Miracle-dz/UniFAR-FTUs huggingface dataset:
Development and validation of antibiotic stewardship metrics for outpatient respiratory tract diagnoses and association of provider characteristics with inappropriate prescribing

Abstract Objective: To determine metrics and provider characteristics associated with inappropriate antibiotic prescribing for respiratory tract diagnoses (RTDs). Design: Retrospective cohort study. Setting: Primary care practices in a university health system. Participants: Patients seen by an attending physician or advanced practice provider (APP) at their primary care office visit with International Classification of Disease, Tenth Revision, Clinical Modification (ICD-10-CM)–coded RTDs. Methods: Medical records were reviewed for 1,200 randomly selected office visits in which an antibiotic was prescribed to determine appropriateness. Based on this gold standard, metrics and provider characteristics associated with inappropriate antibiotic prescribing were determined. Results: Overall, 69% of antibiotics were inappropriate. Metrics utilizing prespecified RTDs most strongly associated with inappropriate prescribing were (1) proportion prescribing for RTDs for which antibiotics are almost never required (eg, bronchitis) and (2) proportion prescribing for any RTD. Provider characteristics associated with inappropriate antibiotic prescribing were APP versus physician (72% vs 58%; P = .02), family medicine versus internal medicine (76% vs 63%; P = .01), board certification 1997 or later versus board certification before 1997 (75% vs 63%; P = .02), nonteaching versus teaching practice (73% vs 51%; P < .01), and nonurban vs urban practice (77% vs 57%; P < .01). Conclusions: Metrics utilizing proportion prescribing for RTDs for which antibiotics are almost never required and proportion prescribing for any RTD were most strongly associated with inappropriate prescribing. APPs and clinicians with family medicine training, with board certification 1997 or later, and who worked in nonteaching or nonurban practices had higher proportions of inappropriate prescribing. These findings could inform design of interventions to improve prescribing and could represent an efficient way to track inappropriate prescribing.
White Matter Integrity of the Corpus Callosum and Psychopathological Dimensions in Deficit and Non-Deficit Schizophrenia Patients

Deficit syndrome (DS) is a subtype of schizophrenia characterized by primary persistent negative symptoms. The corpus callosum (CC) appears to be related to psychopathology in schizophrenia. This study assessed white matter integrity in the CC using diffusion tensor imaging (DTI) in deficit and non-deficit schizophrenia (NDS) patients. We also investigated the psychopathological dimensions of schizophrenia and their relationship to CC integrity. Fifteen DS patients, 40 NDS patients, and 30 healthy controls (HC) underwent psychiatric evaluation and neuroimaging. We divided the CC into five regions and assessed their fractional anisotropy (FA) and mean diffusivity (MD). Psychopathology was assessed with the Positive and Negative Syndrome Scale. DS patients had lower FA than NDS patients and HC, and higher MD in Region 5 of the CC than did HC. NDS patients had higher MD in Region 4 of the CC. The patient groups differed in terms of negative symptoms. After differentiating clinical groups and HC, no significant correlations were observed between DTI measures and psychopathological symptoms. Our results suggest that DS and NDS are characterized by minor impairments of the posterior CC. We confirmed that DS patients have greater negative psychopathology than NDS patients. Our results are preliminary, and further studies are needed.
Transferring Plasmon Effect on a Biological System: Expression of Biological Polymers in Chronic Rejection and Inflammatory Rat Model

