Miracle-dz/UniFAR-FTUs huggingface dataset:
Patient-Centered Data Home: A Path Towards National Interoperability

Objective National interoperability is an agenda that has gained momentum in health care. Although several attempts to reach national interoperability, an alerting system through interconnected network of Health Information Exchange (HIE) organizations, Patient-Centered Data Home (PCDH), has seen preliminary success. The aim was to characterize the PCDH initiative through the Indiana Health Information Exchange's participation in the Heartland Region Pilot, which includes HIEs in Indiana, Ohio, Michigan, Kentucky, and Tennessee. Materials and Methods Admission, Discharge, and Transfer (ADT) transactions were collected between December 2016 and December 2017 among the seven HIEs in the Heartland Region. ADTs were parsed and summarized. Overlap analyses and patient matching software were used to characterize the PCDH patients. R software and Microsoft Excel were used to populate descriptive statistics and visualization. Results Approximately 1.5 million ADT transactions were captured. Majority of patients were female, ages 56–75 years, and were outpatient visits. Top noted reasons for visit were labs, screening, and abdominal pain. Based on the overlap analysis, Eastern Tennessee HIE was the only HIE with no duplicate service areas. An estimated 80 percent of the records were able to be matched with other records. Discussion The high volume of exchange in the Heartland Region Pilot established that PCDH is practical and feasible to exchange data. PCDH has the posture to build better comprehensive medical histories and continuity of care in real time. Conclusion The value of the data gained extends beyond clinical practitioners to public health workforce for improved interventions, increased surveillance, and greater awareness of gaps in health for needs assessments. This existing interconnection of HIEs has an opportunity to be a sustainable path toward national interoperability.
Placental Malaria is Associated with Higher LILRB2 Expression in Monocyte Subsets and Lower Anti-Malarial IgG Antibodies During Infancy

Background Placental malaria (PM) is associated with a higher susceptibility of infants to Plasmodium falciparum (Pf) malaria. A hypothesis of immune tolerance has been suggested but no clear explanation has been provided so far. Our goal was to investigate the involvement of inhibitory receptors LILRB1 and LILRB2, known to drive immune evasion upon ligation with pathogen and/or host ligands, in PM-induced immune tolerance. Method Infants of women with or without PM were enrolled in Allada, southern Benin, and followed-up for 24 months. Antibodies with specificity for five blood stage parasite antigens were quantified by ELISA, and the frequency of immune cell subsets was quantified by flow cytometry. LILRB1 or LILRB2 expression was assessed on cells collected at 18 and 24 months of age. Findings Infants born to women with PM had a higher risk of developing symptomatic malaria than those born to women without PM (IRR=1.53, p=0.040), and such infants displayed a lower frequency of non-classical monocytes (OR=0.74, p=0.01) that overexpressed LILRB2 (OR=1.36, p=0.002). Moreover, infants born to women with PM had lower levels of cytophilic IgG and higher levels of IL-10 during active infection. Interpretation Modulation of IgG and IL-10 levels could impair monocyte functions (opsonisation/phagocytosis) in infants born to women with PM, possibly contributing to their higher susceptibility to malaria. The long-lasting effect of PM on infants’ monocytes was notable, raising questions about the capacity of ligands such as Rifins or HLA-I molecules to bind to LILRB1 and LILRB2 and to modulate immune responses, and about the reprogramming of neonatal monocytes/macrophages.
A Novel Role of PP2A Methylation in the Regulation of Tight Junction Assembly and Integrity

