Miracle-dz/UniFAR-FTUs huggingface dataset:
A Pharmacist-Led, Patient-Centered Program Incorporating Motivational Interviewing for Behavior Change to Improve Adherence Rates and Star Ratings in a Medicare Plan

INTRODUCTION: The Medicare 5-star quality rating system was designed to drive improvements in Medicare quality and to increase accountability among Medicare plans. Medicare star ratings provide significant bonuses for plans that improve medication adherence. Envolve’s pharmacy division, Envolve Pharmacy Solutions, which provides services for Medicare Advantage Prescription Drug plans, developed an in-house medication therapy management (MTM) program to improve adherence rates and subsequent star ratings. As part of this program, Envolve invested in motivational interviewing (MI) as a means to improve adherence to antihypertensives, antihyperlipidemics, and antidiabetics but recognized the need for additional staff training to ensure pharmacist success with MI techniques. Thus, Envolve engaged a consultant to help train pharmacists and evaluate the program. This best practices article describes the implementation of an MI program and subsequent changes in patient adherence and star ratings. PROGRAM DESCRIPTION: A pharmacist-led, patient-centered adherence program incorporating MI for behavior change was developed and implemented at Envolve. The program used didactic learning, coaching and skills assessments, and a train-the-trainer (TtT) intervention. This approach resulted in improved adherence rates in all 3 therapeutic classes immediately. In addition, a quality improvement process was incorporated to evaluate the improvements in adherence with this new program over 24 months. OBSERVATIONS: Key findings of the program are as follows: (a) the program increased adherence rates 5-9 percentage points (chi-square tests for all plans and drug classes measured, P < 0.05) over 5 years and improved Medicare star ratings by 1-2 stars; (b) there is a need for support of pharmacy MTM managers to ensure continued success of the program; and (c) there is value in a TtT program for managers that allows them to provide continuous evaluation and feedback to staff for improvement. IMPLICATIONS: Each year, as the Medicare star ratings system matures and plans are held more accountable for improving adherence measures, high star ratings become more difficult to attain. This MI TtT program for pharmacists allows for rapid cycle change in response to these challenges.
The Role of Social Support in Adolescent/Young Adults Coping with Cancer Treatment

Adolescents/young-adult (AYA) cancer patients are a psychosocially at-risk group as they are often less well-studied than other age cancer cohorts. Therefore, they experience disparities in access to developmentally informed treatment. Social support has been determined as an important aspect of AYAs’ cancer experience, but additional research was needed to describe specific behaviors AYAs found helpful and to explore how AYAs seek opportunities for additional support. As part of a larger qualitative study, study aims were to determine how AYAs (ages 15–26) cope during cancer treatment and examine how social support interacts with individual AYA coping. Participants included 10 AYA cancer patients undergoing treatment (mean age = 18.9 years) and 10 parents (mean age = 45.6 years). Descriptively, participants scored within the normal to high range on measures of hope, depression/anxiety/stress, quality of life, and social support. Participants completed semi-structured, audio-recorded interviews that were transcribed and coded as generated. Qualitative analysis was guided by principles of grounded theory and utilized the constant comparative approach. Themes within social support groups included presence, distraction, positive attitude, and maintaining AYA autonomy, communication, and advocacy. Results suggest social supports provide additional coping resources for AYAs with cancer through supplementing individual coping strategies. Future directions/implications for intervention/treatment are discussed.
Generation of a Collision Cross Section Library for Multi-Dimensional Plant Metabolomics Using UHPLC-Trapped Ion Mobility-MS/MS

