Miracle-dz/UniFAR-FTUs huggingface dataset:
Prospective Bundled Payments in a Changing Environment: The Experience of a Self-Funded, State-Sponsored Plan.

Background Healthcare reimbursement, which has traditionally been based on the quantity of services delivered, is currently moving toward value-based reimbursement-a system that addresses the quantity, quality, and cost of services. One such arrangement has been the evolution of bundled payments for a specific procedure or for an episode of care, paid prospectively or through post-hoc reconciliation. Objective To evaluate the impact of instituting bundled payments that incorporate facility charges, physician fees, and all ancillary charges by the State of Oklahoma HealthChoice public employee insurance plan. Method From January 1 through December 31, 2016, HealthChoice, a large, government-sponsored Oklahoma health plan, implemented a voluntary, prospective, bundled payment system with network facilities, called Select. The Select program allows members at the time of certification of the services to opt to use participating facilities for specified services at a bundled rate, with deductible and coinsurance covered by the health plan. That is, the program allows any plan member to choose either a participating Select facility with no out-of-pocket costs or standard benefits at a participating network facility. Results During 2016, more than 7900 procedures were performed for 5907 patients who chose the Select arrangement (also designated as the intervention group). The most common outpatient Select procedures were for cardiology, colonoscopy, and magnetic resonance imaging scans. The most common inpatient procedures for Select-covered patients were in 6 diagnosis-related groups covering spinal fusions, joint replacement surgeries, and percutaneous coronary artery stenting. The allowable costs were similar for bundled procedures at ambulatory surgery centers and at outpatient hospital facilities; the allowable costs for patients not in the Select program (mean, $813) were lower at ambulatory surgery centers than at outpatient hospital departments (mean, $3086) because of differences in case mix. Patients in the Select system who had outpatient procedures had significantly fewer subsequent claims than those who were not in Select for hospitalization (1.7% vs 2.5%, respectively) and emergency department visits (4.4% vs 11.5%, respectively) in the 30 days postprocedure. Quality measures (eg, wound infection and reoperation) were similar for patients who were and were not in the Select group and had procedures. Surgical complication (ie, return to surgery) rates were higher for the Select group. Conclusion The Select program demonstrated promising results during its first year of operation, suggesting that prospective bundled payment arrangements can be implemented successfully. Further research on reimbursement mechanisms, that is, how to pay physicians and facilities, and quality of outcomes is needed, especially with respect to which procedures are most suitable for this payment arrangement.
Eye-Movement Evidence for Object-Based Attention in Chinese Reading

Is attention allocated to only one word or to multiple words at any given time during reading? The experiments reported here addressed this question using a novel paradigm inspired by classic findings on object-based attention. In Experiment 1, participants (N = 18) made lexical decisions about one of two spatially colocated Chinese words or nonwords. Our main finding was that only the attended word’s frequency influenced response times and accuracy. In Experiment 2, participants (N = 30) read target words embedded in two spatially colocated Chinese sentences. Our key finding here was that only target-word frequencies influenced looking times and fixation positions. These results support the hypothesis that words are attended in a strictly serial (and perhaps object-based) manner during reading. The theoretical implications of this conclusion are discussed in relation to models of eye-movement control during reading and the conceptualization of words as visual objects.
Genetic Markers of Increased Susceptibility to Diabetic Nephropathy

The effect of exposure to diabetes on the kidney appears to be modulated by genetic factors determining a variable degree of susceptibility to diabetic nephropathy. Multiple loci are probably involved. Some of them might be found among the genes coding for components of the renin angiotensin system (renin, angiotensinogen, angiotensin I-converting enzyme, angiotensin receptors), some may regulate the way in which cells manage hyperglycemia (e.g. aldose reductase). Various genes have been examined to date, mainly by means of association studies. Positive results have been found for some of them (e.g. ACE, AGTR1, aldose reductase), but have not been confirmed in other populations. Thus, no genetic marker of increased susceptibility to diabetic nephropathy having clinical utility is currently available. New insights are expected from the systematic scanning of the genome for linkage with diabetic nephrophathy.
Diversity as a natural occurrence: an enrichment strategy of peer learning