Tight junctions (TJs) are multiprotein complexes essential for cell polarity and the barrier function of epithelia. The major signaling molecule, protein serine/threonine phosphatase 2A (PP2A), interacts with the TJ and modulates the phosphorylation state of TJ proteins. An important PP2A regulatory mechanism involves leucine carboxyl methyltransferase-1 (LCMT1)-dependent methylation and protein phosphatase methylesterase-1 (PME1)-mediated demethylation of its catalytic subunit on Leu309. Here, using MDCK cells, we show that overexpression of LCMT1, which enhances cellular PP2A methylation, inhibits TJ formation, induces TJ ruffling, and decreases TJ barrier function. Conversely, overexpression of PME1 accelerates TJ assembly and enhances TJ barrier function. PME1-dependent PP2A demethylation increases during early Ca2+-dependent junctional assembly. Inhibition of endogenous PME1 delays the initial Ca2+-mediated redistribution of TJ proteins to cell-cell contacts and affects TJ morphology and barrier function. Manipulating one-carbon metabolism modulates TJ assembly, at least in part by affecting PP2A methylation state. The integrity of PP2A methylation is critical for proper targeting of PP2A to the TJ. It is necessary for PP2A complex formation with the TJ proteins, occludin and ZO-1, and proteins of the PAR complex, Par3 and atypical protein kinase C ζ (aPKCζ), which play a key role in development of cell polarity. Expression of a methylation incompetent PP2A mutant induces defects in TJ assembly and barrier function. aPKCζ-mediated Par3 phosphorylation is also required for targeting of the PP2A ABαC holoenzyme to the TJ. Our findings provide the first evidence for a role of LCMT1, PME1 and PP2A methylation/demethylation processes in modulating TJ assembly and functional integrity. They also position PP2A at the interface of one-carbon metabolism and the regulation of key TJ and polarity proteins that become deregulated in many human diseases.
Birth and Health Outcomes of Children Migrating With Parents: A Systematic Review and Meta-Analysis

Objective To examine the birth and health outcomes of children migrating with parents internationally and domestically, and to identify whether the healthy migration effect exist in migrant children. Methods Five electronic databases were searched for cross-sectional, case-control, or cohort studies published from January 1, 2000 to January 30, 2021and written by English language, reporting the risk of health outcomes of migrant children (e.g., birth outcome, nutrition, physical health, mental health, death, and substance use) We excluded studies in which participants' age more than 18 years, or participants were forced migration due to armed conflict or disasters, or when the comparators were not native-born residents. Pooled odd ratio (OR) was calculated using random-effects models. Results Our research identified 10,404 records, of which 98 studies were retrained for analysis. The majority of the included studies (89, 91%) focused on international migration and 9 (9%) on migration within country. Compared with native children, migrant children had increased risks of malnutrition [OR 1.26 (95% CI 1.11–1.44)], poor physical health [OR 1.34 (95% CI 1.11–1.61)], mental disorder [OR 1.24 (95% CI 1.00–1.52)], and death [OR 1.11 (95% CI 1.01–1.21)], while had a lower risk of adverse birth outcome [OR 0.92 (95% CI 0.87–0.97)]. The difference of substance use risk was not found between the two groups. Conclusion Migrant children had increased risk of adverse health outcomes. No obvious evidence was observed regarding healthy migration effect among migrant children. Actions are required to address the health inequity among these populations. Systematic Review Registration https://www.crd. york.ac. uk/prospero/#myprospero, identifier: CRD42021214115.
Does Reiki Benefit Mental Health Symptoms Above Placebo?