The plasmon-activated water (PAW) that reduces hydrogen bonds is made of deionized reverse osmosis water (ROW). However, compared with ROW, PAW has a significantly higher diffusion coefficient and electron transfer rate constant in electrochemical reactions. PAW has a boiling point of 97 °C and specific heat of0.94; the energy of PAW is also 1121 J/mol higher than ordinary water. The greater the force of hydrogen bonds between H2O, the larger the volume of the H2O cluster, and the easier it is to lose the original characteristics. The hydrogen bonding force of PAW is weak, so the volume of its cluster is small, and it exists in a state very close to a single H2O. PAW has a high permeability and diffusion rate, which can improve the needs of biological applications and meet the dependence of biological organisms on H2O when performing physiological functions. PAW can successfully remove free radicals, and efficiently reduce lipopolysaccharide (LPS)-induced monocytes to release nitric oxide. PAW can induce expression of the antioxidant gene Nrf2 in human gingival fibroblasts, lower amyloid burden in mice with Alzheimer’s disease, and decrease metastasis in mice grafted with Lewis lung carcinoma cells. Because the transferring plasmon effect may improve the abnormality of physiological activity in a biological system, we aimed to evaluate the influence of PAW on orthotopic allograft transplantation (OAT)-induced vasculopathy in this study. Here, we demonstrated that daily intake of PAW lowered the progression of vasculopathy in OAT-recipient ACI/NKyo rats by inhibiting collagen accumulation, proliferation of smooth muscle cells and fibroblasts, and T lymphocyte infiltration in the vessel wall. The results showed reduced T and B lymphocytes, plasma cells, and macrophage activation in the spleen of the OAT-recipient ACI/NKyo rats that were administered PAW. In contrast to the control group, the OAT-recipient ACI/NKyo rats that were administered PAW exhibited higher mobilization and levels of circulating endothelial progenitor cells associated with vessel repair. We use the transferring plasmon effect to adjust and maintain the biochemical properties of water, and to meet the biochemical demand of organisms. Therefore, this study highlights the therapeutic roles of PAW and provides more biomedical applicability for the transferring plasmon effect.
On and off controls within dynein–dynactin on native cargoes

Significance The dynein–dynactin nanomotor is required for vastly diverse cellular functions, including cell division and cargo transport. Why dynactin interacts separately with the dynein motor and with microtubules is poorly understood and controversial. Here we directly interrogate the function of native dynein–dynactin teams on single phagosomes extracted from cells after disrupting the above interactions in a targeted manner ex vivo. Perturbing the dynactin–dynein interaction reduces dynein’s on rate to microtubules. However, perturbing the dynactin–microtubule interaction increases dynein’s off rate markedly when dynein generates force against an optical trap. Our results therefore ascribe separable functions to different components within the dynein–dynactin machine and provide mechanistic insight into dynein–dynactin dysfunction. The dynein–dynactin nanomachine transports cargoes along microtubules in cells. Why dynactin interacts separately with the dynein motor and also with microtubules is hotly debated. Here we disrupted these interactions in a targeted manner on phagosomes extracted from cells, followed by optical trapping to interrogate native dynein–dynactin teams on single phagosomes. Perturbing the dynactin–dynein interaction reduced dynein’s on rate to microtubules. In contrast, perturbing the dynactin–microtubule interaction increased dynein’s off rate markedly when dynein was generating force against the optical trap. The dynactin–microtubule link is therefore required for persistence against load, a finding of importance because disease-relevant mutations in dynein–dynactin are known to interfere with “high-load” functions of dynein in cells. Our findings call attention to a less studied property of dynein–dynactin, namely, its detachment against load, in understanding dynein dysfunction.
Serum Amyloid A1/Toll-Like Receptor-4 Axis, an Important Link between Inflammation and Outcome of TBI Patients

Traumatic brain injury (TBI) is one of the leading causes of mortality and disability worldwide without any validated biomarker or set of biomarkers to help the diagnosis and evaluation of the evolution/prognosis of TBI patients. To achieve this aim, a deeper knowledge of the biochemical and pathophysiological processes triggered after the trauma is essential. Here, we identified the serum amyloid A1 protein-Toll-like receptor 4 (SAA1-TLR4) axis as an important link between inflammation and the outcome of TBI patients. Using serum and mRNA from white blood cells (WBC) of TBI patients, we found a positive correlation between serum SAA1 levels and injury severity, as well as with the 6-month outcome of TBI patients. SAA1 levels also correlate with the presence of TLR4 mRNA in WBC. In vitro, we found that SAA1 contributes to inflammation via TLR4 activation that releases inflammatory cytokines, which in turn increases SAA1 levels, establishing a positive proinflammatory loop. In vivo, post-TBI treatment with the TLR4-antagonist TAK242 reduces SAA1 levels, improves neurobehavioral outcome, and prevents blood–brain barrier disruption. Our data support further evaluation of (i) post-TBI treatment in the presence of TLR4 inhibition for limiting TBI-induced damage and (ii) SAA1-TLR4 as a biomarker of injury progression in TBI patients.
Objective Scoring of Information Websites for Vascular Anomalies

