Miracle-dz/UniFAR-FTUs huggingface dataset:
Conscientious vaccination exemptions in kindergarten to eighth-grade children across Texas schools from 2012 to 2018: A regression analysis

Background As conscientious vaccination exemption (CVE) percentages rise across the United States, so does the risk and occurrence of outbreaks of vaccine-preventable diseases such as measles. In the state of Texas, the median CVE percentage across school systems more than doubled between 2012 and 2018. During this period, the proportion of schools surpassing a CVE percentage of 3% rose from 2% to 6% for public schools, 20% to 26% for private schools, and 17% to 22% for charter schools. The aim of this study was to investigate this phenomenon at a fine scale. Methods and findings Here, we use beta regression models to study the socioeconomic and geographic drivers of CVE trends in Texas. Using annual counts of CVEs at the school system level from the 2012–2013 to the 2017–2018 school year, we identified county-level predictors of median CVE percentage among public, private, and charter schools, the proportion of schools below a high-risk threshold for vaccination coverage, and five-year trends in CVEs. Since the 2012–2013 school year, CVE percentages have increased in 41 out of 46 counties in the top 10 metropolitan areas of Texas. We find that 77.6% of the variation in CVE percentages across metropolitan counties is explained by median income, the proportion of the population that holds a bachelor's degree, the proportion of the population that self-reports as ethnically white, the proportion of the population that is English speaking, and the proportion of the population that is under the age of five years old. Across the 10 top metropolitan areas in Texas, counties vary considerably in the proportion of school systems reporting CVE percentages above 3%. Sixty-six percent of that variation is explained by the proportion of the population that holds a bachelor’s degree and the proportion of the population affiliated with a religious congregation. Three of the largest metropolitan areas—Austin, Dallas–Fort Worth, and Houston—are potential vaccination exemption "hotspots," with over 13% of local school systems above this risk threshold. The major limitations of this study are inconsistent school-system-level CVE reporting during the study period and a lack of geographic and socioeconomic data for individual private schools. Conclusions In this study, we have identified high-risk communities that are typically obscured in county-level risk assessments and found that public schools, like private schools, are exhibiting predictable increases in vaccination exemption percentages. As public health agencies confront the reemerging threat of measles and other vaccine-preventable diseases, findings such as ours can guide targeted interventions and surveillance within schools, cities, counties, and sociodemographic subgroups.
Role of Oxidative Stress in Male Fertility and Idiopathic Infertility: Causes and Treatment

Role of Oxidative Stress in Male Fertility and Idiopathic Infertility: Causes and Treatment Epidemiological studies regarding male infertility have revealed that more and more infertile men suffer from acute or chronic inflammation of the genitourinary tract, which often occurs without any symptoms. The exact mechanism for unexplained male infertility and its correlation to oxidative stress incidence and/ or the inflammatory reactions within the male genital tract is still controversially unclear till know. Previous studies have shown the presence of cytokines such as tumor necrosis factor-α (TNF-α), a key player in the inflammation process, in the semen of infertile men. However, the mechanism of their effect on human sperm functions is still in need for further under investigations. We expect that, seminal inflammatory cytokine (TNF-α) and its expression regulator, testicular ADAM 17, will be varied, when seminal OS is established, that in turn, will vary cellular integrity and energy status. As conventional treatment of male infertility such as mineral and vitamins supplementation has poor success rates and leaves a lot to be desired, natural antioxidant ingredients are greatly suggested, nowadays, to ameliorate oxidative stress and the inflammatory detrimental effects accompanied to idiopathic male infertility. Thus, the empirical investigations of naturally occurring antioxidant modulators with prospective curative effect may support their administration as safe potent natural remedies against IMI. The role of antioxidants in the treatment of unexplained male infertility correlation to ROS and/or the inflammatory cytokines are discussed in this review.
Needling therapies in the management of myofascial pain of the masticatory muscles: a network meta-analysis of randomized clinical trials.

