Miracle-dz/UniFAR-FTUs huggingface dataset:
Regional variation in post-stroke multidisciplinary rehabilitation care among veteran residents in community nursing homes

Introduction Effective post-acute multidisciplinary rehabilitation therapy improves stroke survivors’ functional recovery and daily living activities. The US Department of Veterans Affairs (VA) places veterans needing post-acute institutional care in private community nursing homes (CNHs). These placements are made under the same rules and regulations across the VA health care system and through individual per diem contracts between local VA facilities and CNHs. However, there is limited information about utilization of these veterans’ health services as well as the geographic variation of the service utilization. Aim The aims of this study were to determine rehabilitation therapy and restorative nursing care utilization by veterans with stroke in VA-contracted CNHs and to assess risk-adjusted regional variations in the utilization of rehabilitation therapy and restorative nursing care. Methods This retrospective study included all veterans diagnosed with stroke residing in VA-contracted CNHs between 2006 and 2009. Minimum Dataset (a health status assessment tool for CNH residents) for the study CNHs was linked with veterans’ inpatient and outpatient data within the VA health care system. CNHs were grouped into five VA-defined geographic regions: the North Atlantic, Southeast, Midwest, Continental, and Pacific regions. A two-part model was applied estimating risk-adjusted utilization probability and average weekly utilization days. Two dependent variables were rehabilitation therapy and restorative nursing care utilization by veterans during their CNH stays. Results The study comprised 6,206 veterans at 2,511 CNHs. Rates for utilization of rehabilitation therapy and restorative nursing care were 75.7% and 30.1%, respectively. Veterans in North Atlantic and Southeast CNHs were significantly (p<0.001) more likely to receive rehabilitation therapies than veterans from other regions. However, veterans in Southeast CNHs were significantly (p<0.001) less likely to receive restorative nursing care compared with veterans in all other regions, before and after risk adjustment. Conclusion The majority of veterans with stroke received rehabilitation therapy, and about one-third had restorative nursing care during their stay at VA-contracted CNHs. Significant regional variations in weekly days for rehabilitation therapy and restorative nursing care utilization were observed even after adjusting for potential risk factors.
The impact of patient's weight on post-stroke rehabilitation

Abstract Purpose To evaluate the influence of patient’s weight on rehabilitation outcomes in first-event stroke patients. Design Retrospective, observational comparative study. 102 first-time stroke male and female patients admitted to the 52-bed neurology rehabilitation department in a rehabilitation hospital were included in the study. Body mass index (BMI), Functional Independence Measure (FIM) on admission and at discharge, as well as the delta-FIM (FIM on admission – FIM at discharge) were evaluated. The Kruskal–Wallis test was used to compare the FIM and the NIHSS scores between BMI groups (normal, overweight, moderate and severe obesity). Results A statistically significant negative correlation (rho = −0.20, p = 0.049) was found between FIM change and BMI, that remained significant after adjustments for age, sex and hospitalisation days. No difference was found between groups in FIM or NIHSS change between BMI groups. Conclusions In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients’ BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. Further investigations are needed to identify the functional parameters affected by the patients’ BMI. Implications for Rehabilitation In sub-acute post-stroke patients undergoing rehabilitation in rehabilitation hospital, BMI was negatively associated with the improvement of functional parameters. Patients’ BMI should be taken into consideration when predicting rehabilitation outcome for stroke patients. New rehabilitation strategies should be designed to improve the functional outcomes of rehabilitation of obese patients.
Deep Brain Stimulation for Parkinson's Disease: An Investigation of Post-Surgical Self-Regulation and Executive Functioning