ABSTRACT Business educators are concerned with integrating diversity-related topics and seek methods by which to teach them. This paper suggests that as classes become more heterogeneous, the opportunity to examine diverse perspectives and experiences naturally arises in the course of class assignments and activities. The differential experiences of majorities and minorities are revealed when students discuss and write about their own experiences related to the content of various business courses. The issues of self and group identity and perceptions of others emerge in the context of small group discussions when students share their experiences as recorded in learning logs, personal cases, research assignments, and typical class discussions. The opportunity for community learning in heterogeneous groups provides a forum for diverse perspectives and experiences to be shared. Students and professors learn about different perceptions and reactions to personal and current events as well as their own perspectives, creating a culture of inclusion in the class. Implications and suggestions for a wider application of our methods to a global context are also offered.
Wound complications after major gastrointestinal operations. The surgeon as a risk factor.

BACKGROUND Wound complications occur quite often after abdominal operations. Numerous studies have been performed in the last decades focusing on closure methods, incisions and suture materials. However, the most important factor, the individual surgeon, has hardly been taken into account in these studies. METHODS This study presents results from a prospective randomised study on abdominal wall closure focusing on the results of the individual surgeon. RESULTS/CONCLUSIONS We found no differences in the complication rate between different suture materials or between continuous and interrupted closure techniques. There are marked individual differences in complication rates between surgeons. Regular audit with feedback to individual surgeons is an important instrument for quality improvement.
A refined method for calculating equivalent effective stratospheric chlorine

Abstract. Chlorine and bromine atoms lead to catalytic depletion of ozone in the stratosphere. Therefore the use and production of ozone-depleting substances (ODSs) containing chlorine and bromine is regulated by the Montreal Protocol to protect the ozone layer. Equivalent effective stratospheric chlorine (EESC) has been adopted as an appropriate metric to describe the combined effects of chlorine and bromine released from halocarbons on stratospheric ozone. Here we revisit the concept of calculating EESC. We derive a refined formulation of EESC based on an advanced concept of ODS propagation into the stratosphere and reactive halogen release. A new transit time distribution is introduced in which the age spectrum for an inert tracer is weighted with the release function for inorganic halogen from the source gases. This distribution is termed the release time distribution . We show that a much better agreement with inorganic halogen loading from the chemistry transport model TOMCAT is achieved compared with using the current formulation. The refined formulation shows EESC levels in the year 1980 for the mid-latitude lower stratosphere, which are significantly lower than previously calculated. The year 1980 is commonly used as a benchmark to which EESC must return in order to reach significant progress towards halogen and ozone recovery. Assuming that – under otherwise unchanged conditions – the EESC value must return to the same level in order for ozone to fully recover, we show that it will take more than 10 years longer than estimated in this region of the stratosphere with the current method for calculation of EESC. We also present a range of sensitivity studies to investigate the effect of changes and uncertainties in the fractional release factors and in the assumptions on the shape of the release time distributions. We further discuss the value of EESC as a proxy for future evolution of inorganic halogen loading under changing atmospheric dynamics using simulations from the EMAC model. We show that while the expected changes in stratospheric transport lead to significant differences between EESC and modelled inorganic halogen loading at constant mean age, EESC is a reasonable proxy for modelled inorganic halogen on a constant pressure level.
Ocean and Atmosphere Storm Tracks: The Role of Eddy Vorticity Forcing

Abstract Signatures of eddy variability and vorticity forcing are diagnosed in the atmosphere and ocean from weather center reanalysis and altimetric data broadly covering the same period, 1992–2002. In the atmosphere, there are localized regions of eddy variability referred to as storm tracks. At the entrance of the storm track the eddies grow, providing a downgradient heat flux and accelerating the mean flow eastward. At the exit and downstream of the storm track, the eddies decay and instead provide a westward acceleration. In the ocean, there are similar regions of enhanced eddy variability along the extension of midlatitude boundary currents and the Antarctic Circumpolar Current. Within these regions of high eddy kinetic energy, there are more localized signals of high Eady growth rate and downgradient eddy heat fluxes. As in the atmosphere, there are localized regions in the Southern Ocean where ocean eddies provide statistically significant vorticity forcing, which acts to accelerate the mean flow .
Controlling quality and amount of mitochondria by mitophagy: insights into the role of ubiquitination and deubiquitination

