Miracle-dz/UniFAR-FTUs huggingface dataset:
Estimating health care delivery system value for each US state and testing key associations

Abstract Objective To estimate health care systems' value in treating major illnesses for each US state and identify system characteristics associated with value. Data sources Annual condition‐specific death and incidence estimates for each US state from the Global Burden Disease 2019 Study and annual health care spending per person for each state from the National Health Expenditure Accounts. Study design Using non‐linear meta‐stochastic frontier analysis, mortality incidence ratios for 136 major treatable illnesses were regressed separately on per capita health care spending and key covariates such as age, obesity, smoking, and educational attainment. State‐ and year‐specific inefficiency estimates were extracted for each health condition and combined to create a single estimate of health care delivery system value for each US state for each year, 1991–2014. The association between changes in health care value and changes in 23 key health care system characteristics and state policies was measured. Data collection/extraction methods Not applicable. Principal findings US state with relatively high spending per person or relatively poor health‐outcomes were shown to have low health care delivery system value. New Jersey, Maryland, Florida, Arizona, and New York attained the highest value scores in 2014 (81 [95% uncertainty interval 72‐88], 80 [72‐87], 80 [71‐86], 77 [69‐84], and 77 [66‐85], respectively), after controlling for health care spending, age, obesity, smoking, physical activity, race, and educational attainment. Greater market concentration of hospitals and of insurers were associated with worse health care value (p‐value ranging from <0.01 to 0.02). Higher hospital geographic density and use were also associated with worse health care value (p‐value ranging from 0.03 to 0.05). Enrollment in Medicare Advantage HMOs was associated with better value, as was more generous Medicaid income eligibility (p‐value 0.04 and 0.01). Conclusions Substantial variation in the value of health care exists across states. Key health system characteristics such as market concentration and provider density were associated with value.
Diurnal expression of CXC receptors 4 (CXCR4) and CXC chemokine ligand 12 (CXCL12) in Pelteobagrus vachellii

ABSTRACT The CXC chemokine ligand 12/CXC receptor 4 ligand/receptor interaction is the most ancient chemokine system in vertebrates, and it plays a pivotal role in the immune system’s response against bacterial infection. In the current study, 1211 bp CXCR4 and 937 bp CXCL12 genes, which encode 364 and 99 amino acids, respectively, were isolated. Within the 24-hour light/dark cycle, the maximum of CXCR4 in the intestine, spleen, and anterior kidney of Pelteobagrus vachellii occurs at 8:00, 16:00, and 16:00, respectively. The maximum of CXCL12 in the intestine, spleen, and anterior kidney of P. vachellii occurs at 20:00, 12:00, and 20:00, respectively. CXCR4 and CXCL12 expressions showed 24-hour variation, which contributed to understanding of the immune rhythm of the teleost.
Using a bimanual lever-driven wheelchair for arm movement practice early after stroke: A pilot, randomized, controlled, single-blind trial

Objective: Many patients with subacute stroke rely on the nonparetic arm and leg to propel manual wheelchairs. We designed a bimanual, lever-driven wheelchair (LARA) to promote overground mobility and hemiparetic arm exercise. This study measured the feasibility of using LARA to increase arm movement, achieve mobility, and improve arm motor recovery (clinicaltrials.gov/ct2/show/NCT02830893). Design: Randomized, assessor-blind, controlled trial. Setting: Two inpatient rehabilitation facilities. Subjects: Nineteen patients with subacute stroke (1 week to 2 months post-stroke) received 30 minutes extra arm movement practice daily, while admitted to inpatient rehabilitation (n = 10) or before enrollment in outpatient therapy (n = 9). Interventions: Patients were randomized to train with the LARA wheelchair (n = 11) or conventional exercises with a rehabilitation therapist (n = 8). Main measures: Number of arm movements per training session; overground speed; Upper Extremity Fugl-Meyer score at three-month follow-up. Results: Participants who trained with LARA completed 254 (median) arm movements with the paretic arm each session. For three participants, LARA enabled wheelchair mobility at practical indoor speeds (0.15–0.30 m/s). Fugl-Meyer score increased 19 ± 13 points for patients who trained with LARA compared to 14 ± 7 points with conventional exercises (P = 0.32). Secondary measures including shoulder pain and increased tone did not differ between groups. Mixed model analysis found significant interaction between LARA training and treatment duration (P = 0.037), informing power analysis for future investigation. Conclusions: Practising arm movement with a lever-driven wheelchair is a feasible method for increasing arm movement early after stroke. It enabled wheelchair mobility for a subset of patients and shows potential for improving arm motor recovery.
Comparison of Membrane Depth Determination Techniques for Active Ingredient Skin Penetration Studies Using Microdialysis

