Miracle-dz/UniFAR-FTUs huggingface dataset:
Decoding Billing Practices in Cochlear Implant Programs

Objectives: The purpose of this study was to examine current cochlear implant (CI) billing practices across CI audiologists in the United States, to determine if CI audiologists are following the National Correct Coding Initiative (NCCI) edits, and to assess the CI audiologist’s exposure to billing education. Design: A 48-question survey was electronically distributed to and completed by audiologists who bill for CI services. Demographic data including work setting, population served, years of experience, number of CI patients managed per week, and exposure to billing education were collected. Data were analyzed to identify codes and modifiers used to bill for commonly performed CI procedures such as unilateral and bilateral CI programming, preoperative and postoperative testing, and objective measures. Results: Data were obtained from 96 audiologists. The majority (86.3%, n = 82) of respondents agreed or strongly agreed they understand billing and coding practices for cochlear implants and 94.7% (n = 89) rated themselves as somewhat to highly efficient when performing these practices. Only 16.8% (n = 16) of respondents reported receiving formal training for practice management, and half of the respondents (51.1%, n = 48) reported unfamiliarity with national billing guidelines. Those who received formal training reported higher billing efficiency. Wide variability was seen for various billing scenarios. Billing questions were presented, and answers were coded as correct or incorrect based on the NCCI edits. Respondents who reported higher agreement with understanding billing and who received formal training scored better on common billing questions related to the NCCI edits. Conclusions: Most CI audiologists rated themselves as efficient in billing; however, wide variance in billing practices was observed. Incorporating practice management and current billing education into daily practice and into audiology training programs is essential to clinic efficiency, practice management, and CI program viability. CI audiologists should be knowledgeable about appropriate billing practices to ensure long-term sustainability of programs.
The Physiological Control of Eating: Signals, Neurons, and Networks.

During the past 30 years, investigating the physiology of eating behaviors has generated a truly vast literature. This is fueled in part by a dramatic increase in obesity and its comorbidities that has coincided with an ever increasing sophistication of genetically based manipulations. These techniques have produced results with a remarkable level of cell-specificity-particularly at the cell signaling level-and have played a lead role in advancing the field. However, putting these findings into a brain-wide context that connects physiological signals and neurons to behavior and somatic physiology requires a thorough consideration of neuronal connections; a field that has also seen an extraordinary technological revolution. Our goal is to present a comprehensive and balanced assessment of how physiological signals associated with energy homeostasis interact at many brain levels to control eating behaviors. A major theme is that these signals engage sets of interacting neural networks throughout the brain, that are defined by specific neural connections. We begin by discussing some fundamental concepts-including ones that still engender vigorous debate-that provide the necessary frameworks for understanding how the brain controls meal initiation and termination. These include: key word definitions, ATP availability as the pivotal regulated variable in energy homeostasis, neuropeptide signaling, homeostatic and hedonic eating, and meal structure. Within this context, we discuss network models of how key regions in the endbrain (or telencephalon), hypothalamus, hindbrain, medulla, vagus nerve, and spinal cord work together with the gastrointestinal tract to enable the complex motor events that permit animals to eat in diverse situations.
Depressive symptoms in primary health care attendees in Sebeta Town, Ethiopia: Prevalence, associated factors, and detection by health workers

