Miracle-dz/UniFAR-FTUs huggingface dataset:
Observing Provider Utilization of Electronic Health Records to Improve Clinical Quality Metrics.

Introduction This study compared changes of healthcare quality in a Michigan Medicaid population before and after physician adoption of electronic health records (EHRs) via the Meaningful Use (MU) program for selected Healthcare Effectiveness Data and Information Set (HEDIS) quality of care measures. Methods Healthcare measures included well-child visits, cancer screening, and chronic illness quality measures. Utilization data were obtained from Medicaid paid claims and encounter data with providers (N=291) receiving their first MU incentive in 2014 and at least one HEDIS-defined outpatient visit with a Michigan Medicaid enrollee. Paired t-tests with a repeated measures design were utilized to analyze the data. Results Improvements in quality of infant well-child visits (mean difference = 10.2) and colorectal cancer screening (mean difference = 8.0 percent) were observed. We found no change or slight decreases for the other selected measures. Conclusion These outcomes inform the performance and ability of EHRs to improve quality of healthcare standards particularly as technology continues to evolve under the Centers for Medicare & Medicaid Services (CMS) Interoperability and Patient Access final rule.
Comparison of hospitalized COVID-19 and influenza patients requiring supplemental oxygen in a cohort study: clinical impact and resource consumption

Abstract Background To compare clinical characteristics, outcomes, and resource consumption of patients with COVID-19 and seasonal influenza requiring supplemental oxygen. Methods Retrospective cohort study conducted at a tertiary-care hospital. Patients admitted due to seasonal influenza between 2017 and 2019, or with COVID-19 between March and May 2020 requiring supplemental oxygen were compared. Primary outcome: 30-day mortality. Secondary outcomes: 90-day mortality and hospitalization costs. Attempted sample size to detect an 11% difference in mortality was 187 patients per group. Results COVID-19 cases were younger (median years, 67 (IQR 54-78) vs 76 (IQR 64-83); p < 0.001) and more frequently overweight whereas influenza cases had more hypertension, immunosuppression, and chronic heart, respiratory and renal disease. Compared to influenza, COVID-19 cases had more pneumonia (98% vs 60%, <0.001), higher MEWS and CURB-65 scores and were more likely to show worse progression on the WHO ordinal scale (33% vs 4%; p < 0.001). The 30-day mortality rate was higher for COVID-19 than for influenza: 15% vs 5% (p = 0.001). The median age of non-surviving cases was 81 (IQR 74-88) and 77.5 (IQR 65-84) (p = 0.385), respectively. COVID-19 was independently associated with 30-day (HR 4.6, 95%CI, 2-10.4) and 90-day (HR 5.2, 95%CI, 2.4-11.4) mortality. Sensitivity and subgroup analyses, including a subgroup considering only patients with pneumonia, did not show different trends. Regarding resource consumption, COVID-19 patients had longer hospital stays and higher critical care, pharmacy, and complementary test costs. Conclusions Although influenza patients were older and had more comorbidities, COVID-19 cases requiring supplemental oxygen on admission had worse clinical and economic outcomes.
Statistical power and sample size requirements to detect an intervention by time interaction in four‐level longitudinal cluster randomized trials

Cluster/group randomized controlled trials (CRTs) have a long history in the study of health sciences. CRT is a special type of intervention trial in which a complete group is randomly assigned to a study condition (or intervention). It is typically performed when individual randomization is difficult/impossible without substantial risk of contamination across study arms or prohibitive from the cost or group dynamics point of view. In this article, the aim is to design and analyze four‐level longitudinal cluster randomized trials. The main interest here is to study the difference between treatment groups over time for such a four‐level hierarchical data structure. This work is motivated by a real‐life study for education based HIV prevention. Such trials are not only popular for administrative convenience, ethical considerations, subject compliance, but also help to reduce contamination bias. A random intercept mixed effects linear regression including a time by intervention interaction is used for modeling. Closed form expression of the power function to detect the interaction effect is determined. Sample size equations depend on correlation among schools but not on correlations among classes or students while, the power function depends on the product of number of units at different levels. Optimal allocation of units under a fixed cost by minimizing the expected standardized variance is also determined and are shown to be independent of correlations among units in any level. Results of detailed simulation studies find the theoretical power estimates based on the derived formulae close to the empirical estimates.
The mechanistic and prognostic implications of heart rate variability analysis in patients with cirrhosis

