Miracle-dz/UniFAR-FTUs huggingface dataset:
Retrospective drug utilization review: impact of pharmacist interventions on physician prescribing

Objectives: To evaluate the impact of retrospective drug utilization review (RDUR), pharmacist’s interventions on physician prescribing, and the level of spillover effect on future prescriptions following the intervention. Methods: A retrospective case–control study was conducted at a pharmacy benefits management company using the available prescription data from April 2004 to August 2005. RDUR conflicts evaluated and intervened by a clinical pharmacist served as a case group, whereas conflicts that were not evaluated and intervened by a clinical pharmacist served as a control group. Results: A total of 40,284 conflicts in cases and 13,044 in controls were identified. For cases, 32,780 interventions were considered nonrepetitive, and 529 were repetitive. There were 22,870 physicians in cases that received intervention letters and 2348 physicians in the control group that would have received intervention letters during the study period. Each physician received on average 1.4 interventions for cases vs 3.0 for controls. Among the case physicians who were intervened during the study period, 2.2% (505) were involved in a repeated intervention vs 18.2% (428) in controls ( P , 0.001), which is an eight-fold difference. The most common conflict intervened on in cases was therapeutic appropriateness (8277, 25.3%), and for controls it was drug–drug interactions (1796, 25.4%). The overall interventional spillover effect in cases was 98.4% vs 89.4% in controls ( P = 0.01). Conclusion: RDUR is an effective interventional program which results in decreased numbers of interventions per physician and provides a significant impact on future prescribing habits.
Pharmacoeconomics and Considerations for Injectable Products: Focus on Colony-Stimulating Factors

BACKGROUND: Provider claims data are used to make medical analyses and decisions, but such databases typically lack important clinical information. OBJECTIVE: To compare the patterns of use of filgrastim in analyses of a claims database and a medical chart review. METHODS: We extracted data from the Medicare 5% sample claims database for the years 1996 through 1998 and from a medical chart review of the Oncology Practice Pattern Survey (OPPS) for the same period to determine the patterns of use of filgrastim in patients with non-Hodgkin’s lymphoma treated with cyclophosphamide, doxorubicin, vincristine, and prednisone. The analyses were restricted to the first 3 cycles of the chemotherapy. RESULTS: A total of 414 patients in the Medicare database were treated with 1,360 cycles of chemotherapy. The mean duration of filgrastim use in these patients was 6.6 days. In the OPPS database, 80 patients were treated with 152 cycles of chemotherapy, with a mean duration of filgrastim use of 9.3 days. CONCLUSION: The mean duration of filgrastim use in the OPPS database was greater than that in the Medicare database and was closer to that shown in clinical trials to produce optimal results (approximately 11 days). The actual use of resources may be underestimated in claims databases, owing to their limitations and potential for bias.
Monitoring the spin environment of coupled quantum dots : towards the deterministic generation of photonic cluster states

Indium gallium arsenide self-assembled quantum dots have attracted a lot of attention due to their ability to trap single electrons and holes whose spin can be manipulated optically. This makes them attractive as qubits and light sources in various quantum computing and communication schemes. However, the spin of electrons and holes rapidly decoheres due to hyper-fine interaction with the atomic nuclei of the dot. The theme of this thesis is to find ways of overcoming this decoherence, in particular to allow generation of photonic cluster states from quantum dots. This was first approached by designing theoretical schemes to measure and compensate for the source of the decoherence, which were experimentally tested. Two new systems were then theoretically designed where the effects of decoherence could be mitigated. It is shown theoretically that exciting a quantum dot with a laser of well-defined polarisation and monitoring the polarisation of emitted photons, it is possible to determine the vector polarisation of the nuclear spin ensemble. It is shown through simulation that this measurement can be performed on and possibly faster than the time-scale of nuclear fluctuations. The fundamental concept behind the measurement procedure is proved in an experiment using coupled quantum dots. Through the course of the experiment anomalous behaviour of the dots was discovered. A second theoretical proposal is made for a system allowing the fast application of an effective field to compensate for the decoherence mechanism. It is then shown by simulation that a coupled dot system with a prepared in-plane nuclear spin polarisation, can allow optical spin rotation and entanglement generation. A different system is then theoretically proposed where the electron spin in quantum dot can be replaced with another qubit, such as embedded manganese atoms. It is shown through simulation that this system also allows the generation of photonic cluster states.
Characterisation of multi-scale of Plasmodium falciparum malaria incidence in children of Camopi, French Guiana, by means of remotely sensed data

