Miracle-dz/UniFAR-FTUs huggingface dataset:
Implementation of Supportive Care Program to Decrease CLABSI in a Middle East Pediatric Hematology and Oncology Inpatient Unit

Background: Central venous catheters (CVCs) support the administration of chemotherapy and other medications, blood products, fluids, and nutrient infusions, and reduce the need for peripheral blood sampling in children with cancer. CVC use is also associated with the risk of central-line-associated bloodstream infection (CLABSI). Despite the implementation of CLABSI care bundles, CLABSI prevention remains challenging. Method: This project implemented supportive preventive care interventions to decrease CLABSI in pediatric hematology/oncology patients in a tertiary hospital in the Middle East region. Interventions included bathing or skin care once daily, oral care twice daily, and ambulating patients three times daily. Parent and staff education materials were developed. The project moniker was Step 1-2-3, inspired by successful implementations of such measures in a U.S. cohort showing reduced CLABSI rates. The project used a mixed methods approach. We report outcomes through August 2022. Results: Pre-project (12/2019–05/2020) five CLABSIs occurred in the inpatient unit. Following the implementation of Step 1-2-3, Pediatric Oncology achieved 492 CLABSI-free days. Six CLABSIs then occurred over a short period of time between October 2021 and January 2022, which was associated with high levels of patient acuity and staff sick leave. The inpatient ward remained CLABSI-free from January 9, 2022, through August 2022. Discussion: Extended periods of CLABSI-free care in a pediatric hematology/oncology unit are achievable. A variety of factors contribute to the sustainability of being CLABSI-free. Data collection and analysis are important factors which aided in our understanding of our own CLABSI events.
A Proposal for the Comprehensive Care of Men on Androgen Deprivation Therapy: Recommendations From the Multidisciplinary Prostate Cancer 360 Working Group

Abstract Introduction: To promote comprehensive care of patients throughout the androgen deprivation therapy (ADT) prescribing process, the Prostate Cancer 360 (PC360) Working Group developed monitoring and management recommendations intended to mitigate or prevent ADT-associated adverse events. Methods: The PC360 Working Group included 14 interdisciplinary experts with a dedicated clinical interest in prostate cancer and ADT management. The working group defined challenges associated with ADT adverse event management and then collaboratively developed comprehensive care recommendations intended to be practical for ADT prescribers. Results: The PC360 Working Group developed both overarching recommendations for ADT adverse event management and specific recommendations across 5 domains (cardiometabolic, bone, sexual, psychological, and lifestyle). The working group recommends an interdisciplinary, team-based approach wherein the ADT prescriber retains an oversight role for ADT management while empowering patients and their primary and specialty care providers to manage risk factors. The PC360 recommendations also emphasize the importance of proactive patient education that involves partners or other support providers. Recommended monitoring and assessment tools, risk factor management, and patient counseling points are also included for the 5 identified domains, with an emphasis on lifestyle and behavioral interventions that can improve quality of life and reduce the risk for ADT-associated complications. Conclusions: Comprehensive care of patients receiving ADT requires early and ongoing coordinated management of a variety of health domains, including cardiometabolic, bone, sexual, psychological health. Patient education and primary care provider involvement should begin prior to ADT initiation and continue throughout treatment to improve patient and partner quality of life.
Assessment of The Utility of The Sarcoma DNA Methylation Classifier In Surgical Pathology

Diagnostic classification of soft tissue tumors is based on histology, immunohistochemistry, genetic findings, and radiologic and clinical correlations. Recently, a sarcoma DNA methylation classifier was developed, covering 62 soft tissue and bone tumor entities. The classifier is based on large-scale analysis of methylation sites across the genome. It includes DNA copy number analysis and determines O6 methylguanine DNA methyl-transferase methylation status. In this study, we evaluated 619 well-studied soft tissue and bone tumors with the sarcoma classifier. Problem cases and typical examples of different entities were included. The classifier had high sensitivity and specificity for fusion sarcomas: Ewing, synovial, CIC-rearranged, and BCOR-rearranged. It also performed well for leiomyosarcoma, malignant peripheral nerve sheath tumors (MPNST), and malignant vascular tumors. There was low sensitivity for diagnoses of desmoid fibromatosis, neurofibroma, and schwannoma. Low specificity of matches was observed for angiomatoid fibrous histiocytoma, inflammatory myofibroblastic tumor, Langerhans histiocytosis, schwannoma, undifferentiated sarcoma, and well-differentiated/dedifferentiated liposarcoma. Diagnosis of lipomatous tumors was greatly assisted by the detection of MDM2 amplification and RB1 loss in the copy plot. The classifier helped to establish diagnoses for KIT-negative gastrointestinal stromal tumors, MPNSTs with unusual immunophenotypes, and undifferentiated melanomas. O6 methylguanine DNA methyl-transferase methylation was infrequent and most common in melanomas (35%), MPNSTs (11%), and undifferentiated sarcomas (11%). The Sarcoma Methylation Classifier will likely evolve with the addition of new entities and refinement of the present methylation classes. The classifier may also help to define new entities and give new insight into the interrelationships of sarcomas.
Preliminary Validation of the Pain Relief Motivation Scales

