Miracle-dz/UniFAR-FTUs huggingface dataset:
Promoting Accountability: Hospital Charity Care in California, Washington and Texas

Debate as to whether private hospitals meet their charitable obligations is heated. This study examines how alternative state approaches for ensuring hospital accountability to the community affects charitable expenditures and potentially affects access to care for the uninsured. Descriptive and multivariate analyses were used to compare private California hospitals' charity care expenditures with those of hospitals in Texas and Washington state. The key finding from this study is that net of hospital characteristics, market characteristics and community need, Texas hospitals were estimated to provide over 3 times more charity care and Washington hospitals were estimated to provide 66% more charity care than California hospitals. This finding suggests that more prescriptive community benefit or charity care requirements may be necessary to ensure that private hospitals assume a larger role in the care of the uninsured.
Music enhances performance and perceived enjoyment of sprint interval exercise.

INTRODUCTION Interval exercise training can elicit physiological adaptations similar to those of traditional endurance training, but with reduced time. However, the intense nature of specific protocols, particularly the "all-out" efforts characteristic of sprint interval training (SIT), may be perceived as being aversive. The purpose of this study was to determine whether listening to self-selected music can reduce the potential aversiveness of an acute session of SIT by improving affect, motivation, and enjoyment, and to examine the effects of music on performance. METHODS Twenty moderately active adults (22 ± 4 yr) unfamiliar with interval exercise completed an acute session of SIT under two different conditions: music and no music. The exercise consisted of four 30-s "all-out" Wingate Anaerobic Test bouts on a cycle ergometer, separated by 4 min of rest. Peak and mean power output, RPE, affect, task motivation, and perceived enjoyment of the exercise were measured. Mixed-effects models were used to evaluate changes in dependent measures over time and between the two conditions. RESULTS Peak and mean power over the course of the exercise session were higher in the music condition (coefficient = 49.72 [SE = 13.55] and coefficient = 23.65 [SE = 11.30]; P < 0.05). A significant time by condition effect emerged for peak power (coefficient = -12.31 [SE = 4.95]; P < 0.05). There were no between-condition differences in RPE, affect, or task motivation. Perceived enjoyment increased over time and was consistently higher in the music condition (coefficient = 7.00 [SE = 3.05]; P < 0.05). CONCLUSION Music enhances in-task performance and enjoyment of an acute bout of SIT. Listening to music during intense interval exercise may be an effective strategy for facilitating participation in, and adherence to, this form of training.
Hemifacial Microsomia: Use of the OMENS‐Plus Classification at the Royal Children's Hospital of Melbourne

&NA; Hemifacial microsomia is the most common facial congenital disability after cleft lip and palate, but as yet its pathogenesis remains unknown. Clinical classification systems have evolved over the last 30 years from those classifying only single components of the disorder, to those classifying according to the combination of deformities, to the most recent systems that grade each anatomical component separately, such as the Orbit, Mandible, Ear, Nerve, and Soft tissue (OMENS) system. The aim of the present study was to review the classification of patients with hemifacial microsomia treated by the Melbourne Craniofacial Unit at the Royal Children's Hospital using the OMENS‐Plus system of classification and to correlate the findings with data from other centers. Records of patients treated by the craniofacial unit were reviewed and included in the study if adequate clinical records, photographs, and radiographs (anteroposterior, lateral, basal cephalometry, panoramic views) were available. The data were entered into a database file developed for this purpose. Seventy‐one patients were identified from the hospital database, of which six were excluded because of incomplete data. Of the 65 patients, there were 31 (48 percent) with right‐sided microsomia. 25 (38 percent) with leftsided microsomia, and nine (14 percent) with bilateral microsomia, with an overall male‐to‐female ratio of 1.2:1. The majority of patients had a normal orbit (77 percent), mildly hypoplastic mandibular ramus‐condyle with functioning temporomandibular joint (57 percent with type M1 or M2a), normal facial nerve (76 percent), and mild soft‐tissue hypoplasia (73 percent). There was a similar proportion of patients with mild ear anomalies (53 percent with grade 0 or 1) compared with those with more severe anomalies (47 percent with grade 2 or 3). Correlative analysis demonstrated a slight but positive correlation between the severity gradings of the five individual components. The correlation was lowest between the grading of the nerve and ear and that of the mandible and nerve. The data demonstrate the phenotypic variability of hemifacial microsomia and suggest a degree of relationship among the components of hemifacial microsomia. The OMENS‐Plus system has provided a major advancement in the classification of hemifacial microsomia. The authors suggest refinements to the grading of the orbit and nerve components.
The case of adherence in the youth: rebel without a cause?

