Miracle-dz/UniFAR-FTUs huggingface dataset:
Selection and Receipt of Kidney Replacement in Critically Ill Older Patients with AKI.

BACKGROUND AND OBJECTIVES Older patients in the intensive care unit are at greater risk of AKI; however, use of kidney replacement therapy in this population is poorly characterized. We describe the triggers and outcomes associated with kidney replacement therapy in older patients with AKI in the intensive care unit. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Our study was a prospective cohort study in 16 Canadian hospitals from September 2013 to November 2015. Patients were ≥65 years old, were critically ill, and had severe AKI; exclusion criteria were urgent kidney replacement therapy for a toxin and ESKD. We recorded triggers for kidney replacement therapy (primary exposure), reasons for not receiving kidney replacement therapy, 90-day mortality (primary outcome), and kidney recovery. RESULTS Of 499 patients, mean (SD) age was 75 (7) years old, Charlson comorbidity score was 3.0 (2.3), and median (interquartile range) Clinical Frailty Scale score was 4 (3-5). Most were receiving mechanical ventilation (64%; n=319) and vasoactive support (63%; n=314). Clinicians were willing to offer kidney replacement therapy to 361 (72%) patients, and 229 (46%) received kidney replacement therapy. Main triggers for kidney replacement therapy were oligoanuria, fluid overload, and acidemia, whereas main reasons for not receiving therapy were anticipated recovery (67%; n=181) and therapy not consistent with patient preferences for care (24%; n=66). Ninety-day mortality was similar in patients who did and did not receive kidney replacement therapy (50% versus 51%; adjusted hazard ratio, 0.78; 95% confidence interval, 0.58 to 1.06); however, decisions to offer kidney replacement therapy varied significantly by patient mix, acuity, and perceived benefit. There were no differences in health-related quality of life or rehospitalization among survivors. CONCLUSIONS Most older, critically ill patients with severe AKI were perceived as candidates for kidney replacement therapy, and approximately one half received therapy. Both willingness to offer kidney replacement therapy and reasons for not starting showed heterogeneity due to a range in patient-specific factors and clinician perceptions of benefit.
Determinants of infant nutrition status in rural farming households before and after harvest.

Infant and young child feeding (IYCF) practices determine infant growth, development and health. Despite global recommendations for exclusive breastfeeding until 6 months, adherence rates are low worldwide for different reasons, largely dependent on environment. In low-income countries, inappropriate IYCF leads to poor nutrition status. This study examined IYCF practices and nutrition outcomes in rural farming households in Tanzania before and after harvest. Mothers and their infants were recruited from two regions in Tanzania. Demographics, health status, IYCF practices, anthropometrics and haemoglobin were measured; preharvest and postharvest. Regression analysis modelled the relationship between IYCF and nutrition outcomes. Despite high rates of breastfeeding a large proportion did not meet early initiation of breastfeeding and minimum acceptable diet standards. Undernutrition was high with 30-40% of infants classified as stunted depending on season, and the majority (81%) were anaemic. Early initiation of breastfeeding was associated with higher Length-for-age z-score and weight-for-age z-score and lower risk of stunting and underweight (p < 0.05). The introduction of fluids other than breast milk in the first 3 days after birth was associated with lower weight-for-age z-score and increased underweight (p < 0.05). Maternal age and height were strongly and positively associated with child anthropometrics. Findings confirm the importance of early infant feeding practices for growth and development and emphasize the significance of mother's nutrition status in relation to infant health. Future interventions should focus on improving maternal nutrition status before, during and after pregnancy as well as educating and supporting mothers to adopt appropriate infant feeding including breastfeeding practices for the prevention of undernutrition.
Exploring distraction and the impact of a child life specialist: Perceptions from nurses in a pediatric setting

