposures, activities, and age groups in Queensland, Australia

BACKGROUND The dangers associated with horse riding, a popular activity throughout Australia, are well documented; yet, few studies have comprehensively described injuries caused by horses to nonriders. This study aimed to facilitate targeted injury prevention strategies and appropriate trauma management by describing all horse-related injuries, for both riders and nonriders, in Queensland, and identifying those at greatest risk. METHODS Horse-related injury data from 2005 to 2009 were extracted from the Queensland Trauma Registry. Descriptive comparisons were undertaken for demographic, injury, and acute care characteristics between riders and nonriders, between pediatric and adult cases, and between sports/leisure and work injuries. The relative risk of surgery by sex and between riders and nonriders was assessed. RESULTS More than 25% of injuries occurred in people not riding a horse. Nonriders sustained a significantly higher proportion of internal organ injuries, open wounds, as well as facial and pelvic/abdominal injuries. Females accounted for more than 80% of children who were injured while riding a horse. For adults, 25% were injured while working, and more than 66% of injured workers were male. Injuries most commonly occurred in regional areas. Surgery was most common among children, nonriders, and those with Injury Severity Score (ISS) of 1 to 8. The likelihood of surgery was 25% higher for nonriders (95% confidence interval, 1.14–1.38%). CONCLUSION Horse-related injuries are most prevalent in identifiable populations, particularly young female riders and adult males injured while working. Injuries inflicted by horses to nonriders contribute more than 27% of all horse-related injuries; however, most previous research has been limited to injured riders. Compared with riders, nonriders more frequently sustain internal, facial, and pelvic injuries; are male; and undergo surgery. The results of this study may be used to tailor prevention strategies and inform trauma management specific to the type of horse exposure, patient age, and activity engaged in when injured. LEVEL OF EVIDENCE Epidemiologic study, level III.
Comparison of mesenchymal stem cells released from poly(N-isopropylacrylamide) copolymer film and by trypsinization

Temperature-responsive platforms containing poly(N-isopropylacrylamide) (PNIPAAm) have been developed as an effective substitute for enzymatic treatment to recover adherent cells, but it remains unclear whether this alternative harvesting method tends to support stem cells preserving them being primitive. This study mainly investigated the biological properties of mesenchymal stem cells derived from rat bone marrow and human adipose tissue (BM-MSCs and AT-MSCs) after being cultured on PNIPAAm copolymer films and recovered by temperature drop, and compared the cells harvested from glass coverslips with trypsinization as controls. The experimental results demonstrated that after three serial passages, the released MSCs from thermal liftoff showed no significant differences in cell morphology, immunophenotype and osteogenesis for BM-MSCs or adipogenesis for AT-MSCs, but had higher viability, stronger proliferation and higher adipogenic differentiation for BM-MSCs or higher osteogenic differentiation for AT-MSCs compared with the trypsinization group. Besides, more proteins remained around or within the cell membranes upon temperature drop. It is concluded that cell detachment with more extracellular matrix proteins facilitates the maintenance of membrane proteins, and accordingly preserves MSC properties related to viability, proliferation and differentiation to some extent. This indicates that the PNIPAAm copolymer films and their matching cooling treatment can be used as effective alternatives to the existing culture substrates and traditional enzymatic digestion for MSCs.
Metabolic Syndrome and Insulin Resistance in Women With Subclinical Hypothyroidism

It is not clear whether or not subclinical hypothyroidism (SH) is associated with an increased risk for cardiovascular disease. We prospectively examined 43 women with SH and 49 healthy controls of similar age. Fasting blood levels of thyrotropin, free thyroxin, antibodies to thyroid peroxidase and thyroglobulin, glucose, total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, triglycerides, and insulin were measured. Body mass index, waist and hip circumferences, blood pressure, homeostasis model assessment 2-insulin resistance index, and the presence of metabolic syndrome (MS) were also evaluated. Mean systolic blood pressure was increased in SH patients versus controls (128.6 vs. 120.7 mm Hg; P 0.04). Mean values of total cholesterol, high-density lipoprotein cholesterol, low-density lipoprotein cholesterol, and insulin were not different in patients with SH compared with controls. SH had significantly higher triglyceride levels (1.50 0.65 mmol/L) and glucose levels (5.26 0.63 mmol/L) compared with controls (1.27 0.59, 5.05 0.52; P 0.04, P 0.04, respectively). Although body mass index values were similar in both groups, patients had greater waist circumference than controls (90.7 13 cm vs. 81.8 10.6; P 0.0007). The percentages of patients with SH having hypertension (34.1%), hypertriglyceridemia (37.2%), hyperglycemia (20.9%), and greater waist circumference (51.2%) were higher than the percentages in controls. Thus, the percentage of MS in patients (41.5%) was significantly higher than in controls (12.2%; P 0.003). SH had significantly higher likelihood of cardiovascular risks (odds ratio, 6.26; 95% confidence interval, 1.6–4.49; P 0.008 for MS). We conclude that SH is associated with greater probability of MS. This may increase the risk of accelerated atherosclerosis and premature cardiovascular disease in these patients.
In vitro osteogenic differentiation of human amniotic fluid-derived stem cells on a poly(lactide-co-glycolide) (PLGA)–bladder submucosa matrix (BSM) composite scaffold for bone tissue engineering

