Miracle-dz/UniFAR-FTUs huggingface dataset:
Higher Incentive Payments in Medicare Advantage's Pay-for-Performance Program Did Not Improve Quality But Did Increase Plan Offerings.

OBJECTIVE To evaluate the effects of the size of financial bonuses on quality of care and the number of plan offerings in the Medicare Advantage Quality Bonus Payment Demonstration. DATA SOURCES Publicly available data from CMS from 2009 to 2014 on Medicare Advantage plan quality ratings, the counties in the service area of each plan, and the benchmarks used to construct plan payments. STUDY DESIGN The Medicare Advantage Quality Bonus Payment Demonstration began in 2012. Under the Demonstration, all Medicare Advantage plans were eligible to receive bonus payments based on plan-level quality scores (star ratings). In some counties, plans were eligible to receive bonus payments that were twice as large as in other counties. We used this variation in incentives to evaluate the effects of bonus size on star ratings and the number of plan offerings in the Demonstration using a differences-in-differences identification strategy. We used matching to create a comparison group of counties that did not receive double bonuses but had similar levels of the preintervention outcomes. PRINCIPAL FINDINGS Results from the difference-in-differences analysis suggest that the receipt of double bonuses was not associated with an increase in star ratings. In the matched sample, the receipt of double bonuses was associated with a statistically insignificant increase of +0.034 (approximately 1 percent) in the average star rating (p > .10, 95 percent CI: -0.015, 0.083). In contrast, the receipt of double bonuses was associated with an increase in the number of plans offered. In the matched sample, the receipt of double bonuses was associated with an overall increase of +0.814 plans (approximately 5.8 percent) (p < .05, 95 percent CI: 0.078, 1.549). We estimate that the double bonuses increased payments by $3.43 billion over the first 3 years of the Demonstration. CONCLUSIONS At great expense to Medicare, double bonuses in the Medicare Advantage Quality Bonus Payment Demonstration were not associated with improved quality but were associated with more plan offerings.
The influence of natural tocopherols during thermal oxidation of refined and partially hydrogenated soybean oils

Samples of refined and partially hydrogenated soybean oils, with iodine values between 60 and 130, tocopherol-stripped or not by aluminium oxide treatment, were submitted to thermal oxidation, at 180 °C (during) for 10 hours. Samples were collected at 0, 2, 5, 8 and 10 hours, for the determination of dimers and polymers (degradation compounds) and tocopherols. The relation of iodine value to the formation of dimers and polymers and the role of originally present tocopherols in the protection of fats and oils against thermal degradation was verified. The degradation curves for tocopherols showed that α and γ -tocopherols were destroyed faster than β and δ -tocopherols. In addition, the degradation rate of tocopherols was greater in the more saturated fats. The formation of dimers and polymers was greater in the oil than in the hydrogenated samples and in the samples treated with aluminium oxide with respect to the original, untreated samples.
Expansion of plasmid mediated blaACT-2 among Pseudomonas aeruginosa associated with postoperative infection and its transcriptional response under cephalosporin stress

Objectives: Organisms harboring multiple plasmid mediated β-lactamases are major concerns in nosocomial infections. Among these plasmid mediated β-lactamases, ACT (EBC family) is a clinically important enzyme capable of hydrolyzing broad spectrum cephalosporins. Therefore, the present study was undertaken to determine the prevalence of ACT determinant along with other co-existing β-lactamase genes in P. aeruginosa strains. Methods: A total of 176 Pseudomonas isolates were phenotypically screened for the presence of AmpC β-lactamase by M3DET Method followed by Molecular detection using PCR assay. Transcriptional evaluation of blaACT-2 gene was analyzed by RT-PCR and its transferability was performed by transformation and conjugation. Results: Present study demonstrates the presence of ACT-2 allele among 12 strains of P. aeruginosa. Co-existence of other β-lactamase genes were encountered among ACT-2 harboring strains which includes CTX-M (n=2), SHV (n=3), TEM (n=2), VEB (n=2), OXA-10 (n=1), CIT (n=2) and DHA (n=3). Fingerprinting by REP PCR revealed the isolates harboring ACT-2 to be distinct and these isolates showed high resistance to expanded-spectrum cephalosporins and even to carbapenem group of drugs. This ACT-2 allele was encoded in the plasmid (L/M, FIA, FIB Inc. Group) and conjugatively transferable. Transcriptional analysis revealed a significant increase in ACT-2 expression (483 fold) when induced by ceftriaxone at 4 μg/ml followed by ceftazidime at 8 μg/ml (31 fold) and cefotaxime 4 μg/ml (8 fold). Conclusion: In this study detection of ACT-2 plasmid mediated AmpC β-lactamase along with other β-lactamase genes in clinical isolates of P. aeruginosa represents a serious therapeutic challenge. Therefore, revision in antimicrobial policy is required for effective treatment of patients infected with pathogen expressing this mechanism. J Microbiol Infect Dis 2017; 7(2): 75-82
A Survey of the SWISS Researchers on the Impact of Sibling Privacy Protections on Pedigree Recruitment