Background Reiki is an energy healing technique or biofield therapy in which an attuned therapist places their hands on or near the client’s body and sends energy to the client to activate the body’s ability to heal itself and restore balance. It was developed in Japan at the end of the 19th century by Mikao Usui of Kyoto. Given the enormous international socioeconomic burden of mental health, inexpensive, safe, and evidenced-based treatments would be welcomed. Reiki is safe, inexpensive, and preliminary research suggests it may assist in treating a wide variety of illnesses. Given that Reiki is a biofield therapy, growing in use, and not yet accepted by the dominant biomedical paradigm, it is important to establish its effectiveness over placebo. This study aimed to examine Reiki’s effectiveness over placebo in treating symptoms of mental health and to explore parameters for its effectiveness. Method A systematic review of randomized placebo-controlled trials (RPCTs) examining Reiki’s effectiveness in treating symptoms of mental health in adults was conducted through a systematic search of PubMed, PsycINFO, MEDLINE, CINAHL, Web of Science, Scopus, Embase, and ProQuest. Fourteen studies met the inclusion criteria, and risk of bias was assessed using Cochrane’s Revised ROB 2 assessment tool. This was followed by a grading of recommendations, assessment, development and evaluations (GRADE) assessment. Results The evidence to date suggests that Reiki consistently demonstrates a greater therapeutic effect over placebo for some symptoms of mental health. The GRADE level of evidence is high for clinically relevant levels of stress and depression, moderate to high for clinically relevant levels of anxiety, low to moderate for normal levels of stress, and low to moderate for burnout, and low for normal levels of depression and anxiety. Conclusion The results suggest that, Reiki may be more effective in treating some areas of mental health, than placebo, particularly if symptoms are clinically relevant. To date, there are a small number of studies in each area, therefore findings are inconclusive and, more RCTs controlling for placebo in Reiki research are needed. Most included studies were also assessed as having a risk of bias of some concern. Incorporating Reiki as a complementary treatment to mainstream psychotherapy for depression, stress, and anxiety may be appropriate. Systematic Review Registration [https://www.crd. york.ac. uk/], identifier [CRD42020194311].
Understanding and Predicting Cognitive Improvement of Young Adults in Ischemic Stroke Rehabilitation Therapy

Accurate early predictions of a patient's likely cognitive improvement as a result of a stroke rehabilitation programme can assist clinicians in assembling more effective therapeutic programs. In addition, sufficient levels of explainability, which can justify these predictions, are a crucial requirement, as reported by clinicians. This article presents a machine learning (ML) prediction model targeting cognitive improvement after therapy for stroke surviving patients. The prediction model relies on electronic health records from 201 ischemic stroke surviving patients containing demographic information, cognitive assessments at admission from 24 different standardized neuropsychology tests (e.g., TMT, WAIS-III, Stroop, RAVLT, etc.), and therapy information collected during rehabilitation (72,002 entries collected between March 2007 and September 2019). The study population covered young-adult patients with a mean age of 49.51 years and only 4.47% above 65 years of age at the stroke event (no age filter applied). Twenty different classification algorithms (from Python's Scikit-learn library) are trained and evaluated, varying their hyper-parameters and the number of features received as input. Best-performing models reported Recall scores around 0.7 and F1 scores of 0.6, showing the model's ability to identify patients with poor cognitive improvement. The study includes a detailed feature importance report that helps interpret the model's inner decision workings and exposes the most influential factors in the cognitive improvement prediction. The study showed that certain therapy variables (e.g., the proportion of memory and orientation executed tasks) had an important influence on the final prediction of the cognitive improvement of patients at individual and population levels. This type of evidence can serve clinicians in adjusting the therapeutic settings (e.g., type and load of therapy activities) and selecting the one that maximizes cognitive improvement.
Changes in Muscle Activation During and After a Shoulder-Fatiguing Task: A Comparison of Elite Female Swimmers and Water Polo Players