The utility of metabolomics is well documented; however, its full scientific promise has not yet been realized due to multiple technical challenges. These grand challenges include accurate chemical identification of all observable metabolites and the limiting depth-of-coverage of current metabolomics methods. Here, we report a combinatorial solution to aid in both grand challenges using UHPLC-trapped ion mobility spectrometry coupled to tandem mass spectrometry (UHPLC-TIMS-TOF-MS). TIMS offers additional depth-of-coverage through increased peak capacities realized with the multi-dimensional UHPLC-TIMS separations. Metabolite identification confidence is simultaneously enhanced by incorporating orthogonal collision cross section (CCS) data matching. To facilitate metabolite identifications, we created a CCS library of 146 plant natural products. This library was generated using TIMS with N2 drift gas to record the TIMSCCSN2 of plant natural products with a high degree of reproducibility; i.e., average RSD = 0.10%. The robustness of TIMSCCSN2 data matching was tested using authentic standards spiked into complex plant extracts, and the precision of CCS measurements were determined to be independent of matrix affects. The utility of the UHPLC-TIMS-TOF-MS/MS in metabolomics was then demonstrated using extracts from the model legume Medicago truncatula and metabolites were confidently identified based on retention time, accurate mass, molecular formula, and CCS.
GRADE-ADOLOPMENT Process to Develop 24-Hour Movement Behavior Recommendations and Physical Activity Guidelines for the Under 5s in the United Kingdom, 2019.

BACKGROUND This article summarizes the approach taken to develop UK Chief Medical Officers' physical activity guidelines for the Under 5s, 2019. METHODS The Grading of Recommendations Assessment, Development and Evaluation (GRADE)-Adaptation, Adoption, De Novo Development (ADOLOPMENT) approach was used, based on the guidelines from Canada and Australia, with evidence updated to February 2018. Recommendations were based on the associations between (1) time spent in sleep, sedentary time, physical activity, and 10 health outcomes and (2) time spent in physical activity and sedentary behavior on sleep outcomes (duration and latency). RESULTS For many outcomes, more time spent in physical activity and sleep (up to a point) was beneficial, as was less time spent in sedentary behavior. The authors present, for the first time, evidence in GRADE format on behavior type-outcome associations for infants, toddlers, and preschoolers. Stakeholders supported all recommendations, but recommendations on sleep and screen time were not accepted by the Chief Medical Officers; UK guidelines will refer only to physical activity. CONCLUSIONS This is the first European use of GRADE-ADOLOPMENT to develop physical activity guidelines. The process is robust, rapid, and inexpensive, but the UK experience illustrates a number of challenges that should help development of physical activity guidelines in future.
Assessing the Use of Wing Morphometrics to Identify Fall Armyworm (Lepidoptera: Noctuidae) Host Strains in Field Collections

Abstract The fall armyworm (Spodoptera frugiperda) (J. E. Smith) (Lepidoptera: Noctuidae), a major agricultural pest in the Western Hemisphere, has recently become established in Africa and Asia. This highly polyphagous species has potential to economically harm multiple crops. Contributing to this host range are two fall armyworm populations historically called ‘host strains’ that differ in host specificity. Understanding behaviors of the two strains is crucial to effective management of this pest. A major difficulty in such studies is that strains have long been considered morphologically indistinguishable, with molecular markers the only reliable means of identification. However, studies of fall armyworm in Colombia reported strain differences in wing morphology sufficiently large to potentially provide a more economical alternative method to determine strain. This study tested whether a similar phenotypic difference was present in Florida populations using geometric morphometric analysis of 15 anatomical landmarks on forewings of 182 specimens from three habitats associated with different host plants. Principle component and linear discriminant analyses identified significant differences in wing size and shape in comparison of strains from different habitats, but not between strains within the same habitat. Data indicate that apparent strain distinctions in wing phenotype are most likely a secondary consequence of differences in developmental growth patterns on different host plants combined with strain-biased host choice. Furthermore, Florida specimens showed much larger phenotypic overlap than observed for strains from Colombia. Together these findings suggest that wing morphology is probably not a reliable indicator of strain identity in field populations where different host plants are available.
A Path-Integral-Based Reinforcement Learning Algorithm for Path Following of an Autoassembly Mobile Robot

Reinforcement learning (RL) combined with deep neural networks has led to a number of great achievements for robot control in virtual computer environments, where sufficient data can be obtained without any difficulty to train various models. However, thus far, only few and relatively simple tasks have been accomplished for practical robots, which is mainly caused by the following two reasons. First, training with real robots, especially with dynamic systems, is too complicated to be fully and accurately represented in simulations. Second, it is very costly to obtain training data from real systems. To address these two problems effectively, in this article, a path-integral-based RL algorithm is proposed for the task of path following of an autoassembly mobile robot, wherein three kernel techniques are introduced. First, a generalized path-integral-control approach is proposed to obtain the numerical solution of a stochastic dynamical system, wherein the calculation of the gradient and kinematics inverse is avoided to ensure fast and reliable training convergence. Second, a novel parameterization method using Lyapunov techniques is introduced into the RL algorithm to ensure good performance of the system when directly transferring simulation results into practical systems. Third, the optimal parameters for all discrete initial states are first learned offline and then tuned online to improve the generalization and real-time performance. In addition to the optimization control for the mobile robot, the proposed method also possesses general applicability for a class of nonlinear systems such as crane systems. Simulation and experimental results are included and analyzed to illustrate the superior performance of the proposed algorithm.
Microphthalmia transcription factor expression contributes to bone marrow failure in Fanconi anemia.

