Miracle-dz/UniFAR-FTUs huggingface dataset:
A novel, re‐usable ‘Safe birth Tray’ for postpartum blood loss monitoring: A preliminary acceptability assessment

As previously reported in the International Journal of Gynecology & Obstetrics, prompt detection of postpartum hemorrhage (PPH) may reduce mortality and measurement of blood loss with an under-buttocks drape is more accurate than visual estimation [1]. The limitations of drapes include the fact that blood pooling around the mother is not immediately measurable and the recurring cost of disposables may be a barrier to use for low-income countries. A reusable orthopedic 'slipper' bedpan (Fig. 1) has been successfully used for blood loss measurement in PPH trials[2]; however, this does not permit real-time monitoring of blood loss.
Identification of Ophiopogonis Radix from different producing areas by headspace-gas chromatography-ion mobility spectrometry analysis.

Ophiopogonis Radix can be divided into Zhemaidong (ZMD) and Chuanmaidong (CMD). The main planting areas of ZMD are Cixi City and Sanmen county. The quality and price of Ophiopogonis Radix from different producing areas are different. In this study, the headspace-gas chromatography-ion mobility spectrometry (HS-GC-IMS) method is used to rapidly identify ZMD and CMD. The method is also used to identify ZMD from Cixi and Sanmen by analyzing volatile organic compounds (VOCs). A total of 58 VOCs was obtained from ZMD samples with more abundant signals of which 41 were identified. The peak intensities of all VOCs in ZMD and CMD, Cixi and Sanmen data were averaged and then those VOCs whose peak intensities were distributed outside of mean ± 2 standard deviation (μ ± 2σ) were selected as characteristic markers. We selected 14 characteristic markers to establish the characteristic fingerprint of ZMD and CMD, among the 14 VOCs, ZMD contained more eucalyptus oil compounds than CMD, CMD contained more volatile aldehydes than ZMD. We selected 12 characteristic markers for the establishment of the characteristic fingerprint of ZMD from Cixi and Sanmen. The principal component analysis (PCA) results indicated that both ZMD and CMD or ZMD from Cixi and Sanmen could be effectively divided. The ZMD and CMD as well as ZMD from Cixi and Sanmen were evaluated by partial least squares regression-discriminants analysis (PLS-DA) resulting to be excellent chemical descriptors for sample discrimination. One hundred percent classification rates for both PLS-DA calibration and prediction models were obtained. These results provided a reference for the traceability of species and origin and market standard of Ophiopogonis Radix. PRACTICAL APPLICATIONS: Ophiopogonis Radix can be divided into Zhejiang Ophiopogonis Radix (ZMD) and Sichuan Ophiopogonis Radix (CMD). As far as ZMD is concerned, its producing areas mainly include the traditional planting areas (Cixi City) and new growth areas (Sanmen county). In this paper, the HS-GC-IMS method was adopted to analyze VOCs in Ophiopogonis Radix from different producing areas and then we screen out the respective characteristic VOCs of ZMD and CMD as well as ZMD from Cixi and Sanmen. These characteristic VOCs can effectively identify ZMD and CMD as well as ZMD from Cixi City and Sanmen country to provide a scientific basis for the origin identification of Ophiopogonis Radix.
Iron metabolism in patients with rheumatoid arthritis.

OBJECTIVE Anemia is the hematological issue that occurs most often as a manifestation in RA. The aim of the study was to assess iron deficiency in RA patients. PATIENTS AND METHODS The study was carried out on 62 RA patients treated between 2016 and 2017. RESULTS A higher percentage of RA patients compared to the control group had TSAT below 20% (43% vs. 5%), ferritin below the reference range (15% vs. 7%), sTfR above 1.59 mg/l (26% vs. 0%) and hepcidin below 14.5 ng/ml (56% vs. 2%). 60% of RA patients had iron deficiency, and 18% - anemia. Correlations were found between reduced levels of ferritin and patients being younger, female, with lower GGT and higher platelet counts. Correlations were also found between iron deficiency and patients being younger, female, having reduced hemoglobin, increased platelet counts, increased GFR, reduced GGT, lower disease activity, and less frequent use of sulfasalazine. CONCLUSIONS Iron deficiency is common (64%) in RA patients where there is high disease activity. RA patients had lower transferrin, lower ferritin, lower hepcidin, and higher sTfR. Decreased DAS-28 and reduced hemoglobin were the strongest determinants of iron deficiency.
The predictive value of quantitative sensory testing for acute and chronic postsurgical pain after total joint arthroplasty: a systematic review.