Malaria remains a major health problem in French Guiana despite the decrease in the number of cases since 2010. A previous study in Camopi, an Amerindian village on the Oyapock River, revealed that Plasmodium falciparum malaria incidence was significantly related to landscape features and that its spatial distribution exhibited some obvious patterns. In the present study, we first identified the spatial patterns that exhibit a significant Moran's index of spatial auto-correlation and that significantly explain P. falciparum malaria incidence within the multiple linear regression framework. Secondly, we linked these patterns with remotely sensed environmental features. The selected model is composed of five spatial components: three patterns, representing 50.7% of the total variance, are associated with large scale variations of the incidence, and the remaining patterns are associated with local scale variations and represent 28.7% of the total variance. Different hamlet clusters that have specificities in terms of P. falciparum malaria incidence rate, environmental characteristics and mosquito control strategies have been identified. The methodology proposed in the present study can provide useful knowledge on the spatial distribution of the P. falciparum malaria incidence in Camopi at different scales and on possible explanation of such distribution, as a function of the scale.
Usability of the dynamic scaffolding system: an adaptive mobility device in children with special needs

Abstract Purpose Maintaining vertical position and moving are essential to healthy development. Children with motor difficulties may need assistive devices to stand upright or move. The Dynamic Scaffolding System (DSS) device was developed to support these skills. This study aims to explain the DSS's developmental stages, compare the device’s usage times based on diagnoses and motor impairment, and investigate the degree of satisfaction among parents of children using the device. Materials and methods The study included children with difficulty standing or stepping and their parents. We compared usage times of DSS depending on diagnosis (cerebral palsy (CP) or other diagnoses) and motor impairment levels. We assessed parental satisfaction by using the Quebec User Evaluation of Satisfaction with Assistive Technology (QUEST 2.0) and recorded adverse events. Results The ages of the participants (n:100) were between 9 and 108 months (44.94 ± 17.59), and 60% of the children had CP, and 40% had other diagnoses (genetic, metabolic, neuromuscular diseases). The duration of daily use of DSS ranged from 44.17 (±26.16) to 110 (±97.98) minutes, and the duration was similar among children at different levels of motor impairment (p = 0.262). The parents were most satisfied with the size, simplicity of use, and effectiveness, and they were least satisfied with the ease of adjustment, safety, and durability. They did not report any adverse events during the study. Conclusions DSS can be considered a useable assistive device option for children with CP and other diagnoses with difficulty standing or stepping and a satisfactory device for parents of such children. Implications for Rehabilitation The Dynamic Scaffolding System (DSS) is a useable trunk-supported adaptive walker for children with moderate to severe motor impairment. Parents are most satisfied with DSS's size, simplicity of use, and effectiveness. Children with moderate and severe motor impairment have similar duration of daily use time of DSS.
MicroRNA Biomarkers: Pitfalls and Potential

Thirty years ago, the small molecules we now know as microRNAs (miRNAs) would have been regarded as “junk” genetic material. Today, miRNAs have been hailed as promising biomarkers for diseases including cancer, neurological disorders, heart conditions, and infections. Although progress has been made toward characterizing the role of miRNAs in different diseases, there remain challenges in bringing them into clinical use. Researchers continue to explore where miRNAs will make the most impact.
Understanding factors affecting the integration of geriatric nurse practitioners into health systems