OBJECTIVE A network meta-analysis (NMA) of randomized clinical trials (RCTs) was performed aiming to compare the treatment outcome of dry needling, acupuncture, or wet needling using different substances in managing myofascial pain of the masticatory muscles (TMD-M). METHOD An electronic search was undertaken to identify RCTs published until September 2019, comparing dry needling, acupuncture, or wet needling using local anaesthesia (LA), botulinum toxin-A (BTX-A), granisetron, platelet-rich plasma (PRP) or passive placebo versus real active placebo in patients with TMD-M. RCTs meeting the inclusion criteria were stratified according to the follow-up time; immediate post-treatment to 3 weeks, and one to 6 months post-treatment. Outcome variables were post-treatment pain intensity, increased mouth opening (MMO) and pressure threshold pain (PPT). The quality of evidence was rated according to Cochrane's tool for assessing risk of bias. Mean difference (MD) was used to analyzed via frequentist NMA using STATA software. RESULTS Twenty-two RCTs involving 959 patients were included. The quality of evidence of the included studies was low or very low. There was significant pain decrease after PRP when compared to an active/passive placebo and acupuncture. There was a significant improvement of MMO after LA (MD=3.65; CI: 1.18-6.1) and dry needling therapy (MD= 2.37; CI: 0.66-4) versus placebo. The three highest-ranked treatments for short-term post-treatment pain reduction in TMD-M (1 to 20 days) were PRP (95.8%), followed by LA (62.5%), and dry needling (57.1%), whereas the three highest-ranked treatments at intermediate-term follow-up (1 to 6 months) were LA (90.2%), dry needling (66.1%), and BTX-A (52.1%) (all very low quality evidence). LA (96.4%) was the most effective treatment regarding the increase of MMO followed by dry needling (72.4%). CONCLUSION Based on this NMA, one can conclude that the effectiveness of needling therapy did not depend on needling type (dry or wet) or needling substance. The outcome this NMA suggests that LA, BTX-A, granisetron and PRP hold some promise as injection therapies, but no definite conclusions can be drawn due to the low-quality of evidence of the included studies. This NMA did not provide enough support for any of the needling therapies for TMD-M.
Prolonged grief disorder in Chinese Shidu parents who have lost their only child

ABSTRACT Background: China has the largest population of ‘“loss-of-only-child’ parents, that are also known as Shidu parents in Chinese society; however, little is known about their unresolved grief. Objective: This is the first study to examine the grief symptoms, prevalence, comorbidity and potential predictors of prolonged grief disorder (PGD) in such parents, taking into consideration that the new PGD diagnostic criteria ICD-11 will soon be implemented in China. Methods: 149 Shidu parents completed assessments of PGD (PG-13), PTSD (PCL-C), depression (CES-D) and general psychiatric morbidity (GHQ-12) via in-person interviews. Results: Of the 149 Shidu parents, 22.2% met the PGD criteria, with a mean of 7.59 years post-loss, and 62.4% experienced daily longing or yearning. Regression analysis indicated that fewer years since loss, subjective perception of poor economic situation, female gender and more hospital visits were prominent risk factors for the development of PGD. Older age of the parents at the time of child loss was also associated with PGD. Parents with PGD had higher comorbidity of PTSD or depression compared with those without PGD. Conclusions: There is a high prevalence of PGD and a high rate of comorbidity between PGD and PTSD or depression in Shidu parents in China, which highlights the need of timely developing effective assessments and interventions to prevent PGD in this population, particularly in female, recently bereaved, low-income and aged parents who lost their only child.
Prediction of medical expenditures of diagnosed diabetics and the assessment of its related factors using a random forest model, MEPS 2000-2015.

