Miracle-dz/UniFAR-FTUs huggingface dataset:
What Is the Minimal Competency for a Clinical Ethics Consult Simulation? Setting a Standard for Use of the Assessing Clinical Ethics Skills (ACES) Tool

Abstract Background: The field of clinical ethics is examining ways of determining competency. The Assessing Clinical Ethics Skills (ACES) tool offers a new approach that identifies a range of skills necessary in the conduct of clinical ethics consultation and provides a consistent framework for evaluating these skills. Through a training website, users learn to apply the ACES tool to clinical ethics consultants (CECs) in simulated ethics consultation videos. The aim is to recognize competent and incompetent clinical ethics consultation skills by watching and evaluating a videotaped CEC performance. We report how we set a criterion cut score (i.e., minimally acceptable score) for judging the ability of users of the ACES tool to evaluate simulated CEC performances. Methods: A modified Angoff standard-setting procedure was used to establish the cut score for an end-of-life case included on the ACES training website. The standard-setting committee viewed the Futility Case and estimated the probability that a minimally competent CEC would correctly answer each item on the ACES tool. The committee further adjusted these estimates by reviewing data from 31 pilot users of the Futility Case before determining the cut score. Results: Averaging over all 31 items, the proposed proportion correct score for minimal competency was 80%, corresponding to a cut score that is between 24 and 25 points out of 31 possible points. The standard-setting committee subsequently set the minimal competency cut score to 24 points. Conclusions: The cut score for the ACES tool identifies the number of correct responses a user of the ACES tool training website must attain to “pass” and reach minimal competency in recognizing competent and incompetent skills of the CECs in the simulated ethics consultation videos. The application of the cut score to live training of CECs and other areas of practice requires further investigation.
Predicting Neonatal Sepsis Using Features of Heart Rate Variability, Respiratory Characteristics, and ECG-Derived Estimates of Infant Motion

This study in preterm infants was designed to characterize the prognostic potential of several features of heart rate variability (HRV), respiration, and (infant) motion for the predictive monitoring of late-onset sepsis (LOS). In a neonatal intensive care setting, the cardiorespiratory waveforms of infants with blood-culture positive LOS were analyzed to characterize the prognostic potential of 22 features for discriminating control from sepsis-state, using the Naïve Bayes algorithm. Historical data of the subjects acquired from a period sufficiently before the clinical suspicion of LOS was used as control state, whereas data from the 24 h preceding the clinical suspicion of LOS were used as sepsis state (test data). The overall prognostic potential of all features was quantified at three-hourly intervals for the period corresponding to test data by calculating the area under the receiver operating characteristics curve. For the 49 infants studied, features of HRV, respiration, and movement showed characteristic changes in the hours leading up to the clinical suspicion of sepsis, namely, an increased propensity toward pathological heart rate decelerations, increased respiratory instability, and a decrease in spontaneous infant activity, i.e., lethargy. While features characterizing HRV and respiration can be used to probe the state of the autonomic nervous system, those characterizing movement probe the state of the motor system—dysregulation of both reflects an increased likelihood of sepsis. By using readily interpretable features derived from cardiorespiratory monitoring, opportunities for pre-emptively identifying and treating LOS can be developed.
Comparison of risk of stroke in patients treated with peritoneal dialysis and hemodialysis: a systematic review and meta-analysis

Abstract Objective: Accumulating evidence has demonstrated that dialysis patients are at increased risk for stroke. However, the impact of dialysis modalities on stroke risk remains controversial. We conducted a systematic review and meta-analysis to determine the effect of peritoneal dialysis (PD) and hemodialysis (HD) on stroke risk. Methods: A systematic search of PubMed, EMBASE, and Web of Science was performed to identify articles comparing the stroke outcomes of dialysis patients. Hazard ratios (HRs) with 95% confidence intervals (95% CIs) were extracted and synthesized to examine stroke outcomes, including ischemic stroke, hemorrhagic stroke, and overall stroke. Results: The search yielded five studies composed of 1,219,245 patients that were evaluated in the final analysis. The results showed that PD was associated with a lower risk for hemorrhagic stroke compared with HD (HR = 0.78; 95% CI: 0.69–0.88; p < 0.001). For ischemic stroke, the results showed that PD was associated with a higher risk compared with HD among the non-Asian patients (HR = 1.13; 95% CI: 1.05–1.23; p = 0.002), but there were no significant differences between PD and HD for the Asian patients. Similarly, there were no significant differences between the effects of the PD and HD approaches on overall stroke risk. Conclusions: We observed that PD patients were less likely to develop hemorrhagic stroke than HD patients, and the risk for ischemic stroke was significantly higher for PD patients than for HD patients among the non-Asian patients. However, our findings could be biased due to the heterogeneity of the included studies.
Growth and fatty acid profiles of Halophytophthora vesicula and Salispina spinosa from Philippine mangrove leaves