Depression often goes unrecognized in the primary health care setting. When depression occurs in clinical settings, it increases the risk of mortality from co-morbid medical conditions. Besides, 70% of patients with depression have somatic complaints, resulting in unnecessary investigations and mismanagement. This study was intended to investigate the prevalence and associated factors of depressive symptoms in primary health care centers and the detection rate in Sebeta Town, Ethiopia. An institution-based cross-sectional study was conducted among 384 visitors of adult outpatient department of four primary health centers in Sebeta Town, Ethiopia from October 1 to November 3, 2020. Depressive symptoms were assessed using PHQ-9 at cut-off score of 5. Data were entered using EPI data version 3.1 and exported to SPSS version 20 for data analysis. Descriptive statistics and binary logistic regression analysis were conducted. The prevalence of depressive symptoms was 27.9% (95% CI: 23.4–32.6). Detection rate of depressive symptoms by PHC providers was 0.93% (95% CI: 0.0–5.1). The factors positively associated with depressive symptoms were being unmarried (adjusted odds ratio (AOR): 3.40, 95% CI: 1.56–7.40, p < 0.01), perceived worsening of illness (AOR: 3.67, 95% CI: 1.73–7.77, p < 0.01), having family history of depression (AOR: 3.78, 95% CI: 1.40–10.23, p < 0.01), current alcohol consumption (AOR: 2.73, 95% CI: 1.22–6.10, p < 0.05), and current khat consumption (AOR: 5.43, 95% CI: 2.55–11.56, p < 0.01). Moderate social support (AOR: 0.16, 95% CI: 0.06–0.41, p < 0.01) and strong social support (AOR: 0.23, 95% CI: 0.09–0.63, p < 0.01) compared to poor social support, and the age group 25–31 (AOR: 0.36, 95% CI: 0.14–0.92, p < 0.05), compared to the age group 18–24, were negatively associated. Prevalence of depressive symptoms was found to be high, while the detection rate was very low. Provision of depression care services integrated into routine health care at PHC level was recommended.
The antidepressant Sertraline inhibits CatSper Ca2+ channels in human sperm

Abstract STUDY QUESTION Do selective serotonin reuptake inhibitor (SSRI) antidepressants affect the function of human sperm? SUMMARY ANSWER The SSRI antidepressant Sertraline (e.g. Zoloft) inhibits the sperm-specific Ca2+ channel CatSper and affects human sperm function in vitro. WHAT IS KNOWN ALREADY In human sperm, CatSper translates changes of the chemical microenvironment into changes of the intracellular Ca2+ concentration ([Ca2+]i) and swimming behavior. CatSper is promiscuously activated by oviductal ligands, but also by synthetic chemicals that might disturb the fertilization process. It is well known that SSRIs have off-target actions on Ca2+, Na+ and K+ channels in somatic cells. Whether SSRIs affect the activity of CatSper is, however, unknown. STUDY DESIGN, SIZE, DURATION We studied the action of the seven drugs belonging to the most commonly prescribed class of antidepressants, SSRIs, on resting [Ca2+]i and Ca2+ influx via CatSper in human sperm. The SSRI Sertraline was selected for in-depth analysis of its action on steroid-, prostaglandin-, pH- and voltage-activation of human CatSper. Moreover, the action of Sertraline on sperm acrosomal exocytosis and penetration into viscous media was evaluated. PARTICIPANTS/MATERIALS, SETTING, METHODS The activity of CatSper was investigated in sperm of healthy volunteers, using kinetic Ca2+ fluorimetry and patch-clamp recordings. Acrosomal exocytosis was investigated using Pisum sativum agglutinin and image cytometry. Sperm penetration in viscous media was evaluated using the Kremer test. MAIN RESULTS AND THE ROLE OF CHANCE Several SSRIs affected [Ca2+]i and attenuated ligand-induced Ca2+ influx via CatSper. In particular, the SSRI Sertraline almost completely suppressed Ca2+ influx via CatSper. Remarkably, the drug was about four-fold more potent to suppress prostaglandin- versus steroid-induced Ca2+ influx. Sertraline also suppressed alkaline- and voltage-activation of CatSper, indicating that the drug directly inhibits the channel. Finally, Sertraline impaired ligand-induced acrosome reaction and sperm penetration into viscous media. LIMITATIONS, REASONS FOR CAUTION This is an in vitro study. Future studies have to assess the physiological relevance in vivo. WIDER IMPLICATIONS OF THE FINDINGS The off-target action of Sertraline on CatSper in human sperm might impair the fertilization process. In a research setting, Sertraline may be used to selectively inhibit prostaglandin-induced Ca2+ influx. STUDY FUNDING/COMPETING INTEREST(S) This work was supported by the Swiss Centre for Applied Human Toxicology (SCAHT), the Département de l’Instruction Publique of the State of Geneva, the German Research Foundation (CRU326), the Interdisciplinary Center for Clinical Research, Münster (IZKF; Str/014/21), the Innovation Fund Denmark (grant numbers 14-2013-4) and the EDMaRC research grant from the Kirsten and Freddy Johansen’s Foundation. The authors declare that no conflict of interest could be perceived as prejudicing the impartiality of the research reported. TRIAL REGISTRATION NUMBER NA.
Extracorporeal Blood Purification is associated with improvement in biochemical and clinical variables in the critically-ill COVID-19 patients.