Chronic liver damage leads to scarring of the liver tissue and ultimately a systemic illness known as cirrhosis. Patients with cirrhosis exhibit multi‐organ dysfunction and high mortality. Reduced heart rate variability (HRV) is a hallmark of cirrhosis, reflecting a state of defective cardiovascular control and physiological network disruption. Several lines of evidence have revealed that decreased HRV holds prognostic information and can predict survival of patients independent of the severity of liver disease. Thus, the aim of this review is to shed light on the mechanistic and prognostic implications of HRV analysis in patients with cirrhosis. Notably, several studies have extensively highlighted the critical role systemic inflammation elicits in conferring the reduction in patients’ HRV. It appears that IL‐6 is likely to play a central mechanistic role, whereby its levels also correlate with manifestations, such as autonomic neuropathy and hence the partial uncoupling of the cardiac pacemaker from autonomic control. Reduced HRV has also been reported to be highly correlated with the severity of hepatic encephalopathy, potentially through systemic inflammation affecting specific brain regions, involved in both cognitive function and autonomic regulation. In general, the prognostic ability of HRV analysis holds immense potential in improving survival rates for patients with cirrhosis, as it may indeed be added to current prognostic indicators, to ultimately increase the accuracy of selecting the recipient most in need of liver transplantation. However, a network physiology approach in the future is critical to delineate the exact mechanistic basis by which decreased HRV confers poor prognosis.
Electrical stimulation promotes the wound‐healing properties of diabetic human skin fibroblasts

This study evaluated the effect of low (20 and 40 mV/mm) intensities of electrical stimulation on the proliferation and migration of skin fibroblasts from diabetic donors. We also examined the effect of electrical stimulation on modulating the capacity of fibroblasts to contract collagen gel, express alpha‐smooth muscle actin, and secrete proteolytic enzymes involved in regulating extracellular matrix synthesis and degradation. Our study shows that 20 and 40 mV/mm of stimulation increased the growth of fibroblasts extracted from diabetic patients but not from non‐diabetic donors. Electrical stimulation increased the migration of diabetic fibroblasts, their capacity to contract collagen gel, and the expression of alpha‐smooth muscle actin and promoted different proteolytic enzymes involved in accelerating wound healing. Overall results confirm the effectiveness of electrical stimulation in modulating the wound healing activities of fibroblasts extracted from diabetic skin donors. This study, therefore, suggests the possible use of electrical stimulation to promote diabetic foot ulcer healing by stimulating the wound healing properties of skin fibroblasts.
Protective effect of ethyl pyruvate on amikacin-induced ototoxicity in rats.

OBJECTIVE Amikacin (AMK) is a widely used antibiotic, but its ototoxic side effects limit its use. This study investigated the effects of ethyl pyruvate (EP), known for its antioxidant and anti-inflammatory effects, against AMK ototoxicity. MATERIALS AND METHODS 32 Wistar albino rats (n: 8) were used in this study. To cause ototoxicity, AMK 600 mg/kg/day dose was applied intramuscularly for 14 days. EP was administered via ip at a dose of 50 mg/kg/day for 14 days. RESULTS The Auditory Brainstem Responses (ABR) and Distortion Product Otoacoustic Emissions (DPOAE) tests were performed on the study's 0, 7, and 14 days. The results have shown that the hearing functions were significantly impaired with the AMK application. A significant improvement was observed in the AMK+EP group. While total oxidant status (TOS), oxidative stress index (OSI), and malondialdehyde (MDA) levels were found to be significantly higher in the AMK group compared to the control group, total antioxidant status (TAS) level was found to be significantly lower. In the AMK+EP group, on the other hand, deterioration in TOS, OSI, and MDA levels detected in the AMK group was not observed. No elevated pro-inflammatory cytokines, such as TNF-α, IL-1β, and IL-6 were present in the EP+AMK group, which were detected in the AMK group. CONCLUSIONS Hearing tests and biochemical results show that ethyl pyruvate has protective effects against amikacin ototoxicity due to its antioxidant and anti-inflammatory effects.
Potent Inhibition of SARS-CoV-2 nsp14 N7-Methyltransferase by Sulfonamide-Based Bisubstrate Analogues

