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Background: Knowledge of vascular anatomy and its possible variations is essential for performing embolization or revascularization procedures and complex surgery in the pelvis. The obturator artery (OA) is a branch of the anterior division of the internal iliac artery (IIA), and it has the highest frequency of variation between branches of the internal iliac artery. Possible anomalies of the origin of the obturator artery (OA) should be known when performing pelvic and groin surgery, where its control or ligation may be required. The purpose of this systematic review and meta-analysis, based on Sanudo’s classification, is to analyse the origin of the obturator artery (OA) and its variants. Methods: Thirteen articles, published between 1952 and 2020, were included in this systematic review and meta-analysis. Results: The obturator artery (OA) was present in almost all cases (99.8%): the pooled prevalence estimate for internal iliac artery (IIA) was 77.7% (95% CI 71.8% – 83.1%) vs 22.3% (95% CI 16.9% – 28.2%) for the external iliac artery (EIA). In most cases, the obturator artery (OA) originated from the anterior division trunk of the internal iliac artery (IIA) (61.6%). Conclusion: Performing preoperative radiological studies to know the pelvic vascular pattern and having awareness to evaluate possible changes in the obturator artery can reduce the risk of iatrogenic injury and complications

On 26 September 2022 the Double Asteroid Redirection Test (DART) spacecraft impacted Dimorphos, a satellite of the asteroid 65803 Didymos. Because it is a binary system, it is possible to determine how much the orbit of the satellite changed, as part of a test of what is necessary to deflect an asteroid that might threaten Earth with an impact. In nominal cases, pre-impact predictions of the orbital period reduction ranged from ~8.8 - 17.2 minutes. Here we report optical observations of Dimorphos before, during and after the impact, from a network of citizen science telescopes across the world. We find a maximum brightening of 2.29 $\pm$ 0.14 mag upon impact. Didymos fades back to its pre-impact brightness over the course of 23.7 $\pm$ 0.7 days. We estimate lower limits on the mass contained in the ejecta, which was 0.3 - 0.5% Dimorphos' mass depending on the dust size. We also observe a reddening of the ejecta upon impact., Accepted by Nature

The relationships of patient factors and caregiver contribution to patients' self-care to different types of self-care have been rarely examined in Korean patients with heart failure.The aim of this study was to examine patient (ie, age, depressive symptoms, and self-care confidence) and caregiver (ie, caregiver contribution to self-care maintenance and self-care management, and caregiver confidence in contributing to self-care) factors related to different types of self-care (ie, self-care maintenance, symptom perception, and self-care management) and self-care confidence in Korean patients with heart failure.In this cross-sectional, correlational study, data from 41 pairs of patients (mean age, 68.0 years) and caregivers (mean age, 54.1 years) were collected and analyzed using multiple regression.Higher levels of self-care confidence in patients were related to higher levels of self-care maintenance in patients. Higher levels of self-care confidence in patients were related to higher levels of symptom perception. Higher levels of self-care confidence in patients and caregiver contribution to self-care maintenance were related to higher levels of self-care management. Less severe depressive symptoms in patients and higher levels of caregiver confidence in contributing to self-care were related to higher levels of self-care confidence.Different patient and caregiver factors were related to different types of self-care and self-care confidence in Korean patients, but patients' self-care confidence was related to all types of self-care. Clinicians and researchers need to develop and deliver effective interventions to both patients and their caregivers to improve patients' self-care confidence and, in turn, self-care, considering different factors associated with each type of self-care.

The purpose of this study was to test the psychometric properties of a brief attitudes and beliefs toward human papillomavirus (HPV) vaccination instrument in college students.Cross-sectional, observational study.Eighty-six nursing students.The Attitudes and Beliefs Toward Human Papillomavirus Vaccination was used to test the reliability (Cronbach's alpha), homogeneity (item-analyses), and validity (factor analysis and correlations).The reliability of this 8-item instrument was supported by a Cronbach's alpha of .854. Item homogeneity was supported by coefficients for all items .30. Convergent validity was supported by significant correlations of attitudes and beliefs assessed by this instrument to attitudes, subjective norm, and perceived behavioral control assessed by different instruments (all ps .001). Construct validity was supported by exploratory and confirmatory factor analyses (all factor loadings ≥ .40). Predictive validity was supported by a significant relationship of attitudes and beliefs to completion of the vaccination (p .001).The Attitudes and Beliefs Toward Human Papillomavirus Vaccination Questionnaire was a reliable and valid instrument. This short instrument can be used to assess and improve attitudes and beliefs toward HPV vaccination, and, in turn, to facilitate the completion of the vaccination.