INTRODUCTION This study tried to investigate the impact of oXiris filter on both clinical and laboratory parameters in critically ill COVID-19 ICU patients receiving extracorporeal blood purification and the clinical setting for the initiation of therapy. METHODS A consecutive sample of 15 ICU patients with COVID-19 was treated with oXiris membrane for blood purification or for support of renal function due to acute kidney injury. We have included 19 non treated ICU COVID-19 patients as a control group. Two chest X-rays were analyzed for determining the chest x-ray severity score. RESULTS We have found a significant decrease of SOFA score, respiratory status improved and the chest X-ray severity score was significantly decreased after 72h of treatment. Il-6 significantly decreased after 72h of treatment while other inflammatory markers did not. Respiratory status in the control group worsened as well as increase in SOFA score and chest X-ray severity score. Survived patients have shorter time from the onset of symptoms before starting with extracorporeal blood purification treatment and shorter time on vasoactive therapy and invasive respiratory support than deceased patients. CONCLUSION Critically-ill patients with COVID-19 treated with extracorporeal blood purification survived significantly longer than other ICU COVID-19 patients. Treatment with oXiris membrane provides significant reduction of Il-6, leads to improvement in respiratory status, chest X-ray severity score, and reduction of SOFA score severity. Our results can suggest that ICU COVID-19 patients in an early course of a disease could be potentially a target group for earlier initiation of extracorporeal blood purification. This article is protected by copyright. All rights reserved.
Transcription factor KLF2 enhances the sensitivity of breast cancer cells to cisplatin by suppressing kinase WEE1

ABSTRACT Cisplatin is an effective chemotherapeutic agent in facilitating the inhibition of proliferation, migration, and invasion in cancerous cells. However, the detailed mechanism of the regulation by cisplatin of human breast cancer cells is still unclear. This study aimed to investigate the mechanism of kruppel-like factor 2 (KLF2) transcription factor in cisplatin therapy for breast cancer. RT-qPCR was performed to quantify the expression of KLF2 and WEE1 in clinical tissue samples from breast cancer patients and in MDA-MB-231 cells. ChIP assay and dual-luciferase reporter assay were used to analyze the potential-binding sites of KLF2 and WEE1 promoter. Gain- or loss-of-function approaches were used to manipulate KLF2 and WEE1 in cisplatin-treated MDA-MB-231 cells, and the mechanism of KLF2 in breast cancer was evaluated both via CCK-8 assay, flow cytometry, Transwell assay, and Western blot. Further validation of the KLF2 was performed on nude mouse models. Breast cancer tissues and cells showed a relative decline of KLF2 expression and abundant WEE1 expression. Cisplatin inhibited the proliferation, migration, and invasion of MDA-MB-231 cells. Overexpression of KLF2 enhanced the inhibitory effect of cisplatin on the malignant characteristics of MDA-MB-231 cells in vitro. KLF2 targeted WEE1 and negatively regulated its expression, thus enhancing the sensitivity to cisplatin of breast cancer cells as well as tumor-bearing mice. Overall, these results suggest that KLF2 can potentially inhibit WEE1 expression and sensitize breast cancer cells to cisplatin, thus presenting a promising adjunct treatment.
Determining the risk factors associated with delayed sputum conversion at the end of the intensive phase among tuberculosis patients.

