Miracle-dz/UniFAR-FTUs huggingface dataset:
Quality Varies Across Health Insurance Marketplace Pricing Regions

Background:Although consumers purchasing health plans in the new Health Insurance Marketplace will be provided information on the cost and quality of participating health plans, it is unclear whether the state-wide plan quality averages that will be reported will accurately represent quality at the pricing region level where care will be received. Objectives:To evaluate whether currently reported state-wide health plan quality scores accurately represent quality within pricing regions established for the Health Insurance Marketplace. Research Design:Observational, historical cohort study using health plan administrative and pharmacy data. Subjects:A total of 5.2 million members enrolled in the preferred provider organization health plans of 1 large commercial California insurer in 2012. Measures:State-wide and pricing region performance on each of the 17 Healthcare Effectiveness Data and Information Set (HEDIS) measures. Results:Across the 17 measures assessed in each of the 19 pricing regions, scores were statistically different (P<0.05) than the overall plan rate for 176 (54%). Variations in scores across regions were observed for each measure ranging from 6.4-percentage points for engagement in treatment for people with dependence of alcohol or other drugs to 47.2-percentage points for appropriate testing for pharyngitis among children. Conclusions:Quality scores in California vary greatly across geographic regions. Statewide averages may misrepresent the quality of care that consumers are likely to receive within a geographic area making difficult assessments about the value of the health care.
Diminishing Returns From Beneficial Mutations and Pervasive Epistasis Shape the Fitness Landscape for Rifampicin Resistance in Pseudomonas aeruginosa

Because adaptation depends upon the fixation of novel beneficial mutations, the fitness effects of beneficial mutations that are substituted by selection are key to our understanding of the process of adaptation. In this study, we experimentally investigated the fitness effects of beneficial mutations that are substituted when populations of the pathogenic bacterium Pseudomonas aeruginosa adapt to the antibiotic rifampicin. Specifically, we isolated the first beneficial mutation to be fixed by selection when 96 populations of three different genotypes of P. aeruginosa that vary considerably in fitness in the presence of rifampicin were challenged with adapting to a high dose of this antibiotic. The simple genetics of rifampicin resistance allowed us to determine the genetic basis of adaptation in the majority of our populations. We show that the average fitness effects of fixed beneficial mutations show a simple and clear pattern of diminishing returns, such that selection tends to fix mutations with progressively smaller effects as populations approach a peak on the adaptive landscape. The fitness effects of individual mutations, on the other hand, are highly idiosyncratic across genetic backgrounds, revealing pervasive epistasis. In spite of this complexity of genetic interactions in this system, there is an overall tendency toward diminishing-returns epistasis. We argue that a simple overall pattern of diminishing-returns adaptation emerges, despite pervasive epistasis between beneficial mutations, because many beneficial mutations are available, and while the fitness landscape is rugged at the fine scale, it is smooth and regular when we consider the average over possible routes to adaptation. In the context of antibiotic resistance, these results show that acquiring mutations that confer low levels of antibiotic resistance does not impose any constraint on the ability to evolve high levels of resistance.
A compilation of sulfur dioxide and carbon dioxide emission-rate data from Cook Inlet volcanoes (Redoubt, Spurr, Iliamna, and Augustine), Alaska during the period from 1990 to 1994

This report contains all of the available daily sulfur dioxide and carbon dioxide emission rates from Cook Inlet volcanoes as determined by the U.S. Geological Survey (USGS) from March 1990 through July 1994. Airborne sulfur dioxide gas sampling of the Cook Inlet volcanoes (Redoubt, Spurr, Iliamna, and Augustine) began in 1986 when several measurements were carried out at Augustine volcano during the eruption of 1986. Systematic monitoring for sulfur dioxide and carbon dioxide began in March 1990 at Redoubt volcano and continues to the present. Intermittent measurements at Augustine and Iliamna volcanoes began in 1990 and continues to the present. Intermittent measurements began at Spurr volcano in 1991, and were continued at more regular intervals from June, 1992 through the 1992 eruption at the Crater Peak vent to the present.
Gene transfer of GLT‐1, a glutamate transporter, into the nucleus accumbens shell attenuates methamphetamine‐ and morphine‐induced conditioned place preference in rats