Teachers need playfulness when designing teaching and learning processes. Acknowledging their playfulness as a pedagogical competence is important. Playfulness as a personality trait and as a quality of activities is studied in children but less often in teachers. To explore teachers’ playfulness, we used a Finnish language version of Staempfi’s (2005) Adolescent Playfulness Scale (APS). In Staempfli’s instrument, the constructs measured are Physical Animation, Social Engagement, Mental Spontaneity, Emotional Fluidity and Humorous Perspective. The participants (N = 123) were professional teachers, retired teachers and pre-service teachers in different educational fields. A multivariate analysis was conducted on the APS subscales to examine the influence of gender and age. Educators evaluated themselves as being high in playfulness. Playfulness was mainly consistent between different age groups and females’ emotional fluidity was a bit higher than males. The study provides knowledge about teachers’ playfulness, and results have valuable implications for teacher education and teacher work.

More than 5,000 exoplanets have been confirmed and among them almost 4,000 were discovered by the transit method. However, few transiting exoplanets have an orbital period greater than 100 days. Here we report a transit detection of Kepler-167 e, a "Jupiter analog" exoplanet orbiting a K4 star with a period of 1,071 days, using the Unistellar ground-based telescope network. From 2021 November 18 to 20, citizen astronomers located in nine different countries gathered 43 observations, covering the 16 hour long transit. Using a nested sampling approach to combine and fit the observations, we detected the mid-transit time to be UTC 2021 November 19 17:20:51 with a 1$\sigma$ uncertainty of 9.8 minutes, making it the longest-period planet to ever have its transit detected from the ground. This is the fourth transit detection of Kepler-167 e, but the first made from the ground. This timing measurement refines the orbit and keeps the ephemeris up to date without requiring space telescopes. Observations like this demonstrate the capabilities of coordinated networks of small telescopes to identify and characterize planets with long orbital periods., Comment: 11 pages, 3 figures, 2 tables, accepted in ApJL

To examine factors associated with overall human papillomavirus (HPV) vaccination status, completion of HPV vaccination, and intention to receive vaccination among nursing students.A Cross-sectional, correlational study.Data from 86 students were analyzed using logistic and multiple regression.Among knowledge, attitudes and beliefs, and recommendation, more positive attitudes and beliefs were the only factors associated with initiation and/or completion of HPV vaccination and the intention to receive HPV vaccination.More positive attitudes and beliefs need to be enhanced for HPV vaccination.Changes in attitudes and beliefs can be important targets of interventions to increase HPV vaccination.

Understanding and predicting cancer survivors’ health care utilization is critical to promote quality care. The consultative system of survivorship care uses a onetime consultative appointment to transition patients from active treatment into survivorship follow-up care. Knowledge of attributes associated with nonattendance at this essential appointment is needed. An ability to predict patients with a likelihood of nonattendance would be of value to practitioners. Unfortunately, traditional data modeling techniques may not be useful in working with large numbers of variables from electronic medical record platforms. A variety of machine-learning algorithms were used to develop a model for predicting 843 survivors’ nonattendance at a comprehensive community cancer center in the southeastern United States. A parsimonious model resulted in a k-fold classification accuracy of 67.3% and included three variables. Practitioners may be able to increase utilization of follow-up care among survivors by knowing which patient groups are more likely to be survivorship appointment nonattenders.

Weight bias is prevalent in many healthcare disciplines and negatively impacts the quality of care for patients with obesity. This warrants interventions to reduce weight bias shown by providers to improve care for individuals with obesity. However, past reviews have identified only marginal success in improving the attitudes and beliefs of healthcare providers about individuals with obesity. This systematic review and meta-analysis identifies and synthesizes recent peer-reviewed intervention studies aimed at reducing weight bias in healthcare students and professionals. The databases Embase, Cumulative Index to Nursing and Allied Health Literature, PsychINFO, PubMed and Google Scholar were searched for peer-reviewed studies published between 2016 and August 2021. Search terms included a combination of surrogate terms for the concepts of weight bias, intervention and healthcare students or professionals. The search yielded 1136 articles, and 14 articles met the inclusion criteria for the systematic review. Nineteen effect sizes from nine studies were included in the meta-analysis. Overall, the interventions in the included studies result in a 0.38 SD reduction (Hedge's g) in obesity-bias with 95% confidence intervals from -0.52 to -0.24, indicating a small to moderate effect size in the reduction of weight bias. Most studies included students and focused on evoking empathy or educating on the causality/controllability of obesity. Measurement tools, intervention type, limitations of the studies and recommendations for future research are discussed.