OF DISSERTATION DEEP BRAIN STIMULATION FOR PARKINSON’S DISEASE: AN INVESTIGATION OF POST-SURGICAL SELF-REGULATION AND EXECUTIVE FUNCTIONING Parkinson’s Disease (PD) is a common neurodegenerative disorder that attacks the basal ganglia and contributes to a range of motor, cognitive, and behavioral impairments (e.g., tremor, rigidity, and executive dysfunction). This dysfunction may contribute to self-regulatory impairment across several domains, including cognitive skills, thought processes, and emotion. Deep Brain Stimulation (DBS) is a neurosurgical procedure that allows for direct and reversible manipulation of brain activity in patients with PD. The procedure is growing in popularity and is commonly used as an adjunct or in some instances an alternative to dopaminometic medications. Preliminary studies suggest mild executive dysfunction follows DBS but as the literature is in its early stages, there is a need to examine further the range of executive deficits and self-regulatory impairment observed in PD following DBS. In the present study, twenty-seven PD patients post-DBS completed a brief neuropsychological test battery and provided measures of heart rate variability (HRV). Patients also completed questionnaires regarding their ability to self-regulate emotions and thought patterns. Scores were compared to the patient’s pre-surgical performance as well as to a group of healthy older adults. Results suggest DBS leads to significant declines in executive function (EF) and self-regulation (SR). Patients had significantly worse scores on neuropsychological tests of EF (i.e., phonemic fluency, semantic fluency, and working memory) when compared to their preoperative performance. Similarly, DBS patients had significantly worse scores than controls on measures of EF (i.e., verbal fluency, attention, mental flexibility) and verbal memory. With regard to physiological functioning, lower baseline HRV was linked to worse EF but fewer impulsive-compulsive behaviors in DBS patients. Correlations among measures of theoretically similar constructs (i.e., EF and SR) modest and variable, challenging the idea that SR in different domains depends on a common resource.
Importance of MM Polarization in QM/MM Studies of Enzymatic Reactions: Assessment of the QM/MM Drude Oscillator Model.

For accurate quantum mechanics/molecular mechanics (QM/MM) studies of enzymatic reactions, it is desirable to include MM polarization, for example by using the Drude oscillator (DO) model. For a long time, such studies were hampered by the lack of well-tested polarizable force fields for proteins. Following up on a recent preliminary QM/MM-DO assessment (J. Chem. THEORY Comput. 2014, 10, 1795-1809), we now report a comprehensive investigation of the effects of MM polarization on two enzymatic reactions, namely the Claisen rearrangement in chorismate mutase and the hydroxylation reaction in p-hydroxybenzoate hydroxylase, using the QM/CHARMM-DO model and two QM methods (B3LYP, OM2). We compare the results from extensive geometry optimizations and free energy simulations at the QM/MM-DO level to those obtained from analogous calculations at the conventional QM/MM level.
Turbofan Interaction Noise Reduction Using Trailing Edge Blowing: Numerical Design and Assessment and Comparison with Experiments

DOI : 10.12762/2014.AL07-03 This paper investigates the effect of a flow control device on turbofan sound generation, applied to a low-speed axial compressor model in a laboratory test rig. This treatment consists in a secondary mass flow ejected through the trailing edge of the rotor blades, designed to fill the velocity defect behind the rotor and to decrease the turbulent kinetic energy related to the wakes, so that broadband interaction noise should be reduced. The design and implementation of the blowing device is first briefly described, as well as the fan stage experiment. Then, the paper focuses on computation methods devoted to the capture of turbulent wakes and to the acoustic response of the stator (with and without blowing). 3D steady RANS and quasi-2D LES approaches are considered for the CFD, both coupled to an integral formulation based on the theory proposed by Amiet, aiming at calculating the in-duct sound power and estimating the acoustic performance of the treatment. Under optimal blowing conditions, significant sound power reductions are predicted by the simulations. First attempts to relate numerical predictions to available measurements, i.e., hot-wire data and in-duct sound power spectra, are proposed and discussed.
Rehabilitative Therapies in Cerebral Palsy: The Good, the Not As Good, and the Possible

In the past decade, growing recognition of the importance of motor activity for the development and maintenance of central nervous system pathways and for recovery of function post injury has provided new avenues for rehabilitation. Physical therapy is likely to have a prominent role in stimulating neuroplastic changes in damaged developing nervous systems that may finally alter the natural history of these disorders, which has not yet been possible. In this article, we discuss the scientific evidence for various physical therapy treatment options for children with cerebral palsy. Newer, more intense, and task-related exercise programs show the strongest level of evidence. Traditional approaches and newer ‘‘packaged’’ approaches have failed to provide evidence of superiority. Their continued prevalence among clinicians is puzzling and disconcerting, as evidence supporting other approaches continues to accumulate.
Effects of a low-fat dietary intervention on glucose, insulin, and insulin resistance in the Women's Health Initiative (WHI) Dietary Modification trial.