Background In pulmonary tuberculosis (PTB), the sputum conversion rate at 2 months is frequently used to evaluate treatment outcomes and effectiveness of a TB control programme. Aims The study aimed to estimate the rate of delayed sputum conversion and explore its predicting factors at the end of the intensive phase among smear-positive PTB (PTB +ve) patients. Methods A 3-year retrospective study was conducted in the government hospital in Pulau Pinang from 2016 to 2018. During the study, a standardized, data collection form was used to collect data from the patient record. Patients aged over 18 years were recruited. Multivariable logistic regression analysis was used to identify significant independent variables associated with delayed sputum conversion. Results A total 1128 of PTB patients were recorded visiting the TB clinic, 736 (65.2%) were diagnosed as PTB +ve; of these, 606 (82.3%) PTB +ve had a record of sputum conversion at the end of the intensive phase. Age ≥ 50 years, blue-collar jobs, smoking, heavy bacillary load, relapsed and treatment interrupted were significantly (P < 0.05) associated with delayed sputum conversion. Delayed sputum conversion rate at the end of the intensive phase was 30.5%. Conclusion The rate of sputum smear conversion in the intensive phase of treatment was independently associated with high sputum smear grading at diagnosis, relapsed and treatment interrupted categories, old age and blue-collar occupations.
Demographic models of the reproductive process: Past, interlude, and future

After 30 years of active development, mechanistic models of the reproductive process nearly stopped attracting scholarly interest in the early 1980s. In the following decades, fertility research continued to thrive, relying on solid descriptive work and detailed analysis of micro-level data. The absence of systematic modelling efforts, however, has also made the ﬁeld more fragmented, with empirical research, theory building, and forecasting advancing along largely disconnected channels. In this paper we outline some of the drivers of this process, from the popularization of user-friendly statistical software to the limitations of early family building models. We then describe a series of developments in computational modelling and statistical computing that can contribute to the emergence of a new generation of mechanistic models. Finally, we introduce a concrete example of this new kind of model, and show how they can be used to formulate and test theories coherently and make informed projections.
In Utero Exposure to Smoking and Alcohol, and Passive Smoking during Childhood: Effect on the Retinal Nerve Fibre Layer in Young Adulthood

ABSTRACT Purpose In utero exposure to cigarette smoke has been suggested to result in thinner retinal nerve fibre layer (RNFL). However, the potential cofounding effects of in utero alcohol exposure and passive smoking during childhood had not been considered. We explored RNFL thickness in young adults in relation to these early life factors. Methods In 1989–1991, pregnant women completed questionnaires on their current smoking and alcohol drinking patterns. Following the birth of their offspring, information on household smokers was obtained between the 1- and 13-year follow-ups. At the 20-year follow-up, these offspring underwent an eye examination including optical coherence tomography imaging of the RNFL. Results Participants (n = 1,287) were 19–22 years old at time of eye examination. Most participants (77%) had no in utero exposure to cigarette smoke; 1.3% were initially exposed but not after 18 weeks’ gestation, while 21% had continual in utero smoking exposure. Half of the mothers never consumed alcohol or only consumed alcohol once during their pregnancies. After correcting for potential confounders, including in utero alcohel exposure and childhood passive smoking, participants who had continued in utero exposure to >10 cigarettes/day and ≤10 cigarettes/day had thinner RNFLs by 6.6 (95% confidence interval [CI] = 4.4–8.7) and 3.7 µm (95%[CI] = 2.3–5.5), respectively, than those with no exposure (p < .001). In utero alcohol exposure and childhood passive smoking were not significantly associated with RNFL thickness after accounting for in utero exposure to smoking. Conclusions In utero exposure to cigarette smoke is associated with thinner RFNL in young adulthood, independent of other early life environmental factors.
Visnagin prevents isoproterenol‐induced myocardial injury by attenuating oxidative stress and inflammation and upregulating Nrf2 signaling in rats

