Miracle-dz/UniFAR-FTUs huggingface dataset:
Datapoints: Medicaid managed care and substance abuse treatment

Conversion of Medicaid substance abuse treatment to managed care has raised concerns about access. However, several states have expanded Medicaid eligibility criteria at the same time. Proponents argue that increasing Medicaid enrollment will ease access to treatment for previously uninsured individuals. It is also possible, however, that Medicaid expansion represents cost shifting from state to federal payers. If so, there would likely be no net increase in publicly funded substance abuse treatment admissions after Medicaid expansion. Another concern is “cream skimming”—giving treatment preferentially to clients whose illness is less severe. Thus the average severity of illness of those treated would decrease after conversion to managed care. Data to test these hypotheses were obtained from a Medicaid demonstration project in Oregon. Data elements from the Oregon Client Process Monitoring System were combined to generate a severity index. In a prospective study, the severity measure was found to be highly correlated with clinicians’ ratings of clients according to the placement criteria of the American Society of Addiction Medicine and with Addiction Severity Index ratings obtained via client interviews. Figure 1 plots the number of adult clients admitted for the three years before substance abuse treatment was integrated into Medicaid managed care in 1995 and the five years afterward. Medicaid admissions started to increase before the integration of substance abuse treatment because eligibility was expanded in 1994 under a federal Section 1115 waiver. After a modest initial reduction in the number of uninsured clients, the total number of publicly funded clients increased dramatically, primarily as a result of expanded Medicaid eligibility. Figure 2 plots the average severity
CHARACTERISTICS OF DRIVERS REFERRED BY POLICE TO VICROADS: EVIDENCE FOR INDICATORS OF DECLINING DRIVING COMPETENCE

Background Cognitive and physical impairments associated with health conditions and ageing may impact on driving capacity. With no age-based mandatory assessment, VicRoads relies on self and community referrals to initiate the process of identifying and managing potentially at-risk drivers. The majority of drivers reported to VicRoads are referred by police. As there is no published research which describes police referred drivers, this is an important study. Aims Researchers sought to understand police referral information and the characteristics and medical review outcomes for a sample of drivers. Methods A retrospective data mining methodology was applied to a sample of active de-identified driver files. Data were analysed using descriptive and χ2 analyses. Results Driver files (n=131) were reviewed and police referrals (n=141) were examined (some files had >1 referral). Average driver age was 76 years and 92% had at least one medical diagnosis. The majority of referrals (n=133) described an instigating event for example, poor driving (80%) and/or a crash (68%), with most occurring at intersections (37%) or in car parks (20%). Events were commonly associated with inappropriate/dangerous driving (62%) or failing to obey road laws (47%). The review process resulted in licence cancellation/suspension for 46% of drivers: licence withdrawal was associated with increasing age, certain medical conditions, poor driving and inappropriate driver behaviour. Significance Police play an important role in DLA medical review systems: results highlight (a) what triggers a review request and driver characteristics, and (b) the need to educate police and the community about indicators of declining driving competency.
Alternative Invasive Positive Pressure Ventilatory Strategies

Conventional modes of mechanical ventilation often cause patient-ventilatory asynchrony and may fail to assure adequate gas exchange while attempting to adhere to lung protective ventilatory strategies. Airway pressure release ventilation, partial liquid ventilation, and high-frequency ventilation are alternative ventilatory strategies used for acute respiratory distress syndrome that aim to protect the lung while providing adequate gas exchange. The closed-loop ventilatory strategies use computer algorithm and feedback monitoring of respiratory system mechanics to improve patient-ventilator interaction and comfort.
Polyhydroxyalkanoates production from synthetic waste using Pseudomonas pseudoflava: Polyhydroxyalkanoate synthase enzyme activity analysis from P. pseudoflava and P. palleronii