This study compared female athletes with different aquatic sports expertise in their neuromuscular activation before, during, and after a shoulder internal rotation fatigue protocol. Eleven water polo players, 12 swimmers, and 14 controls completed concentric maximal voluntary external and internal shoulder rotations before and after a fatigue protocol consisting of concentric internal rotations at 50% of maximal voluntary contraction for at least 3 min or until reporting a rating of perceived effort RPE of 8/10 or higher. Muscle activation was measured for the maximal voluntary contractions, as well as for the first (T1), middle (T2), and third (T3) minute of the fatigue protocol using surface electromyography (EMG) on pectoralis major, anterior and posterior deltoid, upper and middle trapezius, and latissimus dorsi. Intramuscular EMG was used for supraspinatus, infraspinatus, and subscapularis. Pre-fatigue internal rotation torque was significantly correlated with shorter task duration (r = −0.39, p = 0.02), with water polo players producing significantly greater torque than controls but having significantly lower endurance. Swimmers demonstrated decreased latissimus dorsi activation at T3 compared to T2 (p = 0.020, g = 0.44) and T1 (p = 0.029, g = 0.74), differing from water polo players and controls who exhibited increased agonist activation and decreased activation of stabilizers. Comparing the pre-fatigue to the post-fatigue maximal shoulder rotations, water polo players had decreased activation in subscapularis (p = 0.018, g = 0.67); all groups had decreased activation in latissimus dorsi (p < 0.001), though swimmers demonstrated a large effect (g = 0.97); and controls had decreased activation in supraspinatus (p = 0.005, g = 0.71). Together, these results suggest that sports expertise may be associated with different muscle activation both while and after fatigue is induced. Further research should continue to explore sports-specific patterns of muscle recruitment and fatigue adaptations, as well as if certain strategies are adaptive or maladaptive. This may have important consequences for injury prevention among athletes who perform repetitive overhead movements in their sports and who are susceptible to overuse injuries.
Ecotoxicity Studies for On-Site Disposal of Decant Water During Oil Spills: A Review

Mechanical oil recovery, a most used tool for oil spill response, can generate a considerable proportion of oil-contaminated water (10–70%). Large storage space is commonly required to transport the recovered oil and water mixture to shore. Transit and transportation consume loads of time, money, and resources while reducing oil recovery’s overall efficiency and capacity. Techniques of on-site treatment and disposal of oily wastewater provide benefits for oil recovery by freeing storage space. However, the high petroleum content of decant water can lead to uncertain risks, if discharged into the marine ecosystem. Insufficient ecological toxicity data and research limit the standardization and establishment of regulative tools. To fill the knowledge gaps, this review comprehensively summarized recent studies on the potential impacts of the organic composition in decant water, including oil–water accommodated fractions, dispersed oil droplets, and other related chemicals, on various marine species (i.e., bacterium, invertebrates, fishes, plants, reptiles, and mammals). The toxicity effects and the ecological endpoints of oils, TPH, and PAHs on different species were discussed. Recommendations for future ecological impacts and decant water composition were provided to support the on-site disposal of the water fraction.
Precision Compensation Control of a Piezo-Scanning Mechanism

In this study, a controller based on two compensators is developed to support a two-axis piezo-scanning mechanism for tracking control. The hysteresis compensator is designed based on a Prandtl–Ishlinskii hysteresis model in order to reduce the nonlinear hysteresis effect of a piezoelectric actuator. Furthermore, to compensate for uncertainties due to parametric variations, hysteresis-compensated error, and un-modeled dynamics, the uncertainties compensator based on the neural network disturbance observer is proposed. The developed controller is verified with regard to control performance by experiment. Those two observers are used to complete hysteresis compensation and disturbance compensation, which will not reduce the stability and bandwidth of the system and improve the control accuracy. Experimental results show that the proposed hybrid controller can overcome the mentioned nonlinearity and uncertainty efficiently and preserve good positioning accuracy with high-bandwidth varying frequencies (1–150 Hz).
Sex-Specific Associations Between Low Muscle Mass and Glucose Fluctuations in Patients With Type 2 Diabetes Mellitus

Objective Studies have shown that sex differences in lean mass, concentrations of sex hormones, and lifestyles influence cle health and glucose metabolism. We evaluated the sex-specific association between low muscle mass and glucose fluctuations in hospitalized patients with type 2 diabetes mellitus (T2DM) receiving continuous subcutaneous insulin infusion (CSII) therapy. Methods A total of 1084 participants were included. Body composition was determined by dual-energy X-ray absorptiometry. Intraday blood glucose fluctuation was estimated by the Largest amplitude of glycemic excursions (LAGE) and standard deviation of blood glucose (SDBG). Results The prevalence of low muscle mass was higher in males than in females (p<0.001). There was a significant sex-specific interaction between the status of low muscle mass and glucose fluctuations (LAGE and SDBG) (p for interaction=0.025 and 0.036 for SDBG and LAGE, respectively). Among males, low muscle mass was significantly associated with a higher LAGE and SDBG (difference in LAGE: 2.26 [95% CI: 1.01 to 3.51], p < 0.001; difference in SDBG: 0.45 [95% CI: 0.25 to 0.65], p < 0.001) after adjustment for HbA1c, diabetes duration, hyperlipidemia, diabetic peripheral neuropathy, diabetic nephropathy, and cardiovascular disease. These associations remained significant after further adjustment for age and C-peptide. Among females, low muscle mass was not associated with LAGE or SDBG after adjustment for all covariates. Conclusion The prevalence of low muscle mass was higher in males than in females. Low muscle mass was significantly associated with higher LAGE and SDBG among males, but not females.
Development, Reliability, and Validity of the Preschool Learning Skills Scale: A Tool for Early Identification of Preschoolers at Risk of Learning Disorder in Mainland China