Enzymes involved in RNA capping of SARS-CoV-2 are essential for the stability of viral RNA, translation of mRNAs, and virus evasion from innate immunity, making them attractive targets for antiviral agents. In this work, we focused on the design and synthesis of nucleoside-derived inhibitors against the SARS-CoV-2 nsp14 (N7-guanine)-methyltransferase (N7-MTase) that catalyzes the transfer of the methyl group from the S-adenosyl-l-methionine (SAM) cofactor to the N7-guanosine cap. Seven compounds out of 39 SAM analogues showed remarkable double-digit nanomolar inhibitory activity against the N7-MTase nsp14. Molecular docking supported the structure–activity relationships of these inhibitors and a bisubstrate-based mechanism of action. The three most potent inhibitors significantly stabilized nsp14 (ΔTm ≈ 11 °C), and the best inhibitor demonstrated high selectivity for nsp14 over human RNA N7-MTase.
An autopsy case of MV2K‐type sporadic Creutzfeldt‐Jakob disease presenting with characteristic clinical, radiological, and neuropathological findings

In Japan, because MV2‐type sporadic Creutzfeldt–Jakob disease (CJD) is rare, little is known about its clinical and neuropathological characteristics. An autopsy case of MV2K‐type sporadic CJD is presented, and the characteristic clinical, radiological, and neuropathological findings are discussed. The patient was a Japanese woman who died at the age of 72 years. Her initial symptom was rapidly progressive dementia. She then developed truncal ataxia and delusions. Approximately nine months after onset, she exhibited akinetic mutism. The total clinical course was 11 months. Magnetic resonance imaging revealed hyperintensity areas in the basal ganglia, thalamus, and hippocampus on diffusion‐weighted images. In the cerebral cortex, this finding was slight and inconspicuous. Electroencephalography revealed no periodic sharp wave complexes. Prion protein (PrP) gene analysis revealed no mutations, and polymorphic codon 129 exhibited methionine and valine heterozygosity. In the cerebrospinal fluid, levels of both total tau and 14‐3‐3 proteins were elevated. Grossly, the brain weighed 1050 g before fixation and exhibited diffuse cortical atrophy. On histopathological examination, extensive fine vacuole‐type spongiform degeneration was noted in the cerebral cortex. Numerous kuru plaques were observed in the cerebellum. PrP immunohistochemistry revealed extensive diffuse synaptic‐ and perineuronal‐type PrP deposits in the cerebral cortex. Kuru plaques were strongly immunoreactive for PrP. Western blot analysis of brain tissue samples revealed mixed type 2 and intermediate type. Systematic and comprehensive investigations of both clinical and neuropathological aspects are required for accurate diagnosis.
Potential Adverse Effect of Nonsteroidal Anti‐Inflammatory Drugs (NSAIDs) on Bisphosphonate Efficacy: An Exploratory Post Hoc Analysis From a Randomized Controlled Trial of Clodronate

Nonsteroidal anti‐inflammatory drugs (NSAIDs) have been reported to have weak but beneficial effects on bone health, including fracture risk, but many epidemiological studies are likely confounded. We explored the relationship between NSAIDs and fracture risk in a post hoc analysis of a well‐documented, randomized, placebo‐controlled study of the bisphosphonate, clodronate, in which treatment reduced osteoporotic fracture risk by 23%. Concurrent medication use at baseline was used to identify those prescribed oral NSAIDs. Only verified, incident fractures were included in the analysis. A total of 1082 (20.8%) women reported use of NSAIDs at baseline. They were slightly, but significantly, younger (mean 79 versus 80 years, p = 0.004), heavier (mean 66.7 versus 64.7 kg, p < 0.001) than nonusers, with slightly higher femoral neck bone mineral density (FN‐BMD, 0.66 versus 0.64 g/cm2, p < 0.001). In an adjusted model, NSAID use was associated with a significant increase in osteoporotic fracture risk over the 3‐year study period (hazard ratio [HR] 1.27; 95% confidence interval [CI], 1.01–1.62; p = 0.039). However, this increase in risk was not statistically significant in the placebo group (HR 1.11; 95% CI, 0.81–1.52). In women receiving clodronate, the effect of the bisphosphonate to reduce osteoporotic fracture risk was not observed in those receiving NSAIDs (HR 0.95; 95% CI, 0.65–1.41; p = 0.81) in contrast to those not using NSAIDs (HR 0.71; 95% CI, 0.58–0.89; p = 0.002). In a subset with hip BMD repeated at 3 years, BMD loss during clodronate therapy was greater in those women receiving NSAIDs than in nonusers (eg, total hip −2.75% versus −1.27%, p = 0.078; femoral neck −3.06% versus −1.12%, p = 0.028), and was not significantly different from that observed in women receiving placebo. The efficacy of the bisphosphonate, clodronate, to reduce fracture risk was largely negated in those receiving NSAIDs. Although the mechanism is unclear, this clinically significant observation requires exploration in studies of commonly used bisphosphonates. © 2022 The Authors. Journal of Bone and Mineral Research published by Wiley Periodicals LLC on behalf of American Society for Bone and Mineral Research (ASBMR).
Phase-amplitude coupling between low-frequency scalp EEG and high-frequency intracranial EEG during working memory task