ABSTRACT Quantitative Sensory Testing (QST) can be useful to identify high-risk patients for the development of chronic postsurgical pain (CPSP). This systematic review aims to assess if presurgical sensory sensitivity measured using QST is associated with acute and CPSP after total joint arthroplasty.A systematic search was performed in Sep/2020 in PubMed, EMBASE, Web of Science and Scopus, using terms related to total joint arthroplasty and QST. Prospective studies were included if they reported an association between presurgical QST and postsurgical pain in adults with osteoarthritis undergoing primary unilateral total joint arthroplasty.From 2994 identified studies, 18 met the inclusion criteria (1869 patients). Total knee arthroplasty was the most common surgery (16 studies) and pressure pain threshold (PPT) was the most common test (11 studies), followed by dynamic measures (9 studies). Postsurgical pain was assessed at acute (5 studies), subacute (2 studies) and chronic (13 studies) time points. Risk of bias was assessed using the Quality in Prognosis Studies Tool, and evaluated as low-to-moderate in most domains. Fourteen studies reported at least one statistically significant association between QST and pain (acute: 4 studies, subacute: 1 study, chronic: 9 studies). PPT was associated with postsurgical pain in 6 studies (out of 11, 55%), heat pain threshold in 2 (out of 6, 33%), conditioned pain modulation in 1 (out of 6, 17%) and temporal summation of pain in 5 (out of 8, 63%). The predictive role of presurgical QST for post-arthroplasty pain remains unclear, mainly due to heterogeneous methodologies and inconsistent results.
Opening Pandora’s Box

Background: Measuring the effectiveness of transitional care interventions has historically relied on health care utilization as the primary outcome. Although the Care Transitions Measure was the first outcome measure specifically developed for transitional care, its applicability beyond the hospital-to-home transition is limited. There is a need for patient-centered outcome measures (PCOMs) to be developed for transitional care settings (ie, TC-PCOMs) to ensure that outcomes are both meaningful to patients and relevant to the particular care transition. The overall objective of this paper is to describe the opportunities and challenges of integrating TC-PCOMs into research and practice. Methods and Results: This narrative review was conducted by members of the Patient-Centered Outcomes Research Institute (PCORI) Transitional Care Evidence to Action Network. We define TC-PCOMs as outcomes that matter to patients because they account for their individual experiences, concerns, preferences, needs, and values during the transition period. The cardinal features of TC-PCOMs should be that they are developed following direct input from patients and stakeholders and reflect their lived experience during the transition in question. Although few TC-PCOMs are currently available, existing patient-reported outcome measures could be adapted to become TC-PCOMs if they incorporated input from patients and stakeholders and are validated for the relevant care transition. Conclusion: Establishing validated TC-PCOMs is crucial for measuring the responsiveness of transitional care interventions and optimizing care that is meaningful to patients.
Augmented Inverse Probability Weighting and the Double Robustness Property

This article discusses the augmented inverse propensity weighted (AIPW) estimator as an estimator for average treatment effects. The AIPW combines both the properties of the regression-based estimator and the inverse probability weighted (IPW) estimator and is therefore a “doubly robust” method in that it requires only either the propensity or outcome model to be correctly specified but not both. Even though this estimator has been known for years, it is rarely used in practice. After explaining the estimator and proving the double robustness property, I conduct a simulation study to compare the AIPW efficiency with IPW and regression under different scenarios of misspecification. In 2 real-world examples, I provide a step-by-step guide on implementing the AIPW estimator in practice. I show that it is an easily usable method that extends the IPW to reduce variability and improve estimation accuracy. Highlights • Average treatment effects are often estimated by regression or inverse probability weighting methods, but both are vulnerable to bias. • The augmented inverse probability weighted estimator is an easy-to-use method for average treatment effects that can be less biased because of the double robustness property.
Communication Patterns During Routine Patient Care in a Pediatric Intensive Care Unit: The Behavioral Impact of In Situ Simulation