Stem cells have become an important component of tissue regeneration, as they are able to differentiate into various cell types if guided appropriately. It is well known that cellular differentiation is greatly influenced by the surrounding microenvironment. We have developed a composite scaffold system using a collagen matrix derived from porcine bladder submucosa matrix (BSM) and poly(lactide-co-glycolide) (PLGA). In this study, we investigated whether a composite scaffold composed of naturally derived matrix combined with synthetic polymers would provide a microenvironment to facilitate the induction of osteogenic differentiation. We first showed that human amniotic fluid-derived stem cells (hAFSCs) adhered to the composite scaffolds and proliferated over time. We also showed that the composite scaffolds facilitated the differentiation of hAFSCs into an osteogenic lineage. The expression of osteogenic genes, including RUNX2, osteopontin (OPN) and osteocalcin (OCN) was upregulated in cells cultured on the composite scaffolds incubated in the osteogenic medium compared with ones without. Increased alkaline phosphatase (ALP) activity and calcium content indicates that hAFSCs seeded on 3D porous BSM–PLGA composite scaffolds resulted in higher mineralization rates as the duration of induction increased. This was also evidenced by the mineralized matrix within the scaffolds. The composite scaffold system provides a proper microenvironment that can facilitate osteogenic differentiation of AFSCs. This scaffold system may be a good candidate material for bone tissue engineering.
The modernization of hospital food service – findings from a longitudinal study of technology trends in Danish hospitals

Purpose – Hospital food has come into focus during the last decade due to reports of under‐nutrition and at the same time food service has undergone significant changes. The aim of this paper is to document and discuss the change in technology and logistics used in the Danish hospital food service during the years 1995‐2003. Further, the aim is to discuss possibilities for integrating food production and patient nutrition at hospitals in order to improve patient nutrition.Design/methodology/approach – The empirical data consist of quantitative serial data on Danish hospital food service collected over a period starting in 1995 and ending in 2003. Data have been collected as part of two large surveys describing the food service systems in Danish hospitals in 1995 and in 2003. Both surveys were carried out by the Food Research Department of the Danish Food Authorities. Answers were compared by means of Chi‐square (χ2) tests with Yates’ correction. Two‐sided p‐values <0.05 were considered significant.Finding.
Skin and Soft Tissue Infection Management, Outcomes, and Follow-Up in the Emergency Department of an Urban Academic Hospital

Skin and soft tissue infections (SSTIs) are among the most common infections treated by emergency department clinicians. The emergence of community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) as the cause of these infections prompted the Centers for Disease Control and Prevention and the Infectious Disease Society of America to publish guidelines for the outpatient management of SSTIs. This study describes the management and outcomes of emergency department patients treated for uncomplicated SSTIs who returned within 30 days of the initial visit. The study found that of 857 eligible patients, only 17.6% returned and of these, 80% had their wound checked or packing removed. The clinicians prescribed antibiotics for the majority of patients, and the selection of antibiotics typically was active against CA-MRSA. Of 91 lesions drained, 24 specimens were obtained for culture and sensitivity. The majority of the initial treatment of patients consisted of incision and drainage with antibiotic prescription.
Preferential S/Se occupation in an anisotropic ReS2(1-x)Se2x monolayer alloy.

Band structure engineering of two-dimensional (2D) metal dichalcogenides (TMDs) is crucial for their light-matter interaction and optoelectronic applications. Alloying of different metal or chalcogen elements with different stoichiometries in TMDs provides a versatile and efficient approach for modulating the electronic structure and properties of 2D materials. In 2D alloys, quantification of spatial distribution and local coordination of atoms facilitates the establishment of the structure-property relationship at the atomic scale. Here, we have imaged and analyzed the atomic configuration of sulfur and selenium atoms in anisotropic ReS1.4Se0. 6 by scanning transmission electron microscopy (STEM). In Z-contrast images, we have realized the identification and quantification of Re, Se and S at different coordination sites. Different from the random distribution of metal and chalcogen elements in MoS2(1-x)Se2x and Mo1-xWxS2, we find that Se atoms preferentially locate inside of Re4 diamonds in ReS2(1-x)Se2x. Further density function theory (DFT) calculations reveal electronic structure modulation for Se occupation at different sites.
Relationships Among Moral Distress, Level of Practice Independence, and Intent to Leave of Nurse Practitioners in Emergency Departments: Results From a National Survey

The aims of this research study were to investigate moral distress among emergency department (ED) nurse practitioners (NPs) and examine relationships between moral distress and level of practice independence as well as intent to leave a position. Moral distress has been studied regarding registered nurses and physicians (MDs) but less so in NPs. It is important to explore moral distress in NPs because they tread a unique path between nursing and physician roles. Moral distress may play a significant role in staff nurses' intention to leave practice, and level of practice independence is found to have a relationship with NPs' intention to leave. A convenience sample of ED NPs was obtained from a mailing list of a national nursing specialty organization, the Emergency Nurses Association. Using a correlational design, survey methods assessed moral distress with the Moral Distress Scale–Revised (MDS-R), level of practice independence with the Dempster Practice Behavior Scale, and intent to leave with self-report. Correlational and regression analyses of data were conducted to characterize moral distress among ED NPs and associations between moral distress, level of practice independence, and intent to leave. Results found ED NPs do experience moral distress with poor patient care results from inadequate staff communication and working with incompetent coworkers in their practice. The MDS-R was a significant predictor of intention to leave among respondents. This study is the first of its kind to explore moral distress in ED NPs. Results suggest moral distress influences ED NPs' intent to leave their position. Further studies are needed to explore the findings from this research and to formulate interventions to alleviate moral distress in ED NPs and improve retention in the clinical setting.