Synthetic wastewater (SW) at various carbon concentrations (5-60 g/l) were evaluated for polyhydroxyalkanoates (PHA) production using the bacteria Pseudomonas pseudoflava. Bacteria showed highest PHA production with 20 g/l (57±5%), and highest carbon removal at 5 g/l (74±6%) concentrations respectively. Structure, molecular weight, and thermal properties of the produced PHA were evaluated using various analytical techniques. Bacteria produced homo-polymer [poly-3-hydroxybutyrate (P3HB)] when only acetate was used as carbon source; and it produced co-polymer [poly-(3-hydroxybutyrate-co-3-hydroxyvalerate) P(3HB-co-3HV)] by addition of co-substrate propionate. PHA synthase, the enzyme which produce PHA was extracted from two bacterial strains i.e., P. pseudoflava and P. palleronii and its molecular weight was analysed using SDS-PAGE. Protein concentration, and PHA synthase enzyme activity of P. pseudoflava and P. palleronii was carried out using spectrophotometer. Results denoted that P. pseudoflava can be used for degradation of organic carbon persistent in wastewaters and their subsequent conversion into PHA.
Processes on the emergent landscapes of biochemical reaction networks and heterogeneous cell population dynamics: differentiation in living matters

The notion of an attractor has been widely employed in thinking about the nonlinear dynamics of organisms and biological phenomena as systems and as processes. The notion of a landscape with valleys and mountains encoding multiple attractors, however, has a rigorous foundation only for closed, thermodynamically non-driven, chemical systems, such as a protein. Recent advances in the theory of nonlinear stochastic dynamical systems and its applications to mesoscopic reaction networks, one reaction at a time, have provided a new basis for a landscape of open, driven biochemical reaction systems under sustained chemostat. The theory is equally applicable not only to intracellular dynamics of biochemical regulatory networks within an individual cell but also to tissue dynamics of heterogeneous interacting cell populations. The landscape for an individual cell, applicable to a population of isogenic non-interacting cells under the same environmental conditions, is defined on the counting space of intracellular chemical compositions x = (x1,x2, … ,xN) in a cell, where xℓ is the concentration of the ℓth biochemical species. Equivalently, for heterogeneous cell population dynamics xℓ is the number density of cells of the ℓth cell type. One of the insights derived from the landscape perspective is that the life history of an individual organism, which occurs on the hillsides of a landscape, is nearly deterministic and ‘programmed’, while population-wise an asynchronous non-equilibrium steady state resides mostly in the lowlands of the landscape. We argue that a dynamic ‘blue-sky’ bifurcation, as a representation of Waddington's landscape, is a more robust mechanism for a cell fate decision and subsequent differentiation than the widely pictured pitch-fork bifurcation. We revisit, in terms of the chemostatic driving forces upon active, living matter, the notions of near-equilibrium thermodynamic branches versus far-from-equilibrium states. The emergent landscape perspective permits a quantitative discussion of a wide range of biological phenomena as nonlinear, stochastic dynamics.
Use of Oncept melanoma vaccine in 69 canine oral malignant melanomas in the UK

OBJECTIVES Oral malignant melanomas carry a poor-to-guarded prognosis because of their local invasiveness and high metastatic propensity. The Oncept melanoma vaccine is licensed to treat dogs with stage II or III locally-controlled oral malignant melanoma and this retrospective study aimed to assess survival of affected dogs treated with the vaccine in the UK. MATERIAL AND METHODS Medical records of dogs with histopathologically-confirmed oral malignant melanoma that received the vaccine as part of their treatment were evaluated. Survival analyses for potential prognostic factors were performed. RESULTS Sixty-nine dogs were included; 56 dogs, staged I to III, and with previous locoregional therapy, had a median survival time of 455 days (95% CI: 324 to 586 days). Based on Kaplan-Meier survival analysis with associated log-rank testing, no significant prognostic factors were identified for this population. Of the 13 patients with macroscopic disease treated with vaccine alone or in combination therapy, eight showed clinical response. Three patients with stage IV oral malignant melanoma survived 171, 178 and 288 days from diagnosis. CLINICAL SIGNIFICANCE Patients treated with the melanoma vaccine in our study had survival times similar to their counterparts receiving the vaccine in the USA. There were observed responses in patients with macroscopic disease and so the vaccine could be considered as palliative treatment in dogs with stage IV disease.
The natural history of humeral intracondylar fissure: an observational study of 30 dogs