Most published meta-analyses are devoted to establishing the effects of interventions. However, meta-analysis methods can also be useful to get a more precise estimate of a global condition’s frequency, such as prevalence proportions. The focus of a systematic review provides material for data-synthesis, explores heterogeneity and finally paves the way for a research grant to tackle the problem, eventually in particularly vulnerable subgroups.
Parental punitive discipline, negative life events and gene–environment interplay in the development of externalizing behavior

Background To investigate the extent to which three putative ‘environmental’ risk factors, maternal punitive discipline (MPD), paternal punitive discipline (PPD) and negative life events (NLEs), share genetic influences with, and moderate the heritability of, externalizing behavior. Method The sample consisted of 2647 participants, aged 12–19 years, from the G1219 and G1219Twins longitudinal studies. Externalizing behavior was measured using the Youth Self-Report, MPD, PPD and exposure to NLEs were assessed using the Negative Sanctions Scale and the Life Event Scale for Adolescents respectively. Result Genetic influences overlapped for externalizing behavior and each ‘environmental’ risk, indicating gene–environment correlation. When controlling for the gene–environment correlation, genetic variance decreased, and both shared and non-shared environmental influences increased, as a function of MPD. Genetic variance increased as a function of PPD, and for NLEs the only interaction effect was on the level of non-shared environment influence unique to externalizing behavior. Conclusion The magnitude of the influence of genetic risk on externalizing behavior is contextually dependent, even after controlling for gene–environment correlation.
Diamond Park and Spline:Social Virtual Reality with 3D Animation, Spoken Interaction, and Runtime Extendability

Diamond Park is a social virtual reality system in which multiple geographically separated users can speak to each other and participate in joint activities. The central theme of the park is cycling. Human visitors to the park are represented by 3D animated avatars and can explore a square mile of 3D terrain. In addition to human visitors, the park hosts a number of computer simulations, including tour buses and autonomous animated figures. Diamond Park is implemented using a software platform called Spline, which makes it easy to build virtual worlds where multiple people interact with each other and with computer simulations in a 3D visual and audio environment. Spline performs all the processing necessary to maintain a distributed, modifiable, and extendable model of a virtual world that is shared between the participants. For more information visit http://www.merl. com.
Liver Transplantation Does Not Prevent the Development of Life-Threatening Arrhythmia in Familial Amyloidotic Polyneuropathy, Portuguese-Type (ATTR Val30Met) Patients

Background. Orthotopic liver transplantation (OLT) is today the only available treatment to halt the progress of familial amyloidotic polyneuropathy (FAP). Because heart arrhythmia and conduction disturbances are well-known manifestations of FAP, the aim of this study was to investigate the occurrence and development of heart conduction and rhythm disturbances in Swedish FAP patients who underwent liver transplantation. Methods. Ambulatory 24-hour electrocardiography (ECG) recordings (Holter-ECGs) were available from 30 patients, who had been investigated before and reexamined after OLT. Results. The number of patients with abnormalities on their ECG recordings increased after OLT. Four patients developed serious arrhythmia after transplantation that necessitated the insertion of a pacemaker 40 months or longer after OLT. Conclusions. The development of cardiac conduction disturbances and arrhythmias appear not to be halted by liver transplantation, indicating that the physician should be aware of the potential risk for FAP patients receiving transplants to develop fatal arrhythmia. The follow-up after liver transplantation should include Holter-ECG recordings.
Obesity effect on male active joint range of motion