Objectives: Pain typically prompts individuals to seek relief. This study aimed to develop and psychometrically validate the Pain Relief Motivation Scales, applying revised “reinforcement sensitivity theory” to measure the neuropsychological systems underlying motivation for pain relief. We hypothesized a 6-factor structure based on previous work, including one Behavioral Inhibition System (BIS) factor, one Fight-Flight-Freeze System factor, and 4 Behavioral Activation System (BAS) factors. Methods: Items were generated by adapting the reinforcement sensitivity theory of personality questionnaire for relevance to pain relief. Adults with chronic pain were recruited internationally to participate in online survey batteries at baseline and 1 week later in 2021. We randomly split the sample to conduct exploratory factor analysis (n = 253) and confirmatory factor analysis (n = 253). Psychometric properties were estimated using the full sample (N = 506). Results: Parallel analysis revealed that a 5-factor structure best fits the data (21 items): (1) hopelessness about pain relief (BIS), (2) hesitancy for engaging in pain treatments (BIS), (3) persistence in engaging in pain treatments (BAS), (4) relief reactivity (BAS), and (5) risky relief seeking (BAS). Acceptable internal consistency (Cronbach alpha = 0.68 to 0.80) and test-retest reliability (Intraclass correlation coefficients = 0.71 to 0.88) were observed. Construct validity varied from weak to moderate (r = 0.02 to 0.45). Conclusion: As the first attempt to create an instrument measuring neuropsychological systems underlying motivation for pain relief, the findings show that additional work is needed to refine theory and psychometric rigor in this area. Cautiously, the results suggest that a BIS-BAS model, with minimal Fight-Flight-Freeze System contributions, might be useful for understanding the motivation for relief.
RGDK-lipopeptide for targeting genetic vaccines to antigen presenting cells

Transfection into antigen presenting cells (APCs) is a challenging task in DNA/m-RNA vaccination. Mannose receptor (overexpressed in DCs) selective liposomes containing shikimoyl and quionoic head groups were reported earlier for delivering antigen-encoded plasmid DNA to DCs in vivo. Although APCs also have integrin receptors but there is not much report. Herein, we report the integrin receptor selective liposomes of RGDK-lipopeptide I can deliver pCMV-GFP in RAW 264.7 cells (mouse macrophages cells). We also notice more that presence of endosome disrupting histidinylated lipid II increases the transfection efficiency of the liposomes of RGDK-lipopeptide I in RAW 264.7 cells. Future applications of this liposomal DNA vaccine carrier is expected in the development of efficient vaccinations against a variety of infectious illnesses and malignancies.
Interventions to reduce interpersonal stigma towards patients with a mental dysregulation for ambulance and emergency department healthcare professionals: review protocol for an integrative review

Introduction Worldwide, there is an increase in the extent and severity of mental illness. Exacerbation of somatic complaints in this group of people can result in recurring ambulance and emergency department care. The care of patients with a mental dysregulation (ie, experiencing a mental health problem and disproportionate feelings like fear, anger, sadness or confusion, possibly with associated behaviours) can be complex and challenging in the emergency care context, possibly evoking a wide variety of feelings, ranging from worry or pity to annoyance and frustration in emergency care staff members. This in return may lead to stigma towards patients with a mental dysregulation seeking emergency care. Interventions have been developed impacting attitude and behaviour and minimising stigma held by healthcare professionals. However, these interventions are not explicitly aimed at the emergency care context nor do these represent perspectives of healthcare professionals working within this context. Therefore, the aim of the proposed review is to gain insight into interventions targeting healthcare professionals, which minimise stigma including beliefs, attitudes and behaviour towards patients with a mental dysregulation within the emergency care context. Methods and analysis The protocol for a systematic integrative review is presented, using the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols recommendations. A systematic search was performed on 13 July 2023. Study selection and data extraction will be performed by two independent reviewers. In each step, an expert with lived experience will comment on process and results. Software applications RefWorks-ProQuest, Rayyan and ATLAS.ti will be used to enhance the quality of the review and transparency of process and results. Ethics and dissemination No ethical approval or safety considerations are required for this review. The proposed review will be submitted to a relevant international journal. Results will be presented at relevant medical scientific conferences. PROSPERO registration number CRD42023390664 (https://www.crd.york.ac.uk/prospero/).
Is Climate Change Evident in U.S. Streamflow