Supplemental Digital Content is Available in the Text. ABSTRACT Background: Geriatric nurse practitioners (NPs) are introduced into health systems to alleviate provider shortages and improve care for older adults. To achieve these goals, geriatric NPs must be integrated into the health system such that they can efficaciously practice. Internationally, little is known about factors affecting the integration of NPs. Such evidence would improve policymaking and the impact of geriatric NPs on care. In Israel, geriatric NPs were recently introduced. Their ongoing integration is an exemplar for other countries. Purpose: To identify factors affecting the integration of geriatric NPs in Israel and discuss application of these factors in international policy and research. Methodology: The Consolidated Framework for Implementation Research guided this qualitative descriptive study. A semistructured interview guide was used to collect data from four professional groups (geriatric NPs, physicians, administrators, and policymakers), which, together, provide a system-level perspective. Factors were identified using deductive content analysis and designated as facilitators, barriers, neutral, or mixed effects. Results: There were 58 participants across the four professional groups. Twenty-eight factors were identified, including patient needs and leadership engagement (facilitators), available information (barrier), culture (mixed), and evidence strength (neutral). Perspectives on several factors differed by the professional group's role in integrating NPs (e.g., costs). Conclusions: The barriers highlight lacking interprofessional support from a priori policymaking and communication breakdowns. Policies should reflect priorities of administrators, clinicians, and policymakers. Implications: These factors may inform policymaking in other countries but would be most effective if based on country-specific research. This implementation science approach may inform future studies.
Needle Direction and Distance of Arteriovenous Fistula Cannulation in Hemodialysis Adequacy; a Systematic Review and Meta-Analysis

Introduction: This systematic review and meta-analysis aimed to summarize the evidence regarding the impact of needle direction and distance of arteriovenous fistula (AVF) cannulation on KT/V (where k is the dialyzer urea clearance, t, the duration of dialysis, and V, the volume of distribution of urea) and access recirculation (AR) as hemodialysis (HD) adequacy criteria. Methods: A comprehensive systematic search was performed on international and domestic electronic databases from the earliest to June 4, 2022 using keywords. Analysis was performed in STATA software v.14. Results: Three randomized control trials (RCTs) and four non-RCT articles were included in the final review. Six studies reported the effects of direction, while four mentioned the effects of distances of AVF cannulation on outcomes of HD adequacy based on KT/V or AR. Results of three non-RCT studies showed that retrograde direction decreased KT/V more than antegrade direction (ES: 0.44, 95% CI: -0.38 to 1.27). Two non-RCT studies showed that antegrade decreased AR compared to the retrograde direction (ES: -0.64, 95%CI: -1.94 to 0.67). However, the results of two RCTs indicated uncertainty about this issue. Two of the four studies suggested that a distance of 5 cm or more in arterial and venous needles had greater adequacy than a distance of less than 5 cm. However, other studies did not confirm this finding. Conclusion: Overall comparison of the results qualitatively and quantitatively indicated uncertainty about the effects of direction and distance of AVF cannulation on HD adequacy outcomes. More studies with high-quality designs, such as RCTs, are required to better understand and adjudicate the effects of needle direction and distance of AVF cannulation on HD adequacy outcomes.
Spreading Depolarizations Suppress Hematoma Growth in Hyperacute Intracerebral Hemorrhage in Mice

