Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of a Clinical Decision Support Alert on Informed Consent Documentation in the Neonatal Intensive Care Unit

Background: Informed consent is necessary to preserve patient autonomy and shared decision-making, yet compliant consent documentation is suboptimal in the intensive care unit (ICU). We aimed to increase compliance with bundled consent documentation, which provides consent for a predefined set of common procedures in the neonatal ICU from 0% to 50% over 1 year. Methods: We used the Plan-Do-Study-Act model for quality improvement. Interventions included education and performance awareness, delineation of the preferred consenting process, consent form revision, overlay tool creation, and clinical decision support (CDS) alert use within the electronic health record. Monthly audits categorized consent forms as missing, present but noncompliant, or compliant. We analyzed consent compliance on a run chart using standard run chart interpretation rules and obtained feedback on the CDS as a countermeasure. Results: We conducted 564 audits over 37 months. Overall, median consent compliance increased from 0% to 86.6%. Upon initiating the CDS alert, we observed the highest monthly compliance of 93.3%, followed by a decrease to 33.3% with an inadvertent discontinuation of the CDS. Compliance subsequently increased to 73.3% after the restoration of the alert. We created a consultant opt-out selection to address negative feedback associated with CDS. There were no missing consent forms within the last 7 months of monitoring. Conclusions: A multi-faceted approach led to sustained improvement in bundled consent documentation compliance in our neonatal intensive care unit, with the direct contribution of the CDS observed. A CDS intervention directed at the informed consenting process may similarly benefit other ICUs.
Therapeutic potential of dihydroartemisinin in mitigating radiation‐induced lung injury: Inhibition of ferroptosis through Nrf2/HO‐1 pathways in mice

Abstract Background Radiation‐induced lung injury (RILI) is a common consequence of thoracic radiation therapy that lacks effective preventative and treatment strategies. Dihydroartemisinin (DHA), a derivative of artemisinin, affects oxidative stress, immunomodulation, and inflammation. It is uncertain whether DHA reduces RILI. In this work, we investigated the specific mechanisms of action of DHA in RILI. Methods Twenty‐four C57BL/6J mice were randomly divided into four groups of six mice each: Control group, irradiation (IR) group, IR + DHA group, and IR + DHA + Brusatol group. The IR group received no interventions along with radiation treatment. Mice were killed 30 days after the irradiation. Morphologic and pathologic changes in lung tissue were observed with hematoxylin and eosin staining. Detection of hydroxyproline levels for assessing the extent of pulmonary fibrosis. Tumor necrosis factor α (TNF‐α), transforming growth factor‐β (TGF‐β), glutathione peroxidase (GPX4), Nuclear factor erythroid 2‐related factor 2 (Nrf2), and heme oxygenase‐1 (HO‐1) expression in lung tissues were detected. In addition, mitochondrial ultrastructural changes in lung tissues were also observed, and the glutathione (GSH) content in lung tissues was assessed. Results DHA attenuated radiation‐induced pathological lung injury and hydroxyproline levels. Additionally, it decreased TNF‐α and TGF‐β after irradiation. DHA may additionally stimulate the Nrf2/HO‐1 pathway. DHA upregulated GPX4 and GSH levels and inhibited cellular ferroptosis. Brusatol reversed the inhibitory effect of DHA on ferroptosis and its protective effect on RILI. Conclusion DHA modulated the Nrf2/HO‐1 pathway to prevent cellular ferroptosis, which reduced RILI. Therefore, DHA could be a potential drug for the treatment of RILI.
Analysis of Variation in the Origin of the Obturator Artery in Midwestern American Donor Bodies