Supplemental Digital Content is available in the text Abstract One of the challenging aspects of caring for patients with vascular anomalies has been the use of inconsistent terminologies which has resulted in inconsistencies with treatment, miscommunication between clinicians, and subsequently patient misinformation and confusion. In this study, we objectively assessed the quality of online information on vascular anomalies. Our results emphasize the crucial role of vascular anomaly services in the communication and provision of patient information.
Quantitative Investigation of Irinotecan Metabolism, Transport, and Gut Microbiome Activation

The anticancer drug irinotecan shows serious dose-limiting gastrointestinal toxicity regardless of intravenous dosing. Although enzymes and transporters involved in irinotecan disposition are known, quantitative contributions of these mechanisms in complex in vivo disposition of irinotecan are poorly understood. We explained intestinal disposition and toxicity of irinotecan by integrating 1) in vitro metabolism and transport data of irinotecan and its metabolites, 2) ex vivo gut microbial activation of the toxic metabolite SN-38, and 3) the tissue protein abundance data of enzymes and transporters relevant to irinotecan and its metabolites. Integration of in vitro kinetics data with the tissue enzyme and transporter abundance predicted that carboxylesterase (CES)-mediated hydrolysis of irinotecan is the rate-limiting process in the liver, where the toxic metabolite formed is rapidly deactivated by glucuronidation. In contrast, the poor SN-38 glucuronidation rate as compared with its efficient formation by CES2 in the enterocytes is the key mechanism of the intestinal accumulation of the toxic metabolite. The biliary efflux and organic anion transporting polypeptide-2B1–mediated enterocyte uptake can also synergize buildup of SN-38 in the enterocytes, whereas intestinal P-glycoprotein likely facilitates SN-38 detoxification in the enterocytes. The higher SN-38 concentration in the intestine can be further nourished by β-d-glucuronidases. Understanding the quantitative significance of the key metabolism and transport processes of irinotecan and its metabolites can be leveraged to alleviate its intestinal side effects. Further, the proteomics-informed quantitative approach to determine intracellular disposition can be extended to determine susceptibility of cancer cells over normal cells for precision irinotecan therapy. SIGNIFICANCE STATEMENT This work provides a deeper insight into the quantitative relevance of irinotecan hydrolysis (activation), conjugation (deactivation), and deconjugation (reactivation) by human or gut microbial enzymes or transporters. The results of this study explain the characteristic intestinal exposure and toxicity of irinotecan. The quantitative tissue-specific in vitro to in vivo extrapolation approach presented in this study can be extended to cancer cells.
The Impact of High Glucose or Insulin Exposure on S100B Protein Levels, Oxidative and Nitrosative Stress and DNA Damage in Neuron-Like Cells

Alzheimer’s disease (AD) is attracting considerable interest due to its increasing number of cases as a consequence of the aging of the global population. The mainstream concept of AD neuropathology based on pathological changes of amyloid β metabolism and the formation of neurofibrillary tangles is under criticism due to the failure of Aβ-targeting drug trials. Recent findings have shown that AD is a highly complex disease involving a broad range of clinical manifestations as well as cellular and biochemical disturbances. The past decade has seen a renewed importance of metabolic disturbances in disease-relevant early pathology with challenging areas in establishing the role of local micro-fluctuations in glucose concentrations and the impact of insulin on neuronal function. The role of the S100 protein family in this interplay remains unclear and is the aim of this research. Intracellularly the S100B protein has a protective effect on neurons against the toxic effects of glutamate and stimulates neurites outgrowth and neuronal survival. At high concentrations, it can induce apoptosis. The aim of our study was to extend current knowledge of the possible impact of hyper-glycemia and -insulinemia directly on neuronal S100B secretion and comparison to oxidative stress markers such as ROS, NO and DBSs levels. In this paper, we have shown that S100B secretion decreases in neurons cultured in a high-glucose or high-insulin medium, while levels in cell lysates are increased with statistical significance. Our findings demonstrate the strong toxic impact of energetic disturbances on neuronal metabolism and the potential neuroprotective role of S100B protein.
Compact Bandwidth Enhanced Cavity-Backed Magneto-Electric Dipole Antenna with Outer Γ-Shaped Probe for GNSS Bands

