Miracle-dz/UniFAR-FTUs huggingface dataset:
Michigan Pharmacists Transforming Care and Quality: Developing a Statewide Collaborative of Physician Organizations and Pharmacists to Improve Quality of Care and Reduce Costs

BACKGROUND: Inappropriate drug use, increasing complexity of drug regimens, continued pressure to control costs, and focus on shared accountability for clinical measures drive the need to leverage the medication expertise of pharmacists in direct patient care. A statewide strategy based on the collaboration of pharmacists and physicians regarding patient care was developed to improve disease state management and medication-related outcomes. PROGRAM DESCRIPTION: Blue Cross Blue Shield of Michigan (BCBSM) partnered with Michigan Medicine to develop and implement a statewide provider-payer program called Michigan Pharmacists Transforming Care and Quality (MPTCQ), which integrates pharmacists within physician practices throughout the state of Michigan. As the MPTCQ Coordinating Center, Michigan Medicine established an infrastructure integrating clinical pharmacists into direct patient care within patient-centered medical home (PCMH) practices and provides direction and guidance for quality and process improvement across physician organizations (POs) and their affiliated physician practices. The primary goal of MPTCQ is to improve patient care and outcomes related to Medicare star ratings and HEDIS measures through integration of clinical pharmacists into direct patient care. The short-term goal is to adopt and modify Michigan Medicine’s integrated pharmacist practice model at participating POs, with the long-term goal of developing a sustainable model of pharmacist integration at each PO to improve patient care and outcomes. Initially, pharmacists are delivering disease management (diabetes, hypertension, and hyperlipidemia) and comprehensive medication review services with future plans to expand clinical services. OBSERVATIONS: In 2015, 10 POs participated in year 1 of the program. In collaboration with the MPTCQ Coordinating Center, each PO identified 1 “pharmacist transformation champion” (PTC). The PTC implemented the integrated pharmacist model at 2 or 3 practice sites with at least 2 practicing physicians per site. IMPLICATIONS: MPTCQ is a unique collaboration between a large academic institution, physician organizations, a payer, and a statewide coordinating center to improve patient care and address medication-related challenges by integrating pharmacists into a PCMH network. Pharmacists can actively provide their medication expertise to physicians and patients and optimize quality measure performance.
Melanoma in congenital melanocytic naevi

Congenital melanocytic naevi (CMN) are a known risk factor for melanoma, with the greatest risk currently thought to be in childhood. There has been controversy over the years about the incidence of melanoma, and therefore over the clinical management of CMN, due partly to the difficulties of histological diagnosis and partly to publishing bias towards cases of malignancy. Large cohort studies have demonstrated that melanoma risk in childhood is related to the severity of the congenital phenotype. New understanding of the genetics of CMN offers the possibility of improvement in diagnosis of melanoma, identification of those at highest risk, and new treatment options. We review the world literature and our centre's experience over the last 25 years, including the molecular characteristics of melanoma in these patients and new melanoma incidence and outcome data from our prospective cohort. Management strategies are proposed for presentation of suspected melanoma of the skin and the central nervous system in patients with CMN, including use of oral mitogen‐activated protein kinase kinase inhibitors in NRAS‐mutated tumours.
Not all performance validity tests are created equal: The role of recollection and familiarity in the Test of Memory Malingering and Word Memory Test