The study presented here focuses on the changes/trends in U.S. streamflow from 639 unimpaired stations for the period 1951 – 2002. This is particularly relevant since the issue of climate change is of interest to many and studies have also indicated an abrupt change in climate around the year 1976/77. Trends in U.S. streamflow were evaluated using three statistical tests: Spearman’s Rho, Mann-Kendall, and Linear Regression. Step changes in the streamflow data were evaluated using the Rank Sum and Student t test. The multiple tests provide robust results in which areas of the U.S. have experienced significant changes in streamflow data. The number of stations experiencing an increasing or decreasing trend/step change in any given water year were evaluated at a 95% confidence level. Results indicated that the Upper and Middle Mississippi River basin has an increasing trend in streamflow quantity. For the Pacific Northwest and some stations in Florida, the streamflow quantity is
Using OSL to assess hypotheses related to the impacts of land use change with the early nineteenth century arrival of Europeans in south‐eastern Australia: an exploratory case study from Grabben Gullen Creek, New South Wales

A common explanation for intense soil erosion and gullying in SE Australia is the introduction by Europeans of new land use practices following their arrival in Australia in the late 18th century. Eucalyptus woodlands were cleared to introduce farming, and valley bottoms, characterized by chains of ponds with organic‐rich swampy meadow (SM) soils, were subsequently buried by thick deposits of ‘post‐settlement alluvium’ (PSA) generated by erosion in the catchment. In this study, optically stimulated luminescence (OSL) is used to evaluate the source(s) of the PSA in Grabben Gullen Creek (GGC), Australia. We use a portable OSL reader to measure total photon counts on bulk polymineral and polygrain‐size samples from nine profiles along the Creek. We use these luminescence signals as geotracers of sediment source(s) and transport pathways. We obtained higher luminescence signals in the PSA than in the SM sediments, suggesting different sources and fluvial transport conditions for these two widespread sedimentary units. Portable OSL reader data from soils in the GGC catchment that are potential sources for the SM sediments and PSA show that the high luminescence signals recorded in the PSA are similar to those from subsoil samples in granite soils, suggesting that the PSA was derived by gullying of granite subsoils. In the SM sediments, luminescence signals decrease upwards from the base of the profile, as expected in well‐reset fluvial deposits, but with one or more changes in gradient in the profile of photon counts with depth, most likely indicating changes in sediment deposition rates. To calculate deposition rates in the SM sediments, several samples were dated using OSL. The OSL ages produced low scatter in the equivalent doses, confirming the well‐reset nature of the grains composing the SM and indicating a process of sediment transport in dilute flows, as is interpreted from the portable OSL signals. Copyright © 2014 John Wiley & Sons, Ltd.
Predicting fire-based perennial bunchgrass mortality in big sagebrush plant communities

Maintenance and post-fire rehabilitation of perennial bunchgrasses is important for reducing the spread of exotic annual grass species in big sagebrush plant communities. Post-fire rehabilitation decisions are hampered by a lack of tools for determining extent of fire-induced perennial grass mortality. Our objective was to correlate post-fire characteristics with perennial bunchgrass mortality at the plant and plant community scales. We recorded basal area, percent char, depth of burn and soil colour for 174 bunchgrasses across four ecological sites after a 65 000 ha wildfire in south-east Oregon and assessed plant mortality. Mortality was correlated with post-fire soil colour and ecological site; soil colours (black and grey) associated with pre-fire shrub presence had up to five-fold higher mortality than brown soils typical of interspace locations. Models incorporating depth of burn and soil colour correctly predicted mortality for 90% of individual plants; cover of brown soil explained 88% of the variation in bunchgrass mortality at the plant community scale. Our results indicate that soil colour and depth of burn are accurate predictors of bunchgrass mortality at individual plant and plant community scales and could be used to spatially allocate post-fire bunchgrass rehabilitation resources.
Does “Low Cost” Urban Sanitation Exist? Lessons from a Global Data Set

In this paper, we report results from, and demonstrate the value of, a global database for the collection and aggregation of reliable and comparable cost data for urban sanitation systems as they are built and operated on the ground (rather than the “as planned” costs that are often reported). We show that no particular “mode” of urban sanitation (for example “sewered sanitation” or “fecal sludge management”) can be meaningfully described as “low cost” when compared to other modes. We show that economies of scale may operate for systems that transport waste from pits and sealed tanks by road as well as for sewerage. We use a case study example to show the value of being able to compare local costs to global benchmarks and identify that operational considerations such as low connection rates may be more significant in determining overall cost liabilities for urban sanitation than technical considerations such as population density, size, and degree of centralization/decentralization.
Donor pregnancies and transfusion recipient mortality: A role for red blood cell storage?