Despite the prevalence of obesity, how obesity affects human physical capabilities is not well documented. As an effort toward addressing this, the current study investigated the obesity effect on joint range of motion (RoM) based on data collected from 20 obese and 20 non-obese males. In total, 30 inter-segmental motions occurring at the shoulder, elbow, knee and ankle joints and lumbar and cervical spine areas were examined. The obesity effect was found to be non-uniform across the joint motions. Obesity significantly reduced RoM for nine of the 30 motions: shoulder extensions and adductions, lumbar spine extension and lateral flexions and knee flexions. The largest significant RoM reduction was 38.9% for the left shoulder adduction. The smallest was 11.1% for the right knee flexion. The obesity-associated RoM reductions appear to be mainly due to the mechanical interposition and obstruction of inter-segmental motions caused by excess fat in the obese body. Statement of Relevance: Currently, obesity is prevalent worldwide and its prevalence is expected to increase continually in the near future. This study empirically characterised the obesity effects on joint RoM to provide better understanding of the physical capabilities of the obese. The study findings will facilitate designing man–artefact systems that accommodate obese individuals.
Heat Shock Protein 90 as a Drug Target: Some Like It Hot

Heat shock protein 90 (HSP90) is a ubiquitously expressed chaperone that is involved in the posttranslational folding and stability of proteins. Inhibition at the NH2-terminal ATP-binding site leads to the degradation of client proteins by the ubiquitin proteasome pathway. Inhibition of HSP90 leads to the degradation of known oncogenes, such as ERB-B2, BRAF, and BCR-ABL, leading to the combinatorial blockade of multiple signal transduction pathways, such as the RAS-RAF-mitogen-activated protein/extracellular signal-regulated kinase kinase-extracellular signal-regulated kinase and phosphatidylinositol 3-kinase pathways. Multiple structurally diverse HSP90 inhibitors are undergoing early clinical evaluation. The clinical focus of these drugs should be solid tumors, such as breast, prostate, and lung cancers, along with malignant melanoma, in addition to hematologic malignancies, such as chronic myeloid leukemia and multiple myeloma. HSP90 inhibitors can be used as single agents or in combination with other targeted treatments or conventional forms of treatment such as chemotherapy and radiotherapy. Clinical trials evaluating efficacy of these agents should include innovative designs to capture cytostasis evidenced by clinical nonprogression and enrichment of patient populations by molecular characterization. The results of clinical trials evaluating the efficacy of drugs targeting this exciting target are awaited.
Use of the Kinase Inhibitor Analog 1NM-PP1 Reveals a Role for Toxoplasma gondii CDPK1 in the Invasion Step

ABSTRACT Toxoplasma gondii CDPK1 (TgCDPK1) was found to be the target of the toxoplasmocidal compound 1NM-PP1. When TgCDPK1 was mutated at position 128 from glycine to methionine, resistance was gained. Inhibition of gliding motility without inhibition of micronemal secretion by 1NM-PP1 suggests a function for TgCDPK1 in gliding motility.
Effect of nutritional intervention on body composition and performance in elite athletes

Abstract Strength training and positive energy intake are the most important factors related to lean body mass (LBM) gain. Most studies investigating weight-gain interventions are based recreationally active subjects and less is known about optimal weight-gain protocols in elite athletes. The purpose of this study was to evaluate the effect of nutritional guidance in an 8- to 12-week weight-gain period in elite athletes. Thirty-nine elite athletes were randomised to either a ‘nutritional counseling group’ (NCG, n=21, 19.1±2.9 years, 70.9±8.9 kg) or ‘ad libitum group’ (ALG, n=18, 19.6±2.7 years, 75.0±5.9 kg). All athletes continued their sport-specific training which included an additional four strength-training sessions per week. NCG followed a meal plan providing a positive energy balance, while the ALG athletes had an ad libitum energy intake. Body weight (BW), body composition, one repetition maximum (1RM), 40 m sprint and counter movement jump (CMJ) were measured pre- and post-intervention. Energy intake was higher in the NCG than in the ALG (3585±601 vs. 2964±884 kcal) and consequently BW increased more in NCG than in ALG (3.9±0.6% vs. 1.5±0.4%). Fat mass (FM) increased more in NCG than in ALG (15±4 vs. 3±3%), but gain in LBM was not different between groups. All 1RM results improved in both groups (6–12%), whereas 40 m sprint and CMJ remained unchanged, except for a significant decrease in 40 m sprint for the athletes in NCG. Athletes with nutritional guidance increased BW more, however, excess energy intake in a weight-gain protocol should be considered carefully due to undesirable increases in body fat.
Bacteriological Profile of Diabetic Foot Ulcer with Special Reference to Drug-resistant Strains in a Tertiary Care Center in North-East India

