Miracle-dz/UniFAR-FTUs huggingface dataset:
Strengthening Nutrition Interventions in Antenatal Care Services Affects Dietary Intake, Micronutrient Intake, Gestational Weight Gain, and Breastfeeding in Uttar Pradesh, India: Results of a Cluster-Randomized Program Evaluation

ABSTRACT Background Maternal nutrition interventions are inadequately integrated into antenatal care (ANC). Alive & Thrive aimed to strengthen delivery of micronutrient supplements and intensify interpersonal counseling and community mobilization through government ANC services. Objectives We compared nutrition-intensified ANC (I-ANC) with standard ANC (S-ANC) on coverage of nutrition interventions and maternal nutrition practices. Methods We used a cluster-randomized design with cross-sectional baseline (2017) and endline (2019) surveys (n ∼660 pregnant and 1800 recently delivered women per survey) and a repeated-measures longitudinal study in 2018–2019 (n = 400). We derived difference-in-difference effect estimates (DIDs) for diet diversity, consumption of micronutrient supplements, weight monitoring, and early breastfeeding practices. Results Despite substantial secular improvements in service coverage from India's national nutrition program, women in the I-ANC arm received more home visits [DID: 7–14 percentage points (pp)] and counseling on core nutrition messages (DID: 10–23 pp) than in the S-ANC arm. One-third of women got ≥3 home visits and one-fourth received ≥4 ANC check-ups in the I-ANC arm. Improvements were greater in the I-ANC arm than in the S-ANC arm for any receipt and consumption of iron–folic acid (DID: 7.5 pp and 9.5 pp, respectively) and calcium supplements (DID: 14.1 pp and 11.5 pp, respectively). Exclusive breastfeeding improved (DID: 7.5 pp) but early initiation of breastfeeding did not. Maternal food group consumption (∼4 food groups) and probability of adequacy of micronutrients (∼20%) remained low in both arms. Repeated-measures longitudinal analyses showed similar results, with additional impact on consumption of vitamin A–rich foods (10 pp, 11 g/d), other vegetables and fruits (22–29 g/d), and gestational weight gain (0.4 kg). Conclusions Intensifying nutrition in government ANC services improved maternal nutrition practices even with strong secular trends in service coverage. Dietary diversity, supplement consumption, and breastfeeding practices remained suboptimal. Achieving greater behavior changes will require strengthening the delivery and use of maternal nutrition services integrated into ANC services in the health system. This trial was registered at clinicaltrials.gov as NCT03378141.
Material Diffusion and Doping of Mn in Wurtzite ZnSe Nanorods

Light-emitting transition metal ion doped 1D nanorods can be a suitable candidate for fabrication of the advanced opto-electronic-based nanodevices. Among various doped nanocrystals, Mn doped ZnSe nanocrystals are widely studied for their intense Mn d–d emission. However, this is mostly performed in the zinc blende phase of spherical ZnSe quantum dots. But, herein we study the strategy to dope Mn ions in wurtzite phase of 1D ZnSe nanorods. To achieve this, it is essential to control the 1D crystal growth of ZnSe to facilitate the adsorption of dopants. The anisotropic 1D nanostructures are designed following thermally controlled material diffusion process rather than the most widely expected kinetically driven crystal growth protocol, and the dopants are introduced at the appropriate stage of the growth for their adsorption. Using preformed magic size wurtzite ZnSe nanowires as the source material and fragmenting them at higher reaction temperature, ZnSe nanorods with variable aspect ratios are designed.
Changes in daily mental health service use and mortality at the commencement and lifting of COVID-19 ‘lockdown’ policy in 10 UK sites: a regression discontinuity in time design