Abstract Mitophagy is a selective autophagy pathway conserved in eukaryotes and plays an essential role in mitochondrial quality and quantity control. Mitochondrial fission and fusion cycles maintain a certain amount of healthy mitochondria and allow the isolation of damaged mitochondria for their elimination by mitophagy. Mitophagy can be classified into receptor-dependent and ubiquitin-dependent pathways. The mitochondrial outer membrane protein Atg32 is identified as the only known receptor for mitophagy in baker’s yeast, whereas mitochondrial proteins FUNDC1, NIX/BNIP3L, BNIP3 and Bcl2L13 are recognized as mitophagy receptors in mammalian cells. Earlier studies showed that ubiquitination and deubiquitination occurs in yeast, yet there is no direct evidence for an ubiquitin-dependent mitophagy pathway in this organism. In contrast, a ubiquitin-/PINK1-/Parkin-dependent mitophagy pathway was unraveled and was extensively characterized in mammals in recent years. Recently, a quantitative method termed synthetic quantitative array (SQA) technology was developed to identify modulators of mitophagy in baker’s yeast on a genome-wide level. The Ubp3-Bre5 deubiquitination complex was found as a negative regulator of mitophagy while promoting other autophagic pathways. Here we discuss how ubiquitination and deubiquitination regulates mitophagy and other selective forms of autophagy and what argues for using baker’s yeast as a model to study the ubiquitin-dependent mitophagy pathway.
Sodium-glucose Cotransporter 2 Inhibitors (SGLT2i): Their Role in Cardiometabolic Risk Management.

BACKGROUND Sodium-glucose cotransporter 2 inhibitors (SGLT2i) are a novel category of oral antidiabetic drugs that inhibit renal glucose reabsorption and increase renal glucose excretion, thus lowering plasma glucose levels. This unique mechanism of SGLT2i action is insulin independent, thus improving glycemic control without promoting hypoglycemia in the absence of exogenously administered insulin. METHODS The present narrative review addresses the putative associations between SGLT2i and several cardiovascular (CV) and microvascular risk factors, as well as their effects on cardiac and renal function. RESULTS SGLT2i improve several CV risk factors, including fasting and postprandial plasma glucose levels, lipids, blood pressure, body weight, serum uric acid and arterial stiffness. These drugs may also favorably modulate cardiac and renal function via their effects on inflammation, oxidative stress, diuresis, fluid and sodium retention, myocardial function, vascular resistance and 'fuel' metabolism. In the EMPA-REG OUTCOME study, the first published large CV outcome SGLT2i trial, empagliflozin significantly reduced the primary composite outcome (i.e. CV death, nonfatal myocardial infarction or stroke) and all-cause death as well as hospitalization for heart failure. In addition, empagliflozin was associated with a slower progression of kidney disease and lower rates of clinically relevant renal events than was placebo when added to standard care in patients at high CV risk. CONCLUSION Multiple metabolic benefits may account for the positive clinical outcomes in the EMPA-REG OUTCOME study. Ongoing CV outcome trials involving other SGLT2i will help establish whether the reported CV and microvascular risk benefits are compound-specific or drug class effects.
Clearance of Lower-Pole Stones following Shock Wave Lithotripsy: Effect of the Infundibulopelvic Angle