Background Early identification of children at risk of learning disorders (LD) may mitigate the adverse effects of delayed intervention by guiding children to receive preventive services at an earlier age. However, there is no assessment tool for the early identification of children at risk of LD in Mainland China. Therefore, this study aimed to create a Chinese version of the Preschool Learning Skills Scale and investigate its validity and reliability. Methods Firstly, a pilot scale was designed based on literature review and expert review. Secondly, a pre-survey of the pilot scale was conducted. In phase 3, a formal survey was carried out to test the reliability and validity of the scale by involving 2,677 preschool children from 7 kindergartens. Data were collected using a checklist for demographic characteristics, the preschool learning skills scale, the Behavior Rating Inventory of Executive Function-Preschool Version (BRIEF-P), and Conners' Rating Scales. Results The final scale included 38 items under seven factors. The reliability and validity tests confirmed that the Cronbach's alpha, split-half reliability, and test–retest reliability coefficients of the scale were 0.946, 0.888, and 0.941, respectively. The Spearman correlations of factor-total score ranged from 0.685 to 0.876. The results of criterion-related validity showed a direct and significant association between the preschool learning skills scale with the BRIEF-P (r = 0.641, P < 0.001) and the cognitive problems factor of Conners' Rating Scales (r = 0.564, P < 0.001). The model had a good fit (χ2/df = 3.489, RMSEA = 0.047, RMR = 0.024, CFI = 0.912, TLI = 0.900, and IFI = 0.912). Multigroup confirmatory factor analysis supported the structural and measurement invariance on the preschool learning skills scale across gender and grade. Conclusions The developed preschool learning skills scale has good reliability and validity, indicating that the scale can be used to identify preschool children at risk of LD and can be recommended for use in clinical research and practice.
The Effect of Mindfulness Yoga in Children With School Refusal: A Study Protocol for an Exploratory, Cluster-Randomized, Open, Standard Care-Controlled, Multicenter Clinical Trial

Background School refusal occurs in about 1–2% of young people. Anxiety and depression are considered to be the most common emotional difficulties for children who do not attend school. However, at present, no definitive treatment has been established for school refusal, although interventions such as cognitive behavioral therapy have been used. This paper reports a protocol for a cluster-randomized controlled trial of a mindfulness yoga intervention for children with school refusal. Methods This study is a multicenter, exploratory, open cluster-randomized controlled trial. This study will recruit children aged 10–15 years with school refusal. After a 2-week baseline, participants for each cluster will be randomly assigned to one of two groups: with or without mindfulness yoga for 4 weeks. Mindfulness yoga will be created for schoolchildren for this protocol and distributed to the participants on DVD. The primary outcome is anxiety among children with school refusal using the Spence Children's Anxiety Scale-Children. Discussion For this study, we developed a mindfulness yoga program and protocol, and examine whether mindfulness yoga can improve anxiety in children with school refusal. Our mindfulness yoga program was developed based on the opinions of children of the same age, and is a program that children can continue to do every day without getting bored. In this way, we believe that we can contribute to the smooth implementation of support to reduce the anxiety of children with school refusal, and to the reduction of the number of children who refuse to go to school.