ABSTRACT Introduction: The Test of Memory Malingering (TOMM) and the Word Memory Test (WMT) are both performance validity tests (PVTs) that use a two-alternative forced-choice (2AFC) recognition memory format. Several studies have reported that these tests are susceptible to cognitive impairment and that the WMT is more susceptible than the TOMM. The current study explored components of recognition memory (i.e., conscious recollection and familiarity) underlying the TOMM and WMT to identify factors that make them susceptible and resilient to cognitive impairment. Method: Fifty-four nonclinical undergraduate research participants were administered the TOMM and WMT while providing introspective judgments about their recognition memory using the remember/know/guess procedure. In addition, half of participants were administered dual-task interference, a manipulation intended to reduce recollection, during these tests, while the other half completed these tests without interference. Standard cutoffs on the TOMM and WMT were explored, as well as alternative cutoffs based on TOMM Trial 1 scores. Results: The WMT was more impacted by dual-task interference than standard TOMM cutoff trials, while alternative TOMM cutoff trials were equally impacted by dual-task interference relative to the WMT. Dual-task interference reduced recollection on these tests, but spared familiarity. Standard TOMM trials and the WMT were relatively comparable on levels of recollection, but familiarity contributed more to the TOMM than to the WMT. Alternative TOMM trials possessed lower familiarity and recollection than standard TOMM trials and lower recollection than the WMT. Conclusions: Reduced recollection places examinees at risk of failing the TOMM and WMT, while familiarity contributes to the relative resilience of the standard TOMM. Future development of 2AFC recognition memory PVTs should attempt to maximize the contribution of familiarity to their completion.
Randomized, Double‐Blind, Crossover, Clinical‐End‐Point Pilot Study to Examine the Use of Exhaled Nitric Oxide as a Bioassay for Dose Separation of Inhaled Fluticasone Propionate

This was a randomized, double‐blind, crossover, clinical‐end‐point pilot study examining the hypothesis that inhaled fluticasone propionate decreases exhaled nitric oxide (eNO) concentrations within a week of beginning treatment and shows evidence of dose separation across the marketed dose range. Subjects had a ≥6‐month history of asthma and screening eNO ≥60 parts per billion. At the start of each treatment period, eNO was ≥55 parts per billion, and forced expiratory volume in 1 second was ≥50% predicted. Subjects attended a clinic visit daily on consecutive mornings during each of 3 1‐week treatment periods to measure eNO and receive once‐daily doses of 100/50, 250/50, or 500/50 fluticasone propionate/salmeterol combination product (Advair® Diskus). Daily eNO value recorded was the highest of 3 measurements; 1 inhalation of treatment was then administered. Procedures were repeated for 3 treatment cycles, separated by 14‐day minimum washouts. A total of 105 subjects were screened; 22 were randomized; and 17 completed all treatments. Mean percentage eNO decrease (standard deviation) from day 1 baseline for each treatment period was 36.6 (±18.7), 45.3 (±16.5), and 54.6 (±12.5) with Advair® 100/50, 250/50, and 500/50, respectively. Mean percentage decrease in eNO across each treatment (dose) was modeled using a mixed‐model ANOVA. Although the overall treatment was significant (P = .0015), because of the relatively small sample size and within‐subject variability, only the 100/50 vs 500/50 (P = .0003) and 250/50 vs 500/50 (P = .047) treatments were significantly different.
Glutamoptosis: A new cell death mechanism inhibited by autophagy during nutritional imbalance

ABSTRACT Glutaminolysis plays a critical role in nutrient sufficiency and cell signaling activation in mammalian cells. Unexpectedly, our recent investigations revealed that the unbalanced activation of glutaminolysis during nutritional restriction causes a particular form of apoptotic cell death, that we termed “glutamoptosis. “ We found that the inhibition of autophagy is a key step to allow glutamoptosis-mediated cell death. Thus, autophagy controls glutamoptosis during nutritional imbalance.
Mobile phone applications and self‐management of diabetes: A systematic review with meta‐analysis, meta‐regression of 21 randomized trials and GRADE

We conducted a systematic review with meta‐analysis of randomized controlled trials that evaluated the effect of diabetes mobile phone applications. A total of 1550 participants from 21 studies were included. For type 1 diabetes, a significant 0.49% reduction in HbA1c was seen (95% CI, 0.04‐0.94; I2 = 84%), with unexplained heterogeneity and a low GRADE of evidence. For type 2 diabetes, using diabetes apps was associated with a mean reduction of 0.57% (95% CI, 0.32‐0.82; I2 = 77%). The results had severe heterogeneity that was explained by the frequency of HCP feedback. In studies with no HCP feedback, low frequency and high frequency HCP feedback, the mean reduction is 0.24% (95% CI, 0.02‐0.49; I2 = 0%), 0.33% (95% CI, 0.07‐0.59; I2 = 47%) and 1.12% (95% CI, 0.91‐1.32; I2 = 0%), respectively, with a high GRADE of evidence. There is evidence that diabetes apps improve glycaemic control in type 1 diabetes patients. A reduction of 0.57% in HbA1c was found in type 2 diabetes patients. However, HCP functionality is important to achieve clinical effectiveness. Future studies are needed to explore the cost‐effectiveness of diabetes apps and the optimal intensity of HCP feedback.
Decentralized DC Microgrid Monitoring and Optimization via Primary Control Perturbations