Several lines of evidence have suggested that the glutamatergic system in the nucleus accumbens (NAc) plays an important role in the conditioned rewarding effect of drugs of abuse. In addition, it is recognized that extracellular glutamate is rapidly removed from the synaptic cleft by Na+‐dependent glutamate transporters in neurons and glial cells, thereby maintaining physiological levels of glutamate. We previously reported that activation of glutamate uptake by a glutamate transporter activator attenuated the acquisition of conditioned place preference induced by methamphetamine and morphine in mice. In the present study, we examined the effects of gene transfer of a glial glutamate transporter, GLT‐1, into the NAc shell by recombinant adenoviruses on methamphetamine‐ and morphine‐induced conditioned place preference in rats. Bilateral infusion of the recombinant adenoviruses into the NAc shell efficiently increased GLT‐1 expression surrounding the infusion site, at least during the period 2–8 days after the infusion. In the conditioned place preference paradigm, animals were conditioned with repeated subcutaneous injections of methamphetamine (2 mg/kg) or morphine (3 mg/kg). Intra‐NAc shell overexpression of GLT‐1 before the conditioning significantly attenuated the conditioned place preference induced by methamphetamine or morphine, when compared with control. However, it had no effect on the somatic signs of naloxone‐precipitated morphine withdrawal. These results suggest that GLT‐1 within the NAc shell plays an inhibitory role in the conditioned rewarding effects of methamphetamine and morphine but not the physical dependence on morphine.
Improving Culture, One Quality Improvement Project at a Time

Context: A culture of quality improvement (QI) values collaboration, transparency, and staff empowerment. Organizations exhibiting a culture of QI are more likely to engage in QI. Objective: We examined whether local health departments' (LHDs') participation in a longitudinal, experiential QI training program changes QI culture. Design: Prior to and following participation in a QI training program, all employees of participating LHDs were asked to complete an 8-item survey assessing components of QI culture on a 5-point scale. Intervention: From 2010 to 2015, multidisciplinary teams from North Carolina LHDs participated in sequential cohorts of a 6-month QI training program, during which the teams completed a QI project. Main Outcome Measure: We dichotomized culture survey responses, with 4 or 5 being “Supportive. ” We compared adjusted proportions, using linear regression, clustering at LHD, and controlling for cohort. Results: Data from 42 LHDs were included. At baseline, 7.8% responded that their LHD had a supportive culture for all 8 components, compared with 12% at follow-up (P < .001), adjusted for cohort and clustering by LHD. At follow-up, the percentage of employees responding that their LHDs had supportive cultures increased for all components of culture including communication by 4.1% (95% CI: 2.0%-6.2%), problem solving by 2.9% (95% CI: 1.6%-5.5%), team work by 5.2% (95% CI: 2.5%-7.8%), vision by 4.3% (95% CI: 1.1%-7.5%), performance measures by 5.6% (95% CI: 1.6%-9.6%), recognition by 4.7% (95% CI: 1.4%-8.0%), for conflict by 5.5% (95% CI: 1.7%-9.4%), and alignment by 5.8% (95% CI: 2.3%-9.2%). Conclusions: Engagement with structured QI training programs—and perhaps simply completing QI projects—can cause small, but important changes in organizations' cultures, thus increasing engagement in future QI and improving overall care and services. The article demonstrates that when LHDs participate in a longitudinal, experiential QI training program, their cultures of QI improve. Local health departments participating in similar training programs might experience similar improvements in culture, increasing subsequent participation in QI projects and improving related health outcomes.
Shear and stability at the base of the mixed layer in the Arctic Ocean the role of inertial motions

Abstract : The Arctic environment changed significantly over recent decades and declines in perennial sea ice and thickness concentrations have been frequently observed. Current predictive models providing researchers with conservative estimates of sea ice concentrations, the lack of observations and understanding of the physical processes that promote changes in sea ice create inaccuracies that need to be improved. A fusion of buoy observations, satellite derived ice concentrations, and modeled wind data are made in this thesis to provide a better insight into sea ice inertial motions and its influence on the processes that occur in the Arctic Ocean mixed layer and to investigate whether these processes can be parameterized to improve predictive models. Observations made in the Canadian Basin and the Transpolar Drift by high resolution Autonomous Ocean Flux Buoys (AOFBs), SSMI and AMSR-E satellite derived ice concentrations, and ERA-Interim winds are used to examine the relationships between winds, ice coverage and sea ice inertial oscillations. Data collected from AOFBs and collocated Ice-Tethered Profilers (ITPs) are analyzed to investigate whether ocean mixed layer inertial oscillations contribute to shear instability at the base of the mixed layer, which serves as a mechanism for vertical transport of heat in water masses underlying the mixed layer. Results show that simple linear regression models cannot explain the relationship between inertial sea ice velocities and modeled winds. However, they do indicate that the magnitude of the inertial sea ice velocities during summers is greater when compared to winter. Analysis further reveals a relationship between sea ice inertial oscillations and sea ice concentrations. We conclude that parameterizing the conditions that permit significant inertial motions in terms of changing areal ice conditions is viable.
[Pacifier use and its relationship with early weaning in infants born at a Child-Friendly Hospital].

