Miracle-dz/UniFAR-FTUs huggingface dataset:
The Effect of Medicaid Expansion on the Nature of New Enrollees’ Emergency Department Use

We examine changes in emergency department (ED) visit acuity and care intensity for uninsured patients who gained Medicaid insurance in 2014 under the Patient Protection and Affordable Care Act. We use 2013-2015 longitudinal patient visit-level data from 30 EDs across 7 states from an emergency medicine group. We examine changes in ED use by previously uninsured Medicaid patients and patients remaining uninsured who were repeat ED users (≥1 visit before and after expansion) using a propensity-score weighted approach with statistical machine learning to estimate the weights. Compared with those remaining uninsured in nonexpansion states, newly covered Medicaid patients in expansion states showed a 29% relative increase in hospital admissions and 32% increase in admissions for nonambulatory care sensitive conditions with no increases in care intensity. Obtaining Medicaid insurance increased the relative proportion of ED visits requiring hospital admission suggesting increased outpatient access for low-acuity conditions previously addressed with ED care.
DNA breakage, repair and lethality after 125I decay in rec+ and recA strains of Escherichia coli.

Iodine-125 decays by electron capture and is known to cause extensive molecular fragmentation via the Augur effect. 125I was incorporated into the DNA of exponentially-growing E. coli K12 AB2487, a recA mutant, and E. coli K12 AB2497, the corresponding rec+ strain, as 5-iododeoxyuridine (IUdR), an analogue of thymidine. Radioactive bacteria were stored at - 196 degrees C, and samples were periodically assayed for loss of viability and for the induction of double-strand breaks (DSBs) in DNA. Each 125I decay in the DNA of either strain induces one DSB, i.e. alpha(DSB) = 1.0. For the recA strain, alpha(lethal) = 0.9 and for the rec+ strain, 0.4. Assays for biological repair of DSBs, involving incubation of thawed samples in growth-medium at 37 degrees C before the extraction of DNA, demonstrate significant repair of 125I-induced DSBs by rec+ cells but none by recA cells. For small numbers of decays, there is approximately a 1:1 correlation, for either strain, between lethal decays and post-incubation residual DSBs. Comparison with data for larger numbers of decays indicates that a typical rec+ cell can repair no more than three to four DSBs per completed genome (2.5 x 10(9) daltons).
Dielectric-Dependent Strength of Interlipid H-bonding in Biomembranes: a Model Case Study.

Atomistic aspects of the structural organization, dynamics, and functioning of hydrated lipid bilayers - model cell membranes - are primarily governed by the fine balance of intermolecular interactions between all constituents of these systems. Besides the hydrophobic effect, which shapes the overall skeleton of lipid membranes, very important contribution to their behavior is made by hydrogen bonds (H-bonds) between lipid head groups. The latter determine such crucial phenomena in cell membranes, like dynamic ultra-nanodomain organization, hydration, fine-tuning of microscopic physico-chemical properties that allow the membrane to adapt quickly when binding/insertion external agents (proteins, etc.) The characteristics of such H-bonds (strength, spatial localization, etc.) dramatically depend on the local polarity properties of the lipid-water environment. In this work, we calculated free energies of H-bonded complexes between typical donor (NH3+, NH, OH) and acceptor (C=O, OH, COO-, COOH) groups of lipids in vacuo and in a set of explicit solvents with dielectric constants (ε) from 1 to 78.3, which mimic membrane environment at different depth. This was done using Monte Carlo simulations and an assessment of the corresponding Potential of Mean Force profiles. The strongest H-bonded complexes were observed in the nonpolar environment and their strength increased sharply with decreasing ε below 17. When ε changed, the largest free energy gain (> 10.8 kcal/mol) was observed for pairs of acceptors C=O and O(H) with donor NH3+. The complexation of the same acceptors with NH-donor in this range of ε was rather less sensitive to the environmental polarity: by ~1.5 kcal/mol. Dielectric-dependent interactions of polar lipid groups with water were evaluated as well. The results explain the delicate balance that determines the unique pattern of H-bonds for a particular lipid bilayer. Understanding the factors that regulate the propensity to H-bonding in lipid bilayers provides a fundamental basis for the rational design of new membrane nano-objects with predefined properties.
Homeless and incarcerated: An epidemiological study from Canada