We treat the emerging power systems with direct current (dc) microgrids, characterized with high penetration of power electronic converters. We rely on the power electronics to propose a decentralized solution for autonomous learning of and adaptation to the operating conditions of the dc mirogrids; the goal is to eliminate the need to rely on an external communication system for such a purpose. The solution works within the primary droop control loops and uses only local bus voltage measurements. Each controller is able to estimate the generation capacities of power sources, the load demands, and the conductances of the distribution lines. To define a well-conditioned estimation problem, we employ decentralized strategy where the primary droop controllers temporarily switch between operating points in a coordinated manner, following amplitude-modulated training sequences. We study the use of the estimator in a decentralized solution of the optimal economic dispatch problem. The evaluations confirm the usefulness of the proposed solution for autonomous microgrid operation.
Geometric Multiscale Community Detection: Markov Stability and Vector Partitioning

Multiscale community detection can be viewed from a dynamical perspective within the Markov Stability framework, which uses the diffusion of a Markov process on the graph to uncover intrinsic network substructures across all scales. Here we reformulate multiscale community detection as a max-sum length vector partitioning problem with respect to the set of time-dependent node vectors expressed in terms of eigenvectors of the transition matrix. This formulation provides a geometric interpretation of Markov Stability in terms of a time-dependent spectral embedding, where the Markov time acts as an inhomogeneous geometric resolution factor that zooms the components of the node vectors at different rates. Our geometric formulation encompasses both modularity and the multi-resolution Potts model, which are shown to correspond to vector partitioning in a pseudo-Euclidean space, and is also linked to spectral partitioning methods, where the number of eigenvectors used corresponds to the dimensionality of the underlying embedding vector space. Inspired by the Louvain optimisation for community detection, we then propose an algorithm based on a graph-theoretical heuristic for the vector partitioning problem. We apply the algorithm to the spectral optimisation of modularity and Markov Stability community detection. The spectral embedding based on the transition matrix eigenvectors leads to improved partitions with higher information content and higher modularity than the eigen-decomposition of the modularity matrix. We illustrate the results with random network benchmarks.
Comparative analysis between different approaches for electrical properties tomography

This paper presents a comparative analysis between three numerical methods used in the electrical properties tomography to reconstruct the conductivity and permittivity of biological tissues from the radiofrequency magnetic field map measurable in a magnetic resonance system. The analysis is performed on model problems, whose solution provides the magnetic field values to be used as virtual measurements. The effects on the result accuracy of very high and very low conductivity materials (mimicking the presence of medical implants) are finally evaluated
Highly elastic‐constant vicosity fluids

The rheological properties of three types of fluids that exhibit large normal stresses are examined and compared. These fluids have a constant or nearly constant viscosity and can be used as model viscoelastic fluids, covering a range of viscosity from 0.1 to 124 Pa.s. One lubricant, Emkarox FC 31-45000, is shown to have the characteristics of a second-order fluid. Series difficulties encountered in measuring the rheological properties of the Separan—corn syrup solutions (Boger fluids) are reported. The Emkarox and solutions of polyacrylamide (Pusher 700) in mixtures of glycerine and water are proposed as better model fluids.
Risk factors for, and prevention of, shoulder injuries in overhead sports: a systematic review with best-evidence synthesis