The obturator artery (OA) is typically a branch of the anterior division of the internal iliac artery. However, an aberrant obturator artery origin may lead to clinical complications. Because of its location in the pelvic cavity, the OA is at high risk of injury or laceration during a variety of pelvic surgeries. Regarding this, variations in the origins of the OA may result in bleeding that can often be overlooked, rendering treatment ineffective. Our study aimed to assess the origins and course of the OA in Midwestern American donor bodies. Sixty-two donor bodies were obtained from the Gift of Body Donation Program at A.T. Still University’s Kirksville College of Osteopathic Medicine. The origin of each OA was documented and photographed. The OA was identified by observing the vessel's passage through the obturator foramen. Of 132 OAs studied, 72 (54.5%) had an aberrant OA. Further, 22 (16.7%) had an aberrant OA origin from the inferior epigastric artery, 20 (15.2%) had an aberrant OA origin from the posterior division of the internal iliac artery, 22 (16.7%) had an aberrant OA origin from dual origins of the anterior division of the internal iliac artery and the inferior epigastric artery, and eight (6.1%) had other aberrant OA origins. Overall, our results indicated anatomical variations are common in the origins and course of the OA. These data highlight the importance of considering variations in the OA and the prevalence of those variations during vascular and orthopedic procedures.
Historical changes in baby names in China

Based on previous research on names and naming practices, I propose three suggestions to Bao et al. (2021), which investigated historical changes in given names of Han Chinese in China between 1920 and 2005. Their study analyzed a one-shot cross-sectional survey conducted in 2005 and reported that unique names increased from 1920 to 2005. The authors concluded that China became more individualistic over time for the period. However, three questions have remained unanswered in Bao et al. (2021). First, were the samples of older birth cohorts truly representative? Second, did unique names increase only after the 1970s? Third, how are the historical changes in average name length interpreted? Answering these three questions would contribute to a further understanding of the historical changes in given names and their underlying psychological/cultural shifts in China.
LAPAROSCOPIC RIGHT AND LEFT COLECTOMY: WHICH PROVIDES BETTER POSTOPERATIVE RESULTS FOR ONCOLOGY PATIENTS?

ABSTRACT BACKGROUND: The laparoscopic approach considerably reduced the morbidity of colorectal surgery when compared to the open approach. Among its benefits, we can highlight less intraoperative bleeding, early oral intake, lower rates of surgical site infection, incisional hernia, and postoperative pain, and earlier hospital discharge. AIMS: To compare the perioperative morbidity of right versus left colectomy for cancer and the quality of laparoscopic oncologic resection. METHODS: Retrospective analysis of patients submitted to laparoscopic right and left colctomy between 2006 and 2016. Postoperative complications were classified using the Clavien-Dindo scale, 30 days after surgery. RESULTS: A total of 293 patients were analyzed, 97 right colectomies (33.1%) and 196 left colectomies (66.9%). The averageage was 62.8 years. The groups were comparable in terms of age, comorbidities, body mass index, and the American Society of Anesthesiology (ASA) classification. Preoperative transfusion was higher in the right colectomy group (5.1% versus 0.4%, p=0.004, p<0.05). Overall, 233 patients (79.5%) had no complications. Complications found were grade I and II in 62 patients (21.1%) and grade III to V in 37 (12.6%). Twenty-three patients (7.8%) underwent reoperation. The comparison between left and right colectomy was not statistically different for operative time, conversion, reoperation, severe postoperative complications, and length of stay. The anastomotic leak rate was comparable in both groups(5.6% versus 2.1%, p=0.232, p>0.05). The oncological results were similar in both surgeries. In multiple logistic regression, ASA statistically influenced the worst results (≥ III; p=0.029, p<0.05). CONCLUSIONS: The surgical and oncological results of laparoscopic right and left colectomies are similar, making this the preferred approach for both procedures.
Uterine fibroids and longitudinal profiles of the vaginal microbiota in a cohort presenting for transvaginal ultrasound