To understand the perceptions and attitudes about privacy safeguardsin researchand investigate the impact of letter-based proband-initiated contact on recruitment, we surveyed researchers in the Siblings With Ischemic Stroke Study (SWISS). All 49 actively recruiting sites provided at least 1 response, and 61% reported that potential probands were enthusiastic. Although 66% of researchers valued proband-initiated contact, only 23% said that probands viewed this strategy as important to protecting the privacy of siblings. A substantial minority of researchers (37%) said the strategy impeded enrollment, and 44% said it was overly burdensome to probands.
The relationship between tobacco use, substance-use disorders and mental health: results from the National Survey of Mental Health and Well-being.

AIMS To examine comorbidity between tobacco use, substance-use disorders and mental health problems among Australian adults aged 18 years and over. METHOD Data from the 1997 Australian National Survey of Mental Health and Well-being were analyzed. This survey was a stratified, multistage probability sample of 10,641 adults, representative of the Australian population. Univariate associations between tobacco use, substance use and mental health were examined, and then multivariate analyses were conducted to control for demographic characteristics, neuroticism, and other drug use. MEASUREMENTS Tobacco use status was defined as: never smoker, former smoker and current smoker. DSM-IV diagnoses of substance use, anxiety, and affective disorders were derived using the Composite International Diagnostic Interview (CIDI). Other measures included a screener for psychosis and measures of psychological distress and disability. FINDINGS Current tobacco use was strongly associated with abuse/dependence upon alcohol, cannabis, and other substances, and with higher rates of anxiety and affective disorders. Current smokers were more likely to screen positively for psychosis and reported greater psychological distress and disability than non-smokers and never smokers. These higher rates of other problems were not explained by differences in demographic characteristics, neuroticism scores, or by other drug use. Former smokers did not have higher rates of affective or anxiety disorders; however, they had higher rates of alcohol-use disorders, and of cannabis-use disorders after adjusting for covariates. CONCLUSIONS Current tobacco use is associated with a range of other substance-use and mental health problems. These are likely to reduce the success of attempts to quit smoking. The presence of these other problems needs to be considered when considering smoking-cessation treatment, and further research may provide information on more effective treatment strategies for persons with co-existing substance-use and mental health problems.
Identification of Seven TreponemaSpecies in Health- and Disease-Associated Dental Plaque by Nested PCR

ABSTRACT Species-specific nested PCR was used to detect Treponema amylovorum, Treponema denticola, Treponema maltophilum, Treponema medium, Treponema pectinovorum, Treponema socranskii, andTreponema vincentii in dental plaque. Subjects with periodontitis harbored all species, but T. pectinovorum andT. vincentii were not found in plaque from disease-free subjects.
Active immunotherapy in HER2 overexpressing breast cancer: current status and future perspectives.