Objective To assess the evidence for risk factors and prevention measures for shoulder injuries in overhead sports. Design Systematic review with best-evidence synthesis. Data sources Medline (Ovid), PubMed (complementary search), Embase (Elsevier), Cochrane (Wiley), SPORTDiscus (Ebsco) and Web of Science Core Collection (Thomson Reuters), from 1 January 1990 to 15 May 2017. Eligibility criteria for selecting studies Randomised controlled trials, cohort studies and case-control studies on risk factors or prevention measures for shoulder injuries in overhead sports. The eligible studies were quality assessed using the Scottish Intercollegiate Guidelines Network criteria. Results Of 4778 studies identified, 38 were eligible for quality review and 17 met the quality criteria to be included in the evidence synthesis. One additional quality study presented a shoulder injury prevention programme. Most studies focused on baseball, lacrosse or volleyball (n=13). The risk factors examined included participation level (competition vs training) (n=10), sex (n=4), biomechanics (n=2) and external workload (n=2). The evidence for all risk factors was limited or conflicting. The effect of the prevention programme within the subgroup of uninjured players at baseline was modest and possibly lacked statistical power. Conclusions All investigated potential risk factors for shoulder injury in overhead sports had limited evidence, and most were non-modifiable (eg, sex). There is also limited evidence for the effect of shoulder injury prevention measures in overhead sports. PROSPERO trial registration number CRD42015026850.
Internal Friction of TiNi Shape Memory Alloy Wires/Epoxy Composites Measured by Dynamic Mechanical Analysis

Internal friction of TiNi wires/epoxy composites were investigated by dynamic mechanical analysis (DMA) in this study. TiNi wires/epoxy composite and neat epoxy both show significant Tg transition peaks with tan δ above 0.40 at around Tg temperature and lower internal friction peaks with tan δ below 0.06 at around -40 °C. The internal friction peaks at lower temperature is attributed to the crankshaft motion of the glyceryl-like groups in diglycidyl ether of bisphenol A. TiNi wires/epoxy composite also possesses two B19'→R and R→B2 martensitic transformation internal friction peaks at around room temperature with tan δ about 0.04 The peak temperatures of the Tg transition and the low temperature peaks of the TiNi wires/epoxy composites increases with the increase of applied frequency and their activation energies are calculated as 419.1 and 48.7 kJ/mole, respectively. Embedding TiNi wires into epoxy matrix can enhance the Young's modulus and ultimate strength of the composite.
Combined environmental risk assessment for the antiviral pharmaceuticals ganciclovir and valganciclovir in Europe

Potential environmental risks of the old antiviral pharmaceuticals ganciclovir (GCV) and valganciclovir (VGCV) were reassessed based on new environmental fate and chronic ecotoxicity tests and on actual use data for Europe. Valganciclovir is hydrolyzed to GCV by intestinal and hepatic esterases, and hence the new environmental tests only refer to GCV. A sorption study showed that GCV will not sorb significantly, excluding the soil as a relevant environmental compartment. Despite earlier data suggesting nondegradability, a new water/sediment fate test showed GCV to be primarily and ultimately degraded and to be nonpersistent. The chronic ecotoxicity tests with algae and daphnids resulted in no inhibition at the highest tested concentrations, whereas a fish partial life cycle test, selected in view of mammalian mutagenicity and reprotoxicity data, showed effects on growth of the young fish, but not on gametogenesis, fertilization, embryogenesis, or teratogenicity. Predicted environmental concentrations were derived based on actual per capita use data for European countries for 2004 to 2014, and the highest was selected for the risk assessment. A comparison of predicted environmental concentrations with predicted no‐effect concentrations shows no significant risk for wastewater treatment, surface waters, groundwater, or sediment. In addition, potential risks to (semi)aquatic top predators or to human consumers of water and fish are exceedingly low. Environ Toxicol Chem 2017;36:2205–2216. © 2017 The Author. Environmental Toxicology and Chemistry Published by Wiley Periodicals, Inc. on behalf of SETAC
Harnessing adolescent values to motivate healthier eating