Objective Effective communication minimizes medical errors and leads to improved team performance while treating critically ill patients. Closed-loop communication is routinely applied in high-risk industries but remains underutilized in healthcare. Simulation serves as an educational tool to introduce, practice, and appreciate the efficacy of closed-loop communication. Methods This observational before-and-after study investigates behavioral changes in communication among nurses brought on by simulation team training in a pediatric intensive care unit (PICU). The communication patterns of PICU nurses, who had no prior simulation experience, were observed during routine bedside care before and after undergoing in situ simulation. One month before and 1 and 3 months after simulation (intervention), 2 trained raters recorded nurse communications relative to callouts, uttered by the sender, and callbacks, reciprocated by the recipient. The impact of simulation on communication patterns was analyzed quantitatively. Results Among the 15 PICU nurses included in this study, significant changes in communication behavior were observed during patient care after communication-focused in situ simulation. The PICU nurses were significantly less likely to let a callout go unanswered during clinical routine. The effect prevailed both 1 month (P = 0.039) and 3 months (P = 0.033) after the educational exposure. Conclusions This observational before-and-after study describes the prevalence and pattern of communication among PICU nurses during routine patient care and documents PICU nurses transferring simulation-acquired communication skills into their clinical environment after a single afternoon of in situ simulation. This successful transfer of simulation-acquired skills has the potential to improve patient safety and outcome.
Exhaustion of the Executive Control Capacity Eliminates Retrieval Induced Forgetting

Retrieval Induced Forgetting (RIF) demonstrates that retrieval of information can lead to forgetting of related information. The standard RIF paradigm involves studying a certain number of category-exemplar pairs; thereafter, half of the exemplars from half of the categories are retrieved. Finally, all studied pairs are recalled. RIF is revealed when unretrieved exemplars from the retrieved categories are more poorly recalled than exemplars from the unretrieved categories. One explanation for RIF asserts that inhibition prevents interference from the exemplars of the same category during the interpolated retrieval practice phase, which leads to forgetting of these items at final recall. An ongoing debate concerns whether this inhibition requires executive control or whether it is automatic. If inhibition in RIF involves executive control, then a task that will exhaust this limited capacity should reduce or eliminate the RIF effect. The effects of concurrent tasks during the retrieval practice phase have been shown to reduce or eliminate RIF, however, to our knowledge, the effects of prior tasks on RIF has not been investigated. In the present study, in one condition, we conducted an exhaustive inhibition task before the retrieval practice phase and compared this condition to the one in which the prior task was non-exhaustive. Results showed that the RIF effect was eliminated when the prior task was exhaustive. The results supported the executive control view for the inhibition mechanism behind RIF and further showed that exhaustion of the executive control capacity can impair inhibition in subsequent tasks.
Evolving varietal and quality distinctiveness of Australia’s wine regions

ABSTRACT In an ever-more-competitive global market, vignerons compete for the attention of consumers by differentiating their product while responding to technological advances, climate changes and evolving demand patterns. In doing so, they increasingly highlight their regional and varietal distinctiveness. This paper examines the extent to which the mix of winegrape varieties in Australia differs from the rest of the world and differs across wine regions within the country, and how that picture has altered over the first decade of this century. It reports varietal intensity indexes for different regions, indexes of similarity of varietal mix between regions and over time, and quality indexes across regions and varieties within Australia. The study is based mainly on a new global database of vine bearing areas circa 2000 and 2010, supplemented by a more detailed database for Australia back to the 1950s. It reveals that the varietal distinctiveness of Australia vis-à-vis the rest of the world, and varietal differentiation between regions within the country, is far less than for most other countries – a pattern that has become even more pronounced since 2000. It concludes that there is much scope for Australia’s winegrape plantings to become more diversified as producers respond to market and climate changes.
miR-144-3p inhibited the growth, metastasis and epithelial-mesenchymal transition of colorectal adenocarcinoma by targeting ZEB1/2