Introduction: The skin is a major physical barrier to the environment, and thus, percutaneous delivery of active ingredients to the dermal target site faces a unique set of hurdles. The efficacy of these active ingredients is governed by their release into the underlying epidermal and dermal tissue, especially when administered topically. Objective: The aim of this study was to understand if different physicochemical properties influence the skin penetration of active ingredients and the depth to which they penetrate into the dermis. Methods: A microdialysis (MD) setup was used to compare the percutaneous penetration in superficial and deep implanted MD membranes in porcine skin. The precise MD membrane depth was determined using histological sectioning paired with microscopy, ultrasound, and a novel computed tomographic approach. Results: In study A, the measured depth of the superficial and deep implanted MD membranes was compared using histological sectioning, ultrasound, and computed tomography. Experimental determination of the depth up to which penetration occurs was found to be crucial to percutaneous penetration studies. In study B, the lipophilic differences of the active ingredients and its influences on the penetration was tested using hydrophilic caffeine and lipophilic LIP1 as model compounds, which have an identical molecular weight with different lipophilic characteristics. It is assumed that the lipophilic characteristics of active ingredients influence their penetration and thus governs the concentration of these molecules reaching their target site. Conclusion: The transdermal penetration of caffeine was found to exceed that of LIP1 through the hydrophilic environment of the dermis. Thus, the findings of this study show that the precise MD dermis localization and the physicochemical properties, such as lipophilicity, influence the penetration rate of active ingredients and lay the foundation for creating optimized transdermal delivery systems.
'Oh no, not a group!' The factors that lonely or isolated people report as barriers to joining groups for health and well-being.

OBJECTIVES Belonging to groups can significantly affect people's health and well-being for the better ('the social cure') or worse ('the social curse'). Encouraging people to join groups is a central component of the Social Prescribing movement; however, not everyone who might benefit from Social Prescribing aspires to participating in groups. This study aims to identify what barriers are preventing people from experiencing the associated health and well-being benefits of group belonging. METHOD Semi-structured interviews analysed using reflexive thematic analysis. Participants were 11 white British people (aged 48-86), 1 male and 10 female, recruited by a charity partner of a Social Prescribing project. RESULTS The themes derived from the interviews are as follows: (1) 'The dread, the fear of being in a group': When groups do not meet needs; (2) 'I can remember as quite a young child backing out of things': Accumulative barriers over the lifetime, and (3) 'I'm singing away and feeling terribly miserable': the challenges of fitting in with others in groups. The themes reflect how people can feel deterred from social interaction, which interferes with their ability to derive a sense of belonging or shared identity associated with the 'social cure'. CONCLUSIONS A key challenge for Social Prescribing is to meet the social needs of people disinclined to join groups; groups can be detrimental to health and well-being if there are barriers to integration. Alternative ways of structuring groups or activities may be more effective and can still avail of the belonging and identity associated with 'the social cure'.
Prediction of future cardiovascular events by Framingham, SCORE and asCVD risk scores is less accurate in HIV‐positive individuals from the HIV‐HEART Study compared with the general population