BACKGROUND Glycemic effects of the Women's Health Initiative (WHI) low-fat dietary intervention are unknown. OBJECTIVE Our objective was to analyze the effects of the WHI low-fat dietary intervention on serum glucose and insulin and insulin resistance up to 6 y after random assignment. DESIGN Postmenopausal WHI Dietary Modification trial intervention (DM-I) and comparison (DM-C) participants with blood measures at least at baseline and year 1 (n = 2263) were included. Anthropometric measures, dietary assessments, serum glucose and insulin concentrations, homeostasis model assessment of insulin resistance (HOMA-IR) measures, and quantitative insulin sensitivity check index (QUICKI) values were obtained at baseline, year 1, year 3, and year 6. Changes in measures were compared between groups at years 1, 3, and 6 overall and within stratified analyses. RESULTS Mean (±SD) differences in changes at year 1 between the DM-I and DM-C groups were as follows: glucose, -1.7 ± 17.9 mg/dL; insulin, -0.7 ± 5.1 μIU/mL; HOMA-IR, -0.2 ± 1.9; and QUICKI, 0.004 ± 0.019 (all P < 0.05). Similar findings resulted from repeated-measures analyses comparing the intervention and comparison groups over the 6 y. Whereas normoglycemic women at baseline had a decrease in glucose at year 1 that was 1.9 ± 17.2 mg/dL greater in the DM-I than in the DM-C group, diabetic women had an increase in glucose that was 7.9 ± 20.3 mg/dL greater in the DM-I than in the DM-C group (P for interaction <0.001). CONCLUSIONS A low-fat diet was not significantly associated with adverse glycemic effects up to 6 y after random assignment in postmenopausal women. However, diabetic women experienced adverse glycemic effects of the low-fat diet. This trial is registered at clinicaltrials.gov as NCT00000611.
Comparisons among Mg, Zn, Sr, and Si doped nano-hydroxyapatite/chitosan composites for load-bearing bone tissue engineering applications

In load-bearing bone tissue engineering (BTE), ionic doping is a promising strategy to make up for the inherent defects of hydroxyapatite (HAp). However, the influence of doped elements on the structures and properties of in vitro mineralized HAp has not been investigated in detail so far. In addition, no systematic investigations have been found comparing the properties of different kinds of element doped HAp-based organic/inorganic composites. In this work, the hydroxyapatite/chitosan composite (CS/HAp) and Mg, Zn, Sr, and Si doped hydroxyapatite/chitosan composites (Mg-CS/HAp, Zn-CS/HAp, Sr-CS/HAp, and Si-CS/HAp) were synthesized by using a facile in situ precipitation method. The impacts of different kinds of doped elements on the crystallinity, crystal morphology, and crystal structure of the mineralized HAp were carefully studied. In addition, we also investigated and compared the surface morphology, surface roughness, thermal stability, mechanical strength, and in vitro cytocompatibility of the five samples in detail. We anticipate that our work could shed new light on the influence of ionic doping on the mineralization of HAp and inspire researchers to prepare an HAp-based organic/inorganic composite load-bearing bone substitute in the future.
Influences of Phonological Context on Tense Marking in Spanish-English Dual Language Learners.