OBJECTIVES To determine the risk of condylar fracture, or of needing to have a transcondylar screw placed, and to identify risk factors in a cohort of dogs with humeral intracondylar fissure (also known as incomplete ossification of the humeral condyle) that was initially managed non-surgically. METHODS A retrospective owner survey of dogs diagnosed with humeral intracondylar fissure as an incidental finding and managed non-surgically with a minimum of two years follow-up. Body weight, age, estimated fissure size, gender and contralateral fracture at the time of diagnosis were evaluated as potential risk factors for the development of a humeral condylar fracture or for having a transcondylar screw placed. RESULTS Data were available for 30 dogs (34 elbows). Six humeral condyles with a mean fissure size of 50% fractured at a mean of 14 months after diagnosis. A transcondylar screw was placed across two humeral condyles with fissure sizes of 60 and 100% at 11 and 17 months. No risk factors were identified for fracture/screw placement. For those cases that did not fracture or have a screw placed mean fissure size was 52% and mean follow-up time was 56 months (range 29 to 79 months). CLINICAL SIGNIFICANCE Eighteen percent of cases progressed to fracture and 24% in total required surgery. This information allows clinicians and owners to make an informed decision regarding surgery when faced with a dog with humeral intracondylar fissure identified as an incidental finding.
Mortality due to trauma in cats attending veterinary practices in central and south‐east England

OBJECTIVES To identify important demographic and spatial factors associated with the risk of trauma and, more specifically, road traffic accident-related mortality, relative to other diagnoses in cats. METHODS A sample of 2738 cats with mortality data derived from the VetCompass primary-care veterinary database was selected for detailed study. Generalised linear models investigated risk factors for mortality due to trauma and due to road traffic accidents versus other causes. RESULTS A greater proportion of younger cats died through traumatic and road traffic accident-attributed causes relative to other causes of mortality. There was no apparent association of trauma- or road traffic accident-related death with urban environments or areas where there is increased human population density. CLINICAL SIGNIFICANCE These findings highlight that veterinary advice which aims to reduce the likelihood of death through trauma, and specifically road traffic accidents, should focus on demographic attributes including age. All geographical locations should be considered as of equal risk.
Secure settings and the scope for recovery: service users' perspectives on a new tier of care

This research attempts to explore in‐patient perspectives on the long‐stay, medium‐secure hospital wards in which they are based. Semi‐structured interviews focused on the care provided by the hospital in comparison with the high‐secure hospitals from which the participants had been transferred. Questions focused on the participants' perceptions of recovery and the scope for it at both sites.The data suggests that participants identify increased scope for recovery at the long‐stay, medium‐secure facility, and that this is promoted by increased flexibility due to less emphasis on security. Important factors discussed by participants were increased access to a range of activities, graded access into the community, the different atmosphere in the hospital sites and the differences in potential for developing trusting relationships with staff and fellow in‐patients.
Evidence for heritability of adult men's sexual interest in youth under age 16 from a population-based extended twin design.