BACKGROUND The use of anti-HER2 monoclonal antibodies (mAbs) has improved the clinical outcome of HER2-overexpressing breast cancers (BCs). Unfortunately, often these tumors tend to relapse and, when metastatic, the duration of clinical benefit is limited over time and almost invariably followed by tumor progression. Alternative approaches to this essentially passive immunotherapy are therefore needed in HER2-overexpressing BC patients. As HER2 is one of the most suitable targets for active immunotherapy in BC, manipulating the immune system is a highly attractive approach. MATERIAL AND METHODS A computer-based literature search was carried out using PubMed (keywords: breast neoplasm, HER2 vaccine, immunology); data reported at international meetings were included. RESULTS This review provides a focus on the following active vaccinal approaches under clinical investigation against HER2-overexpressing BC: (i) peptide and protein based; (ii) DNA based; (iii) whole tumor cell based; (iv) dendritic cell based. Moreover, the review discuss future challenges in the field, trying to define the best setting for the development of this innovative strategy, considering both immunological and clinical aspects of HER2 targeting. CONCLUSIONS Development of effective vaccines for BC remains a distinct challenge but is likely to become a substantial advance for patients with HER2-overexpressing BCs.
Computational models of structure–function relationships in the pulmonary circulation and their validation

The pulmonary airway, arterial, venous and capillary networks are vast complex branching and converging systems that are mechanically coupled to the surrounding lung tissue. Early studies that examined vascular or airway geometry relied on measurements from casts, but medical imaging now enables measurement of the lung in vivo, at controlled lung volumes. The high‐quality data that imaging provides have prompted development of increasingly sophisticated models of the geometry of the airway and pulmonary vascular trees. The accurate spatial relationships between airway, vessel and tissue in these imaging‐derived models are necessary for computational analysis that aims to elucidate regional airway–vessel–tissue interactions. Predictions of blood flow through multiscale imaging‐derived models of the pulmonary arteries and capillary bed reveal geometry‐dependent patterns of perfusion in response to gravity and lung orientation that cannot be predicted with simplified, summary representations of the pulmonary transport trees. Validation of such predictions against measures from functional imaging holds significant potential for explaining and differentiating normal and disease‐related heterogeneity in regional blood flow calculated using perfusion imaging.
Crystal structure of a component of glycine cleavage system: T‐protein from Pyrococcus horikoshii OT3 at 1.5 Å resolution

Introduction. The glycine cleavage system (GCS; EC 2.1.2.10) is a multicomponent enzyme system that catalyzes the cleavage of glycine to yield carbon dioxide, ammonia, the methylene carbon unit in 5,10-CH2-tetrahydrofolate, and reduced nicotinamide adenine dinucleotide (NADH) H . This system is composed of 4 proteins, namely, a pyridoxal phosphate enzyme (P-protein), a carrier protein containing covalently bound lipoic acid (H-protein), a folate dependent enzyme (T-protein), and a protein exhibiting lipoamide dehydrogenase activity (Lprotein). The oxidative cleavage of glycine, catalyzed by the GCS system, is a major catabolic pathway in various organisms. In the first step, the P-protein catalyzes the decarboxylation of the glycine molecule and subsequent transfer of the residual methylamine to the oxidized H-protein (Hox), generating the methylamine-loaded Hprotein (Hmet). In the second step, the T-protein, a folate dependent enzyme, catalyzes the transfer of a methylene carbon from Hmet to tetrahydrofolate, resulting in the release of ammonia and the generation of reduced Hprotein (Hred). In the last step, the hydrolipoyl group of Hred is oxidized by the L-protein and Hox is generated, thereby completing the catalytic cycle. These sequential reactions are reversible. The biochemical properties of GCS in bacteria and mitochondria of plants and mammals have been extensively studied. In humans, a genetic disease termed nonketotic hyperglycinemia, caused by the absence of CGS (due to a number of mutations in the T-protein), results in a dramatic accumulation of glycine in blood, leading to metabolic and neurological disorders. Although the H-protein and the L-protein from several sources have been well studied by X-ray crystallography, the three-dimensional (3D) structures of the Pprotein and the T-protein have not yet been reported. Here, we report the crystal structure of the T-protein from Pyrococcus horikoshii OT3.
Productive infection of human neural progenitor cells by R5 tropic HIV-1: opiate co-exposure heightens infectivity and functional vulnerability