BACKGROUND: Spreading depolarizations (SDs) occur in all types of brain injury and may be associated with detrimental effects in ischemic stroke and subarachnoid hemorrhage. While rapid hematoma growth during intracerebral hemorrhage triggers SDs, their role in intracerebral hemorrhage is unknown. METHODS: We used intrinsic optical signal and laser speckle imaging, combined with electrocorticography, to investigate the effects of SD on hematoma growth during the hyperacute phase (0–4 hours) after intracortical collagenase injection in mice. Hematoma expansion, SDs, and cerebral blood flow were simultaneously monitored under normotensive and hypertensive conditions. RESULTS: Spontaneous SDs erupted from the vicinity of the hematoma during rapid hematoma growth. We found that hematoma growth slowed down by >60% immediately after an SD. This effect was even stronger in hypertensive animals with faster hematoma growth. To establish causation, we exogenously induced SDs (every 30 minutes) at a remote site by topical potassium chloride application and found reduced hematoma growth rate and final hemorrhage volume (18.2±5.8 versus 10.7±4.1 mm3). Analysis of cerebral blood flow using laser speckle flowmetry revealed that suppression of hematoma growth by spontaneous or induced SDs coincided and correlated with the characteristic oligemia in the wake of SD, implicating the vasoconstrictive effect of SD as one potential mechanism of action. CONCLUSIONS: Our findings reveal that SDs limit hematoma growth during the early hours of intracerebral hemorrhage and decrease final hematoma volume.
Rat Hepatitis E Virus in Norway Rats, Ontario, Canada, 2018–2021

We tested liver samples from 372 Norway rats (Rattus norvegicus) from southern Ontario, Canada, during 2018–2021 to investigate presence of hepatitis E virus infection. Overall, 21 (5.6%) rats tested positive for the virus. Sequence analysis demonstrated all infections to be rat hepatitis E virus (Rocahepevirus ratti genotype C1).
Isoniazid preventive therapy completion and factors associated with non-completion among patients on antiretroviral therapy at Kisenyi Health Centre IV, Kampala, Uganda

Background Isoniazid preventive therapy (IPT) is given to HIV patients to reduce the risk of active tuberculosis (TB). However, treatment completion remains suboptimal among those that are initiated. This study aimed to determine the completion level of IPT and the factors associated with non-completion among patients on antiretroviral therapy (ART) at Kisenyi Health Center IV in Kampala, Uganda. Methods A mixed-methods facility-based retrospective cohort study utilizing routinely collected data from 341 randomly selected HIV patients initiated on IPT was conducted. Data extracted from the registers was used to determine IPT completion. Robust Poisson regression was conducted to determine the associated factors of IPT non-completion, while in-depth interviews were conducted to explore barriers to IPT completion from the patient’s perspective. Results A total of 341 patients who started on isoniazid (INH) were retrospectively followed up, with 69% (236/341) being female. Overall IPT completion was 83%. Multivariate analysis revealed the prevalence of IPT non-completion among males was 2.24 times the prevalence among females (aPR 2.24, 95% CI: 1.40–3.58, p = 0.001). The prevalence of IPT non-completion among patients with a non-suppressed HIV viral load was 3.00 times the prevalence among those with a suppressed HIV viral load (aPR 3.00, 95% CI: 1.44–6.65, p = 0.007). The prevalence of IPT non-completion among patients who were married, or cohabiting was 0.31 times the prevalence among those who were single (aPR 0.31, 95% CI: 0.17–0.55, p<0.000). Lack of IPT-related health education, pill burden, distance to the health facility, and patient relocation were reported as barriers to IPT completion. Conclusion IPT completion was found to be 83% among the cohort studied. However, lower completion levels persist among males and HIV-virally non-suppressed patients. Lack of IPT-related health education, pill burden, distance to the health facility, and patient relocation were reported as barriers to IPT completion. Interventions that target these groups of people need to be intensified.
Multimodal Assessment of Schizophrenia Symptom Severity From Linguistic, Acoustic and Visual Cues

