Miracle-dz/UniFAR-FTUs huggingface dataset:
Patient–provider therapeutic connections to improve health care: Conceptual development and systematic review of patient measures

Supplemental digital content is available in the text. Background The Triple Aim (improved population health, improved patient experiences, and lower costs) has influenced U.S. health care since it was introduced in 2008. With it, value-based purchasing has brought unprecedented focus on patient experience measurement. Despite having devoted extensive resources toward improving patient experiences, inconsistent improvements suggest there are some dimensions not yet being widely measured or addressed. Furthermore, a renewed focus on health disparities calls for stronger patient–provider connections in order to reduce health care inequities. Purpose The aim of this study was to articulate the concept of therapeutic connections (TCs) in health care and examine existing survey measures, from the patient perspective, to learn whether they capture the TC construct. Method We interviewed subject matter experts (n = 24) and patients (n = 22) about measuring TCs and then conducted a systematic review of quantitative measures from three databases using PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines and COSMIN (COnsensus-based Standards for the selection of health Measurement INstruments) criteria. Results Of 31 unique measures, none captured all of the theorized TC dimensions. Most were measures of collaboration and shared decision-making or caring. Discussion Focusing on the nature of patient–provider connections is vital because they are the backbone of most delivery models seeking to achieve the Triple Aim. Further development of the TC concept and measures is warranted to facilitate organizational and financing policies that meaningfully support widespread improvement. Practice Implications A focus on barriers and facilitators of TCs is needed. Without advancing our understanding of the role TCs play in care, policymakers and practitioners will be limited in their ability to make impactful changes.
Effects of short and long milking intervals on milking characteristics and changes of milk constituents during the course of milking in crossbred Istrian × Awassi × East-Friesian ewes

Abstract The main objective of this experiment was to evaluate the effects of two milking intervals (8 and 16 h) on milk constituents (fat, protein, lactose, dry matter, and log10 SCC) of nineteen Istrian × Awassi × East-Friesian crossbred ewes in different milk fractions (0–25, 25–50, 50–75 and 75–100%) during the course of milking and in machine stripping (MS) milk. Furthermore, we sought to determine the effect of the two milking intervals on milking characteristics (average milk flow rate, peak milk flow rate, machine-on time, total milk yield, and milk production rate) and whether each milk constituent within each milking interval is best described by a linear, quadratic, or cubic function. Average milk flow rate and milk yield per milking decreased in the 8 h milking interval compared to the 16 h milking interval (P < 0.05). Peak milk flow rate, machine-on time, and milk production rate were not different between the two milking intervals. Overall, milk fat content, dry matter content, and log10 SCC increased in the 8 h milking interval compared to the 16 h milking interval (P < 0.05). Milk protein content did not change through the main milk fractions at either milking interval. Milk lactose content did not change through the milk fractions at the 8 h milking interval, whereas it decreased in the 75–100% and stripping milk fractions at the 16 h milking interval (P < 0.05). The 0–25% and stripping milk fractions contained the highest log10 SCC compared to all other milk fractions (P < 0.05). Changes of milk fat and dry matter content throughout milking were best described by quadratic functions, whereas milk protein content, milk lactose content, and log10 SCC were best described by different functions depending on the milking interval. These results demonstrate that milking interval influenced all milk constituents in various milk fractions during the course of ewe milking. Moreover, milking characteristics such as average milk flow and total milk yield, and the appropriate mathematical function to characterize milk constituents throughout a milking, were affected by milking interval.
Characterization of a Novel Linezolid Resistance Gene optrA and Bacitracin Resistance Locus-Carrying Multiple Antibiotic Resistant Integrative and Conjugative Element ICESsu1112S in Streptococccus Suis

Antimicrobial resistance (AMR) caused by the imprudent use of antimicrobials has become a global problem, which poses a serious threat to treatment of S. suis infection in pigs and humans. Importantly, AMR genes can horizontally spread among commensal organisms and pathogenic microbiota, thereby accelerating the dissemination of AMR determinants. ABSTRACT Streptococcus suis strain 1112S was isolated from a diseased pig in a feedlot from Henan, China, in 2019. The isolate harbored a linezolid resistance gene optrA. WGS data revealed that the optrA gene was associated with a single copy ETAf ISS1S, in tandem with erm(B) and tet(O), located in a novel 72,587 bp integrative and conjugative element (ICE). Notably, this novel element, designated ICESsu1112S, also carried a novel bacitracin resistance locus. ICESsu1112S could be excised from chromosome and transferred to the recipient strain S. suis P1/7 with a frequency of 5.9 × 10−6 transconjugants per donor cell. This study provided the first description of the coexistence of optrA and a novel bacitracin locus on a multiple antibiotic resistant ICE and highlighted that ICE were major vehicle and contribute to the potential transfer of clinically relevant antibiotic resistance genes. IMPORTANCE Antimicrobial resistance (AMR) caused by the imprudent use of antimicrobials has become a global problem, which poses a serious threat to treatment of S. suis infection in pigs and humans. Importantly, AMR genes can horizontally spread among commensal organisms and pathogenic microbiota, thereby accelerating the dissemination of AMR determinants. These transfers are mainly mediated by mobile genetic elements, including ICEs. In S. suis, ICEs are the major vehicles that contribute to the natural transfers of AMR genes among different bacterial pathogens. However, ICEs that carry optrA and bacitracin resistance locus are rarely investigated in S. suis isolates. Here, we investigated a S. suis isolate carrying an optrA and a novel bacitracin resistance locus, which were co-located on a novel multiple antibiotic resistant ICESsu1112S. Our study suggests that more research is needed to access the real significance of ICEs that horizontally spread clinical important resistance genes.
The profile of unusual beliefs associated with metacognitive thinking and attributional styles