Background: Incarceration and homelessness are closely related yet studied rarely. This article aimed to study the incarcerated homeless and identify specific vulnerabilities, which rendered them different from the nonincarcerated homeless. It also aimed to describe the homeless population and its significant involvement with the criminal justice and enforcement system. Methods: Data were derived from the British Columbia Health of the Homeless Study (BCHOHS), carried out in three cities in British Columbia, Canada: the large urban center Vancouver (n = 250), Victoria (n = 150) and Prince George (n = 100). Measures included socio-demographic information, the Maudsley Addiction Profile (MAP), the Childhood Trauma Questionnaire (CTQ) and the Mini International Neuropsychiatric Interview (MINI) Plus. Results: Incarcerated homeless were more often male (66.6%), were in foster care (56.4%) and had greater substance use especially of crack cocaine (69.6%) and crystal methamphetamine (78.7%). They also had greater scores on emotional and sexual abuse domains of CTQ, indicating greater abuse. A higher prevalence of depression (57%) and psychotic disorders (55.3%) was also observed. Risk factors identified which had a positive predictor value were male gender (p < .001; odds ratio (OR) = 2.8; 95% confidence interval (CI): 1.7–4.4), a diagnosis of depression (p = .02; 95% CI: 1.1–4.4) and severe emotional neglect (p = .02; 95% CI: 1.1–3.2) in the childhood. Conclusion: Homeless individuals may be traumatized at an early age, put into foster care, rendered homeless, initiated into substance use and re-traumatized on repeated occasions in adult life, rendering them vulnerable to incarceration and mental illness.
Ultrasound‐Guided Interscalene Blocks

nesthesiologists routinely use peripheral nerve blocks as an alternative or an adjunct to general anesthesia in addition to postoperative analgesia for a wide variety of procedures. More recently, emergency physicians have also begun using regional techniques in lieu of procedural sedation for a wide variety of extremity procedures such as reduction of shoulder dislocation.1 The goal of a peripheral nerve block is to apply a local anesthetic directly onto a peripheral nerve or nerve plexus to completely anesthetize the surgical site. Historically, anesthesiologists have performed peripheral nerve blocks using the paresthesia technique, in which the needle is inserted at a point determined by standard anatomic landmarks and then advanced until the patient feels paresthesia in the relevant sensory distribution.2 In the 1970s and 1980s, anesthesiologists began using a nerve stimulator to improve needle localization.3 Essentially, a nerve stimulator is a device that sends current through the block needle to elicit contraction of relevant muscle groups when in close proximity to the nerve of interest. These techniques are effective and are still in use, although they have many drawbacks. Over the past decade, ultrasound has gained popularity for peripheral nerve blockade because it allows the anesthesiologist to directly visualize the nerves of interest, the needle tip itself, and the spread of the local anesthetic in the desired location. In addition, the ultrasound image reliably depicts other structures such as blood vessels and lungs that the anesthesiologist wants to avoid. For these reasons, ultrasound guidance has increasingly become the standard technique for regional anesthesia.4 Brachial plexus blockade has long been used for upper extremity surgery, and there are several standard techniques. The interscalene block is especially useful for shoulder surgery. In this article, we will describe the technique of an ultrasound-guided interscalene block and then discuss its advantages over the traditional landmark technique.
Swedish child health care in a changing society.