Assessing the condition of every schizophrenia patient correctly normally requires lengthy and frequent interviews with professionally trained doctors. To alleviate the time and manual burden on those mental health professionals, this paper proposes a multimodal assessment model that predicts the severity level of each symptom defined in Scale for the Assessment of Thought, Language, and Communication (TLC) and Positive and Negative Syndrome Scale (PANSS) based on the patient’s linguistic, acoustic, and visual behavior. The proposed deep-learning model consists of a multimodal fusion framework and four unimodal transformer-based backbone networks. The second-stage pre-training is introduced to make each off-the-shelf pre-trained model learn the pattern of schizophrenia data more effectively. It learns to extract the desired features from the view of its modality. Next, the pre-trained parameters are frozen, and the light-weight trainable unimodal modules are inserted and fine-tuned to keep the number of parameters low while maintaining the superb performance simultaneously. Finally, the four adapted unimodal modules are fused into a final multimodal assessment model through the proposed multimodal fusion framework. For the purpose of validation, we train and evaluate the proposed model on schizophrenia patients recruited from National Taiwan University Hospital, whose performance achieves 0.534/0.685 in MAE/MSE, outperforming the related works in the literature. Through the experimental results and ablation studies, as well as the comparison with other related multimodal assessment works, our approach not only demonstrates the superiority of our performance but also the effectiveness of our approach to extract and integrate information from multiple modalities.
Anaplasma bovis–Like Infections in Humans, United States, 2015–2017

We detected the DNA of an Anaplasma bovis–like bacterium in blood specimens from 4 patients from the United States with suspected tickborne illnesses. Initial molecular characterization of this novel agent reveals identity to A. bovis–like bacteria detected in Dermacentor variabilis ticks collected from multiple US states.
The influence of environmental parameters on quantity and structure of the phytoplankton in eutrophic Głębokie Uścimowskie lake

Light conditions, nutrient concentration and phytoplankton species composition were studied in shallow eutrophic Glebokie Uścimowskie Lake. During two seasons (2006 and 2007) between June and September, clear-cut dominance (80%) of Cyanobacteria was recorded: Planktolyngbya limnetica and species of the genus Limnothrix spp. Statistical analyses showed that the following factors influenced phytoplankton quantity and taxonomic composition: water temperature, light intensity in water depths and the amount of dissolved nutrients (P-PO4, NO3 , NH4 ). In particular, considerable light absorption in turbid, frequently mixed waters and dissolved phosphorus shortage affected the structure of algae communities.
The current state of research on influenza antiviral drug development: drugs in clinical trial and licensed drugs

ABSTRACT Influenza viruses (IVs) threaten global human health due to the high morbidity, infection, and mortality rates. Currently, the influenza drugs recommended by the FDA are oseltamivir, zanamivir, peramivir, and baloxavir marboxil. Notably, owing to the high variability of IVs, no drug exists that can effectively treat all types and subtypes of IVs. Moreover, the current trend of drug resistance is likely to continue as the viral genome is constantly mutating. Therefore, there is an urgent need to develop drugs related to the treatment of influenza to deal with the next pandemic. Here, we summarized the cutting-edge research in mechanism of action, inhibitory activity, and clinical efficacy of drugs that have been approved and drugs that are still in clinical trials for influenza treatment. We hope this review will provide up-to-date and comprehensive information on influenza antivirals and generate hypotheses for screens and development of new broad-spectrum influenza drugs in the near future.
Racial differences in concussion diagnosis and mechanism of injury among adults presenting to emergency departments across the United States

ABSTRACT Objectives The purpose of this study was to examine the association between race and concussion diagnosis as well as the association between race and mechanism of injury (MOI) for concussion diagnoses in adult patients (>19 years old) visiting the emergency department (ED). Methods A retrospective analysis of patient visits to the ED for concussion between 2010 and 2018, using the National Hospital Ambulatory Medical Care Survey, was conducted. Outcome measures included concussion diagnosis and MOI. Multivariable and multinomial logistic regression analyses were conducted to assess associations between race and outcome variables. The results were weighted to reflect population estimates with a significance set at p < 0.05. Results Overall, 714 patient visits for concussions were identified, representing an estimated 4.3 million visits nationwide. Black adults had lower odds of receiving a concussion diagnosis [p < 0.05, Odds Ratio (OR), 0.54; 95% Confidence Interval (CI), 0.38–0.76] compared to White adults in the ED. There were no significant differences in MOI for a concussion diagnosis by race. Conclusion Racial differences were found in the ED for concussion diagnosis. Disparities in concussion diagnosis for Black or other minoritized racial groups could have significant repercussions that may prolong recovery or lead to long-term morbidity.