OBJECTIVE To assess the use of pacifiers and its relationship with early weaning among children born at a Child-Friendly Hospital. METHODS A cohort study was carried out with 250 healthy singleton babies, with birthweight > or =2,500 g, and with ongoing breastfeeding, born at Hospital de Clínicas de Porto Alegre. All mothers lived in Porto Alegre. Data were collected through interviews with the mothers, both at the maternity ward and at their homes, at the end of the first and sixth month of life; and over the phone, in the second and fourth months. Survival curves were built to compare the prevalence of breastfeeding and exclusive breastfeeding during the first six months of life among pacifier and non-pacifier users. RESULTS Among the 237 newborns contacted in the first month of life, 61.6% had been using pacifiers, most of them since the first week of life. The use of pacifiers was more frequent among male newborns and among those with poorly educated mothers; among babies who were being breastfed, the use of pacifiers was more commonly observed among non-exclusively breastfed ones. Considering the babies who were still being breastfed by the end of the first month of life, the incidence of weaning between months 1 and 6 was 22.4% for non-pacifier users and 50.8% for pacifier users (p<0.001). Almost 2/3 of pacifier users stopped being exclusively breastfed before the end of the second month; among non-pacifier users, this rate was 45% (p<0.001). CONCLUSION The use of pacifiers is deeply rooted in our culture, even in a population oriented towards avoiding it. The association between pacifier use and shorter duration of breastfeeding and exclusive breastfeeding was confirmed in this population.
Geographic Origin of High-Seas Chum Salmon Determined by Genetic and Thermal Otolith Markers

Genetic stock identification (GSI) and thermal otolith marking techniques were used for determining the stock origin of chum salmon (Oncorhynchus ketal caught in two offshore transects (165°W and 145°W) in the Gulf of Alaska during June and July 1998. In the central Gulf of Alaska (49-56°N, 145°W), 49 thermally-marked chum salmon were found (14.5%, n = 339 fish). Most of these marked salmon were immature fish originated from four hatcheries in southeast Alaska (SEAK) and Prince William Sound (PWS), while two immature fish were from Nitinat Hatchery on southwest Vancouver Island, British Columbia (BG). In the western Gulf of Alaska (45-50 o N, 165°W), however, we found only two marked chum salmon (1.1 %, n = 188 fish) that had been released from the Hidden Falls and Gastineau hatcheries in SEAK. The GSI results indicated that North American chum salmon were common in the central Gulf of Alaska (15% west Alaska, 25% Alaska Peninsula/Kodiak, 28% SEAKlPWS, and 18% BC stocks), and Asian chum salmon were predominant in the westem Gulf of Alaska (25% Japan, 53% Russia, and 13% west Alaska stocks). The GSI and thermal mark results suggest that in the central Gulf of Alaska, the contribution of SEAKlPWS hatchery stocks was high among the ocean age . 1 group, but decreased with increasing ocean age mainly because other stocks such as west Alaska stocks penetrated these waters after the second year of their ocean life.
Defective Extracellular Pyrophosphate Metabolism Promotes Vascular Calcification in a Mouse Model of Hutchinson-Gilford Progeria Syndrome That Is Ameliorated on Pyrophosphate Treatment