Hematopoietic stem cell (HSC) attrition is considered the key event underlying progressive bone marrow failure (BMF) in Fanconi anemia (FA), the most frequent inherited BMF disorder in humans. However, despite major advances, how the cellular, biochemical and molecular alterations reported in FA lead to HSC exhaustion remains poorly understood. Here, we demonstrated in human and mouse cells that loss-of-function of FANCA or FANCC, products of two genes affecting more than 80% of FA patients worldwide, is associated with constitutive expression of the transcription factor Microphthalmia (MiTF) through the cooperative, unscheduled activation of several stress signaling pathways, including the SMAD2/3, p38MAPK, NF-kB and AKT cascades. We validated the unrestrained Mitf expression downstream of p38 in Fanca-/- mice, which display hallmarks of hematopoietic stress, including loss of HSC quiescence, DNA damage accumulation in HSCs and reduced HSC repopulation capacity. Importantly, we demonstrated that shRNA-mediated downregulation of Mitf expression or inhibition of p38 signaling rescued HSC quiescence and prevented DNA damage accumulation. Our data support the hypothesis that HSC attrition in FA is the consequence of defects in the DNA damage response combined with chronic activation of otherwise transiently activated signaling pathways, which jointly prevent the recovery of HSC quiescence.
The Human Isoform of RNA Polymerase II Subunit hRPB11bα Specifically Interacts with Transcription Factor ATF4

Rpb11 subunit of RNA polymerase II of Eukaryotes is related to N-terminal domain of eubacterial α subunit and forms a complex with Rpb3 subunit analogous to prokaryotic α2 homodimer, which is involved in RNA polymerase assembly and promoter recognition. In humans, a POLR2J gene family has been identified that potentially encodes several hRPB11 proteins differing mainly in their short C-terminal regions. The functions of the different human specific isoforms are still mainly unknown. To further characterize the minor human specific isoform of RNA polymerase II subunit hRPB11bα, the only one from hRPB11 (POLR2J) homologues that can replace its yeast counterpart in vivo, we used it as bait in a yeast two-hybrid screening of a human fetal brain cDNA library. By this analysis and subsequent co-purification assay in vitro, we identified transcription factor ATF4 as a prominent partner of the minor RNA polymerase II (RNAP II) subunit hRPB11bα. We demonstrated that the hRPB11bα interacts with leucine b-Zip domain located on the C-terminal part of ATF4. Overexpression of ATF4 activated the reporter more than 10-fold whereas co-transfection of hRPB11bα resulted in a 2.5-fold enhancement of ATF4 activation. Our data indicate that the mode of interaction of human RNAP II main (containing major for of hRPB11 subunit) and minor (containing hRPB11bα isoform of POLR2J subunit) transcription enzymes with ATF4 is certainly different in the two complexes involving hRPB3–ATF4 (not hRPB11a–ATF4) and hRpb11bα–ATF4 platforms in the first and the second case, respectively. The interaction of hRPB11bα and ATF4 appears to be necessary for the activation of RNA polymerase II containing the minor isoform of the hRPB11 subunit (POLR2J) on gene promoters regulated by this transcription factor. ATF4 activates transcription by directly contacting RNA polymerase II in the region of the heterodimer of α-like subunits (Rpb3–Rpb11) without involving a Mediator, which provides fast and highly effective activation of transcription of the desired genes. In RNA polymerase II of Homo sapiens that contains plural isoforms of the subunit hRPB11 (POLR2J), the strength of the hRPB11–ATF4 interaction appeared to be isoform-specific, providing the first functional distinction between the previously discovered human forms of the Rpb11 subunit.
Weekly Chemotherapy of 5-Fluorouracil plus Cisplatin Concurrent with Radiotherapy for Esophageal Squamous Cell Carcinoma Patients with Postoperative Locoregional Recurrence: Results from a Phase II Study.