Oxidative tissue injury and inflammatory responses play major roles in cardiovascular diseases and heart failure. Visnagin (VIS) is a natural bioactive component of Ammi visnaga, with promising radical scavenging and anti‐inflammatory activities. This study explored the protective effect of VIS against isoproterenol (ISO)‐induced acute myocardial injury and oxidative stress in rats. VIS was supplemented for 14 days, and the rats received ISO (100 mg/kg) twice at an interval of 24 h. ISO‐induced myocardial injury was characterized by elevated serum CK‐MB, LDH, and troponin‐I associated with increased heart weight and several histopathological changes. ISO increased reactive oxygen species (ROS), malondialdehyde (MDA), NF‐κB p65, TNF‐α, IL‐6, and decreased glutathione and antioxidant enzymes in rats' hearts. VIS prevented myocardial injury and ameliorated the cardiac function markers, ROS, MDA, NF‐κB p65, and pro‐inflammatory cytokines in ISO‐intoxicated rats. In addition, VIS decreased Bax mRNA and caspases, and upregulated Nrf2, HO‐1, Bcl‐2, and PPARγ. Molecular docking simulations revealed the binding method of VIS to NF‐κB, Keap1, and PPARγ. In conclusion, VIS protects against ISO‐induced acute myocardial injury by attenuating oxidative tissue injury and reducing key inflammatory and apoptosis markers. In vivo and in silico results showed that activation of Nrf2/HO‐1 signaling and PPARγ mediates the cardioprotective effect of VIS.
Periprosthetic infection risks and predictive value of C-reactive protein / albumin ratio for total joint arthroplasty

Background and aim: There are no gold standard markers to estimate the risk of developing periprosthetic infections. Our aim is to compare the risks of periprosthetic infection in patients with THA and THA and to investigate the predictive significance of the CRP / albumin ratio. Methods: This is a retrospective study containing data from 241 osteoarthritis patients and 19 patients with periprosthetic infections who underwent TKA and THA in our hospital from January 2014 to January 2019.12 risk factors(CRP/ albumin, albumin, CRP, age, gender, BMI, DM, ASA, nasal culture, urine culture, hospital stay, operation time) were analyzed. Results: In the binary logistic regression model and multivariate regression analysis, the rate of CRP / albumin was 17.161 times higher than the patients with ≤0.16 cut-off value. (CRP / albumin ratio (odds ratio (OR) = 17.16, 95% CI: 1.55-189.03, P: 0.02). High BMI increased the risk of periprosthetic infection 1.3 times. Nasal bacterial colonization (OR = 0.99, 95% CI: 0.868-1.38, P: 0.7) and bacterium in urine (OR = 0.502, 95% CI: 0.07-3.598, P: 0.703) did not pose a significant risk for periprosthetic infection. Conclusion: According to our findings, the CRP / albumin ratio has a more prognostic capacity than other risks in determining the risk of periprosthetic infection for total joint arthroplasty. CRP / albumin ratio is a cheap and easy to apply marker. Routine urine and nasal bacteria screening is not required before total joint arthroplasty.
Correlation of hair cortisol and interleukin 6 with structural change in the active progression of keratoconus

This study shows correlation between IL6 and cortisol with progression and structural damage in keratoconus. These markers may allow earlier detection of progression and potentially enable intervention before irreversible changes. Purpose: To evaluate interleukin (IL) and hair cortisol concentrations (HCCs) in progressive keratoconus (KC) and compare them with KC-stable eyes and healthy control, and to determine the correlation of these inflammatory mediators and HCCs and their relationship with structural damage represented by increased corneal curvature. Setting: University of Sao Paulo, Brazil. Design: Prospective observational comparative study. Methods: 133 eyes of 74 patients were included. The concentrations of tear cytokines: IL1B, IL6, IL8, IL10, IL12p70, and tumor necrosis factor α were obtained by capillary flow and measured using a flow cytometer. HCCs were determined from the most proximal hair segment as an index of cumulative secretion and measured by liquid chromatography mass spectrometry. Results: 133 eyes of 74 patients. Only IL6 was increased in progressive KC tears compared with stable KC (6.59 ± 3.25 pg/mL vs 4.72 ± 1.91 pg/mL; P < .0001) with a positive correlation between IL6 and maximum keratometry (Kmax) (P < .0001). Progressive KC exhibited significantly higher HCC than stable KC (0.624 ± 0.160 ng/mg vs 0.368 ± 0.0647 ng/mg; P < .0001) and healthy controls (0.624 ± 0.160 ng/mg vs 0.351 ± 0.0896 ng/mg; P < .0001). There was a significant correlation between HCC and Kmax (P < .0001). Conclusions: KC eyes that are progressing have a higher concentration of IL6 and long-term cortisol than patients with stable forms of KC; second, there is a significant correlation between this increase in IL6 and cortisol with corneal structural damage. Finally, there is a meaningful relationship between this interleukin and the previous few months' cortisol levels.