Objective: HIV type-1 (HIV-1) causes a spectrum of central nervous system (CNS) complications; many are worsened by opiate co-exposure. Human neural progenitor cells (hNPCs) give rise to all CNS neurons and macroglia. We tested the hypothesis that hNPC maturation and fate are altered by HIV and opiates, contributing to HIV-1-related neuropathology. Reports of hNPC infection remain controversial. We rigorously examined this question, testing whether hNPCs propogated infection, and whether HIV affected hNPCs absent their infection. Design and methods: Primary hNPCs were characterized over multiple passages. Following R5 HIV-1BaL exposure, p24, Nef, and tat assays monitored infection; a serial dilution approach tested infection transfer to naive hNPCs. Bromodeoxyuridine uptake, population doubling time, and immunostaining assessed proliferation and differentiation. Morphine co-exposure assessed opiate interactions. Supernatant from HIV-1BaL-infected PBMCs (HIVsup), HIV-1BaL, and ultraviolet light-inactivated HIVsup were compared to test effects of inflammatory milieu versus virus or infection per se. Results: The hNPCs (CD4−/CD8−/Iba−/CXC3CL1−/CD11b−) were infectable and could transfer infection to naive hNPCs. Infection was partly blocked by maraviroc, implicating CCR5. HIVsup reduced hNPC proliferation and caused premature differentiation into neurons/astroglia. Effects on proliferation were due to soluble factors/viral proteins, not infection per se. Morphine co-exposure exacerbated certain functional consequences of HIVsup, and sustained the infection of hNPCs. Conclusion: hNPCs can be infected and propagate virus in vitro. hNPCs or their progeny may represent an underappreciated viral reservoir. Factors from infected cells alter hNPC proliferation and neural cell maturation, which likely compromises CNS structure and function. Morphine–HIV interactions may worsen dysfunction and sustain infection.
Distribution and toxin genes of Bacillus cereus spores isolated from vegetables

The objectives of this study were to evaluate the prevalence of Bacillus cereus spores in vegetables and to investigate the toxigenic characteristics of spore isolates. The detection rate of spores was 26.7% (12 out of 45 samples) which possess a higher risk of food poisoning than vegetative cell. The occurrence rate of toxin genes in spore isolates were 91.7, 100 and 100% for hblCDA, nheABC and entFM enterotoxin genes, respectively. The cry gene and insecticidal toxin gene was detected in 10 out of 12 (83.3%) spore isolates. The presence and absence of cry genes is the only differentiated characteristic between B. cereus and Bacillus thuringiensis. Most vegetables were contaminated with B. thuringiensis spores. HBL and NHE enterotoxin were detected in 11 out of 12 (91.3%) spore isolates. Emetic toxin was only detected in one spore isolates. The insecticidal toxin (δendotoxin) was detected in 10 out of 12 (83.3%) spore isolates. Although we investigated a small number of spore isolates, most of them were B. thuringiensis which produced the insecticidal toxin and enterotoxins. Thus, it is necessary to reduce the contamination levels of B. cereus and B. thuringiensis spores in vegetables for the prevention of food poisoning.
Retention of neonatal resuscitation skills and knowledge: a randomized controlled trial.

BACKGROUND AND OBJECTIVES This study compared the effectiveness of two booster strategies designed to improve retention of skills and knowledge in neonatal resuscitation by family practice residents. METHODS Residents were randomly allocated to one of three groups: video, hands on, or control. Residents in the two experimental groups received a "booster" 3-5 months after the Neonatal Resuscitation Program (NRP) course. All participants completed the follow-up test 6-8 months after taking the course. The main outcome measures consisted of the NRP written examination and the performance checklists. RESULTS A total of 44 residents completed the study (video, n = 13; hands-on, n = 14; control, n = 17). Overall, participants had significantly lower scores at follow-up than at baseline, indicating deterioration in both neonatal skills and knowledge. Residents in the hands-on booster group made significantly fewer errors across all five checklists in life-supporting but not in lifesaving scores than those allocated to the control and video groups. CONCLUSIONS The beneficial effect of mannequin practice or video boosters on skills and knowledge retention was less than what had been anticipated, and no benefit could be demonstrated in comparison to the control group. Deteriorating knowledge and skills remain a major concern, since boostering by hands-on or video at 3-5 months do not seem to have an impact on the retention of knowledge or lifesaving skills.
The effect of hemodialysis and hemoperfusion on serum valproic acid concentration

We report a patient with dialysis-induced encephalopathy who was taking divalproex sodium for a seizure disorder. Her serum valproic acid concentration appeared to be in the low therapeutic range at 54 mg/1 yet she continued to have seizure activity. The elimination half-life and apparent clearance of valproic acid were the same for both a dialysis and nondialysis day, indicating that hemodialysis/hemoperfusion has little effect on the overall removal of valmoic acid from the body.
[Inactivation kinetics of Vibrio parahaemolyticus in peeled shrimp treated with organic acids].