miR-144-3p is aberrantly expressed in several types of human cancer and functions as a tumor suppressor by inhibiting metastasis. However, the clinical significance and biological function of miR-144-3p in colorectal adenocarcinoma (CRA) have yet to be elucidated. Here we reported that miR-144-3p expression level was significantly down-regulated in CRA tissues compared with matched noncancerous colorectal mucosae tissues. Low miR-144-3p expression was correlated with adverse clinicopathologic characteristics and poor prognosis of CRA patients. Cox regression analysis showed that low miR-144-3p expression was an independent risk factor for DFS and OS in CRA. In vitro and in vivo assays showed that miR-144-3p significantly inhibited proliferation, migration and invasion of CRA cells. In particular, miR-144-3p could suppress EMT process of CRA cells by regulating the cytoskeleton and EMT markers. Bioinformatics analysis indicated that EMT associated transcription factors ZEB1 and ZEB2 were potential targets of miR-144-3p, and miR-144-3p inhibited ZEB1 and ZEB2 expression and was negatively correlated with their expression in CRA. Finally, we confirmed that ZEB1 and ZEB2 down-regulation collaboratively mediated the inhibitory effect of miR-144-3p on proliferation, invasion and EMT of CRA cells. In conclusion, our study provided evidence that miR-144-3p could inhibit CRA cell proliferation, invasion and EMT by targeting ZEB1/2.
Castration delays epigenetic aging and feminizes DNA methylation at androgen-regulated loci

In mammals, females generally live longer than males. Nevertheless, the mechanisms underpinning sex-dependent longevity are currently unclear. Epigenetic clocks are powerful biological biomarkers capable of precisely estimating chronological age and identifying novel factors influencing the aging rate using only DNA methylation data. In this study, we developed the first epigenetic clock for domesticated sheep (Ovis aries), which can predict chronological age with a median absolute error of 5.1 months. We have discovered that castrated male sheep have a decelerated aging rate compared to intact males, mediated at least in part by the removal of androgens. Furthermore, we identified several androgen-sensitive CpG dinucleotides that become progressively hypomethylated with age in intact males, but remain stable in castrated males and females. Comparable sex-specific methylation differences in MKLN1 also exist in bat skin and a range of mouse tissues that have high androgen receptor expression, indicating that it may drive androgen-dependent hypomethylation in divergent mammalian species. In characterizing these sites, we identify biologically plausible mechanisms explaining how androgens drive male-accelerated aging.
Stress levels of Flemish emergency medicine residents and the implications for clinical practice and education

ABSTRACT Background mergency physicians are often confronted with challenging situations. As acute stress can adversely affect the health of physicians and the safety of patients, both could benefit from the integration of performance psychology insights in the education of physicians. A better understanding of stress is a prerequisite for the successful integration of a stress management program into residency training. Methods All Flemish emergency medicine residents were questioned about stressors, perceived stress, and the impact of stress on their performance. Furthermore, participants were asked to evaluate the role of training in performance under stress during residency. Results The response rate was 47.0%. Almost half of the residents indicated to be moderately to highly stressed. Half of the residents said that their performance could improve significantly if they could control their stress completely. The large majority of the residents (91.5%) indicated to see an advantage in increased training in performance enhancing techniques during residency. Conclusion Although a training program could considerably contribute to reduce stress levels and its impact on performance, there is a gap between the needs of residents and the current training program. An evidence-based education program in stress reduction is urgently warranted.
Entrepreneurship and nurse entrepreneurs lead the way to the development of nurses' role and professional identity in clinical practice: A qualitative study.