Background— Progerin is a mutant form of lamin A responsible for Hutchinson-Gilford progeria syndrome (HGPS), a premature aging disorder characterized by excessive atherosclerosis and vascular calcification that leads to premature death, predominantly of myocardial infarction or stroke. The goal of this study was to investigate mechanisms that cause excessive vascular calcification in HGPS. Methods and Results— We performed expression and functional studies in wild-type mice and knock-in LmnaG609G/+ mice expressing progerin, which mimic the main clinical manifestations of HGPS. LmnaG609G/+ mice showed excessive aortic calcification, and primary aortic vascular smooth muscle cells from these progeroid animals had an impaired capacity to inhibit vascular calcification. This defect in progerin-expressing vascular smooth muscle cells is associated with increased expression and activity of tissue-nonspecific alkaline phosphatase and mitochondrial dysfunction, which leads to reduced ATP synthesis. Accordingly, LmnaG609G/+ vascular smooth muscle cells are defective for the production and extracellular accumulation of pyrophosphate, a major inhibitor of vascular calcification. We also found increased alkaline phosphatase activity and reduced ATP and pyrophosphate levels in plasma of LmnaG609G/+ mice without changes in phosphorus and calcium. Treatment with pyrophosphate inhibited vascular calcification in progeroid mice. Conclusions— Excessive vascular calcification in LmnaG609G mice is caused by reduced extracellular accumulation of pyrophosphate that results from increased tissue-nonspecific alkaline phosphatase activity and diminished ATP availability caused by mitochondrial dysfunction in vascular smooth muscle cells. Excessive calcification is ameliorated on pyrophosphate treatment. These findings reveal a previously undefined pathogenic process in HGPS that may also contribute to vascular calcification in normal aging, because progerin progressively accumulates in the vascular tissue of individuals without HGPS.
Analysis of Antioxidant and Anti-Inflammatory Activities of Solvent Fractions from Rhynchosia nulubilis Cultivated with Ganoderma lucidum Mycelium

In this study, the crude ethanol Rhynchosia nulubilis cultivated with Ganoderma lucidum mycelium (RNGM) extract was solvent fractionated with organic solvents such as n-hexane, chloroform, ethyl acetate, and water. The anticancer activities, anti-inflammatory activity total polyphenols, total flavonoids, isoflavones, and β-glucan of the solvent fractions of RNGM were studied. The ethyl acetate fraction showed the highest 2,2-diphenyl-1-picrylhydrazyl scavenging activity of 76.60% at 800 μg/mL. The ethyl acetate fraction also showed higher antioxidant activity in 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid) and ferric reducing ability of plasma assays compared to the other fractions. In addition, this study confirmed that the ethyl acetate fraction strongly inhibited nitric oxide production. The ethyl acetate fraction had the highest amount of total polyphenol and total flavonoid (65.33 mg gallic acid equivalent/g and 18.50 mg quercetin equivalent/g, respectively). The ethyl acetate fraction (13.02%) showed the highest amount of total β-glucan, followed by the water (6.32%), chloroform (1.43%), and n-hexane fraction (0.85%). Therefore, it is suggested that the ethyl acetate fraction of Rhynchosia nulubilis cultivated with Ganoderma lucidum mycelium may be potential natural sources for nutritional and pharmaceutical applications.
FURTHER INVESTIGATIONS OF SHIPBOARD VS . SHORE-BASED SPECTRAL DATA : IMPLICATIONS FOR INTERPRETING LEG 164 SEDIMENT COMPOSITION

Diffuse reflectance spectra measured during shipboard core description with a hand-held Minolta spectrophotometer are reliable data for interpreting sediment composition. Factor analysis of these spectra indicates that only Glad Cling Wrap, a polyethylene food wrap, should be used to cover wet cores during measurement because it introduces substantially less noise into the spectra than other brands of plastic food wrap. This validates our previous recommendation that only Glad Cling Wrap should be used to cover wet core surfaces before spectral analysis on board ship. Factor analysis also indicates that the red end of the spectrum was a little noisy; however, it is unclear if this noise was produced by the Glad Cling Wrap, by the Minolta instrument, or by the sediment being analyzed when wet (water tends to affect the red end of the spectrum more than the violet). Comparison of spectra taken directly from wet cores on board ship with the Minolta CM-2002 to those taken from dried, prepared samples with our shore-based Perkin-Elmer Lambda 6 spectrophotometer indicates that water mutes the spectral signal. Although factor analysis of the Perkin-Elmer data produced five factors, four of those factors are the same as the factors extracted from the wet core data with the Minolta. This suggests that the water content in the wet cores was not high enough to seriously hinder interpretation of sediment composition. These four common factors are interpreted as carbonate, chlorite or glauconite, organic matter, and iron oxides (probably a mixture of hematite and goethite). The presence of hematite can be attributed to hematite-rich sediment derived from the Canadian Maritime provinces, which has been transported southward by the Western Boundary Undercurrent (WBUC) along North American continental margin. Based on the distribution of hematite down the Leg 164 holes, the WBUC apparently has washed over the Leg 164 sites on the crest of the Blake Ridge only during the Holocene and very latest Pleistocene.
Vasodilation by the Calcium-mobilizing Messenger Cyclic ADP-ribose*