OBJECTIVE To establish the kinetic inactivation models of Vibrio parahaemolytius in saline and peeled shrimp treated with acetic acid, lactic acid and citric acid for guidance of their potential application in shrimp decontamination. METHODS To determine the survival rate (P) of V. parahaemolyticus in saline and peeled shrimp treated with organic acids, dose-response in peeled shrimp between P and concentrations of organic acids was modeled directly. Logit (P) was transformed from survival P with the formula ln [P/(1-P)] for linear modeling. Both linear models were used to interpolate 50% and 90% effective inhibitory concentrations (EC50 and EC90), which were then used to compare the difference of inhibitory potency between saline and peeled shrimp. RESULTS Organic acids in saline were more inhibitory to V. parahaemolyticus in saline than in peeled shrimp, seen as 160 to 200-fold increase of EC50 and EC90 for lactic acid and citric acid, and more than 70-fold increase for acetic acid. These results indicate that food matrix had significant impact on the antimicrobial activity of organic acids. We also found that EC90 of the tested organic acids in peeled shrimp was far below the 2.5% limit for use as food ingredients regulated by USDA. With equimolar concentration in the test solutions, the order of inhibitory potency is citric acid > lactic acid > acetic acid. CONCLUSION Food matrix could have negative impact on antimicrobial activity of organic acids. Concentrations of organic acids around 2% could lead to significant reduction of V. parahaemolyticus contamination of peeled shrimp for improved food safety.
Can dietary intervention produce long-term reductionin insulin resistance?

Insulin sensitivity is potentially enhanced by a range of diet-related changes including reduction of visceral adiposity, a reduction in saturated fatty acids, and possibly a redistribution of the proportions of various unsaturated fatty acids. While there is evidence to suggest that lifestyle changes can reduce the risk of progression of impaired glucose tolerance to type 2 diabetes, there are no clinical trials which have conclusively demonstrated that any measure can reduce insulin resistance in the long term to an extent that can prevent the development of type 2 diabetes and other clinical complications. Evidence concerning the possibilities for reducing visceral adiposity and altering the nature of dietary fat are therefore considered. Attempts to achieve prolonged and substantial weight reduction in adults have not been encouraging, and it may be that preventing further weight gain is the most realistic target in this age group. In childhood the attempts have been more successful. The development of new approaches to achieving behavioural change and an environment which facilitates physical activity and appropriate food choices will be essential for more successful individual and population attempts to facilitate reduction in insulin resistance by weight loss. Changes in the nature of dietary fat appear to be more easily achieved. This is already a component of dietary advice aimed at cardiovascular risk reduction, and should be reinforced now with a view to also achieving a reduction in insulin resistance.
Respiratory function in the muscular dystrophies

The purpose of this investigation was to compare the respiratory function of patients with different clinical types of muscular dystrophy (MD). A total of 190 patients representing facioscapulohumeral MD (n = 20), limb‐girdle MD (n = 50), Becker MD (n = 20), Duchenne MD (n = 90), and the “intermediate” type of MD (n = 10) were studied using simple spirometric respiratory function tests. The respiratory modifications observed in the 3 adult forms indicate that pulmonary function was almost normal. Respiratory function in Duchenne muscular dystrophy (DMD) was always characterized by a restrictive syndrome which severely impaired pulmonary function. The vital capacity (VC) underwent ascending, plateau, and descending phases during the course of the disease. The VC at the plateau stage may be used as an estimate of life span. The most interesting finding was the high degree of variability in the restrictive syndrome associated with DMD. In the DMD group 30% presented a severe restrictive respiratory syndrome associated with a life span of less than 20 years (Type 1), 40% had a serious restrictive syndrome and variable mortality (Type 2), and the remaining 30% had a moderate restrictive respiratory syndrome (Type 3).