PURPOSE The purpose of this study is to explore perceptions held by nurses on the use of distraction and the role of a child life specialist in caring for children undergoing painful procedures. DESIGN AND METHODS A qualitative focus-group design was conducted with 18 nurses from a 24-bed pediatric unit in New South Wales, Australia; this represented 51% of the staff from the unit. Three focus groups were conducted and transcribed verbatim followed by thematic analysis. RESULTS Findings revealed five main themes that reflected the perceptions of the nurses' use of distraction and the impact of the child life specialist. The theme "Distraction as part of everyday nursing practice" was viewed by nurses as an integral component of nursing practice. The theme "Influence of child life specialist" revealed that the child life specialist created a feeling of ease during procedures. Differences were acknowledged between the two roles, "Contrast of roles" the child life specialist was seen as positive for children and families, whereas nurses viewed themselves as mean and unkind due to the nature of their work. The theme "The value of collaboration for positive healthcare experiences" acknowledged distraction as a contributing factor in ensuring the child and their family had a positive healthcare experience. The types of "nurses perception of the child's experience with distraction" shared in each of the focus groups identified nurses felt their techniques for distraction were much more simplified than the child life specialist; nurses felt disadvantaged at times in not having access to the same tools. PRACTICE IMPLICATIONS The findings indicate the positive impact that a child life specialist has on a nurse's role while caring for children undergoing painful procedures. Nurses felt they were able to focus on the procedure, therefore ensuring the physician received the right amount of assistance. This reassured the nurses in knowing the child and their families emotional needs were being taken care of. The child life specialist was viewed as being able to provide a positive healthcare experience for the child and families, nurses felt this added to the value of care provided in the pediatric unit. Recommendations include further exploration of the child life specialist role in the pediatric inpatient setting.
Environmental Music Therapy (EMT): Music’s Contribution to Changing Hospital Atmospheres and Perceptions of Environments

Abstract There are a myriad of sensory elements that contribute to the hospital sensory experience. Environmental Music Therapy is a human-centered, trauma informed strategy that encompasses a process using the metaphoric and associative properties of live music that seeks to modulate patients’ and staff’s perception of the hospital milieu as hostile. While there have been a few studies that have measured EMT’s actual impact quantifiably [1-5], this is the first article to outline the steps and provide orientation, theoretical grounding, and training guidelines for its actual implementation. It is hoped that EMT can be instituted in hospital ICUs as a viable, accessible practice for music therapists whereby its institution will address the sound environment, and perhaps most particularly in those ICUs that are extremely noisy or eerily quiet. Keywords: Environmental Music Therapy, soundscape, soundtrack, ICU, milieu perception
A Distributed Architecture for Human-Drone Teaming: Timing Challenges and Interaction Opportunities

Drones are expected to operate autonomously, yet they will also interact with humans to solve tasks together. To support civilian human-drone teams, we propose a distributed architecture where sophisticated operations such as image recognition, coordination with humans, and flight-control decisions are made, not on-board the drone, but remotely. The benefits of such an architecture are the increased computational power available for image recognition and the possibility to integrate interfaces for humans. On the downside, communication is necessary, resulting in the delayed reception of commands. In this article, we discuss the design considerations of the distributed approach, a sample implementation on a smartphone, and an application to the concrete use case of bookshelf inventory. Further, we report experimentally-derived first insights into messaging and command response delays with a custom drone connected through Wi-Fi.
Interaction of copper nanoparticles with DNA: structural and docking studies

Copper nanoparticles are known to induce drastic changes in organisms. The present work is an attempt to understand how such changes may occur. Theoretical studies of docking of copper cluster of variable size with some DNA fragments were carried out, followed by Molecular Dynamics (MD) simulation study of interaction between copper nanoparticles and DNA. The results show clear size dependence of the interaction of copper cluster with DNA fragments.
Influence of infiltrant application time on the reduction of opaqueness of proximal enamel caries