Cardiovascular diseases (CVDs) occur more often in people living with HIV (PLWH) than in the general population. It has been reported that CVD risk scores developed for the general population underestimate the CVD risk in PLWH. Performances of the Framingham Risk Score (FRS), the Systematic Coronary Risk Evaluation (SCORE) and the atherosclerotic cardiovascular disease (asCVD) risk score in PLWH were compared with the general population to quantify score‐specific differences in risk prediction.
Hearing preservation/rehabilitation surgery for small vestibular schwannoma: preliminary experience with the presigmoid retrolabyrinthine approach

Abstract Background The presigmoid retrolabyrinthine approach (PRA) for small vestibular schwannoma (VS) has unique advantages. Combination with partial labyrinthectomy further makes up its defect of high demand for anatomy. Objective Aimed to describe our use of the PRA with partial labyrinthectomy in VS surgery. Methods We retrospectively analyzed 10 patients diagnosed with VS who underwent PRA between September 2017 and November 2020. Their perioperative data were analyzed. Results Six tumors were on the left and three were on the right. One case was due to neurofibromatosis type 2 with bilateral involvement and underwent internal auditory canal decompression by PRA without tumor removal; all other patients underwent total tumor resection. Four patients underwent cochlear implantation simultaneously because of hearing loss that was detected during surgery. Three patients underwent partial labyrinthectomy. Five patients achieved hearing preservation, and one experienced hearing improvement. One of the three patients who underwent partial labyrinthectomy maintained hearing. All patients’ pre- and postoperative facial nerve functions were House-Brackmann grade I. After a median follow-up time of 13 months, no tumors recurred. Conclusions PRA for small VS is a safe and effective surgery that can achieve facial nerve and hearing preservation. Combination with partial labyrinthectomy can also preserve hearing.
Measurement of the amplitude and phase of the electrophoretic and electroosmotic mobility based on fast single‐particle tracking

The electrophoretic mobility of micron‐scale particles is of crucial importance in applications related to pharmacy, electronic ink displays, printing, and food technology as well as in fundamental studies in these fields. Particle mobility measurements are often limited in accuracy because they are based on ensemble averages and because a correction for electroosmosis needs to be made based on a model. Single‐particle approaches are better suited for examining polydisperse samples, but existing implementations either require multiple measurements to take the effect of electroosmosis into account or are limited in accuracy by short measurement times. In this work, accurate characterization of monodisperse and polydisperse samples is achieved by measuring the electrophoretic mobility on a particle‐to‐particle basis while suppressing electroosmosis. Electroosmosis can be suppressed by measuring in the middle of a microchannel while applying an AC voltage with a sufficiently high frequency. An accurate measurement of the electrophoretic mobility is obtained by analyzing the oscillating particle motion for 1.5s per particle with a high‐speed camera measuring at 850Hz , synchronized to the applied electric field. Attention is paid to take into account the effect of the rolling shutter and the non‐uniform sampling in order to obtain the accurate amplitude and phase of the electrophoretic mobility. The accuracy of method is experimentally verified and compared with a commercial apparatus for polystyrene microspheres in water. The method is further demonstrated on a range of particle materials and particle sizes and for a mixture of positively and negatively charged particles.
Fear of Crime Among Caribbean Women in University: A Qualitative Exploration Using the Free Association Narrative Method

Women attending university are generally at a heightened risk of victimization. As such, there is an emerging body of literature exploring fear of crime among them. Although several studies have explored this phenomenon quantitatively, relatively few have investigated fear of crime among this group of women in their own words. Using a sample of women at the University of the West Indies, this study seeks to address this gap. The study reveals strong support for the shadow of sexual assault theory as the women interviewed overwhelmingly describe their fear of crime against the background of their perceived vulnerability to rape.
Bottom-Up Assembled Photonic Crystals for Structure-Enabled Label-Free Sensing