Objectives To investigate changes in daily mental health (MH) service use and mortality in response to the introduction and the lifting of the COVID-19 ‘lockdown’ policy in Spring 2020. Design A regression discontinuity in time (RDiT) analysis of daily service-level activity. Setting and participants Mental healthcare data were extracted from 10 UK providers. Outcome measures Daily (weekly for one site) deaths from all causes, referrals and discharges, inpatient care (admissions, discharges, caseloads) and community services (face-to-face (f2f)/non-f2f contacts, caseloads): Adult, older adult and child/adolescent mental health; early intervention in psychosis; home treatment teams and liaison/Accident and Emergency (A&E). Data were extracted from 1 Jan 2019 to 31 May 2020 for all sites, supplemented to 31 July 2020 for four sites. Changes around the commencement and lifting of COVID-19 ‘lockdown’ policy (23 March and 10 May, respectively) were estimated using a RDiT design with a difference-in-difference approach generating incidence rate ratios (IRRs), meta-analysed across sites. Results Pooled estimates for the lockdown transition showed increased daily deaths (IRR 2.31, 95% CI 1.86 to 2.87), reduced referrals (IRR 0.62, 95% CI 0.55 to 0.70) and reduced inpatient admissions (IRR 0.75, 95% CI 0.67 to 0.83) and caseloads (IRR 0.85, 95% CI 0.79 to 0.91) compared with the pre lockdown period. All community services saw shifts from f2f to non-f2f contacts, but varied in caseload changes. Lift of lockdown was associated with reduced deaths (IRR 0.42, 95% CI 0.27 to 0.66), increased referrals (IRR 1.36, 95% CI 1.15 to 1.60) and increased inpatient admissions (IRR 1.21, 95% CI 1.04 to 1.42) and caseloads (IRR 1.06, 95% CI 1.00 to 1.12) compared with the lockdown period. Site-wide activity, inpatient care and community services did not return to pre lockdown levels after lift of lockdown, while number of deaths did. Between-site heterogeneity most often indicated variation in size rather than direction of effect. Conclusions MH service delivery underwent sizeable changes during the first national lockdown, with as-yet unknown and unevaluated consequences.
Augmented renal clearance: a retrospective, cohort study of urinary creatinine clearance in critically ill patients in the United Kingdom

Objective Augmented renal clearance (ARC) is associated with sub-therapeutic antibiotic, anti-epileptic, and anticoagulant serum concentrations leading to adverse patient outcomes. We aimed to describe the prevalence and associated risk factors for ARC development in a large, single-centre cohort in the United Kingdom. Methods We conducted a retrospective observational study of critically unwell patients admitted to intensive care between 2014 and 2016. Urinary creatinine clearance was used to determine the ARC prevalence during the first 7 days of admission. Repeated measures logistic regression was used to determine risk factors for ARC development. Results The ARC prevalence was 47.0% (95% confidence interval [95%CI]: 44.3%–49.7%). Age, sex, Acute Physiology and Chronic Health Evaluation (APACHE) II score, and sepsis diagnosis were significantly associated with ARC. ARC was more prevalent in younger vs. older (odds ratio [OR] 0.95 [95%CI: 0.94–0.96]), male vs. female (OR 0.32 [95%CI: 0.26–0.40]) patients with lower vs. higher APACHE II scores (OR 0.94 [95%CI: 0.92–0.96]). Conclusions This patient group probably remains unknown to many clinicians because measuring urinary creatinine clearance is not usually indicated in this group. Clinicians should be aware of the ARC risk in this group and consider measurement of urinary creatinine clearance.
Investigating the Success of "Asklepieio Voulas" Hospital Information System

Hospital Information Systems assessment is important to ensure the quality of provided healthcare services. This research evaluates the success of the clinical information system used in the General Hospital "Asklepieio Voulas". A questionnaire was developed based on the DeLone & McLean information systems success model, and used on February 2020, to record the users' opinions regarding the information system. The reliability of the questionnaire was tested by applying Cronbach's alpha analysis, descriptive statistics was calculated for all variables of the questionnaire, and new variables was created to investigate the relationships between the model's factors. Correlation analysis between the factors and linear multiple regression analysis between some of the factors of the DeLone & McLean success model were conducted 218 users responded to the survey, 56.3% of them were medical doctors, 24.1% nurses, and 19.6% other staff of the hospital. Results highlight that the users of the system are satisfied with it. A77.3% of the participants believe that they perform their work more easily when using the system, while 89.3% of the participants believe that the system is useful in their work. According to the results of the model, system quality and information quality seems to be related with the system usage. Information quality plays the most important role in the use of the system while the system quality plays the most important role in user satisfaction. Based on the users' opinions, the "Asklepieio Voulas" Hospital Information System can be assumed as successful.
An Investigation of Energy Consumption, Solar Fraction and Hybrid Photovoltaic–Thermal Solar Dryer Parameters in Drying of Chamomile Flower