OBJECTIVE To predict the medical expenditures of individual diabetics and assess the related factors of it. DESIGN AND SETTING Cross-sectional study. SETTING AND PARTICIPANTS Data were collected from the US household component of the medical expenditure panel survey, 2000-2015. MAIN OUTCOME MEASURE Random forest (RF) model was performed with the programs of randomForest in R software. Spearman correlation coefficients (rs), mean absolute error (MAE) and mean-related error (MRE) was computed to assess the prediction of all the models. RESULTS Total medical expenditure was increased from $105 Billion in 2000 to $318 Billion in 2015. rs, MAE and MRE between the predicted and actual values of medical expenditures in RF model were 0.644, $0.363 and 0.043%. Top one factor in prediction was being treated by the insulin, followed by type of insurance, employment status, age and economical level. The latter four variables had no impact in predicting of medical expenditure by being treated by the insulin. Further, after the sub-analysis of gender and age-groups, the evaluating indicators of prediction were almost identical to each other. Top five variables of total medical expenditure among male were same as those among all the diabetics. Expenses for doctor visits, hospital stay and drugs were also predicted with RF model well. Treatment with insulin was the top one factor of total medical expenditure among female, 18-, 25- and 65-age-groups. Additionally, it indicated that RF model was little superior to traditional regression model. CONCLUSIONS RF model could be used in prediction of medical expenditure of diabetics and assessment of its related factors well.
Outcomes of Physicians with Substance Use Disorders in State Physician Health Programs: A Narrative Review

ABSTRACT The prevalence rate of addiction among physicians is similar to the general population, with approximately 10% to 12% of U.S.-based physicians developing substance use disorders (SUDs) during their lifetimes. To address this public health concern, physician health programs (PHPs) have been created to facilitate the early identification, evaluation, treatment, and monitoring of physicians. Although a number of published studies provide outcome information from PHPs, there has been no comprehensive review of the related literature. The objective of this narrative review is to summarize the treatment outcomes, including treatment types, rates of relapse, rates of contract completion or extension, as well as licensure and work status rates of a nationally representative physician cohort and related subpopulations from a single dataset. Based on the studies included in this review, our findings reveal that physicians who completed their PHP contracts have more favorable treatment outcomes than members of the general population who receive mainstream treatment. In addition, our review describes unique features of physician rehabilitation facilitated by PHPs. However, further prospective research is needed to ensure a standardized and comparable dataset and facilitate performance improvement.
Paliperidone LAI and Aripiprazole LAI Plasma Level Monitoring in the Prophylaxis of Bipolar Disorder Type I with Manic Predominance

Abstract Introduction The objective of this study was the evaluation of utility of plasma level monitoring in the clinical stabilizing efficacy and tolerability of paliperidone palmitate (PP) vs. aripiprazole monohydrate (AM) in bipolar disorder I (BD I) with manic predominance. Methods Fifty-six outpatients of both sexes, age ranging from 18 to 65 years, affected by BD I with manic predominance, orally treated and stabilized after acute episode for at least 2 weeks with paliperidone or aripiprazole (n=31, paliperidone; n=25, aripiprazole) underwent a prospective observational study of switching to the corresponding long-acting injection (LAI) on the basis of clinical evaluation. The efficacy and tolerability of the 2 treatments were assessed by BPRS, PANSS, HAMD21, and MRS rating scales and a check list every month for 12 months. Drug plasma levels determinations (PLs) were performed at the same times. Results A good clinical stability and tolerability of both drugs were reported. Lower mean PLs of PP showed a positive effect on depressive symptoms. AM PLs variability was associated with greater instability of manic symptoms whereas intermediate PLs seem to have more influence on depressive symptomatology. Discussion PLs drug monitoring has been proven to be useful, and further investigations to identify optimal therapeutic ranges for LAI formulations are needed.
New Insights into Mechanisms of Long-term Protective Anti-tumor Immunity Induced by Cancer Vaccines Modified by Virus Infection

The topic is how to achieve long-term protective anti-tumor immunity by anti-cancer vaccination and what are its mechanisms. Cancer vaccines should instruct the immune system regarding relevant cancer targets and contain signals for innate immunity activation. Of central importance is T-cell mediated immunity and thus a detailed understanding of cognate interactions between tumor antigen (TA)-specific T cells and TA-presenting dendritic cells. Microbes and their associated molecular patterns initiate early inflammatory defense reactions that can contribute to the activation of antigen-presenting cells (APCs) and to costimulation of T cells. The concommitant stimulation of naive TA-specific CD4+ and CD8+ T cells with TAs and costimulatory signals occurs in T-APC clusters that generate effectors, such as cytotoxic T lymphocytes and T cell mediated immunological memory. Information about how such memory can be maintained over long times is updated. The role that the bone marrow with its specialized niches plays for the survival of memory T cells is emphasized. Examples are presented that demonstrate long-term protective anti-tumor immunity can be achieved by post-operative vaccination with autologous cancer vaccines that are modified by virus infection.
Neutrophil-To-Lymphocyte and Platelet-To-Lymphocyte Ratios as Prognostic Markers of Survival in Patients with Head and Neck Tumours—Results of a Retrospective Multicentric Study