Objective: To assess the effect of anatomic factors, especially the angle of the lower-pole infundibulum, on stone clearance following shock wave lithotripsy (SWL) in order to determine selection criteria for percutaneous nephrolithotomy. Methods: We retrospectively analyzed 116 patients with single lower-pole stones measuring 11–20 mm treated with SWL. Intravenous urograms were reviewed to measure the infundibulopelvic angle, the angle of the infundibulum to the vertical, and the anatomy of lower-pole calyces. Results: The overall stone-free rate was 52%. Factors most closely associated with a stone-free status were obtuse infundibulopelvic angle, lack of calyceal distortion, and a large infundibular diameter. The infundibulopelvic angle was the only factor to attain significance in predicting stone-free status (p = 0.012). The size of the stone did not predict eventual stone-free status (p = 0.911), but larger stones were more likely to require intervention after SWL. Conclusion: For solitary lower-pole stones 11–20 mm in size, the angle of the lower-pole infundibulum as it relates to the pelvis plays a role in eventual stone clearance and should be taken into account before choosing a mode of treatment.
Statistical features extraction of discrete curvelet transform for surface quality evaluation of mangosteen

Fast discrete curvelet transform can be used in differentiating between good and defect of mangosteen surfaces. However, the transformed surface image need to be extracted by features extraction methods to be used by Linear Discriminant Analysis (LDA) for detecting whether the surface condition is a defect or not. In this paper, we test commonly used extraction methods consist of mean, energy, entropy, standard deviation, variance, sum, correlation, contrast, and homogeneity to see which are suitable to be used in detecting mangosteen surface defects. Furthermore, we use K-Fold Cross Validation method to check the accuracy and 120 images as test materials. Finally, the highest accuracy is shown standard deviation by 91,7% and followed by the variance by 88,4%.
Biological function of Dictyocaulus viviparus asparaginyl peptidase legumain-1 and its suitability as a vaccine target

SUMMARY The present study characterized the biological function of the asparaginyl peptidase legumain-1 (LEG-1) of the bovine lungworm Dictyocaulus viviparus and its suitability as a recombinant vaccine against dictyocaulosis. Quantitative real-time PCR and immunoblot analysis revealed LEG-1 to be almost exclusively transcribed and expressed in parasitic lungworm stages. Immunohistochemistry localized the enzyme in the parasite's gut, which was confirmed by immunoblots detecting LEG-1 in the gut as well as male testes. LEG-1 was recombinantly (rLEG-1) expressed in the yeast Pichia pastoris and subsequently analysed in activity assays for its enzyme functions and substrate specificity. For sufficient functionality, rLEG-1 needed trans-activation through D. viviparus cathepsin L-2, indicating a novel mechanism of legumain activation. After trans-activation, rLEG-1 worked best at pH 5·5 and 35–39 °C and cleaved a legumain-specific artificial substrate as well as the natural substrates bovine collagen types I and II. In a clinical vaccination trial, rLEG-1 did not protect against challenge infection. Results of in vitro characterization, transcription pattern and localization enhance the presumption that LEG-1 participates in digestion processes of D. viviparus. Since rLEG-1 needs trans-activation through a cathepsin, it is probably involved in an enzyme cascade and therefore remains interesting as a candidate in a multi-component vaccine.
Land use growth simulation and optimization in the urban area

Developing countries nowadays have been trying to manage their metropolitan area because of urban growth problem. Improper location, sprawl, environmental degradation, etc. are typical problems appeared in Jakarta Metropolitan Region. Jakarta province exhibits a “post-suburbia” phenomenon which is characterized by a decline of central city population and the growth and the dominance of its vicinity (Bogor, Depok, Tangerang, and Bekasi). Bekasi city, in the Jakarta Metropolitan Region, faces many problems regarding the urban growth. Helping the local city planners by giving a modeling and simulation tool would be beneficial in managing land use. This typical “what-if” analysis model would be able to give the planners the consequences of their plans. However, they need another tool for allocating some land uses through a land use optimization tool. This study showed that modeling, simulation, and optimization can work together to handle the urban growth in an urban area.
Online SoC estimation for Li-ion batteries: A survey explore the distributed secure cloud management to battery packs