Objective. Revealing the relationship between simultaneous scalp electroencephalography (EEG) and intracranial electroencephalography (iEEG) is of great importance for both neuroscientific research and translational applications. However, whether prominent iEEG features in the high-gamma band can be reflected by scalp EEG is largely unknown. To address this, we investigated the phase-amplitude coupling (PAC) phenomenon between the low-frequency band of scalp EEG and the high-gamma band of iEEG. Approach. We analyzed a simultaneous iEEG and scalp EEG dataset acquired under a verbal working memory paradigm from nine epilepsy subjects. The PAC values between pairs of scalp EEG channel and identified iEEG channel were explored. After identifying the frequency combinations and electrode locations that generated the most significant PAC values, we compared the PAC values of different task periods (encoding, maintenance, and retrieval) and memory loads. Main results. We demonstrated that the amplitude of high-gamma activities in the entorhinal cortex, hippocampus, and amygdala was correlated to the delta or theta phase at scalp locations such as Cz and Pz. In particular, the frequency bin that generated the maximum PAC value centered at 3.16–3.84 Hz for the phase and 50–85 Hz for the amplitude. Moreover, our results showed that PAC values for the retrieval period were significantly higher than those of the encoding and maintenance periods, and the PAC was also influenced by the memory load. Significance. This is the first human simultaneous iEEG and scalp EEG study demonstrating that the amplitude of iEEG high-gamma components is associated with the phase of low-frequency components in scalp EEG. These findings enhance our understanding of multiscale neural interactions during working memory, and meanwhile, provide a new perspective to estimate intracranial high-frequency features with non-invasive neural recordings.
A Design of Ginseng Planting Environment Monitoring System Based on WSN

Through the analysis of ginseng products industry chain, this paper designs and implements ginseng planting environment monitoring system. The system realized data collection and detection of ginseng planting environment in real time by using wireless sensor, transmission of environmental parameters in real time by using GPRS wireless transmission module, and video monitor and alarm of ginseng land by using unattended machine. It is the foundation of information transformation of ginseng products industry chain based on the Internet of Things. The experiment of ginseng planting base in Fusong indicates the system can offer support of original data for scientific cultivation of ginseng, comprehensive analysis of ginseng products and propaganda of ginseng brand. Copyright © 2014 IFSA Publishing, S. L.
Any colour you like: fish interacting with bioinspired robots unravel mechanisms promoting mixed phenotype aggregations

Collective behaviours in homogeneous shoals provide several benefits to conspecifics, although mixed-species aggregations have been reported to often occur. Mixed aggregations may confer several beneficial effects such as antipredator and foraging advantages. However, the mechanisms promoting phenotypically heterogeneous fish aggregations have been poorly explored so far. Herein, the neon tetra Paracheirodon innesi was selected as the ideal model organism to test the role of visible phenotypic traits in promoting fish shoaling. Robotic fish replicas of different colours, but with a morphology inspired by P. innesi, were developed to test the affiliation behaviour of neon tetra individuals towards fish replicas with different phenotypic traits. P. innesi individuals showed a decreasing preference in shoaling with the biomimetic, the blue, the red, and the grey replicas. This could be due to the greater visibility of the blue colour even in dark conditions. Furthermore, an increased reddening of the livery is often caused by physiological processes related to a nonoptimal behavioural status. The time spent in shoaling with each fish replica was strongly influenced by different ecological contexts. The longest shoaling duration was observed when a biomimetic predator was present, while the shortest shoaling duration was recorded in the presence of food. This confirms the hypothesis that heterogeneous shoals are promoted by the antipredator benefits, and reduced by competition. This study allowed us to understand basic features of the behavioural ecology favouring heterogeneous aggregations in shoaling fish, and provided a novel paradigm for biohybrid robotics.
Increased carotid artery stiffness after preeclampsia in a cross‐sectional study of postpartum women