BACKGROUND Staff in Swedish child health care today feel a gap between policy and practice. By revealing the main lines in the development of child health care, we hoped to achieve a better understanding of the current trends and problems in today's Swedish child health care. METHODS A selection of official documents about the development of child health care during the period 1930-2000 was studied with the aid of discourse analysis. RESULTS Four discourses were identified, which serve as a foundation for a periodization of the development of child health care. In the first period the main task of child health care, alongside checking on the development of the child, was to inform and educate the mothers. During the second period health supervision became the crucial task, to identify risks and discover abnormalities and disabilities. The third period focused on the discussion concerning the identification of health-related and social 'risk groups', and the work of child health care was increasingly geared to supervision of the parents' care of their children. Parents were to be given support so that they could cope with their difficulties by themselves. During the current period child health care is increasingly expected to direct its work towards the child's surroundings and the family as a whole and is now explicitly defined as an institution that should strengthen parents' self-esteem and competence. The level of responsibility for the child's health changed gradually during the different periods, from public responsibility to parental responsibility. The focus of efforts in child health care was changed from being general in the first and second periods to general and selective in period three, and then gradually becoming selective again in period four. While control of the child's physical health was central during the first two periods, psychosocial health came into focus in the last two, along with the importance of supporting the parents to enable them to handle their difficulties by themselves. CONCLUDING REMARKS We noted that it was difficult to translate policy recommendations into practice. One reason was the shifting focus in child health care from the child's physical health to psychosocial problems which in itself meant a shift from descriptions of concrete and well-defined duties to more abstract and general descriptions of tasks which are by definition open to interpretation. Another reason for the noted difficulty was the transition from unambiguously described measures in terms of paternalistic regulation to more participatory and at the same time more expansive definitions of roles and responsibilities.
TBQ(σ): Improving Efficiency of Trace Utilization for Off-Policy Reinforcement Learning

Off-policy reinforcement learning with eligibility traces faces is challenging because of the discrepancy between target policy and behavior policy. One common approach is to measure the difference between two policies in a probabilistic way, such as importance sampling and tree-backup. However, existing off-policy learning methods based on probabilistic policy measurement are inefficient when utilizing traces under a greedy target policy, which is ineffective for control problems. The traces are cut immediately when a non-greedy action is taken, which may lose the advantage of eligibility traces and slow down the learning process. Alternatively, some non-probabilistic measurement methods such as General Q($lambda$) and Naive Q($lambda$) never cut traces, but face convergence problems in practice. To address the above issues, this paper introduces a new method named TBQ(σ), which effectively unifies the tree-backup algorithm and Naive Q($lambda$). By introducing a new parameter σ to illustrate the degree of utilizing traces, TBQ(σ) creates an effective integration of TB($lambda$) and Naive Q($lambda$) and continuous role shift between them. The contraction property of TB(σ) is theoretically analyzed for both policy evaluation and control settings. We also derive the online version of TBQ(σ) and give the convergence proof. We empirically show that, for e\in(0,1]$ in e-greedy policies, there exists some degree of utilizing traces for $lambda\in[0,1]$, which can improve the efficiency in trace utilization for off-policy reinforcement learning, to both accelerate the learning process and improve the performance.
A Preliminary Comparison of Job, Talent, and Web Search

Copyright held by the author(s). This paper presents an initial comparison of user behavior in job, talent, and web search using query and click logs from a popular employment marketplace. The observations suggest that the understanding of users’ search behavior in this scenario is still at its infancy and that some of the assumptions made in general web search may not hold true.
Photosensitivity in the Circadian Hatching Rhythm of the Carotenoid-Depleted Silkworm, Bombyx mori