Introduction: Infiltrant resins were developed to hamper carious lesion progression and mask the whitish appearance of first evidence of caries. Objective: This study aimed at testing the hypothesis that a long application time of resin infiltrant in proximal enamel caries improves esthetic outcome compared to the commercially recommended time. Materials and Methods: Twenty teeth with uncavitated inactive proximal white enamel caries lesions (selected by two calibrated examiners; inter-examiner κ = 0.87) were divided into two groups (experimental and control group; n = 10) that agreed regarding lesion surface area. Lesions were infiltrated following the protocol recommended by the manufacturer (two applications, 3 min application first and another 1 min application later; control) and by the protocol tested in this study (one application of 30 min; experimental). Enamel opaqueness (esthetic outcome) was measured by a calibrated examiner (intra-class coefficient of 0.9) before and after infiltration using fluorescence microscopy. Results: Reduction of enamel opaqueness was significantly higher in the experimental group (40.0% ± 18.5%) than in the control group (18.6% ± 14.9%) (P = 0.0105, one-tailed t-test; Hedge's g of 1.28, 95% confidence interval of 0.43/2.13, and power of 86%). Conclusions: It can be concluded that the application time of 30 min provides a greater reduction in opaqueness of proximal enamel lesion compared to the application time recommended by the manufacturer. The high effect size could stimulate patients to comply with the treatment time.
The Relationship between Perfectionism and Obsessive Compulsive Disorder (OCD): Self-Regulation Processes as Moderator

Background: Obsessive compulsive disorder (OCD) can negatively impact human functions and bother the close people around the patients. Perfectionism is among the factors associated with OCD. Investigating this relationship and other concepts such as self-regulation processes influencing this relationship can help us find better approaches to treat OCD. This study aimed to determine the moderating role of self-regulation processes in the relationship between perfectionism and OCD in 2019. Methods: In this correlational study conducted in Shiraz, Iran, we selected 535 10-to-18-year-old students with an average and SD of 14.15 and 2.75 by multi-stage sampling method. We selected 30 schools and three classes in each of them. Afterwards, six students in each class willingly filled the questionnaires. In order to gather the data, we made use of Tehran Multidimensional Perfectionism Scale, Padua inventory for obsessive-compulsive disorder, integrative self-knowledge questionnaire, self-control scale, and self-compassion scale as research instruments. Data were analyzed by Pearson’s correlation coefficient and stepwise regression analysis. Results: Perfectionism was an important predictor of OCD (B=0.38, Beta=0.08, S.E=0.39, P=0.001), self-control was a major predictor of OCD (B=-0.18, Beta=0.08, S.E=-0.19, P=0.04), and the interaction between perfectionism and integrative selfknowledge was a significant predictor of OCD (B=-0.24, Beta=0.09, S.E=-0.24, P=0.03). Conclusions: Perfectionism and self-control are predictors of OCD, hence important mental concepts. Furthermore, integrative self-knowledge plays a moderating role in the relationship between perfectionism and OCD.
Listening to students for tomorrow, today: engaging students to define the future of higher education

This article examines the voices of students engaged in a cross-European student symposium organized by the European Consortium of Innovative Universities (ECIU) in 2018. Entitled ‘Learning for Tomorrow, Today: Future Fit Universities for 2040’, its aim was to explore how students perceived a ‘future fit’ university for 2040. This date was chosen as a mid-horizon point. Twenty students from 11 universities attended with university leaders and higher education policy makers. A dataset consisting of field notes, written expressions on table cloths, post-event student evaluations, and over 3 hours of video-material was accumulated, and has been analysed through video-hermeneutics and content-analysis. Five students became co-authors after critically reading and validating the text and analysis. The research question posed is how students perceive teaching and learning in a future fit university in 2040. Using an ‘engagement through partnership’ model, we argue that combining the voices of current and future stakeholders moves the sector a step closer to ‘future fit’ higher education. Our main finding is that students are eager to contribute to policy and strategy, and to practice. The students demonstrate a wish to help shape teaching and learning in the future university. Furthermore, they express a view that universities must play a significant role in securing core societal values. And finally, they state that higher education is an important vehicle for developing future citizens able to take part in a democratic Europe and world. At no stage in the discussions did students question the existence of universities in 2040.
Cortico-hippocampal network connections support the multidimensional quality of episodic memory