Bacterial vaginosis, characterized in part by low levels of vaginal Lactobacillus species, has been associated with pro-inflammatory cytokines which could fuel uterine fibroid development. However, prior work on the associations between uterine fibroids and vaginal bacteria is sparse. Most studies have focused on assessment of individual taxa in a single sample. To address research gaps, we sought to compare short, longitudinal profiles of the vaginal microbiota in uterine fibroid cases versus controls with assessment for hormonal contraceptives (HCs), a possible confounder associated with both protection from fibroid development and increases in Lactobacillus-dominated vaginal microbiota. This is a secondary analysis of 83 reproductive-age cisgender women who presented for transvaginal ultrasound (TVUS) and self-collected mid-vaginal swabs daily for 1–2 weeks before TVUS (Range: 5–16 days, n = 697 samples). Sonography reports detailed uterine fibroid characteristics (N = 21 cases). Vaginal microbiota was assessed by 16S rRNA gene amplicon sequencing and longitudinal microbiota profiles were categorized by hierarchical clustering. We compared longitudinal profiles of the vaginal microbiota among fibroid cases and controls with exact logistic regression. Common indications for TVUS included pelvic mass (34%) and pelvic pain (39%). Fibroid cases tended to be older and report Black race. Cases less often reported HCs versus controls (32% vs. 58%). A larger proportion of cases had low-Lactobacillus longitudinal profiles (48%) than controls (34%). In unadjusted analysis, L. iners-dominated and low-Lactobacillus profiles had higher odds of fibroid case status compared to other Lactobacillus-dominated profiles, however these results were not statistically significant. No association between vaginal microbiota and fibroids was observed after adjusting for race, HC and menstruation. Results were consistent when number of fibroids were considered. There was not a statistically significant association between longitudinal profiles of vaginal microbiota and uterine fibroids after adjustment for common confounders; however, the study was limited by small sample size.
Eastern Polynesian Sandalwood Oil (Santalum insulare Bertero ex A. DC.) – a Detailed Investigation

Three qualities of Eastern Polynesian sandalwood oil were analyzed using GC and GC-MS. Sixty-six constituents were identified: 5 monoterpenes, 58 sesquiterpenes and 3 others. The main constituents of the essential oils were (Z)-α-santalol and (Z)-β-santalol. Beside chemical composition, olfactory evaluation and chiral gas chromatography of β- and epi-β-bisabolol isomers confirmed the close relationship of Eastern Polynesian to East Indian and New Caledonian sandalwood oil.
The Batanes Archaeological Project and the "Out of Taiwan Hypothesis for Austronesian Dispersal

This paper summarises the archaeological results of the Batanes fieldwork undertaken between 2002 and 2005 by teams from the Australian National University, the National Museum of the Philippines, and the University of the Phiiippines. The evidence is believed to support a Neolithic settlement of the Batanes from Taiwan before 4000 BP, followed by continuing contacts, lasting until at least 1300 BP, that involved a movement of slate and nephrite from Taiwan (possibly via Ludao and Lanyu Islands) to Batan and Itbayat. Evidence that initial Neolithic settlement of the Batanes came from the south, via Luzon, is not indicated in the assemblages so far excavated.
The Impact of Climate Change on Rural Livelihoods in the North Nguu Mountains in Kilindi District, Tanzania

This study was set to investigate the impact of climate change on rural livelihoods in the North Nguu Mountains in Kilindi District, Tanzania. Objectives of the study were to assess people’s perceptions on the relationship between climate change and livelihoods; to analyze the influence of climate change on people’s daily living and to examine potential of the forest for adapting to climate change. The conceptual model for this study was modified from the comprehensive conceptual model for disaster management by Kelly, (1998) with ideas on climate change, the forest and livelihoods from Burges, (2000); Groot et al., (2002) and Heal et al., (2004). Data was collected through interview, focus group discussions, observations and documentary review. A simple descriptive statistical approach using content analysis were applied for data analysis. The impact of climate change on livelihoods in The North Nguu Mountains was revealed to include pressure on the forest (47.8%); unsustainable production and productivity of the forest (29.8%); unsustainable livelihood systems and options for adaptation (14.6%) and income poverty (7.8%). The rich mountain-top natural forests base was a potential livelihood asset (93.2%). Food insecurity and income poverty contributes to unsustainable livelihoods (94.7%). The study recommends diversification of livelihoods parallel to sustaining the economic, ecological and social structures for rural livelihoods. The conceptual framework for this study succeeded in generating information on intensification of the detrimental effects of climate change resulting to deterioration of the forest (as the main livelihood asset) hence poor resilience and mitigation portfolios leading to unsustainable livelihoods as set out in the main focus of the study.
Hormonal regulation of tight junction closure in the mouse mammary epithelium during the transition from pregnancy to lactation.