Purpose The emergence of tense-morpheme marking during language acquisition is highly variable, which confounds the use of tense marking as a diagnostic indicator of language impairment in linguistically diverse populations. In this study, we seek to better understand tense-marking patterns in young bilingual children by comparing phonological influences on marking of 2 word-final tense morphemes. Method In spontaneous connected speech samples from 10 Spanish-English dual language learners aged 56-66 months (M = 61.7, SD = 3.4), we examined marking rates of past tense -ed and third person singular -s morphemes in different environments, using multiple measures of phonological context. Results Both morphemes were found to exhibit notably contrastive marking patterns in some contexts. Each was most sensitive to a different combination of phonological influences in the verb stem and the following word. Conclusions These findings extend existing evidence from monolingual speakers for the influence of word-final phonological context on morpheme production to a bilingual population. Further, novel findings not yet attested in previous research support an expanded consideration of phonological context in clinical decision making and future research related to word-final morphology.
The pursuit of joint outcomes and equality in outcomes: An integrative model of social value orientation.

The author provides a conceptual framework for understanding differences among prosocial, individualistic, and competitive orientations, Whereas traditional models conceptualize prosocial orientation in terms of enhancing joint outcomes, the author proposes an integrative model of social value orientation in which prosocial orientation is understood in terms of enhancing both joint outcomes and equality in outcomes. Consistent with this integrative model, prosocial orientation (vs. individualistic and competitive orientarions) was associated with greater tendencies to enhance both joint outcomes and equality in outcomes; in addition, both goals were positively associated (Study 1). Consistent with interaction-relevant implications of this model, prosocial orientation was strongly related to reciprocity. Relative to individualists and competitors, prosocials were more likely to engage in the same level of cooperation as the interdependent other did (Study 2) and the same level of cooperation as they anticipated from the interdependent other (Study 3).
A Quantitative Approach to the Prioritization of Zoonotic Diseases in North America: A Health Professionals’ Perspective

Background Currently, zoonoses account for 58% to 61% of all communicable diseases causing illness in humans globally and up to 75% of emerging human pathogens. Although the impact of zoonoses on animal health and public health in North America is significant, there has been no published research involving health professionals on the prioritization of zoonoses in this region. Methodology/Principal Findings We used conjoint analysis (CA), a well-established quantitative method in market research, to identify the relative importance of 21 key characteristics of zoonotic diseases for their prioritization in Canada and the US. Relative importance weights from the CA were used to develop a point-scoring system to derive a recommended list of zoonoses for prioritization in Canada and the US. Study participants with a background in epidemiology, public health, medical sciences, veterinary sciences and infectious disease research were recruited to complete the online survey (707 from Canada and 764 from the US). Hierarchical Bayes models were fitted to the survey data to derive CA-weighted scores for disease criteria. Scores were applied to 62 zoonotic diseases to rank diseases in order of priority. Conclusions/Significance We present the first zoonoses prioritization exercise involving health professionals in North America. Our previous study indicated individuals with no prior knowledge in infectious diseases were capable of producing meaningful results with acceptable model fits (79.4%). This study suggests health professionals with some knowledge in infectious diseases were capable of producing meaningful results with better-fitted models than the general public (83.7% and 84.2%). Despite more similarities in demographics and model fit between the combined public and combined professional groups, there was more uniformity across priority lists between the Canadian public and Canadian professionals and between the US public and US professionals. Our study suggests that CA can be used as a potential tool for the prioritization of zoonoses.
Local Intra-Arterial Eptifibatide for Intraoperative Vessel Thrombosis during Aneurysm Coiling

SUMMARY: We report on our experience with the intra-arterial administration of eptifibatide for thrombolysis during aneurysm-embolization procedures. In 4 cases (3 stent-assisted coiling procedures and 1 with posthemorrhagic vasospasm), we noted the formation of thrombus occluding a vessel. We administered eptifibatide (10–15 mg) through a microcatheter proximal to the thrombus. The thrombus rapidly dissolved, resulting in the recanalization of the occluded vessels with no rethrombosis or hemorrhagic complications.
Cancer-associated oxidoreductase ERO1-α promotes immune escape through up-regulation of PD-L1 in human breast cancer