Studies on marine‐sourced fatty acids have gathered significant interest recently as an important component of aquaculture feeds and of biofuel production. Of the organisms capable of producing fatty acids, marine oomycetes are promising model organisms. One group of marine oomycetes are the Halophytophthora spp. which is known to have an important role in leaf decomposition, thereby changing the plant debris into exudates which are usable to consumers in the mangrove ecosystems. This study reports the three mangrove oomycetes isolated from Philippine mangrove forests, identified herein as Halophytophthora vesicula AK1YB2 (Aklan), H. vesicula PQ1YB3 (Quezon) and Salispina spinosa ST1YB3 (Davao del Norte). These isolates were subjected to growth analyses using varying incubation parameters (salinity level and pH), and for fatty acid production. Results revealed the presence of different fatty acids such as Arachidonic acid, Linoleic acid and Vaccenic acid when grown on V8S and PYGS media. This study is the first observation of fatty acids from S. spinosa and H. vesicula from the Philippines.
Poly-Lactic Acid-Based Biopolymer Formulations Are Safe for Sustained Intratympanic Dexamethasone Delivery.

HYPOTHESIS AND BACKGROUND The clinical treatment of sudden sensorineural hearing loss currently relies on the administration of steroids, either systemically or via intratympanic injections. Intratympanic injections bypass the hemato-cochlear barrier, reducing its systemic side effects. The efficacy of the injections is limited through rapid drug clearance via the Eustachian tube, and through nonoptimal properties of slow-release drug carriers. A new slow-release drug delivery vehicle based on hexyl-substituted-poly-lactic-acid (HexPLA), with the highest possible safety profile and complete bio-degradability, has been evaluated for safety and efficacy in a standardized guinea pig model of intratympanic injection. METHODS A total of 83 animals received through retrobullar injection either empty Nile-red-colored HexPLA vehicle, 5%-dexamethasone-HexPLA, 5%-dexamethasone suspension, or a sham operation. Long-term residence time of vehicle, biocompatibility, click- and pure-tone hearing thresholds, and dexamethasone levels in the perilymph were prospectively assessed. RESULTS At 1 week after injection, HexPLA vehicle was morphologically present in the middle ear and perilymph levels in the 5%-dexamethasone-HexPLA were on average 2 to 3 μg/ml and one order of magnitude higher compared with those of the 5%-dexamethasone suspension group. No significant postoperative morphological or functional changes were observed up to 3 months postdelivery. CONCLUSIONS HexPLA is safe, fully biocompatible, and efficient for sustained high-dose, intratympanic delivery of dexamethasone at least for 1 week and therefore of high interest for the treatment of sudden sensorineural hearing loss and other acute inner ear diseases. Due to the favorable chemical properties, a wide range of other drugs can be loaded into the vehicle further increasing its potential value for otological applications.
Progesterone affects sex differentiation and alters transcriptional of genes along circadian rhythm signaling and hypothalamic‐pituitary‐gonadal axes in juvenile Yellow River Carp (Cyprinus carpio var.)