Aim: This study was carried out to determine the bacteriological profile of infected diabetic foot ulcers (DFUs) and the antibiotic resistance pattern from the isolates. An attempt was made to suggest an empiric antibiotic regimen to treat such patients. Materials and Methods: Tissue samples were collected from 150 patients between February 2015 and January 2016 with DFUs under aseptic precautions and they were processed as per the Clinical and Laboratory Standards Institute guidelines. Results: A total of 185 bacterial isolates were obtained from 150 persons with diabetic and with foot ulcers. The age group of these persons ranged from 35 to 80 years and the maximum number of persons with DFUs was in the age group of 60–65 years. Among the isolates, Gram-negative bacilli were isolated in 112/185 (61%) and Gram-positive cocci in 73/185 (39%) cases. The most common isolate was Staphylococcus spp. 46 (25%), followed by Escherichia coli (20%) and Enterococcus spp. (15%). The antibiotic sensitivity profile of the bacteria was also studied. Among the isolates, 59/112 (53%) of the Gram-negative bacilli were extended spectrum beta-lactamase producers, 19/46 (41%) were methicillin-resistant Staphylococcus aureus, and 5/27 (19%) were vancomycin-resistant Enterococcus. Conclusions: This study showed a preponderance of multidrug-resistant strains among the isolates from the DFUs. Knowledge on the antibiotic sensitivity pattern of the isolates will be helpful in determining the drugs for the empirical treatment of diabetic ulcers. Thus, indiscriminate use of antibiotics and chances of subsequent development of antibiotic resistance can also be reduced.
Influence of prednisolone-induced osteoporosis on bone mass and bone quality of the mandible in rats.

OBJECTIVES The aim of this study was to clarify the effects of steroid treatment on the mandible. METHODS We divided 24 male Fisher rats, aged 10 weeks, into 2 groups: a control group (n = 11) and a prednisolone (Pred) treatment group (n = 13). The dose for the Pred group was 40 mg kg(-1) and was administered orally three times per week for 8 weeks. At the end of the experiment, we measured bone mass, bone strength and trabecular structure of the mandible and femur. RESULTS Pred treatment decreased cortical bone mineral content (BMC), cortical thickness, stress/strain index and tissue volume of the mandible. However, there were no marked changes in trabecular structure parameters. A strong correlation was seen between mandibular and femoral cortical BMC (r = 0.71). CONCLUSIONS These findings suggest that steroid treatment decreases the cortical BMC, bone area and bone strength of the mandible.
Role of forward‐motility‐stimulating factor as an extracellular activator of soluble adenylyl cyclase

Forward‐motility‐stimulating factor (FMSF) is a protein, originally purified from bubaline serum, that promotes progressive motility of mature spermatozoa. FMSF binds to sperm surface receptors and activates transmembrane adenylyl cyclase (tmAC), causing a rise in intracellular cyclic AMP level ([cAMP]i) and subsequent activation of a protein kinase A/tyrosine kinase‐mediated pathway that enhances forward motility. This article further evaluates how FMSF works in the caprine system, particularly identifying the stimulatory effect of this glycoprotein on soluble adenylyl cyclase (sAC). Elevated [cAMP]i, initially resulting from FMSF‐dependent activation of tmAC, was associated with the release of Ca2+ from an intracellular calcium store in the sperm head, likely via an inositol triphosphate‐sensitive calcium ion channel. This peak Ca2+ concentration of ∼125–175 nM was capable of stimulating sAC in vitro in a calmodulin‐independent manner, thereby triggering more cAMP production. Our model proposes that a positive‐feedback loop mediated by cAMP and Ca2+ is established in FMSF‐stimulated sperm, with cAMP playing the role of a chemical messenger at multiple steps, resulting in the observed progressive motility. Thus, FSMF stimulates a novel signaling cascade that synergistically activate both tmAC and sAC to achieve forward sperm motility. Mol. Reprod. Dev. 82: 1001–1014, 2015. © 2015 Wiley Periodicals, Inc.
Novel FDG-PET Findings in Anti-NMDA Receptor Encephalitis