INTRODUCTION Sexual interest in children resembles sexual gender orientation in terms of early onset and stability across the life span. Although a genetic component to sexual interest in children seems possible, no research has addressed this question to date. Prior research showing familial transmission of pedophilia remains inconclusive about shared environmental or genetic factors. Studies from the domains of sexual orientation and sexually problematic behavior among children pointed toward genetic components. Adult men's sexual interest in youthfulness-related cues may be genetically influenced. AIM The aim of the present study was to test whether male sexual interest in children and youth under age 16 involves a heritable component. MAIN OUTCOME MEASURES The main outcome measure was responses in a confidential survey concerning sexual interest, fantasies, or activity pertaining to children under the age of 16 years during the previous 12 months. METHODS The present study used an extended family design within behavioral genetic modeling to estimate the contributions of genetic and environmental factors in the occurrence of adult men's sexual interest in children and youth under age 16. Participants were male twins and their male siblings from a population-based Finnish cohort sample aged 21-43 years (N = 3,967). RESULTS The incidence of sexual interest in children under age was 3%. Twin correlations were higher for monozygotic than for dizygotic twins. Behavioral genetic model fitting indicated that a model including genetic effects as well as nonshared environmental influences (including measurement error), but not common environmental influences, fits the data best. The amount of variance attributable to nonadditive genetic influences (heritability) was estimated at 14.6%. CONCLUSIONS The present study provides the first indication that genetic influences may play a role in shaping sexual interest toward children and adolescents among adult men. Compared with the variance attributable to nonshared environmental effects (plus measurement error), the contribution of any genetic factors seems comparatively weak. Future research should address the possible interplay of genetic with environmental risk factors, such as own sexual victimization in childhood.
The antidepressants fluoxetine and bupropion differentially affect proceptive behavior in the naturally cycling female rat.

INTRODUCTION Fluoxetine, like other selective serotonin reuptake inhibitors, inhibits women's sexual desire and female rats' sexual behavior. Bupropion produces pro-sexual effects in women with and without depression, and yohimbine increases men's and male rats' sexual motivation, but their effects on female rats' proceptivity are unknown. AIM To investigate the effects of fluoxetine, bupropion, and yohimbine on proceptivity and receptivity in the naturally cycling female rat. METHODS We studied the effect of chronic (minimum 14 days) fluoxetine (1.25 mg/kg, subcutaneous) and bupropion (5 mg/kg, intraperitoneal) and acute yohimbine (1 mg/kg, intraperitoneal) on sexual behavior of female rats selected in natural proestrus during an ejaculatory series. We also analyzed the effects of these treatments on locomotor activity. MAIN OUTCOME MEASURES The main outcome measures were frequencies of hops/darts and ear wiggling, lordosis quotient and intensity, and locomotor activity. RESULTS Fluoxetine inhibited ear wiggling and hopping/darting, while bupropion stimulated hopping/darting. These treatments did not modify the lordosis quotient and its intensity. Yohimbine did not change any aspect of female sexual behavior. At the doses and treatments used, fluoxetine and bupropion did not alter locomotor activity or disturb the length of the estrous cycle; however, yohimbine inhibited locomotor activity. CONCLUSIONS The motivational components of female sexual behavior are more sensitive than the receptive components to the inhibitory actions of fluoxetine. Bupropion selectively stimulated hopping/darting, while yohimbine lacked an action on female sexual behavior.
Do hormones influence women's sex? Sexual activity over the menstrual cycle.

INTRODUCTION In mammals, the effects of ovarian steroids influence sexual behavior. In humans, there are a few studies that take into account if ovulation occurs. AIM The study aims to investigate if a woman's sexuality changes during the week and over the menstrual cycle, and if so, in what way. METHODS This is a prospective cohort study; 1,957 heterosexual women were involved over the period January 2004-December 2011. Two subgroups were taken into consideration, women having a partner and singles. MAIN OUTCOME MEASURE Sexual interview and the Female Sexual Function Index and Female Sexual Distress Scale questionnaires were used to exclude women with sexual dysfunction. Women with ovulation confirmed by sonography were enrolled. Women were given diary cards on which to report their daily sexual activity. Serum concentrations of estradiol, progesterone, total testosterone, sex hormone binding globulin, and free androgen index were measured during the follicular, periovular, and luteal phase of the menstrual cycle. RESULTS One thousand one hundred eighty women (age range 18-40 years) were included in the analyses. Of them, 925 had a heterosexual relationship and 255 were single. Women with a partner had more sexual activity during the weekend, while the singles had a constant sexual activity over the week. The sexual activity of singles was higher during the ovulatory phase and lower during menses than that of the women with a partner. A linear correlation between sexual activity and androgenic hormonal profile during the menstrual cycle in women with and without a partner was observed. CONCLUSIONS Ovarian steroids modulate a woman's sexual activity. This aspect was more evident in singles than in women having a partner, in which a variety of nonhormonal factors can have a role.
Determinants of sexual activity in four birth cohorts of Swedish 70-year-olds examined 1971-2001.