Closure of the tight junctions of the mammary epithelium has been shown to accompany the onset of copious milk secretion or lactogenesis, stage 2, in both goats and humans. Here we use injection of [(14)C]sucrose and FITC-albumin (fluorescein isothiocyanate-albumin) into the mammary duct to follow the course of tight junction closure during lactogenesis in mice. To examine the hormonal changes responsible, we ovariectomized day 16 or 17 pregnant mice and found that closure followed ovariectomy with a mean delay of 13.6+/-1.5 (s.e.m. ) h. That progesterone withdrawal is the trigger for closure was shown by the finding that injection of progesterone within 4 h of ovariectomy delayed closure and that closure occurred after injection of the progesterone antagonist RU 486 in intact late pregnant mice. Endocrine ablation studies showed that low to moderate concentrations of corticosterone and either placental lactogen or prolactin are necessary for tight junction closure triggered by progesterone withdrawal. Thus the hormonal requirements for tight junction closure are similar to those shown by other investigators to promote lactogenesis, stage 2. Further, the tight temporal control of tight junction permeability suggests that ovariectomy of the late pregnant mouse may be a good model for molecular studies of the lactogenic switch.
Mapping and modelling the effects of land use and land management change on ecosystem services from local ecosystems and landscapes to global biomes

Herstel en duurzaam beheer van biodiversiteit en ecosysteemdiensten worden steeds meer geintegreerd in nationaal en internationaal beleid. In dit proefschrift wordt een methodologie ontwikkeld voor de kwantificering van effecten van landmanagement op de ruimtelijke verspreiding van ecosysteemdiensten, zodat de door landmanagement veroorzaakte trade-offs tussen ecosysteemdiensten bepaald kunnen worden voor zowel lokale ecosystemen en landschappen als regionale en mondiale biomen. Een groot aantal ecosysteemdiensten zijn bestudeerd. De karterings- en modelleringsmethoden zijn toegepast en gecombineerd met scenario-analyse in de Nederlandse en Zuid-Afrikaanse studies. Voor Nederland is het landschap van Het Groene Woud bestudeerd.
The role of GpsB in Staphylococcus aureus cell morphogenesis

ABSTRACT For decades, cells of the Gram-positive bacterial pathogen Staphylococcus aureus were thought to lack a dedicated elongation machinery. However, S. aureus cells were recently shown to elongate before division, in a process that requires a shape elongation division and sporulation (SEDS)/penicillin-binding protein (PBP) pair for peptidoglycan synthesis, consisting of the glycosyltransferase RodA and the transpeptidase PBP3. In ovococci and rod-shaped bacteria, the elongation machinery, or elongasome, is composed of various proteins besides a dedicated SEDS/PBP pair. To identify proteins required for S. aureus elongation, we screened the Nebraska Transposon Mutant Library, which contains transposon mutants in virtually all non-essential staphylococcal genes, for mutants with modified cell shape. We confirmed the roles of RodA/PBP3 in S. aureus elongation and identified GpsB, SsaA, and RodZ as additional proteins involved in this process. The gpsB mutant showed the strongest phenotype, mediated by the partial delocalization from the division septum of PBP2 and PBP4, two penicillin-binding proteins that synthesize and cross-link peptidoglycan. Increased levels of these PBPs at the cell periphery versus the septum result in higher levels of peptidoglycan insertion/crosslinking throughout the entire cell, possibly overriding the RodA/PBP3-mediated peptidoglycan synthesis at the outer edge of the septum and/or increasing stiffness of the peripheral wall, impairing elongation. Consequently, in the absence of GpsB, S. aureus cells become more spherical. We propose that GpsB has a role in the spatio-temporal regulation of PBP2 and PBP4 at the septum versus cell periphery, contributing to the maintenance of the correct cell morphology in S. aureus. IMPORTANCE Staphylococcus aureus is a Gram-positive clinical pathogen, which is currently the second cause of death by antibiotic-resistant infections worldwide. For decades, S. aureus cells were thought to be spherical and lack the ability to undergo elongation. However, super-resolution microscopy techniques allowed us to observe the minor morphological changes that occur during the cell cycle of this pathogen, including cell elongation. S. aureus elongation is not required for normal growth in laboratory conditions. However, it seems to be essential in the context of some infections, such as osteomyelitis, during which S. aureus cells apparently elongate to invade small channels in the bones. In this work, we uncovered new determinants required for S. aureus cell elongation. In particular, we show that GpsB has an important role in the spatio-temporal regulation of PBP2 and PBP4, two proteins involved in peptidoglycan synthesis, contributing to the maintenance of the correct cell morphology in S. aureus.
FIELD, GEOCHRONOLOGIC, AND GEOCHEMICAL CONSTRAINTS ON LATE PRECAMBRIAN TO EARLY PALEOZOIC TERRANE ACCRETION IN THE SOUTHERN APPALACHIAN BLUE RIDGE PROVINCE