In this paper, a wideband small cavity-backed magneto-electric (ME) antenna is proposed. This antenna is linearly polarized and designed to cover all the Global Navigation Satellite System (GNSS) bands. It exhibits small external dimensions of 90 × 90 × 40 mm3 (0.34 × 0.34 × 0.15 λ3 at lowest frequency) and achieves a wide impedance bandwidth of 40.5% (from 1.14 to 1.72 GHz) due to the excitation of a third resonance of the ME structure. It also provides a regular broadside gain of 5.2 dBi and stable radiation pattern in both E and H planes of the antenna.
Investigating Sex Differences in Rates and Correlates of Food Addiction Status in Women and Men with PTSD

Background: Food addiction (FA) is a dysregulated eating pattern characterized by difficulties in controlling the intake of certain foods. There is an overlap in physical and mental health correlates of FA and post-traumatic stress disorder (PTSD). The purpose of this study was to examine sex differences in the rates of positive FA status in individuals with threshold/subthreshold PTSD, and to examine sex differences in the physical and mental health correlates of FA. Methods: Post-9/11 veterans/service members seeking PTSD treatment were recruited. Participants were diagnosed with PTSD via the administration of a clinical interview. FA status was determined using Modified Yale Food Addiction Scale-2, binary sex and body mass index were assessed with demographics questions. Results: Nearly half (43%) of the sample were women. There were no sex differences in the rates of FA, with an overall FA prevalence of 18%. There were no sex differences in FA symptom count in the whole sample (M = 1.63) or those with FA status (M = 6.21). Individuals with FA reported higher frequency of disordered eating, higher severity of PTSD, and depression symptoms. Conclusions: FA should be assessed in tandem with PTSD symptoms, as its prevalence in that sample is higher than in the general population, and it appears to affect both sexes at similar rates.
Unified theory of silicon carbide oxidation based on the Si and C emission model

We have attempted to establish a unified theory of SiC oxidation by reproducing all the SiC oxide growth rates on the (0 0 0 1) Si-face, (1 1 2¯ 0) a-face and (0 0 0 1¯) C-face at various oxidation temperatures and oxide partial pressures. Growth rates were calculated using the Si and C emission model and were confirmed to fully reproduce the observed data when an enhanced surface oxide growth rate was added to the previously defined growth rate. The parameters deduced from the calculations indicated that the activation energy for the initial interfacial reaction rate corresponds to the number of Si back-bond(s) on the crystalline surface. Although the C emission ratio was found to have no significant dependence on the surface orientation, the Si emission ratio varied significantly and so likely determines the oxide growth rate. The densities of Si and C interstitials at the SiC-oxide interface were simulated both on the oxide and SiC substrate sides, and the optimal oxidation sequence is discussed in terms of the formation of the interface state.
Determinants of Physical Activity in Older Adults: Integrating Self-Concordance into the Theory of Planned Behavior

Based on the theory of planned behavior (TPB), augmented by the concept of self-concordance (derived from self-determination theory, SDT), we conducted a study to identify the key determinants of physical activity in older adults. We applied structural equation modeling of telephone survey data from a random sample of adults aged 65 years and older living in Germany (N = 865). Relations of attitude, subjective norms, and perceived behavioral control (PBC) with intention strength and self-concordance of intention to be physically active were tested. Habit strength was analyzed as a moderator. Data analysis showed this model to be well-suited for explaining the intention to be physically active—especially for people with a weak habit. The influence of TPB components on intention would have been underestimated if we had investigated intention strength only, without considering the self-concordance of intention. While attitude and PBC had positive relations with a strong and self-determined intention, the subjective norm showed no relation with intention strength but, rather, with non-self-determined regulation forms. We conclude that the combined model provides a better theoretical foundation from which to explain physical activity intentions than does just one of the theories.
Selection favors adaptive plasticity in a long-term reciprocal transplant experiment