The clinical manifestation and nuclear imaging findings in a 15-year-old boy with anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis are described in this case report. The previously healthy patient presented with new onset hallucinations, seizure, and within a week, his mental status rapidly deteriorated to nonverbal with oro-lingual-facial dyskinesias. An extensive laboratory work-up for encephalopathy was negative. Repeated brain magnetic resonance imaging (MRI) studies were normal. On day 26 of admission, nuclear imaging using fluorodeoxyglucose positron emission tomography (FDG-PET) showed global hypometobolism with a prominent focally intense hypermetabolic lesion in the right cerebellar cortex. Diagnosis of anti-NMDAR encephalitis was confirmed with quantitative serology. The patient showed clinical signs of improvement after 2 courses of intravenous immunoglobulin therapy over 4 weeks. On day 46, repeat brain FDG-PET showed overall improvement but in contrast to the previous, the right cerebellar cortex showed focal hypometabolism. This is the first reported case of such findings using FDG-PET in anti-NMDAR encephalitis.
The Self‐Medication Hypothesis of Substance Use Disorders: A Reconsideration and Recent Applications

&NA; The self‐medication hypothesis of addictive disorders derives primarily from clinical observations of patients with substance use disorders. Individuals discover that the specific actions or effects of each class of drugs relieve or change a range of painful affect states. Self‐medication factors occur in a context of self‐regulation vulnerabilities–‐primarily difficulties in regulating affects, self‐esteem, relationships, and self‐care. Persons with substance use disorders suffer in the extreme with their feelings, either being overwhelmed with painful affects or seeming not to feel their emotions at all. Substances of abuse help such individuals to relieve painful affects or to experience or control emotions when they are absent or confusing. Diagnostic studies provide evidence that variously supports and fails to support a self‐medication hypothesis of addictive disorders. The cause‐consequence controversy involving psychopathology and substance use/abuse is reviewed and critiqued. In contrast, clinical observations and empirical studies that focus on painful affects and subjective states of distress more consistently suggest that such states of suffering are important psychological determinants in using, becoming dependent upon, and relapsing to addictive substances. Subjective states of distress and suffering involved in motives to self‐medicate with substances of abuse are considered with respect to nicotine dependence and to schizophrenia and posttraumatic stress disorder comorbid with a substance use disorder.
Risk Factors for Rejection and Infection in Pediatric Liver Transplantation

Rejection and infection are important adverse events after pediatric liver transplantation, not previously subject to concurrent risk analysis. Of 2291 children (<18 years), rejection occurred at least once in 46%, serious bacterial/fungal or viral infections in 52%. Infection caused more deaths than rejection (5.5% vs. 0.6% of patients, p < 0.001). Early rejection (<6 month) did not contribute to mortality or graft failure. Recurrent/chronic rejection was a risk in graft failure, but led to retransplant in only 1.6% of first grafts. Multivariate predictors of bacterial/fungal infection included recipient age (highest in infants), race, donor organ variants, bilirubin, anhepatic time, cyclosporin (vs. tacrolimus) and era of transplant (before 2002 vs. after 2002); serious viral infection predictors included donor organ variants, rejection, Epstein‐Barr Virus (EBV) naivety and era; for rejection, predictors included age (lowest in infants), primary diagnosis, donor‐recipient blood type mismatch, the use of cyclosporin (vs. tacrolimus), no induction and era. In pediatric liver transplantation, infection risk far exceeds that of rejection, which causes limited harm to the patient or graft, particularly in infants. Aggressive infection control, attention to modifiable factors such as pretransplant nutrition and donor organ options and rigorous age‐specific review of the risk/benefit of choice and intensity of immunosuppressive regimes is warranted.