Enlightened by the ”Totally Innovative Cloud Things of Connectedness” from the theme of 2017 round Australian National Wide Cyber Security Challenge1, cloud back-end and the hardware devices are identified as important components for cyber security investigation. On the other hand, rechargeable Lithium-ion (Li-ion) battery packs are widely used for energy storages and back-up power supplies. There are numerous embedded sensors in the Battery Management Systems, which provide the first hand data for optimizing the collective performance of the battery packs. Therefore, these sensor nodes are the desired initial starting points for exploring the vulnerabilities and security protections to the decentralized end nodes in IoT. This paper surveys the online SoC estimation of Li-ion batteries, endeavors to understand the models, control and management of the networked rechargeable batteries. This brief aims to initiate a research on decentralized secure cloud management to the end nodes of IoT.
University of Birmingham Lower-limb hot-water immersion acutely induces beneficial hemodynamic and cardiovascular responses in peripheral arterial disease and healthy, elderly controls

31 Passive heat induces beneficial perfusion profiles, provides substantive 32 cardiovascular strain and reduces blood pressure, thereby holding potential for 33 healthy and cardiovascular disease populations. The aim of this study was to assess 34 acute responses to passive heat via lower-limb hot-water immersion in patients with 35 peripheral arterial disease (PAD) and healthy, elderly controls. Eleven patients with 36 PAD (age 71±6 y, 7 male) and ten Controls (age 72±7 y, 8 male) underwent hot-water 37 immersion (30 min waist-level immersion in 42.1±0.6°C water). Before, during and 38 following immersion, brachial and popliteal artery diameter, blood flow and shear 39 stress were assessed using duplex ultrasound. Lower-limb perfusion was measured 40 also using venous occlusion plethysmography and near-infrared spectroscopy. 41 During immersion, shear rate increased ( p <0.0001) comparably between groups in 42 the popliteal artery (Controls: +183±26%; PAD: +258±54%) and brachial artery 43 (Controls: +117±24%; PAD: +107±32%). Lower-limb blood flow increased significantly 44 in both groups, as measured from duplex ultrasound (>200%), plethysmography 45 (>100%) and spectroscopy, while central and peripheral pulse wave velocity 46 decreased in both groups. Mean arterial blood pressure was reduced by 22±9 mmHg 47 (main effect p <0.0001, interaction p =0.60) during immersion, and remained 7±7 48 mmHg lower 3 h afterward. In PAD, popliteal shear profiles and claudication both 49 compared favourably with those measured immediately following symptom-limited 50 walking. A 30-min hot-water immersion is a practical means of delivering heat 51 therapy to PAD patients and healthy, elderly individuals to induce appreciable
CXCL12 and CXCR7 are relevant targets to reverse cell adhesion‐mediated drug resistance in multiple myeloma

Cell adhesion‐mediated drug resistance (CAM‐DR) by the bone marrow (BM) is fundamental to multiple myeloma (MM) propagation and survival. Targeting BM protection to increase the efficacy of current anti‐myeloma treatment has not been extensively pursued. To extend the understanding of CAM‐DR, we hypothesized that the cytotoxic effects of novel anti‐myeloma agents may be abrogated by the presence of BM stroma cells (BMSCs) and restored by addition of the CXCL12 antagonist NOX‐A12 or the CXCR4 inhibitor plerixafor. Following this hypothesis, we evaluated different anti‐myeloma agents alone, with BMSCs and when combined with plerixafor or NOX‐A12. We verified CXCR4, CD49d (also termed ITGA4) and CD44 as essential mediators of BM adhesion on MM cells. Additionally, we show that CXCR7, the second receptor of stromal‐derived‐factor‐1 (CXCL12), is highly expressed in active MM. Co‐culture proved that co‐treatment with plerixafor or NOX‐A12, the latter inhibiting CXCR4 and CXCR7, functionally interfered with MM chemotaxis to the BM. This led to the resensitization of MM cells to the anti‐myeloma agents vorinostat and pomalidomide and both proteasome inhibitors bortezomib and carfilzomib. Within a multicentre phase I/II study, NOX‐A12 was tested in combination with bortezomib‐dexamethasone, underlining the feasibility of NOX‐A12 as an active add‐on agent to antagonize myeloma CAM‐DR.