Photonic crystals (PhCs) display photonic stop bands (PSBs) and at the edges of these PSBs transport light with reduced velocity, enabling the PhCs to confine and manipulate incident light with enhanced light–matter interaction. Intense research has been devoted to leveraging the optical properties of PhCs for the development of optical sensors for bioassays, diagnosis, and environmental monitoring. These applications have furthermore benefited from the inherently large surface area of PhCs, giving rise to high analyte adsorption and the wide range of options for structural variations of the PhCs leading to enhanced light–matter interaction. Here, we focus on bottom-up assembled PhCs and review the significant advances that have been made in their use as label-free sensors. We describe their potential for point-of-care devices and in the review include their structural design, constituent materials, fabrication strategy, and sensing working principles. We thereby classify them according to five sensing principles: sensing of refractive index variations, sensing by lattice spacing variations, enhanced fluorescence spectroscopy, surface-enhanced Raman spectroscopy, and configuration transitions.
Characterizing Sleep Disruption and Delirium in Children After Cardiac Surgery: A Feasibility Study

OBJECTIVES: Patients in the pediatric cardiac ICU are frequently exposed to pharmacologic and environmental factors that predispose them to sleep disturbances and may increase the risk of delirium. In this pilot study, we sought to demonstrate the feasibility of actigraphy monitoring in pediatric cardiac ICU patients to investigate the association between sleep characteristics and delirium development. DESIGN: Prospective observational pilot study. SETTING: Pediatric cardiac ICU in an academic children’s hospital in the United States. PATIENTS: Children admitted to the pediatric cardiac ICU after cardiac surgery. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Nineteen enrolled patients wore actigraphy watches that provided data for a total of 63 pediatric cardiac ICU days. The median pediatric cardiac ICU length of stay was 2 days (interquartile range, 1–3 d). The median sleep episode among all patients was 37 minutes in duration (interquartile range, 18–46 min), and the longest sleep episode was a median of 117 minutes (interquartile range, 69–144 min). Sixty-one percent of patients (95% CI, 36–83%) screened positive for delirium at least once during admission, and the median number of delirious days among those who were positive was 2 days (interquartile range, 1–3 d). The median percent sleep time was 43% for delirious patients and 49% for those with no delirium, with similar median sleep and longest sleep episodes. The median ratio of daytime activity/24-hr activity was 54% (interquartile range, 49–59%) in both groups. CONCLUSIONS: Actigraphy monitoring in conjunction with delirium screening is feasible in infants and children admitted to the pediatric cardiac ICU after cardiac surgery. Our data suggest that most children in the pediatric cardiac ICU experience severe sleep disruption and delirium is common. These pilot data provide important insights for the design of a large-scale observational study to investigate potential causal relationships between sleep disruption and delirium in the pediatric cardiac ICU.
Spinal myelolipoma – an extremely rare pathology within the lumbar spine: a case report and literature review

Abstract Myelolipoma is a benign tumor containing mature adipose cells and a combination of myeloid and erythroid elements. This tumor is typically found in the adrenal glands; however, it has been detected outside the adrenal glands in rare cases. We report an extremely rare case of myelolipoma in the lumbar spine causing significant neural compression due to the involvement of the posterior spinal elements. Given the significant neurological deficit, the patient was surgically managed as soon as possible. Extra-adrenal myelolipomas are rare lesions, and only one case has been reported in the spine so far. However, this diagnosis should be considered in cases with its characteristic imaging features.
A novel classification method of lymph node metastasis in colorectal cancer