Abstract In this research, drying of a medicinal plant (chamomile) in a hybrid photovoltaic–thermal solar dryer with and without heat pump was investigated. The experiments were performed at three air speeds (0.5, 1, and 1.5 m/s), three levels of air temperature (40, 50, and 60°C), with and without using a heat pump. Results of analysis indicated that adding a heat pump to the photovoltaic solar dryer decreases drying time, energy consumption, and required specific energy. Solar energy fraction increased with decreasing air temperature and velocity. Analysis of the dryer-related parameters showed that the maximum and minimum thermal efficiencies were 33.8 and 16.4%, respectively, both in the no-heat-pump mode while with the heat pump, its maximum and minimum values were 38.4 and 19.7%, respectively. Moreover, the highest and lowest electrical efficiencies for the no-heat-pump mode were 13.4 and 9.1%, respectively; while using the heat pump, its maximum and minimum values were 14.1 and 10.4%, respectively. Results of analyzing the dryer’s coefficient of performance for drying chamomile showed that the highest and lowest coefficients of performance were 3.41 and 1.82, respectively. Eleven mathematical models were tested, and Page’s model was selected as the best for describing the drying behavior of chamomile flower.
Young children conform more to norms than to preferences

As members of cultural groups, humans continually adhere to social norms and conventions. Researchers have hypothesized that even young children are motivated to act conventionally, but support for this hypothesis has been indirect and open to other interpretations. To further test this hypothesis, we invited 3.5-year-old children (N = 104) to help set up items for a tea party. Children first indicated which items they preferred but then heard an informant (either an adult or another child) endorse other items in terms of either conventional norms or personal preferences. Children conformed (i.e., overrode their own preference to follow the endorsement) more when the endorsements were framed as norms than when they were framed as preferences, and this was the case whether the informant was an adult or another child. The priority of norms even when stated by another child opposes the interpretation that children only conformed in deference to adult authority. These findings suggest that children are motivated to act conventionally, possibly as an adaptation for living in cultural groups.
Anatomic Variations of Ethmoid Roof and Risk of Skull Base Injury in Endoscopic Sinus Surgery: Statistical Correlations

Background Recent developments in endoscopic sinus surgery (ESS) have increased the need to investigate the complex anatomic variations in the ethmoid roof and skull base, to inform the surgeon about the risk of damaging these crucial areas during ESS. Objective To offer a detailed description of sinus anatomy focusing on the key surgical landmarks in ESS and frontal recess surgery to standardize a systematic approach during the preoperative sinuses imaging evaluation. Methodology: A total of 220 computed tomography (CT) scans were reviewed to obtain six sets of measurements: the depth of the cribriform plate (CP); the length of the lateral lamella of the cribriform plate (LLCP); the angle formed by the LLCP and the continuation of the horizontal plane passing through the CP; the position of the anterior ethmoidal artery (AEA) at the skull base; the extent of frontal sinus pneumatization (FSP); the type of superior attachment of the uncinate process (SAUP). Results The length of the LLCP was statistically significantly correlated with the different Keros classification types, the angle formed by the LLCP with the continuation of the horizontal plane passing through the CP, and with the AEA position at the skull base. The depth of the olfactory fossa was correlated with FSP. Conclusions According to the Keros and Gera classifications, the data obtained from these evaluations allow the assessment of anatomic-radiological risk profiles and can help identify those patients who are high risk for ethmoid roof injury.
Aberrant right subclavian artery: the association with chromosomal defects and the related post-natal outcomes in a third level referral centre