In artery smooth muscle, adenylyl cyclase-coupled receptors such as β-adrenoceptors evoke Ca2+signals, which open Ca2+-activated potassium (BKCa) channels in the plasma membrane. Thus, blood pressure may be lowered, in part, through vasodilation due to membrane hyperpolarization. The Ca2+ signal is evoked via ryanodine receptors (RyRs) in sarcoplasmic reticulum proximal to the plasma membrane. We show here that cyclic adenosine diphosphate-ribose (cADPR), by activating RyRs, mediates, in part, hyperpolarization and vasodilation by β-adrenoceptors. Thus, intracellular dialysis of cADPR increased the cytoplasmic Ca2+ concentration proximal to the plasma membrane in isolated arterial smooth muscle cells and induced a concomitant membrane hyperpolarization. Smooth muscle hyperpolarization mediated by cADPR, by β-adrenoceptors, and by cAMP, respectively, was abolished by chelating intracellular Ca2+ and by blocking RyRs, cADPR, and BKCa channels with ryanodine, 8-amino-cADPR, and iberiotoxin, respectively. The cAMP-dependent protein kinase A antagonistN-(2-[p-bromocinnamylamino]ethyl)-5-isoquinolinesulfonamide hydrochloride (H89) blocked hyperpolarization by isoprenaline and cAMP, respectively, but not hyperpolarization by cADPR. Thus, cADPR acts as a downstream element in this signaling cascade. Importantly, antagonists of cADPR and BKCa channels, respectively, inhibited β-adrenoreceptor-induced artery dilation. We conclude, therefore, that relaxation of arterial smooth muscle by adenylyl cyclase-coupled receptors results, in part, from a cAMP-dependent and protein kinase A-dependent increase in cADPR synthesis, and subsequent activation of sarcoplasmic reticulum Ca2+release via RyRs, which leads to activation of BKCachannels and membrane hyperpolarization.
In vitro antagonism of beta-lactam antibiotics by cefoxitin

We assessed the extent and mechanisms of antagonism of beta-lactam antibiotics by cefoxitin. In tests with 41 gram-negative isolates, cefoxitin antagonized cephalothin, cefamandole, cefsulodin, cefotaxime, moxalactam, ampicillin, carbenicillin, piperacillin, mezlocillin, and azlocillin, but not cephalexin, mecillinam, or N-formimidoyl thienamycin. The extent of antagonism varied with the beta-lactam and genus studied. However, antagonism occurred most often with strains possessing inducible cephalosporinases. Antagonism of cephalothin and cefamandole correlated closely with the induction of beta-lactamases capable of inactivating these drugs. Although antagonism of the remaining drugs occurred more often with strains possessing inducible beta-lactamases, these enzymes did not inactivate the drugs. Morphological studies revealed that cefoxitin inhibited filamentation and lysis produced by various beta-lactam drugs. Results of this investigation suggest that cefoxitin antagonizes beta-lactams via (i) induction of drug-inactivating beta-lactamases, and (ii) the induction of beta-lactamases that cannot inactivate the drug but serve as barriers against access to target proteins. This barrier appears most efficient for drugs that bind to penicillin-binding proteins 1 and 3.
Transition Probabilities for the 1815 and 3344 Å Forbidden Lines of Ne III

We have measured the radiative lifetime of the 2s22p4 1S0 metastable level of Ne2+ (Ne III) to be 223 ± 11 ms at the 90% confidence level by observing the photons emitted at 1815 Å by a decaying population of 1S0 Ne2+ ions produced and stored in a radio-frequency ion trap. This is the first lifetime measurement for an excited term of a ground configuration ion in the second row of the periodic table. The transition probabilities (A-values) for the forbidden transitions in the ground configurations of these ions are required for astrophysical line-ratio diagnostics. Using calculated branching ratios, we estimate that A(λ1815) = 1.94 ± 0.17 and A(λ3344) = 2.55 ± 0.19 s-1. Because these numbers have a sum with an experimentally determined uncertainty of 5%, they will provide more accurate results than the calculated A-values for determining electron temperature and density from astrophysical Ne III line ratios.