INTRODUCTION Knowledge about determinants of sexual activity in older adults in the general population is limited. Human senescence has been delayed by a decade, and people are reaching old age in better health. AIM The aim of this study was to investigate determinants of sexual activity in four birth cohorts of non-demented 70-year-olds examined in 1971-1977 and 1992-2001. MAIN OUTCOME MEASURE The main outcome measure was sexual activity (defined as intercourse) during the past year. METHODS The study is based on cross-sectional data from four population samples of 70-year-olds from Gothenburg, Sweden (N = 1,407) systematically sampled from the Swedish population register. RESULTS In the time periods 1971-1972 and 2000-2001, sexual activity among men increased from 47% to 66%, and in women from 12% to 34%. Sexual activity was related to positive attitude toward sexuality, sexual debut before age 20, having a very happy relationship, having a physically and mentally healthy partner, self-reported good global health, interviewer-rated good mental health, being married/cohabiting, satisfaction with sleep, and drinking alcohol more than three times a week. Having an older partner, diabetes mellitus, coronary heart disease, higher physical health-sum score, and depression were related to less sexual activity. Interaction effects for birth cohort, with stronger positive associations in 1971-1972, were found for positive attitude toward sexuality, strong desire at age 20-30, premarital sexuality, having a younger partner, self-reported good global health, interviewer-rated good global mental health, overweight, and satisfaction with sleep. Having an older partner and depression showed stronger negative associations in the 1970s. Physical health-sum score showed a stronger negative association in 1992-2001. CONCLUSIONS We found that determinants of sexual activity in older people are numerous and varied, and change over time. It is thus important that health professionals and others take a holistic approach when dealing with sexual problems in older adults. Sexual aging should be part of health care and medical education. Clinicians should be trained to ask older patients about sexual concerns.
Characterization of the Stool Microbiome in Hispanic Preschool Children by Weight Status and Time.

BACKGROUND Variations in gut microbiota composition and diversity have been associated with childhood adiposity, although most studies describing this have been cross-sectional in nature. Our objective was to evaluate associations between body weight and the gut microbiota over time in obese preschool-age children. METHODS Obese, preschool-age, Hispanic children provided stool samples at baseline and following a 6-month behavioral intervention. Normal-weight (NW) children also provided stool samples. Stool microbial community composition was characterized using 16S rRNA gene sequencing. Estimates of within-sample diversity were calculated on operational taxonomic unit (OTU) count data, and the Firmicutes:Bacteroidetes (F:B) ratio was determined on per-sample basis. Estimates of between-sample diversity were generated using the weighted Unifrac metric, differential abundances were evaluated using Wilcoxon rank-sum tests, and associations of microbiome features with clinical data were quantified using Spearman rank correlations. RESULTS For the 30 obese children sampled preintervention and postintervention, a decrease in body mass index (BMI) z-score from 2.55 to 2.34 (p = 0.004, paired t-test) was observed. Bacteroides massiliensis was significantly enriched in obese children, while B. plebius was significantly enriched in NW controls. We identified significant correlations between multiple Bacteroides-like OTUs and BMI z-score, but neither F:B ratios nor OTU-level abundances were altered in conjunction with weight change in the obese children. Rather, highly individualized OTU-level responses were observed. CONCLUSIONS Although differences exist between the gut microbiota of obese and NW children, we detected highly individualized responses of the gut microbiota of obese children over time and following weight loss.