Donor characteristics have been implicated in transfusion‐related adverse events. Uncertainty remains about whether sex, and specifically pregnancy history of the blood donor, could affect patient outcomes. Whether storage duration of the blood product could be important for patient outcomes has also been investigated, and a small detrimental effect of fresh products remains a possibility. Here, we hypothesize that fresh red blood cell products donated by ever‐pregnant donors are associated with mortality in male patients.
Do postpartum insomnia, fatigue and depression affect the maternal role of primiparous women?

ABSTRACT Many factors negatively affect the motherhood role. Fatigue, insomnia and depression, which are among these factors, have not been investigated together in any study. Therefore, we carried out this study to determine the effect of insomnia, fatigue and depressive symptoms on the motherhood role in primiparous mothers. In this descriptive and cross-sectional study, we included 153 women who met the inclusion criteria using the simple, random sampling method. To determine the independent variables affecting the motherhood role, we used the backward regression model. In this study, we determined that the women’s spending more energy while they performed the activities of daily living in the postpartum period, their suffering from insomnia due to baby care and their depressive symptoms affected their motherhood role by 32.6 percent. We also determined that there was a moderately significant relationship between insomnia, fatigue and depressive symptoms in the postpartum period. In particular, because depressive symptoms are the variable most related with the motherhood role (r = -0.520; p < .001), women should be followed-up regularly in the postpartum period from this aspect. It is also important to deal with insomnia in the early postpartum period, because it is a common problem in most women after childbirth.
An Innovative Community Health Nursing Virtual Reality Experience: A Mixed Methods Study

Background: Virtual reality (VR) simulation in nursing education, especially about non-acute care including community health, is an emerging learning strategy; more research is needed about its effectiveness. Purpose: This study aimed to evaluate the effectiveness of an innovative community health nursing VR simulation on prelicensure students’ knowledge about social determinants of health and cultural competence, with a goal of enhancing students’ preparation for practice. Methods: In a convergent mixed methods study, 100 prelicensure nursing students in a community health nursing course at a Midwestern U.S., urban, public university completed a pretest, a VR simulation, a posttest, and an evaluation. Pre- and posttests containing content questions adapted from leading community health nursing text faculty resources were used to assess learning, and the Simulation Effectiveness Tool-Modified (SET-M) was used to assess perceived effectiveness of the intervention. Results: The majority of participants’ posttest scores were higher than their pretest scores. Most participants strongly agreed that the VR simulation was effective, and reported on new knowledge/skills learned, material found most helpful, and benefit to their nursing practice. Conclusions: The community health nursing VR simulation was effective at increasing participants’ knowledge and their confidence in their knowledge and abilities.
What generative AI means for trust in health communications

ABSTRACT Large language models are fundamental technologies used in interfaces like ChatGPT and are poised to change the way people access and make sense of health information. The speed of uptake and investment suggests that these will be transformative technologies, but it is not yet clear what the implications might be for health communications. In this viewpoint, we draw on research about the adoption of new information technologies to focus on the ways that generative artificial intelligence (AI) tools like large language models might change how health information is produced, what health information people see, how marketing and misinformation might be mixed with evidence, and what people trust. We conclude that transparency and explainability in this space must be carefully considered to avoid unanticipated consequences.
In situ vaccination via tissue-targeted cDC1 expansion enhances the immunogenicity of chemoradiation and immunotherapy

Even with the prolific clinical use of next-generation cancer therapeutics, many tumors remain unresponsive or become refractory to therapy, creating a medical need. In cancer, DCs are indispensable for T cell activation, so there is a restriction on cytotoxic T cell immunity if DCs are not present in sufficient numbers in the tumor and draining lymph nodes to take up and present relevant cancer antigens. To address this bottleneck, we developed a therapeutic based on albumin fused with FMS-related tyrosine kinase 3 ligand (Alb-Flt3L) that demonstrated superior pharmacokinetic properties compared with Flt3L, including significantly longer half-life, accumulation in tumors and lymph nodes, and cross-presenting-DC expansion following a single injection. We demonstrated that Alb-Flt3L, in combination with standard-of-care chemotherapy and radiation therapy, serves as an in situ vaccination strategy capable of engendering polyclonal tumor neoantigen–specific immunity spontaneously. In addition, Alb-Flt3L–mediated tumor control synergized with immune checkpoint blockade delivered as anti–PD-L1. The mechanism of action of Alb-Flt3L treatment revealed a dependency on Batf3, type I IFNs, and plasmacytoid DCs. Finally, the ability of Alb-Flt3L to expand human DCs was explored in humanized mice. We observed significant expansion of human cross-presenting-DC subsets, supporting the notion that Alb-Flt3L could be used clinically to modulate human DC populations in future cancer therapeutic regimens.