LESSONS LEARNED Weekly treatment with 5-fluorouracil and cisplatin, concurrent with radiotherapy, achieved promising response rates in patients with postoperative recurrent esophageal squamous cell carcinoma. Superior toxicity results were also found. BACKGROUND Concurrent chemoradiotherapy (CCRT) is one of the treatment strategies for patients with esophageal squamous cell carcinoma (ESCC) with postoperative locoregional recurrence. However, the once every 3 weeks chemotherapy regimen causes a high incidence of toxicity. The aim of this study was to evaluate the efficacy and toxicity of weekly 5-fluorouracil (5-FU) and cisplatin concurrent with radiotherapy in postoperative locoregional recurrent ESCC. MATERIALS AND METHODS Patients received four weekly chemotherapy cycles of cisplatin (25 mg/m2 , day 1) plus 5-FU (1,176 mg/m2 , day 1-3), and concurrent with radiotherapy (50.4-60 Gy). The primary endpoint was objective response rate (ORR). Secondary objectives were toxicity, disease control rate (DCR), progression-free survival (PFS), and overall survival (OS). RESULTS Between January 2013 and December 2015, 48 patients were enrolled. The ORR was 68.8% (12 patients with complete response, 21 patients with partial response), with DCR 68.8%. No treatment-related grade 4 adverse events occurred. Grade 3 hematologic toxicities were observed in eight (17%) patients. Grade 3 vomiting or esophagitis occurred in four (8%) patients each. The median PFS and OS were 13.94 months (95% confidence interval [CI], 0.75-51.05) and 27.43 months (95% CI, 5.278-49.58; Fig. 1). CONCLUSION Weekly 5-FU and cisplatin concurrent with radiotherapy achieved a promising response rate and improved toxicity in patients with postoperative locoregional recurrent ESCC.
Impact of Nanocapsules on Red Blood Cells Interplay Jointly Assessed by Optical Tweezers and Microscopy

In the framework of novel medical paradigm the red blood cells (RBCs) have a great potential to be used as drug delivery carriers. This approach requires an ultimate understanding of the peculiarities of mutual interaction of RBC influenced by nano-materials composed the drugs. Optical tweezers (OT) is widely used to explore mechanisms of cells’ interaction with the ability to trap non-invasively, manipulate and displace living cells with a notably high accuracy. In the current study, the mutual interaction of RBC with polymeric nano-capsules (NCs) is investigated utilizing a two-channel OT system. The obtained results suggest that, in the presence of NCs, the RBC aggregation in plasma satisfies the ‘cross-bridges’ model. Complementarily, the allocation of NCs on the RBC membrane was observed by scanning electron microscopy (SEM), while for assessment of NCs-induced morphological changes the tests with the human mesenchymal stem cells (hMSC) was performed. The combined application of OT and advanced microscopy approaches brings new insights into the conception of direct observation of cells interaction influenced by NCs for the estimation of possible cytotoxic effects.
Simultaneous energy transfer from molecular-like silver nanoclusters to Sm3+/Ln3+ (Ln = Eu or Tb) in glass under UV excitation.

Molecular-like silver nanoclusters (ML-Ag NCs) with size dependent tunable luminescence properties and high-quantum yield has been explored as a new type of sensitizer for rare earth (RE) ions in glasses recently. In this research, the borosilicate glasses containing ML-Ag NCs and RE3+ (RE = Sm, Eu, Tb) ions were prepared with melt-quenching method. The absorption, TEM and steady spectra measurements indicated that compare with Sm3+ and Tb3+, the introduction of Eu3+ can more effectively promote the formation of luminescent ML-Ag NCs and their further aggregation. Besides the predictable efficient energy transfer from ML-Ag NCs to a single type of RE3+ ion in the codoped glasses, the simultaneously sensitization of Sm3+/Eu3+ and Sm3+/Tb3+ couples by ML-Ag NCs were further realized in the tri-doped glasses. Benefited from the excitation wavelength dependence of energy transfer from ML-Ag NCs to Sm3+/Eu3+ and Sm3+/Tb3+ couples and excitation efficiency on ML-Ag NCs and RE3+ ions, the tri-doped glasses exhibit broad tunable emission simply by changing the excitation wavelength, and the white light emission was achieved in GAgSmEu under UV excitation.
Advances in Structure Modeling Methods for Cryo-Electron Microscopy Maps