Silkworms (Bombyx mori) were reared on a carotenoid-deprived artificial diet, and the carotenoid-depleted eggs of the next generation were incubated so that we could observe the effect of the depletion on the circadian rhythm of hatching. The phototactic response curves of newly hatched larvae showed that the visual photosensitivity in ocelli of larvae from the carotenoid-depleted eggs was at least 4 log units lower than that of a carotenoid-rich control group. However, the phase-shift experiment revealed that carotenoid depletion did not reduce the photosensitivity in the hatching rhythm. When the hatching rhythm was generated by exposure to a single light pulse in constant darkness, the first peak in the rhythm of the carotenoid-depleted silkworms occurred significantly earlier than that of the carotenoid-rich group, but the following second peaks of both groups were found at the same time. These results suggest that for the silkworm, carotenoid is not involved in photoreception for the hatching rhythm, but is involved in the timing of hatching.
Physically-motivated dynamical algorithms for the graph isomorphism problem

The graph isomorphism problem (GI) plays a central role in the theory of computational complexity and has importance in physics and chemistry as well [1, 2]. No polynomial-time algorithm for solving GI is knowm We investigate classical and quantum physics-based polynomial-time algorithms for solving the graph isomorphism problem in which the graph structure is reflected in the behavior of a dynamical system. We show that a classical dynamical algorithm proposed by Gudkov and Nussinov [25] as well as its simplest quantum generalization fail to distinguish pairs of non-isomorphlc strongly regular graphs. However, by combining the algorithm of Gudkov and Nussinov with a construction proposed by Rudolph [26] in which one examines a graph describing the dynamics of two particles on the original graph, we find an algorithm that successfully distinguishes all pairs of non-isomorphic strongly regular graphs that we tested with up to 29 vertices.
Gossip-based Hybrid Multi-attribute Overlay for Resource Discovery in Federated Clouds

Federated clouds establish a model for independent cloud providers to cooperate and share resource to cope with unforeseen demand loads. One of the challenges in federated clouds is how to find suitable virtual machines to locate resource requests, with constrains of multiple resource attributes. This paper proposes a Gossip-based Hybrid Multi-attribute Overlay (GHMO) for effective resource discovery in federated clouds. GHMO enhances structured overlay with gossip protocol, expanding possible routing ranges to improve the efficiency multi-attribute search. A weight overlay is introduced in the case of routing costs among federated clouds, and an improved neighbor selection strategy is raised to reduce routing costs in process of multi-attribute search. Experimental evaluations show that the performance of the proposed approach is acceptable and stable, and the routing hop and cost is reduced compared with other multi-attribute search methods.
Understanding Network Requirements for Smart City Applications: Challenges and Solutions

Smart cities are contemporary revolutions that can handle the complexities of growing urban density. Smart applications reside in the cloud datacenter, where Internet of Everything devices or sources access these applications to obtain city services. Accessing applications from the distant cloud implies higher latency, huge network traffic, and possibilities of security and privacy breaches. These issues are not sustainable for real-time applications. This article describes network requirements and challenges faced by applications and solutions to encounter them.
Polymerase Gamma 1 Mutations: Clinical Correlations

Background:Mitochondrial disorders result from primary defects in the mitochondrial DNA (mtDNA) or from defects in nuclear genes which cause disease by affecting the mtDNA. POLG1 is a nuclear gene which encodes for the catalytic subunit of the mtDNA polymerase gamma, essential for mtDNA replication. Less than a decade ago, POLG1 mutations were discovered in patients with progressive external ophthalmoplegia. Since then, it has emerged that POLG1 mutations can result in a spectrum of clinical manifestations, resulting in autosomal recessive or dominant mitochondrial diseases. Review Summary:Here we summarize the common clinical phenotypes associated with POLG1 mutations. Alpers syndrome, progressive external ophthalmoplegia with or without limb myopathy, ataxia-neuropathy syndrome, and epilepsy are frequent clinical manifestations of the POLG1-related disease. Childhood progressive encephalopathy, Parkinsonism, stroke-like events, and isolated exercise intolerance can occur in association with POLG1 mutations. Muscle biopsy can show signs of mitochondrial dysfunction by histologic and biochemical studies or it can be unrevealing. mtDNA analysis of affected tissues can reveal depletion, multiple deletions or point mutations, but it can be occasionally noninformative by routine analysis. Conclusions:POLG1 mutations result in extremely heterogenous phenotypes which often have overlapping clinical findings, making it difficult to categorize patients into syndromes. The lack of signs of mitochondrial dysfunction in the muscle biopsy does not exclude a POLG1-related disease. Analysis of mtDNA of clinically affected tissues is often informative, but not always. Molecular analysis of POLG1 is essential when POLG1-related disease is suspected. Sodium valproate should be avoided because of the risk of liver failure.
Environment-Adaptive Calibration System for Outdoor Low-Cost Electrochemical Gas Sensors