Spatial and temporal environmental variation can favor the evolution of adaptive phenotypic plasticity, such that genotypes alter their phenotypes in response to local conditions to maintain fitness across heterogeneous landscapes. When individuals show greater fitness in one habitat than another, asymmetric migration can restrict adaptive responses to selection in the lower quality environment. In these cases, selection is predicted to favor traits that enhance fitness in the higher-quality source habitat at the expense of fitness in the marginal habitat, resulting in specialization to the high-quality environment. Here, we test whether plasticity is adaptive in a system regulated by demographic source-sink dynamics. Vaccinium elliottii (Ericaceae) occurs in dry upland and flood-prone bottomland forests throughout the southeastern United States, and shows patterns consistent with source-sink dynamics. We conducted a multi-year field experiment to evaluate whether plasticity in foliar morphology is advantageous. Both across habitats and within the high-quality upland environment, selection favored plasticity in specific leaf area and stomatal density. Stabilizing selection acted on plasticity in these traits, suggesting that extreme levels of plasticity are disadvantageous. We conclude that even in systems driven by source-sink dynamics, temporal and spatial variation in conditions can favor the evolution of plasticity.
The causal-effect of bed rest and post-dural puncture headache in patients receiving diagnostic lumbar puncture: A prospective cohort study

Background: Post-dural puncture headache (PDPH) is the most common complication of lumbar puncture. Patients who received lumbar puncture were previously suggested to remain in bed for a certain time to prevent PDPH; however, this concept was challenged by recent studies. We aimed to investigate whether ambulation instead of resting supine following lumbar puncture could increase the risk of PDPH. Methods: The study used a prospective cohort design, applying convenience sampling among patients who received diagnostic lumbar puncture between January and September 2018 in the neurology ward of a tertiary medical center. The patients who fulfilled the inclusion criteria were informed that the current practice suggests lying supine for 6 to 8 hours after lumbar puncture, but they were allowed to either follow the suggestion or ambulate by their wills. The timing of bed rest was recorded, in addition to other possible risk factors of PDPH. The study endpoint is the presence or absence of PDPH within 48 hours of lumbar puncture. Results: A total of 137 patients who received lumbar puncture were enrolled, including 103 with bed rest following lumbar puncture and 34 without. There was no difference in demographics between the two groups. PDPH was found in 21 patients, with a total follow-up period of 5959 person-hours and an incidence density of 0.35%. There was no significant difference between the incidence of PDPH between the two groups (non-bed rest group 5.9% vs bed rest group 18.4%; p = 0.078), nor was incidence density (non-bed rest group 0.13% vs bed rest group 0.43%, p = 0.113). The results remained the same after adjusting for age. Conclusion: Bed rest following lumbar puncture does not prevent PDPH, and even leads to a marginally increased risk of PDPH. Amendment to the current practice guideline post-lumbar puncture care might be needed to improve patient care.
Fabrication of Graphene Nanomesh FET Terahertz Detector

High sensitivity detection of terahertz waves can be achieved with a graphene nanomesh as grating to improve the coupling efficiency of the incident terahertz waves and using a graphene nanostructure energy gap to enhance the excitation of plasmon. Herein, the fabrication process of the FET THz detector based on the rectangular GNM (r-GNM) is designed, and the THz detector is developed, including the CVD growth and the wet-process transfer of high quality monolayer graphene films, preparation of r-GNM by electron-beam lithography and oxygen plasma etching, and the fabrication of the gate electrodes on the Si3N4 dielectric layer. The problem that the conductive metal is easy to peel off during the fabrication process of the GNM THz device is mainly discussed. The photoelectric performance of the detector was tested at room temperature. The experimental results show that the sensitivity of the detector is 2.5 A/W (@ 3 THz) at room temperature.
Health Benefits Related to Tree Nut Consumption and Their Bioactive Compounds

Long-term studies with regular tree nut consumption have indicated positive outcomes for multiple health benefits. Here, we review the beneficial effects of tree nuts, highlighting the impact on glucose modulation, body weight management, cardiovascular risk, inflammation, oxidative stress, cognitive performance, and gut microbiota. Nuts are important sources of nutrients and phytochemicals, which, together with a healthy lipid profile, could help prevent certain chronic diseases, protect against oxidative stress and inflammation, and improve cognitive performance, thus reducing the impact of aging and neurodegeneration.