Abstract Aberrant right subclavian artery (ARSA) is the most common embryologic abnormality of the aortic arch. The presence of ARSA has been previously associated with an increased risk of Down syndrome. ARSA at birth may be associated with dysphagia, respiratory distress and stridor and there is no clear evidence‐based management. The aim of this study was to describe the associations with chromosomal abnormalities and the postnatal outcome of fetuses diagnosed with ARSA. We analysed fetuses diagnosed antenatally with ARSA between January 2013 and September 2019 in the fetal echocardiography unit of the Hospital Monaldi, University ‘Vanvitelli’ of Naples, Italy. The results showed fifty fetuses diagnosed with ARSA, all confirmed after birth. The ARSA was an isolated finding in 46 fetuses (92%), while in 4 fetuses the ARSA was associated with other cardiac and/or extra-cardiac anomalies. Only one fetus was diagnosed with trisomy 21 (2%). In this fetus the ARSA was the only ultrasound anomaly identified. There were no cases necessitating referral due to the presence of compression symptoms at birth. The presence of ARSA was associated with trisomy 21 in the 2% of cases in our series and there were no neonatal complications due to airway compression at birth. IMPACT STATEMENT What is already known on this subject? Aberrant right subclavian artery (ARSA) is the most common embryologic abnormality of the aortich arch. ARSA at birth could be associated with dysphagia, respiratory distress and stridor and no evidence-based management of these fetuses has been described yet. The presence of ARSA has been previously associated with an increased risk of Down syndrome. What do the results of this study add? This study confirms known data on association with chromosomal defects and provides some original data on the absence of symptomatology due to tracheal compression with a postnatal follow-up up to three years of age. What are the implications of these findings for clinical practice and/or further research? Our findings suggest that in cases with adequate prenatal assessment performed by experienced clinicians, delivery can safely take place at local hospitals, with no need of referral soon after birth. The use of transthoracic echocardiography to confirm the diagnoses of ARSA after birth and to plan the next follow-up appointments can be supported.
Comparing Different Interventions’ Effects on Latinas’ Screening Mammography Attainment and Participant-Driven Information Diffusion

Evaluation of multiple community-based approaches to improve Latinas’ breast cancer (BC) screening utilization has resulted in inconsistent findings. Factors contributing to this variation include heterogeneity in approaches (e.g., types of conceptual frameworks) and study quality (e.g., lack of measurement of spillover effects). This pilot study sought to clarify which approach may be most effective by evaluating the relative efficacy of two conceptual approaches using an area-level design with 145 Latinas nonadherent to U.S. Preventive Services Taskforce (USPSTF) BC screening guidelines. Each study arm included identical intervention format and duration (e.g., three group-based sessions, logistic assistance (LA) via five monthly calls and referral to free/low-cost screening programs). However, study content differed. While educate+LA addressed participants’ BC prevention and screening behavior, empower+LA addressed participants’ and their social networks’ BC screening. After adjusting for age, insurance status, and baseline mammography intention, when compared with educate+LA participants, empower+LA participants were more likely to report obtaining mammograms, engaging more individuals about BC, initiating BC conversations in public settings, and discussing mammography specifically. Our study has important implications regarding the utility of evaluating behavioral interventions overall in terms of behavioral and spillover network effects.
Losartan improved hippocampal long‐term potentiation impairment induced by repeated LPS injection in rats

Cognitive impairment has been known as a common consequence of brain inflammation. Long‐term potentiation (LTP), the generally accepted cellular mechanism for memory formation in the mammalian brain, has been shown to be suppressed by inflammation. Studies have shown that angiotensin II (Ang II) through the Ang II type 1 receptor (AT1R) has a role in brain and peripheral immune system communication and brain inflammation. Here, the effect of AT1R blockade on hippocampal LTP in rats undergoing repeated lipopolysaccharide (LPS) injection was investigated. Rats received intraperitoneal (ip) injections of LPS (250 μg kg−1 day−1) for seven days. Treatment with losartan (ip; 3 mg kg−1 day−1) was started 3 days before LPS injection and continued during the LPS injections. Rats were anesthetized, and field excitatory postsynaptic potential (fEPSP) was recorded from the stratum radiatum of the CA1 area of the hippocampus in response to stimulation of the Schaffer collateral pathway. Results showed that LTP was suppressed in the LPS‐injected rats as no significant differences were found in the fEPSP slope and amplitude before and after the LTP induction. AT1R blockade by losartan restored fEPSP to the control levels. These findings indicate that Ang II, through AT1R, has a role in LTP suppression induced by systemic inflammation.
Happy is easy: the influence of affective states on cognitive control and metacognitive reports