OF THESIS FIELD, GEOCHRONOLOGIC, AND GEOCHEMICAL CONSTRAINTS ON LATE PRECAMBRIAN TO EARLY PALEOZOIC TERRANE ACCRETION IN THE SOUTHERN APPALACHIAN BLUE RIDGE PROVINCE Xenolith-bearing orthogneiss of Amazonian affinity discovered in the Dellwood quadrangle in the Blue Ridge basement complex represents the oldest crustal component of the southern Appalachians (1.33 – 1.37 Ga: Quinn, 2012). New U-Pb zircon ages for migmatitic paragneiss of the Cartoogechaye terrane exposed in the Dellwood quadrangle reveal two unique detrital zircon age signatures that indicate either a local eastern Laurentian margin source or an exotic source. Detailed mapping, whole rock geochemistry, and U-Pb zircon geochronology were conducted to determine whether this exotic crustal component extends farther south into the Hazelwood 7.5” quadrangle. Lithological similarities exist between paragneisses in the Dellwood quadrangle and those in the Hazelwood quadrangle. However, the increase in proportion of leucosome and polyphase folding prevent direct correlation of lithologies between the areas. Whole rock major element compositions overlap the composition of basement orthogneisses. Zircon ages of six paragneiss samples reveal multiple detrital zircon age modes that are dominated by two Grenville modes at ~1050 and 1150 Ma. Minor zircon populations exist at ~450 – 480, 700 – 900, and 1300 – 1500 Ma. Age distributions and compositional trends are evidence that the protolith of the paragneiss in the Hazelwood quadrangle was Neoproterozoic rift sediments with a dominant Laurentian margin source.
Factors associated with HPV vaccine hesitancy among college students: A cross-sectional survey based on 3Cs and structural equation model in China

ABSTRACT Despite the high effectiveness of HPV vaccines in preventing infection, vaccine hesitancy remains a concern, particularly in China. This study aimed to explore college students’ attitudes toward HPV vaccination and identify associated factors. Data was collected through a cross-sectional survey using self-administered questionnaires in four cities from May to June 2022. Chi-square tests and logistic regression analyses were conducted to identify factors. Additionally, an integrated structural equation model (SEM) based on the 3Cs (confidence, convenience, complacency) was developed to understand underlying factors contributing to hesitancy. The results from 2261 valid questionnaires were enlightening. A significant 89.47% (59.4% for females) considered HPV vaccination necessary, with 9.82% remaining neutral and only 0.71% deeming it unnecessary. Factors like higher education, being a medical student, residing in urban areas, having medical insurance, more extraordinary living expenses, a family history of tumors, and a solid understanding of HPV played a role in perceiving the vaccine as necessary. Among the 1438 female respondents, 84.36% had no hesitancy toward HPV vaccination, 13.53% expressed hesitancy, and 2.11% refused vaccination. Factors like age, understanding of HPV, medical staff recommendations, living expenses, and family history influenced hesitancy levels. SEM revealed that the 3Cs significantly affected vaccine hesitancy. Factors like price, booking process, vaccination times, trust in vaccines, medical staff recommendations, efficiency, and risk perception collectively influenced hesitancy. In conclusion, this study found high acceptance of HPV vaccination but acknowledged the complexity of hesitancy factors. It recommends medical staff disseminate scientific knowledge, offer recommendations, simplify booking procedures, and expand vaccination sites to address vaccine hesitancy effectively.