ABSTRACT Colorectal cancer lymph node metastasis, which is highly associated with the patient’s cancer recurrence and survival rate, has been the focus of many therapeutic strategies that are highly associated with the patient’s cancer recurrence and survival rate. The popular methods for classification of lymph node metastasis by neural networks, however, show limitations as the available low-level features are inadequate for classification, and the radiologists are unable to quickly review the images. Identifying lymph node metastasis in colorectal cancer is a key factor in the treatment of patients with colorectal cancer. In the present work, an automatic classification method based on deep transfer learning was proposed. Specifically, the method resolved the problem of repetition of low-level features and combined these features with high-level features into a new feature map for classification; and a merged layer which merges all transmitted features from previous layers into a map of the first full connection layer. With a dataset collected from Harbin Medical University Cancer Hospital, the experiment involved a sample of 3,364 patients. Among these samples, 1,646 were positive, and 1,718 were negative. The experiment results showed the sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were 0.8732, 0.8746, 0.8746 and 0.8728, respectively, and the accuracy and AUC were 0.8358 and 0.8569, respectively. These demonstrated that our method significantly outperformed the previous classification methods for colorectal cancer lymph node metastasis without increasing the depth and width of the model. Graphical abstract
Nutritional care of older people: Investigating nurses’ attitudes in medical and surgical units

Background: Malnutrition in older people in hospitals leads to negative patient outcomes. Nurses often underestimate the problem, showing negative attitudes. Aims: To compare nurses' attitudes towards nutritional care of older people in surgical and medical wards. Design: Multicentre cross-sectional survey, conducted in January 2015. Methods: All nurses in surgical and medical wards in 10 hospitals in northern Italy were surveyed using the Staff Attitudes to Nutritional Nursing Care Geriatric Scale (SANN-G scale). Results: 799 out of 1,293 questionnaires were returned (61.8%). 23.2% (185) had a negative attitude, 56.6%(452) had a neutral attitude, and 20.2%(162), positive. Multivariate analysis showed no significant differences between medical and surgical wards (OR = 1.298; CI95% = .883-1.886, p = .18). Conclusions: It is necessary to raise nurses' awareness of poor nutritional care in both settings. More research is needed within the barriers to nutritional care. Impact statement: Strategies such as education and more clearly defined nutritional responsibilities are needed to improve nurses' attitudes.
“Concurrent Ropes and Ladders”: Mapping and Conceptualizing the Emotional Loss Experience of Parents Following Pediatric Acquired Brain Injury

This grounded theory study aims to map, conceptualize, and theorize the emotional loss experienced by parents following their child’s pediatric acquired brain injury (pABI). Data were obtained from 47 semi-structured interviews conducted with parents (72% mothers) at least 1 year following pABI. The study’s theory of “concurrent ropes and ladders” emerged from a process of initial in vivo coding followed by focused and thematic coding. Codes were consolidated into five thematic categories capturing parents’ emotional continuous loss experience: (a) comparing life before and after, (b) struggling to construct new realities, (c) recognizing instability and permanency, (d) adjusting and readjusting, and (e) grieving as an emotional shadow. These categories are at work simultaneously in parents’ accounts, thus supporting a model of dynamic concurrency within and across their lived experiences. Recommendations for practitioners were derived from the theory to support parents’ emotional coping with living loss throughout the chronic stage.
A division of labor between two biotin protein ligase homologs

Group I biotin protein ligases (BPLs) catalyze the covalent attachment of biotin to its cognate acceptor proteins. In contrast, Group II BPLs have an additional N‐terminal DNA‐binding domain and function not only in biotinylation but also in transcriptional regulation of genes of biotin biosynthesis and transport. Most bacteria contain only a single biotin protein ligase, whereas Clostridium acetobutylicum contains two biotin protein ligase homologs: BplA and BirA′. Sequence alignments showed that BplA is a typical group I BPL, whereas BirA′ lacked the C‐terminal domain conserved throughout extant BPL proteins. This raised the questions of why two BPL homologs are needed and why the apparently defective BirA′ has been retained. We have used in vivo and in vitro assays to show that BplA is a functional BPL whereas BirA′ acts as a biotin sensor involved in transcriptional regulation of biotin transport. We also successfully converted BirA′ into a functional biotin protein ligase with regulatory activity by fusing it to the C‐terminal domain from BplA. Finally, we provide evidence that BplA and BirA′ interact in vivo.