Background: The neutrophil-to-lymphocyte ratio (NLR) and the platelet-to-lymphocyte ratio (PLR) may be useful for drawing conclusions about the survival of head and neck squamous cell carcinoma (HNSCC) patients. Methods: Clinical data of 156 patients managed for HNSCC at two head and neck surgery centres were analyzed retrospectively. We studied the relationships between survival and PLR as well as NLR. Results: With regards to 5-year survival, the difference between the two groups with PLR values lower or higher than the threshold was statistically significant (p = 0.004), and we found the same for disease-free survival (p = 0.05), and tumour-specific mortality (p = 0.009). Concerning NLR, the difference in tumour-specific survival was statistically significant (p = 0.006). According to the multivariate analysis, NLR values higher than the threshold indicated an enhanced risk for overall as well as for tumour-specific mortality. Conclusion: In HNSCC patients, a high NLR may be considered as an independent risk factor for 5-year overall survival.
Differences of Quality in End-of-Life Care across Settings: Results from the U.S. National Health and Aging Trends Study of Medicare Beneficiaries.

Background: More than 2.5 million older Americans die each year. Place of residence in which dying patients receive care plays a crucial role in the quality of end-of-life (EOL) care. Objective: This study aimed to compare proxies' overall rating and ratings for 13 indicators across five major domains of EOL care by place of residence in the last month of decedents' lives. Design: We used data from the National Health and Aging Trends Study, a nationally representative study of Medicare beneficiaries at age 65 years and older in the United States. Setting/Subjects: Analyses included proxies (N = 1336) of Medicare beneficiaries who passed away between 2013 and 2016. Proxies were categorized into four groups, depending on place of residence in the last month of life and the involvement of hospice. Measurements: Quality of EOL care was assessed using questions modeled after quality of EOL care instruments. We adjusted for demographic data of decedents and proxies. Results: Hospice recipients, regardless of setting, were more likely to experience pain and talk about religion in the last month of life; families of patients without hospice in residential care settings were more likely to report not being kept informed; proxies of patients living in private residences with hospice care reported higher overall ratings. Among hospice recipients, those living in private residences were more likely to be treated with respect. Conclusions: Disparities exist across settings and in overall ratings for quality of EOL domains-particularly, the subdomains of symptom management, decision making, and spiritual needs.
Expanding Bias-instability of MEMS Silicon Oscillating Accelerometer Utilizing AC Polarization and Self-Compensation

This paper presents a MEMS (Micro-Electro-Mechanical System) Silicon Oscillating Accelerometer (SOA) with AC (alternating current) polarization to expand its bias-instability limited by the up-converted 1/f noise from front-end transimpedance amplifier (TIA). In contrast to the conventional DC (direct current) scheme, AC polarization breaks the trade-off between input transistor gate size and white noise floor of TIA, a relative low input loading capacitance can be implemented for low noise consideration. Besides, a self-compensation technique combining polarization source and reference in automatic-gain-control (AGC) is put forward. It cancels the 1/f noise and drift introduced by the polarization source itself, which applies to both DC and AC polarization cases. The experimental result indicates the proposed AC polarization and self-compensation strategy expand the bias-instability of studied SOA from 2.58 μg to 0.51 μg with a full scale of ± 30 g, a 155.6 dB dynamic range is realized in this work.
SRRF-stream imaging of optogenetically controlled furrow formation shows localized and coordinated endocytosis and exocytosis mediating membrane remodeling.