Many human cancers have been reported to have enhanced expression of the immune checkpoint molecule programmed death-ligand 1 (PD-L1), which binds to programmed cell death-1 (PD-1) expressed on immune cells. PD-L1/PD-1 plays a role in inhibition of antitumor immunity by inducing T cell apoptosis and tolerance. Thus, it is crucial to elucidate mechanisms of PD-L1 expression on cancer cells. ERO1-α is an oxidase located in the endoplasmic reticulum. It is overexpressed in a variety of tumor types and it plays a role in disulfide bond formation in collaboration with PDI. Here, we investigated the influence of ERO1-α on expression of PD-L1 and immune escape. We demonstrated that ERO1-α augmented the expression of PD-L1 via facilitation of oxidative protein folding within PD-L1. In addition, we showed that overexpression of ERO1-α increased HIF-1α protein expression, resulting in an increase of PD-L1 mRNA as well as protein. In clinical cases, we observed that the expression of ERO1-α in triple negative breast cancer was related to the expression of PD-L1. Moreover, apoptosis of Jurkat leukemia T cells, which express PD-1, induced by tumor PD-L1 was inhibited when ERO1-α was depleted. The results suggest that targeting ERO1-α in tumor cells can be a novel approach for cancer immunotherapy. Therefore, the role of ERO1-α in tumor-mediated immunosuppression should be further explored.
Simulating Forest Cover Changes of Bannerghatta National Park Based on a CA-Markov Model: A Remote Sensing Approach

Establishment of protected areas (PA) has been one of the leading tools in biodiversity conservation. Globally, these kinds of conservation interventions have given rise to an increase in PAs as well as the need to empirically evaluate the impact of these PAs on forest cover. Few of these empirical evaluations have been geared towards comparison of pre and post policy intervention landscapes. This paper provides a method to empirically evaluate such pre and post policy interventions by using a cellular automata-Markov model. This method is tested using remotely sensed data of Bannerghatta National park (BNP) and its surrounding, which have experienced various national level policy interventions (Indian National Forest Policy of 1988) and rapid land cover change between 1973 and 2007. The model constructs a hypothetical land cover scenario of BNP and its surroundings (1999 and 2007) in the absence of any policy intervention, when in reality there has been a significant potential policy intervention effect. The models predicted a decline in native forest cover and an increase in non forest cover post 1992 whereas the actual observed landscape experienced the reverse trend where after an initial decline from 1973 to 1992, the forest cover in BNP is towards recovery post 1992. Furthermore, the models show a higher deforestation and lower reforestation than the observed deforestation and reforestation patterns for BNP post 1992. Our results not only show the implication of national level policy changes on forest cover but also show the usefulness of our method in evaluating such conservation efforts.
Rheological properties of biological materials: from cell suspensions to tissues

We characterize the rheological properties of cell suspensions and tissues. The suspension concentration is varied over a wide range. CHO cell suspensions are used. In particular, we are able to characterize the flow properties of cells as well as their viscoelastic properties. The concentration-dependent yield stress and elastic plateau modulus are explained in the context of fractal aggregates under shear. These effects are related to intrinsic microscopic parameters. Then a model tissue is constructed, by including the same cells in a collagen matrix. To characterize the structural changes, confocal microscopy is used. A new important feature is observed, which is the breakdown of the collagen network, due to the presence of cells. Indeed, cells elongate within the gel and can remodel it, in a concentration dependent manner: adhesion of cells is easier when collagen concentration increases, but space is reduced. These two mechanisms compete and can explain the behaviours observed.
Effect of hydraulic retention time on microbial community structure in wastewater treatment electro‐bioreactors

The impact of hydraulic retention time (HRT) on the performance and microbial community structure of control and electro‐bioreactors was investigated. Control bioreactors and electro‐bioreactors were operated at HRT ranging between 6 and 75 hr. The total bacterial counts in addition to the removal efficiency of NH4+–N, sCOD, and PO43−–P was assessed in all the reactors tested. In addition, Illumina sequencing was performed to determine the microbial communities that developed in these reactors under each HRT condition. Phylogenetic analysis showed that Proteobacteria and Bacteroidetes were the dominant phyla in those reactors. In addition, Nitrospira sp. and Pseudomonas sp. were found to be present in electro‐bioreactors with higher relative abundance than in control bioreactors. The results presented here are the first to determine what different microbial communities in wastewater electro‐bioreactors due to the application of an electric current under different HRTs.