ABSTRACT In many situations, engaging cognitive control is required to override automatic responses and to behave in an adaptive manner. However, cognitive control is also effortful and costly which makes it aversive. A fundamental question is how individuals decide to engage or not in cognitive control based on the costs of this effort and the motivation to achieve the goals. In the present study, we explored the hypothesis that affective states can influence this decision by changing participants’ subjective experiences during the task. Participants performed a conflict task (arrow priming) and judged their feeling of difficulty after each trial. Affective states were induced by presenting emotional faces (happy, fearful or neutral) at the beginning of each trial. We found that participants subjectively judged happy trials as easier even though they objectively made more errors in this condition. Follow-up analyses revealed that participants engaged less cognitive control with happy than with neutral or fearful faces. We conclude that affective states influence the recruitment of cognitive control and associated metacognitive experiences.
Nurse Practitioners' Implementation of Evidence-Based Practice Into Routine Care: A Scoping Review.

BACKGROUND Implementation of evidence-based practice (EBP) is essential for ensuring high-quality health care at minimum cost. Although all nurses have a responsibility to implement EBP at an individual patient level, nurse practitioners (NPs) as clinical leaders have additional responsibilities in leading and collaborating with transdisciplinary teams to implement EBP across patient groups and embed practice change into routine care. AIM To explore the factors affecting the implementation of EBP into routine care by NPs. Specifically, to examine NP beliefs, levels of EBP implementation, and barriers and enablers to EBP implementation into routine care. METHODS A scoping review was conducted using the Arksey and O'Malley (International Journal of Social Research Methodology, 8, 2005, 19) framework. The electronic databases CINAHL, Medline, and PsycINFO were searched for studies published between 2009 and 2018 along with gray literature and reference lists of included articles. Abstracts and studies were screened using predefined eligibility criteria. Data extraction was undertaken using a standardized framework and data synthesis completed. RESULTS Seven studies were included in the review. Findings indicated NPs valued EBP and believed it to be important in standardizing patient care. NPs' implementation of EBP was found to be relatively low overall. It was not possible to fully determine the extent to which NPs implemented EBP into routine care. NPs experienced similar barriers to EBP implementation as do nurse generalists such as lack of time, lack of EBP competence, lack of support from colleagues and managers, and inadequate resources. In particular, NPs identified collaborative practice issues as factors affecting EBP implementation. Identified barriers included physician-driven practice and the need to maintain professional and political boundaries. Supportive collaborative relationships and having professional confidence were identified facilitators. LINKING EVIDENCE TO ACTION An exploration of NPs' experience of interprofessional collaboration when implementing EBP into routine care is needed to identify requirements for support in this area.
A novel BRD4‐LEUTX fusion in a pediatric sarcoma with epithelioid morphology and diffuse S100 expression

Malignant epithelioid soft tissue tumors encompass a wide spectrum of lesions. Among them, Epithelioid Malignant Peripheral Nerve Sheath Tumors (MPNST) constitute a distinct subgroup, accounting for <5% of all MPNST. Epithelioid MPNST are infrequently associated with neurofibromatosis type 1, occasionally arise in a schwannoma and show diffuse S100 and CD34 expression, often combined with INI‐1 loss. However, the molecular mechanisms underlying the tumorigenesis of epithelioid MPNST remain largely unknown. We describe a case of a 10‐year‐old girl with an epithelioid malignancy of the orbit. The tumor proved positive for S100, CD34 and SOX10, and, although INI‐1 expression was maintained, the overall features suggested the possibility of an epithelioid MPNST, arising in an unusual location. NGS analysis revealed a novel in‐frame BRD4‐LEUTX fusion gene. LEUTX plays an important role in embryonal genome activation and its expression is mostly suppressed postnatally. We were able to detect increased levels of LEUTX transcript in the tumor, indicating that BRD4‐LEUTX fusion leads to LEUTX re‐activation. To our knowledge, this fusion has never been reported previously. Whether the current case represents an example of epithelioid MPNST or a distinct tumor entity remains to be determined.