Cryo-electron microscopy (cryo-EM) has now become a widely used technique for structure determination of macromolecular complexes. For modeling molecular structures from density maps of different resolutions, many algorithms have been developed. These algorithms can be categorized into rigid fitting, flexible fitting, and de novo modeling methods. It is also observed that machine learning (ML) techniques have been increasingly applied following the rapid progress of the ML field. Here, we review these different categories of macromolecule structure modeling methods and discuss their advances over time.
Development and In Situ Application of Deformation Monitoring System for Concrete-Face Rockfill Dam Using Fiber Optic Gyroscope

Deformation monitoring is of importance to ensure the operation status of concrete-face rockfill dams (CFRD). This paper reported a novel fiber optic gyroscope (FOG) monitoring system for continuously monitoring face slab deformation of CFRD, which consisted of a permanent monitoring pipeline and a sensing vehicle. The monitoring pipeline was made of steel pipes and polyvinyl chloride polymer connectors, which was embedded in a slot of the crushing-type sidewall beneath the concrete face slab of CFRD, forming a permanent monitoring channel. The sensing vehicle was equipped with a high-precision FOG sensor. A low-pass filter was designed to eliminate the vibration noise of the angular velocities of the sensing vehicle during the monitoring process. An in situ test was carried out on the Shuibuya dam, the highest CFRD in the world. The measurements of the FOG monitoring system agreed well with traditional instrument measurements, serving as validation of the system. The FOG monitoring system has the advantages of excellent repeatability, long service life, distributed monitoring, and automatic measurement.
Efficient total nitrogen removal from wastewater by Paracoccus denitrificans DYTN‐1

Bioaugmentation is an effective treatment method to reduce nitrogenous pollutants from wastewater. A strain of DYTN‐1, which could effectively remove TN from sewage, was isolated from the sludge of a wastewater treatment plant and was identified as Paracoccus denitrificans. The TN in wastewater reduced to <20 mg l−1 within 12 h under optimal conditions by free cells of P. denitrificans DYTN‐1. To enhance the removal of TN, P. denitrificans DYTN‐1 cells were immobilized in sodium alginate (SA) using different divalent metal ions as cross‐linking agents. It was found that the immobilized P. denitrificans DYTN‐1 cells could reduce the TN concentration from 100 to below 20 mg l−1 within 8 h. After the optimization of an orthogonal experiment, the immobilized P. denitrificans DYTN‐1 cells could reduce the TN concentration from 100 mg l−1 to below 20 mg l−1 within 1 h and significantly reduce the fermentation cycle. These findings would provide an economical and effective method for the removal of total nitrogen in wastewater by immobilized cells of P. denitrificans DYTN‐1.
A Deep Transfer Learning Approach to Reducing the Effect of Electrode Shift in EMG Pattern Recognition-Based Control

An important barrier to commercialization of pattern recognition myoelectric control of prostheses is the lack of robustness to confounding factors such as electrode shift, skin impedance variations, and learning effects. To overcome this challenge, a novel supervised adaptation approach based on transfer learning (TL) with convolutional neural networks (CNNs) is proposed which requires only a short training session (a few seconds for each class) to recalibrate the system. TL is proposed as a solution to the problem of insufficient calibration data due to short training times for both classification and regression-based control schemes. This approach was validated for electrode shift of roughly 2.5cm with 13 able-bodied subjects to estimate individual and combined wrist motions. With this method, the original CNN (trained before the shift) was fine-tuned with the calibration data from after shifting. The results show that the proposed technique outperforms training a CNN from scratch (random initialization of weights) or a support vector machine (SVM) using the minimal calibration data. Moreover, it demonstrates superior performance than previous LDA and QDA-based adaptation approaches. As the outcomes confirm, the proposed CNN TL method provides a practical solution for adaptation to external factors, improving the robustness of electromyogram (EMG) pattern recognition systems.