Progesterone (P4) is a biologically active steroid hormone that is involved in the regulation of oocyte growth and maturation, as well as development of the endometrium and implantation in the uterus of humans. It can also stimulate oocyte maturation in female fish, as well as spermatogenesis and sperm motility in male fish. Thus, P4 has been extensively used in human and animal husbandry as a typical progestin. However, P4 remaining in the water environment will pose a potential hazard to aquatic organisms. For example, it can interfere with sex differentiation and reproduction in aquatic vertebrates such as fish. Therefore, we investigated the effects of prolonged progesterone exposure on the expression of genes related to circadian rhythm signaling and the hypothalamic‐pituitary‐gonadal (HPG) axes in Yellow River Carp, which may have a potential impact on their sex differentiation. Our results suggested that P4 exposure altered the expression of genes related to circadian rhythm signaling, which can lead to disorders in the endocrine system and regulate the HPG axes‐related activities. Furthermore, the expression of genes related to the HPG axes was also altered, which might affect gonadal development and the reproductive systems of Yellow River Carp. In addition, these changes may provide a plausible mechanism for the observed shifts in their sex ratio toward females.
An observational study of the maintenance of the 30° side‐lying lateral tilt position among aged care residents at risk of developing pressure injuries when using the standard care pillow and a purpose‐designed positioning device

The aim of the study was to evaluate the maintenance of the 30° side‐lying lateral tilt position among aged care residents at the risk of developing pressure injuries when using the standard care pillow and a purpose‐designed positioning device. An observational study was conducted. Participants were monitored during positioning under two conditions, with pillows and with a fluidised positioner. Body angle measurements were taken at three time points (baseline, 1 hour, and 2 hours) on 10 occasions. Repeated‐measures analysis assessed the difference in the degree of the angle of the body. The sample (n = 12) had an average age of 83 years, and the participants were immobile when in bed. The average angle with the pillow condition was 26.7° at baseline, 21.5° at 1 hour, and 16.6° at 2 hours. The average angle with the fluidised positioner condition was 30.7° at baseline, 29.3° at 1 hour, and 26.8° at 2 hours. The main effects of Condition and Time were significant: Condition: F(1,11) = 14.378, P < . 001, Time: F(2,22) = 45.858, P < . 001. There was a statistically significant interaction between the effects of Condition and Time on the average lateral tilt position, F(2,22) = 15.574, P < . 001. The lateral tilt body position was better maintained with the positioning device than the pillow. Further research is required to determine the effectiveness of the fluidised positioner for pressure injury prevention.
Correction: Development and validation of the Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI): a novel instrument to quantify organ damage in systemic sclerosis

1 Development and Validation of the Scleroderma Clinical Trials Consortium Damage Index (SCTC-DI): a novel instrument to quantify organ damage in systemic sclerosis Ferdowsi N1,2, Huq M1,2, Stevens W2, Hudson M3, Wang M3, T Tay1,2, Burchell JL1, Mancuso S1, Rabusa C1,2, Sundararajan V1, Prior D1, Proudman S4,5, The Scleroderma Clinical Trials Consortium Damage Index Working Group, The Australian Scleroderma Interest Group, Canadian Scleroderma Research Group, Baron M*3, Nikpour M*1,2. * Equal contributors 1 The University of Melbourne at St Vincent’s Hospital, Melbourne, Australia 2 St. Vincent’s Hospital, Melbourne, Australia 3 Lady Davis Institute for Medical Research, Jewish General Hospital and McGill University, Montreal, Canada 4 University of Adelaide, Adelaide, Australia 5 Royal Adelaide Hospital, Adelaide, Australia
Smartphone Application with Virtual Reality Goggles for the Reliable and Valid Measurement of Active Craniocervical Range of Motion