Episodic memories reflect a bound representation of multimodal features that can be reinstated with varying levels of precision. Yet little is known about how brain networks involved in memory, including the hippocampus and posterior-medial (PM) and anterior-temporal (AT) cortical systems, functionally interact to support the quality and the content of recollection. Participants learned color, spatial, and emotion associations of objects, later reconstructing the visual features using a continuous color spectrum and 360-degree panorama scenes. Behaviorally, dependencies in memory were observed for the gist but not precision of these event associations. Supporting this integration, hippocampus, AT, and PM regions showed increased inter-network connectivity and reduced modularity during retrieval compared to encoding. These network connections, particularly to hippocampus, tracked a multidimensional, continuous measure of objective memory quality. Moreover, distinct patterns of connectivity tracked item color precision and spatial memory precision. These findings demonstrate not only how hippocampal-cortical connections reconfigure during episodic retrieval, but how such dynamic interactions might flexibly support the multidimensional quality of remembered events.
Heterocellular contact can dictate arterial function

Resistance arteries use different dilatory heterocellular signaling mechanisms than conduit arteries (endothelial derived hyperpolarization versus nitric oxide). Anatomically, resistance arteries use myoendothelial junctions (MEJs), endothelial cell (EC) extensions that make contact with smooth muscle cells (SMCs), which are not present in conduit arteries. The objective of this study was to determine if the presence of MEJs in conduit arteries can alter heterocellular signaling. We previously demonstrated that plasminogen activator inhibitor‐1 (PAI‐1) can regulate formation of MEJs. Thus, we applied pluronic gel containing PAI‐1 directly to conduit arteries (carotid arteries, CAs) in live mice to determine if this could induce formation of MEJs. We found a significant increase in EC projections that resemble MEJs, correlating with increased biocytin dye transfer from ECs to SMCs and dilation to NS309. Next, we used pressure myography to investigate whether these structural changes were accompanied by a functional change in vasodilatory signaling. Interestingly, PAI‐1‐treated CAs underwent a switch from conduit to resistance artery vasodilatory profile via increased endothelial‐derived hyperpolarization (EDH) signaling and diminished nitric oxide (NO) signaling. Following PAI‐1 application, we also found a significant increase in carotid expression of endothelial alpha globin, a protein predominantly expressed in resistance arteries. Carotids from mice lacking alpha globin (Hba1−/−) demonstrated that L‐NAME, an inhibitor of NO signaling, was able to prevent vasodilation. Thus, the presence or absence of MEJs is an important determinant for protein expression to influence heterocellular communication. In particular, our data suggests that alpha globin may allow for EDH to predominate in resistance arteries.
A genetic switch for worker nutrition-mediated traits in honeybees

Highly social insects are characterized by caste dimorphism, with distinct size differences of reproductive organs between fertile queens and the more or less sterile workers. An abundance of nutrition or instruction via diet-specific compounds has been proposed as explanations for the nutrition-driven queen and worker polyphenism. Here, we further explored these models in the honeybee (Apis mellifera) using worker nutrition rearing and a novel mutational screening approach using the clustered regularly interspaced short palindromic repeats/CRISPR-associated protein 9 (CRISPR/Cas9) method. The worker nutrition-driven size reduction of reproductive organs was restricted to the female sex, suggesting input from the sex determination pathway. Genetic screens on the sex determination genes in genetic females for size polyphenism revealed that doublesex (dsx) mutants display size-reduced reproductive organs irrespective of the sexual morphology of the organ tissue. In contrast, feminizer (fem) mutants lost the response to worker nutrition-driven size control. The first morphological worker mutants in honeybees demonstrate that the response to nutrition relies on a genetic program that is switched “ON” by the fem gene. Thus, the genetic instruction provided by the fem gene provides an entry point to genetically dissect the underlying processes that implement the size polyphenism.
Service climate and service behavior to customer satisfaction: A multilevel study of Muslim-friendly hotel