Cleavage furrow formation during cytokinesis involves extensive membrane remodeling. In the absence of methods to exert dynamic control over these processes, it has been a challenge to examine the basis of this remodeling. Here we used a subcellular optogenetic approach to induce this at will and found that furrow formation is mediated by actomyosin contractility, retrograde plasma membrane flow, localized decrease in membrane tension and endocytosis. FRAP, 4-D imaging and inhibition or upregulation of endocytosis or exocytosis show that ARF6 and Exo70 dependent localized exocytosis supports a potential model for intercellular bridge elongation. TIRF and Super Resolution Radial Fluctuation (SRRF) stream microscopy show localized VAMP2-mediated exocytosis and incorporation of membrane lipids from vesicles into the plasma membrane at the front edge of the nascent daughter cell. Thus, spatially separated but coordinated plasma membrane depletion and addition are likely contributors to membrane remodeling during cytokinetic processes.
Coalgebraic Operational Semantics for an Imperative Language

Operational semantics is a known and popular semantic method for describing the execution of programs in detail. The traditional deﬁnition of this method deﬁnes each step of a program as a transition relation. We present a new approach on how to deﬁne operational semantics as a coalgebra over a category of conﬁgurations. Our approach enables us to deal with a program that is written in a small but real imperative language containing also the common program constructs as input and output statements, and declarations. A coalgebra enables to deﬁne operational semantics in a uniform way and it describes the behavior of the programs. The state space of our coalgebra consists of the conﬁgurations modeling the actual states; the morphisms in a base category of the coalgebra are the functions deﬁning particular steps during the program’s executions. Polynomial endofunctor determines this type of systems. Another advantage of our approach is its easy implementation and graphical representation, which we illustrate on a simple program.
Primary paediatric chest wall tumours necessitating surgical management.

INTRODUCTION Limited literature exists on oncological chest wall reconstruction in the paediatric population, with the field still largely undecided on the best surgical reconstructive techniques to employ. The use of biological grafts/meshes is gaining popularity in certain adult surgical procedures but their use in paediatric procedures is rarely reported in the literature. We present the outcomes of our institution's multidisciplinary approach to managing paediatric chest wall tumours as well as our experience with the use of biological grafts for chest wall reconstruction following oncological resections. METHODS Data were analysed retrospectively from eight paediatric patients who were treated for primary chest wall tumours between 2010 and 2018. RESULTS The tumours comprised two lipoblastomas, three Ewing's sarcomas, an undifferentiated sarcoma with osteosarcomatous differentiation, a high grade undifferentiated sarcoma and a myofibroma. Seven of the eight patients underwent chest wall reconstruction with a biological graft. There were no postoperative mortalities and no evidence of recurrence in any of the patients in the series. No further chest wall operations were required and there were no postoperative infection related complications. CONCLUSIONS We support the use of biological grafts for chest wall reconstruction after oncological resections and maintain that a multidisciplinary approach is essential for the management of paediatric chest wall tumours.
Adverse Drug Reactions and Outcome Analysis of MDR TB Patients on DOTS Plus Regimen

"Introduction: The emergence of drug resistant mycobacteria has become a significant public health problem world over creating an obstacle to effective TB control. Present study was conducted to evaluate pattern and frequency of adverse drug reactions (ADR) of CAT IV, to analyze demographic, radiological and bacteriological profile and treatment outcome in MDR TB patients. Method: Total 102 MDR TB patients (with in vitro resistance to Isoniazid and Rifampicin) were analyzed retrospectively who had completed treatment from august 2007 to June 2014. Analysis was made for extent of lung lesion, correlation of sputum smear and culture conversion with clinical and radiological improvement, risk factors for adverse outcome and adverse drug reactions. Result: Forty six patients (45.09%) were cured/treatment completed, nine patients (8.82%) failed, 21 patients (20.05%) defaulted and 26 patients (25.49%) died of total 102 patients. Mean time for sputum smear and culture conversion were 4.2±2.0 and 4.19±2.3 months, respectively. Advanced lung lesion, cavitations, poor adherence to treatment and BMI less than 18 are variables associated with poor outcome. Fifty (52.94%) patients experienced adverse drug reactions and 42 of them required drug modifications. Conclusion: The ADRs were more common in the first 60 days of the regimen & in patient with BMI