Significance Behavioral science has rarely offered effective strategies for changing adolescent health behavior. One limitation of previous approaches may be an overemphasis on long-term health outcomes as the focal source of motivation. The present research uses a rigorous randomized trial to evaluate an approach that aligns healthy behavior with values about which adolescents already care: feeling like a socially conscious, autonomous person worthy of approval from one’s peers. It improved the health profile of snacks and drinks participants chose in an ostensibly unrelated context and did so because it caused adolescents to construe the healthy behavior as being aligned with prominent adolescent values. This suggests a route to an elusive result: effective motivation for adolescent behavior change. What can be done to reduce unhealthy eating among adolescents? It was hypothesized that aligning healthy eating with important and widely shared adolescent values would produce the needed motivation. A double-blind, randomized, placebo-controlled experiment with eighth graders (total n = 536) evaluated the impact of a treatment that framed healthy eating as consistent with the adolescent values of autonomy from adult control and the pursuit of social justice. Healthy eating was suggested as a way to take a stand against manipulative and unfair practices of the food industry, such as engineering junk food to make it addictive and marketing it to young children. Compared with traditional health education materials or to a non–food-related control, this treatment led eighth graders to see healthy eating as more autonomy-assertive and social justice-oriented behavior and to forgo sugary snacks and drinks in favor of healthier options a day later in an unrelated context. Public health interventions for adolescents may be more effective when they harness the motivational power of that group’s existing strongly held values.
Control of Visceral Leishmaniasis in Latin America—A Systematic Review

Background While three countries in South Asia decided to eliminate anthroponotic visceral leishmaniasis (VL) by 2015, its control in other regions seems fraught with difficulties. Is there a scope for more effective VL control in the Americas where transmission is zoonotic? We reviewed the evidence on VL control strategies in Latin America—diagnosis, treatment, veterinary interventions, vector control—with respect to entomological and clinical outcomes. Methodology/Principal Findings We searched the electronic databases of MEDLINE, LILACS, and the Cochrane Central Register of Controlled Trials, from 1960 to November 2008 and references of selected articles. Intervention trials as well as observational studies that evaluated control strategies of VL in the Americas were included. While the use of rapid diagnostic tests for VL diagnosis seems well established, there is a striking lack of evidence from clinical trials for drug therapy and few well designed intervention studies for control of vectors or canine reservoirs. Conclusion Elimination of zoonotic VL in the Americas does not seem a realistic goal at this point given the lack of political commitment, gaps in scientific knowledge, and the weakness of case management and surveillance systems. Research priorities and current strategies should be reviewed with the aim of achieving better VL control.
The opercular mouth-opening mechanism of largemouth bass functions as a 3D four-bar linkage with three degrees of freedom

ABSTRACT The planar, one degree of freedom (1-DoF) four-bar linkage is an important model for understanding the function, performance and evolution of numerous biomechanical systems. One such system is the opercular mechanism in fishes, which is thought to function like a four-bar linkage to depress the lower jaw. While anatomical and behavioral observations suggest some form of mechanical coupling, previous attempts to model the opercular mechanism as a planar four-bar have consistently produced poor model fits relative to observed kinematics. Using newly developed, open source mechanism fitting software, we fitted multiple three-dimensional (3D) four-bar models with varying DoF to in vivo kinematics in largemouth bass to test whether the opercular mechanism functions instead as a 3D four-bar with one or more DoF. We examined link position error, link rotation error and the ratio of output to input link rotation to identify a best-fit model at two different levels of variation: for each feeding strike and across all strikes from the same individual. A 3D, 3-DoF four-bar linkage was the best-fit model for the opercular mechanism, achieving link rotational errors of less than 5%. We also found that the opercular mechanism moves with multiple degrees of freedom at the level of each strike and across multiple strikes. These results suggest that active motor control may be needed to direct the force input to the mechanism by the axial muscles and achieve a particular mouth-opening trajectory. Our results also expand the versatility of four-bar models in simulating biomechanical systems and extend their utility beyond planar or single-DoF systems. Editors’ Choice: Extension of the traditional 2D four-bar linkage to a high-mobility, 3D four-bar linkage accurately predicts the motion of a mouth-opening mechanism in the skull of ray-finned fishes.