AIMS AND OBJECTIVES To explore the experiences and perspectives of nurses' transition into entrepreneurship in a clinical and cultural nursing setting and the impact of entrepreneurship on the nurses' role and professional identity. BACKGROUND Entrepreneurship is a relatively unknown phenomenon in international nursing research, and the prevalence of entrepreneurial nurses is only 0.5-1% of all working nurses globally. Unfortunately, several barriers occur within the healthcare system and existing nursing culture that may affect the potential of bringing entrepreneurship into the nursing profession. DESIGN The qualitative study used a phenomenological-hermeneutical approach based on an interpretative phenomenological analysis and COREQ-guided reporting. METHODS Nine individual, semi-structured interviews were conducted face to face (n = 6) and by telephone (n = 3) with Danish nurse entrepreneurs between February and March 2019. RESULTS The analysis revealed four themes: (a) prejudice towards entrepreneurship; (b) to become an entrepreneur in a nursing culture; (c) rebellion against the traditional role as employee and (d) challenged professional identity and new professional roles. CONCLUSION Nurse entrepreneurs are caught between traditional and new ways of viewing nursing identity, norms, values and roles, and they face a conflict of professional values and a stereotyped view of 'real' nursing. Our findings show that entrepreneurship entails a huge learning process that develops nurses' ability to think outside the box in a broader health perspective and challenge the existing nursing culture and role. However, nurse entrepreneurs' ability to engage in entrepreneurship is compromised by professional values, the duty to behave as a good nurse and their own prejudices towards entrepreneurs. IMPACT Entrepreneurship and nurse entrepreneurs pose a huge potential development of the nursing role and identity, as they challenge the current view on the nursing profession. This development is important for patients and health professionals, as future health challenges call for new ways of thinking and acting.
Expression of the Ebola Virus VP24 Protein Compromises the Integrity of the Nuclear Envelope and Induces a Laminopathy-Like Cellular Phenotype

The Ebola virus (EBOV) VP24 protein is a nucleocapsid-associated protein with multiple functions. Proteomic studies have identified the cellular nuclear membrane component emerin as a potential VP24 interactor. ABSTRACT Ebola virus (EBOV) VP24 protein is a nucleocapsid-associated protein that inhibits interferon (IFN) gene expression and counteracts the IFN-mediated antiviral response, preventing nuclear import of signal transducer and activator of transcription 1 (STAT1). Proteomic studies to identify additional EBOV VP24 partners have pointed to the nuclear membrane component emerin as a potential element of the VP24 cellular interactome. Here, we have further studied this interaction and its impact on cell biology. We demonstrate that VP24 interacts with emerin but also with other components of the inner nuclear membrane, such as lamin A/C and lamin B. We also show that VP24 diminishes the interaction between emerin and lamin A/C and compromises the integrity of the nuclear membrane. This disruption is associated with nuclear morphological abnormalities, activation of a DNA damage response, the phosphorylation of extracellular signal-regulated kinase (ERK), and the induction of interferon-stimulated gene 15 (ISG15). Interestingly, expression of VP24 also promoted the cytoplasmic translocation and downmodulation of barrier-to-autointegration factor (BAF), a common interactor of lamin A/C and emerin, leading to repression of the BAF-regulated CSF1 gene. Importantly, we found that EBOV infection results in the activation of pathways associated with nuclear envelope damage, consistent with our observations in cells expressing VP24. In summary, here we demonstrate that VP24 acts at the nuclear membrane, causing morphological and functional changes in cells that recapitulate several of the hallmarks of laminopathy diseases. IMPORTANCE The Ebola virus (EBOV) VP24 protein is a nucleocapsid-associated protein with multiple functions. Proteomic studies have identified the cellular nuclear membrane component emerin as a potential VP24 interactor. Here, we demonstrate that VP24 not only interacts with emerin but also with lamin A/C and lamin B, prompting nuclear membrane disruption. This disruption is associated with nuclear morphological abnormalities, activation of a DNA damage response, the phosphorylation of extracellular signal-regulated kinase (ERK), and the induction of interferon-stimulated gene 15 (ISG15). Interestingly, VP24 also promotes the cytoplasmic translocation and downmodulation of barrier-to-autointegration factor (BAF), leading to repression of the BAF-regulated CSF1 gene. Finally, we show that EBOV infection also results in the activation of pathways associated with nuclear envelope damage, consistent with our observations in cells expressing VP24. These results reveal novel activities of EBOV VP24 protein, resulting in a cell phenotype similar to that of most laminopathies, with potential impact on EBOV replication.