Objective: This study aimed to determine the intra-rater and inter-rater reliability and validity of a hybrid device, combining virtual reality goggles, a magnetometer and an inclinometer application for smartphones, to measure craniocervical range. Summary of Background Data: Accurate evaluation of craniocervical range of motion is important for early detection of certain diseased conditions and monitoring the progress of interventions. The universal goniometer is widely used for the measurement but it requires experienced practitioners. Whether a combination of virtual reality goggles and smartphone applications can provide the same or better performance compared with the goniometer is still unknown. Methods: Forty-one healthy adults from the department of physical medicine and rehabilitation were recruited for craniocervical range examination (flexion, extension, side-bending to the right or left and rotating to the right or left) by using the hybrid device and universal goniometer. Using the hybrid device, repeated measurements were performed twice by a primary rater and once by a second rater. The primary rater also conducted a measurement using the universal goniometer in the same cohort. The intra-rater and inter-rater reliability (intra-class correlation coefficient (ICC)) were calculated using the two-way random effect model, whereas the validity was examined by the Pearson correlation coefficient and Bland-and-Altman plot. The interval between the first and second sessions of the measurement for intra-rater reliability was set at 30 min. Results: Excellent intra-rater (ICC ≥ 0.925) and inter-rater (ICC ≥ 0.880) reliability was noted for the hybrid device. The minimal detectable changes from intra-observer and inter-observer comparisons ranged between 4.12° and 7.42° in all six directions. The Bland-and-Altman plot revealed small mean differences (≤1.68°) between the hybrid device and universal goniometer. Both instruments had highly correlated measurements of craniocervical motion (r values ≥ 0.918). Conclusion: For healthy participants, excellent intra-rater and inter-rater reliability was noted for the hybrid device, and the measurements were consistent with the universal goniometer measurements. Future studies are needed to examine whether the device can perform similarly for patients with neck disorders.
Complete Genome Assembly of an Auritidibacter ignavus Isolate Obtained from an Ear Infection in Switzerland and a Comparison to Global Isolates

We present the whole-genome sequence of an isolate of Auritidibacter ignavus, associated with ear infections. This complete assembly was compared to genomes of four global isolates, which revealed a high diversity within the species. ABSTRACT We present the whole-genome sequence of an isolate of Auritidibacter ignavus, associated with ear infections. This complete assembly was compared to genomes of four global isolates, which revealed a high diversity within the species.
Vocabulary size and structure affects real-time lexical recognition in 18-month-olds

The mature lexicon encodes semantic relations between words, and these connections can alternately facilitate and interfere with language processing. We explore the emergence of these processing dynamics in 18-month-olds (N = 79) using a novel approach that calculates individualized semantic structure at multiple granularities in participants’ productive vocabularies. Participants completed two interleaved eye-tracked word recognition tasks involving semantically unrelated and related picture contexts, which sought to measure the impact of lexical facilitation and interference on processing, respectively. Semantic structure and vocabulary size differentially impacted processing in each task. Category level structure facilitated word recognition in 18-month-olds with smaller productive vocabularies, while overall lexical connectivity interfered with word recognition for toddlers with relatively larger vocabularies. The results suggest that, while semantic structure at multiple granularities is measurable even in small lexicons, mechanisms of semantic interference and facilitation are driven by the development of structure at different granularities. We consider these findings in light of accounts of adult word recognition that posits that different levels of structure index strong and weak activation from nearby and distant semantic neighbors. We also consider further directions for developmental change in these patterns.
Whole-Genome Sequences of Staphylococcus pseudintermedius Isolates from Canine and Human Bacteremia Infections

Here, we report the complete and draft genome sequences of 8 Staphylococcus pseudintermedius isolates, 4 from human bacteremia infections and 4 from canine bacteremia infections. This species is recognized primarily as an important canine pathogen, but it is increasingly being identified in human infections. ABSTRACT Here, we report the complete and draft genome sequences of 8 Staphylococcus pseudintermedius isolates, 4 from human bacteremia infections and 4 from canine bacteremia infections. This species is recognized primarily as an important canine pathogen, but it is increasingly being identified in human infections.
Notoginsenoside R1 protects WI‐38 cells against lipopolysaccharide‐triggered injury via adjusting the miR‐181a/TLR4 axis