Preeclampsia (PE) is a hypertensive obstetrical complication associated with increased cardiovascular disease risk. Carotid artery functional assessments allow for identification of subclinical vascular dysfunction. This cross‐sectional study measured carotid artery functional indices in healthy women with a recent pregnancy complicated by PE, versus women with a prior uncomplicated pregnancy. Women with a history of PE (N = 30) or an uncomplicated pregnancy (N = 30), were recruited between 6 months and 5 years postpartum. Left and right carotid artery ultrasound measured carotid intima media thickness, plaque burden, peak systolic velocity, end diastolic flow velocity and carotid far‐wall circumferential strain (FWCS). Carotid FWCS is inversely related to vessel stiffness, where a decrease in FWCS indicates increased vessel stiffness. Right‐side FWCS did not differ between women with a history of PE versus normotensive pregnancy. Left carotid artery FWCS was lower in formerly preeclamptic women after adjustment for diameter, pulse pressure, and heart rate compared to women following an uncomplicated pregnancy (3.35 ± 1.08 × 10−3 vs. 4.46 ± 1.40 × 10−3; p = 0.003). Those with prior severe PE had the greatest decrease in FWCS adjusted to diameter, pulse pressure, and heart rate compared to healthy controls (p = 0.02). Adjusted FWCS and total serum cholesterol were independent indicators of PE history when present in a logistic regression model with confounding variables including age, body mass index, and resting blood pressure. Further investigation is needed to elucidate if FWCS can be used as a risk stratification tool for future cardiovascular disease following a pregnancy complicated by PE. A history of PE is associated with decreased left FWCS (increased left carotid artery stiffness).
Discovery of unusual dimeric piperazyl cyclopeptides encoded by a Lentzea flaviverrucosa DSM 44664 biosynthetic supercluster

Significance Actinomycetes produce many clinically useful drugs, especially antibiotics and anticancer agents. Rare actinomycetes are known to produce bioactive molecules but they remain underexplored compared to more common Streptomyces spp. Natural molecules having piperazate building blocks are often bioactive, and genome analyses previously indicated the rare actinomycete Lentzea flaviverrucosa DSM 44664 may encode for the production of such molecules. To discover these from complex fermentation mixtures, we devised and employed a targeted metabolomic approach that revealed petrichorin A, an unusual heterodimeric biaryl-cyclohexapeptide. Its structure was determined by using multi-dimensional nuclear magnetic resonance, theoretical calculations, and strain mutagenesis, and its biosynthesis implicated an atypical cytochrome p450 heterodimerization event. Petrichorin A demonstrated potent cytotoxicity, highlighting heterodimeric-biaryls as interesting features for future drug design.
Biology of Cancer and PET Imaging: Pictorial Review

CE credit: For CE credit, you can access the test for this article, as well as additional JNMT CE tests, online at https://www.snmmilearningcenter. org. Complete the test online no later than June 2025. Your online test will be scored immediately. You may make 3 attempts to pass the test and must answer 75% of the questions correctly to receive Continuing Education Hour (CEH) credit. Credit amounts can be found in the SNMMI Learning Center Activity. SNMMI members will have their CEH credit added to their VOICE transcript automatically; nonmembers will be able to print out a CE certificate upon successfully completing the test. The online test is free to SNMMI members; nonmembers must pay $15.00 by credit card when logging onto the website to take the test. Development and spread of cancer is a multistep and complex process that involves a number of alterations, interactions, and molecular networks. PET imaging is closely related to cancer biology and pathology, as it uses various radiotracers targeting biologic and pathologic changes in cancer cells and the tumor microenvironment. In this review article, the biology of the development and spread of cancer and the role of PET imaging in oncology are summarized and supported by various PET images demonstrating patterns of cancer spread.