To date, air pollution has caused over seven million deaths worldwide. Real-time monitoring is an efficient solution to prevent and mitigate air pollution. However, air quality monitoring networks are not currently dense enough to cover a large area because of the cost. With the development of low-cost electrochemical gas sensors, the current air quality monitoring network could be extended to a large area with a relatively high-resolution ratio. Nevertheless, the electrochemical gas sensors are not accurate enough compared to standard sensors if they are not carefully calibrated. Therefore, we proposed an environment-adaptive calibration (EAC) system dedicated to the implementation of a collaborative calibration technique for outdoor low-cost electrochemical gas sensors. The EAC system uses a new practical calibration algorithm operating on the Raptor IoT cloud platform that was developed as part of the H2020 Captor project. The system can identify the linear characteristics of gas sensors according to weather conditions, which is valuable prior knowledge for the calibration and the unique character of the EAC system. The outstanding performance of the EAC system is verified by the evaluation of a long-term measurement campaign, in which various metrics are considered, e.g., the goodness-of-fit, target diagram, and daily residuals.
Quantitative Evaluation of Female Pelvic Floor Muscle Biomechanics Using Ultrasound Elastography

Female pelvic floor dysfunction is a common disease which has become one of the five common chronic diseases threatening women’s health. As the supporting structures, pelvic floor muscle is critical to support the pelvic organs, maintain continence, and prevent prolapse. The quantitative evaluation of pelvic floor muscle biomechanics is of great value for the diagnosis and treatment of female pelvic floor dysfunction. Our study aims to propose a noninvasive, quantitative, and objective method for motion analysis of the pelvic floor muscles. Ultrasound data, force data during continuous contractive activities from 37 subjects are synchronously collected using an ultrasound scanner and a self-designed intravaginal pressure acquisition device. A two-dimensional motion tracking algorithm is used to monitor the displacement of the pelvic floor muscles. The muscle displacement field is then computed. The parameter, defined as $\mathrm {M}_{\mathrm {pu}}$ , which is the tangential displacements of one interested point near pubis shows good correlation with clinical measurement parameter ( $\mathrm {L}_{\mathrm {BP}}$ ) (r = −0.93, P < 0.05). The continuous control ability of the pelvic muscles is further evaluated by measuring the average maintaining time of the maximal contraction force and the muscle thickness during this maintaining period. Both of them are well correlated with the clinical grading results of prolapse. It is concluded that the ultrasound measurements of tissue motions and biomechanics are of great value for the clinical pelvic floor prolapse diagnosis.
A Review of Secure and Privacy-Preserving Medical Data Sharing

In the digital healthcare era, it is of the utmost importance to harness medical information scattered across healthcare institutions to support in-depth data analysis and achieve personalized healthcare. However, the cyberinfrastructure boundaries of healthcare organizations and privacy leakage threats place obstacles on the sharing of medical records. Blockchain, as a public ledger characterized by its transparency, tamper-evidence, trustlessness, and decentralization, can help build a secure medical data exchange network. This paper surveys the state-of-the-art schemes on secure and privacy-preserving medical data sharing of the past decade with a focus on blockchain-based approaches. We classify them into permissionlessblockchain-based approaches and permissioned blockchain-based approaches and analyze their advantagesand disadvantages. We also discuss potential research topics on blockchain-based medical data sharing.