Notoginsenoside R1 (NGR1) is a neoteric phytoestrogen extracted from Panax notoginseng, and possesses comprehensive pharmacological functions in multitudinous ailments. But, whether NGR1 is utilized in neonatal pneumonia is not clear. This research study aspired to disclose the protective activity of NGR1 in neonatal pneumonia. WI‐38 cells were co‐stimulated with NGR1 and lipopolysaccharide (LPS, 10 ng/mL), CCK‐8 and flow cytometry assays were implemented for cell viability and apoptosis assessment. Real‐time quantitative plymerase chain reaction (RT‐qPCR), enzyme‐linked immunosorbent assay (ELISA), and Western blot analysis were executed for inflammatory cytokine determination. MicroRNA‐181a (miR‐181a) expression was evaluated through RT‐qPCR, simultaneously, the impact of miR‐181a was estimated in NGR1 and LPS co‐managed cells. Dual luciferase report assay was performed to disclose the relation between miR‐181a and Toll‐like receptor 4 (TLR4). The nuclear factor‐κB (NF‐κB) and TAK1/JNK pathways were ultimately appraised. We found that NGR1 decreased cell viability, evoked apoptosis and impeded interleukin‐1β (IL‐1β), IL‐6, and tumor necrosis factor‐α (TNF‐α) expression and secretions in LPS‐managed WI‐38 cells. MiR‐181a expression was enhanced by NGR1, and miR‐181a inhibition inverted the impacts of NGR1 in LPS‐managed WI‐38 cells. Besides, TLR4 was predicted to be a firsthand direct target of miR‐181a. Furthermore, NGR1 hindered NF‐κB and TAK1/JNK pathways through modulating TLR4. These discoveries disclosed the fact that NGR1 protected WI‐38 cells against LPS‐triggered injury via adjusting the miR‐181a/TLR4 and NF‐κB and TAK1/JNK pathways.
A Low-Cost Continuous Turbidity Monitor

Turbidity describes the cloudiness, or clarity, of a liquid. It is a principal indicator of water quality, sensitive to any suspended solids present. Prior work has identified the lack of low-cost turbidity monitoring as a significant hurdle to overcome to improve water quality in many domains, especially in the developing world. Low-cost hand-held benchtop meters have been proposed. This work adapts and verifies the technology for continuous monitoring. Lab tests show the low-cost continuous monitor can achieve 1 nephelometric turbidity unit (NTU) accuracy in the range 0–100 NTU and costs approximately 64 USD in components to construct. This level of accuracy yields useful and actionable data about water quality and may be sufficient in certain applications where cost is a primary constraint. A 38-day continuous monitoring trial, including a step change in turbidity, showed promising results with a median error of 0.45 and 1.40 NTU for two different monitors. However, some noise was present in the readings resulting in a standard deviation of 1.90 and 6.55 NTU, respectively. The cause was primarily attributed to ambient light and bubbles in the piping. By controlling these noise sources, we believe the low-cost continuous turbidity monitor could be a useful tool in multiple domains.
Distinct Transcriptional Changes in Response to Patulin Underlie Toxin Biosorption Differences in Saccharomyces cerevisiae

Patulin (4-hydroxy-4H-furo[3,2c]pyran-2[6H]-one) is a mycotoxin produced by a suite of fungi species. Patulin is toxic to humans and is a sporadic contaminant in products that were made from fungi-infected fruits. The baker yeast Saccharomyces cerevisiae (S. cerevisiae) has been shown to decrease patulin levels likely by converting it to the less harmful E-ascladiol, yet this capacity is dependent on the strain utilized. In this study we show that four representative strains of different S. cerevisiae lineages differ in their ability to tolerate and decrease patulin levels in solution, demonstrating that some strains are better suitable for patulin biocontrol. Indeed, we tested the biocontrol capacities of the best patulin-reducer strain (WE) in contaminated apple juice and demonstrated their potential role as an efficient natural biocontrol solution. To investigate the mechanisms behind the differences between strains, we explored transcriptomic changes of the top (WE strain) and worst (WA strain) patulin-biocontroller strains after being exposed to this toxin. Large and significant gene expression differences were found between these two strains, the majority of which represented genes associated with protein biosynthesis, cell wall composition and redox homeostasis. Interestingly, the WE isolate exhibited an overrepresentation of up-regulated genes involved in membrane components, suggesting an active role of the membrane towards patulin detoxification. In contrast, WA upregulated genes were associated with RNA metabolism and ribosome biogenesis, suggesting a patulin impact upon transcription and translation activity. These results suggest that different genotypes of S. cerevisiae encounter different stresses from patulin toxicity and that different rates of detoxification of this toxin might be related with the plasma membrane composition. Altogether, our data demonstrates the different molecular mechanisms in S. cerevisiae strains withstanding patulin exposure and opens new avenues for the selection of new patulin biocontroller strains.