Literature has emphasised on the importance of internal integration and external environment towards the quality of services. As Muslim-friendly hotels (MFH) are service organisations, this research aims to integrate the organisation, employee and customers who are involved in the service encounters. This research is purposely conducted to test the proposition that an employee’s service climate determines the employee’s service behaviour and consequently customer satisfaction. This cross-sectional multilevel study involved 25 MFH (n=25) with 5 employees and 5 customers for each organisation, employees (n=125) and employees (n=125). The finding revealed the organisational service climate hada positive and significant impact on individual employee’s service behaviour. In short, the employees at MFH acknowledge the conducive working environment which can motivate them in delivering quality service (γ10= 0.77, SE = 0.09, p-value<0.001). The result shows that MFH has provided a motivational environment to support service delivery. However, it is insufficient to lead to customer satisfaction in relation to the inconsistencyof the other hypotheses.l.
Risk‐Adjusted Comparison of In‐Hospital Outcomes of Transcatheter and Surgical Aortic Valve Replacement

Background Transfemoral transcatheter aortic valve replacement (TF‐TAVR) is recommended for patients suffering from aortic valve stenosis at increased operative risk. Beyond that, patients with different comorbidities could benefit from TF‐TAVR. The present study compares real‐world in‐hospital outcomes of surgical aortic valve replacement and TF‐TAVR. Methods and Results For all 33 789 isolated TF‐TAVR and surgical aortic valve replacement procedures performed in Germany in 2014 and 2015, comorbidities and in‐hospital outcomes were identified by International Classification of Diseases (ICD)‐ and OPS (Operation and procedure key)‐codes. Patients undergoing TF‐TAVR were older and at increased estimated risk. Outcomes were risk‐adjusted to allow comparison. TF‐TAVR was associated with a lower risk for acute kidney injuries (odds ratio [OR] 0.62, P<0.001), for bleeding (OR 0.17, P<0.001), and for prolonged mechanical ventilation (>48 hours, OR 0.21, P<0.001). Risk for stroke was similar (OR 1.07, P=0.558). As expected, the risk for pacemaker implantations was higher after TF‐TAVR (OR 4.61, P<0.001). In all patients, none of the treatment strategies had a clear advantage on the risk for in‐hospital mortality (OR 0.83, P=0.068). However, in patients aged >80 years and at high operative risk undergoing TF‐TAVR in‐hospital mortality was lower (TF‐TAVR versus surgical aortic valve replacement 80–84, OR 0.55; P=0.002; ≥85 years, OR 0.42, P=0.006; EuroSCORE (European System for Cardiac Operative Risk Evaluation) >9: OR 0.62, P=0.001). TF‐TAVR was superior in patients with renal failure and in NYHA (New York Heart Association)‐Class III/IV. Other risk groups were not found to be factors favoring a treatment strategy. Conclusions The present study indicates a superiority of TF‐TAVR in clinical practice for patients at increased operative risk, aged >80 years, in NYHA‐Class III/IV, and with renal failure.
Validation of a Hidradenitis Suppurativa Self-Assessment Tool

Background: Hidradenitis suppurativa (HS) is a debilitating dermatologic condition presenting with recurrent abscesses. While there are multiple scales to determine HS severity, none are designed for self-administration. A validated severity self-assessment tool may facilitate survey research and improve communication by allowing patients to objectively report their HS severity between clinic visits. Objectives: The purpose of this study was to assess a self-administered HS measure. Methods: An HS self-assessment tool (HSSA) with 10 photographs of different Hurley stages was developed. The tool was administered to patients diagnosed with HS who visited the Wake Forest Baptist Health dermatology clinic over a span of 2 months. Physician-administered Hurley stage was recorded to determine criterion validity. To assess test-retest reliability of the measure, patients completed the HSSA again at least 30 minutes after the first completion. Results: Twenty-four patients completed the measure, and 20 of these patients completed it twice. Agreement between physician-determined Hurley stage and self-determined Hurley stage was 66.7% with a weighted kappa of 0.57 (95% confidence interval [CI]: 0.30-0.84). The weighted kappa for agreement between patients’ initial and second completion of the HSSA was 0.81 (95% CI: 0.64-0.99). Conclusions: The self-administered measure provides moderate agreement with physician-determined Hurley stage and good test-retest reliability.