Abstract Cognitive interpretations of daily events may differ in people from the general population who hold unusual beliefs. It is also important to understand whether different belief profiles exist to appreciate which patterns of beliefs are less psychologically healthy. Cluster analysis was used to form unusual belief profiles in a general population sample (n = 578; M age = 22 years, SD = 6.98; 80% female) across paranoid, paranormal, and magical ideation beliefs, and we assessed whether they differed in attribution style and metacognitive beliefs about worry. Four clusters were formed: low on all measures (low all); high on all measures (high all); comparably higher on paranormal beliefs (paranormal group); and comparably higher on paranoid beliefs (paranoid group). For total Metacognitions Questionnaire‐30, the high all and high paranoid clusters did not differ, and both clusters scored higher than the high paranormal group, who all scored higher than the low all cluster. For attributional styles (Attributional Styles Questionnaire), lower scores on internal positive attribution were found for the high all and high paranoid clusters compared to the low all and high paranormal clusters. The high paranormal cluster had higher scores than the high paranoid cluster on self‐serving bias. Differences in attributional style appeared to be driven by mental health diagnosis. Our results suggest different profiles of unusual beliefs are detectable in the general population that differ in their metacognitive beliefs and perceived causation of events in their environment. Future studies investigating delusional proneness need to consider multiple unusual beliefs as well as assessing mood state and distress.
The Built Environment Influence on Resilient Healthcare: A Systematic Literature Review of Design Knowledge

Objective: The aim of this study was to develop built environment (BE) design knowledge to support resilient healthcare by systematically reviewing the evidence-based design (EBD) literature. Background: Although the EBD literature is vast, it has not made explicit its contribution to resilient healthcare, which is a key component of the highly complex health service. Method: This review followed the steps recommended by the Preferred Reporting Items for Systematic reviews and Meta-Analyses method. After applying the inclusion and exclusion criteria, 43 journal papers were selected. The papers were analyzed in light of five guidelines for coping with complexity, allowing for the development of BE design knowledge that supports resilient healthcare. Results: The design knowledge compiled by the review was structured according to four levels of abstraction: five design-meta principles, corresponding to the five complexity guidelines, seven design principles, 21 design prescriptions, and 58 practical examples. The design knowledge emphasizes the interactions between the BE as physical infrastructure and the functions that it supports. Conclusions: The design knowledge is expected to be useful not only to architects but also to those involved in the functional design of health services as they interact with the BE. Furthermore, our proposal provides a knowledge template that can be continuously updated based on the experience of practitioners and academic research.
Spatial Binding Impairments in Visual Working Memory following Temporal Lobectomy

Abstract Disorders of the medial temporal lobe (MTL) adversely affect visual working memory (vWM) performance, including feature binding. It is unclear whether these impairments generalize across visual dimensions or are specifically spatial. To address this issue, we compared performance in two tasks of 13 epilepsy patients, who had undergone a temporal lobectomy, and 15 healthy controls. In the vWM task, participants recalled the color of one of two polygons, previously displayed side by side. At recall, a location or shape probe identified the target. In the perceptual task, participants estimated the centroid of three visible disks. Patients recalled the target color less accurately than healthy controls because they frequently swapped the nontarget with the target color. Moreover, healthy controls and right temporal lobectomy patients made more swap errors following shape than space probes. Left temporal lobectomy patients, showed the opposite pattern of errors instead. Patients and controls performed similarly in the perceptual task. We conclude that left MTL damage impairs spatial binding in vWM, and that this impairment does not reflect a perceptual or attentional deficit.
Leadership Development in U.S. Undergraduate Medical Education: A Scoping Review of Curricular Content and Competency Frameworks

Purpose To inform research on developing or adopting leadership competency frameworks for use in U.S. undergraduate medical education (UME), this scoping review describes the content of U.S. UME leadership curricula, associated competency frameworks, and content delivery. Method The authors searched PubMed, Embase, and ERIC databases on June 22, 2020. They included English-language studies that described U.S. UME curricula in which the primary end goal was leadership development. They excluded studies published before January 1, 2000. Data were extracted on leadership competency frameworks and curricular content, audience, duration, electivity, selectivity, learning pedagogies, and outcome measures. The curricular content was coded and categorized within the Medical Leadership Competency Framework (MLCF) using the constant comparative method. A repeated search of the literature on May 14, 2021, did not yield any additional studies. Results Of 1,094 unique studies, 25 studies reporting on 25 curricula met inclusion criteria. The course content of the curricula was organized into 91 distinct themes, most of which could be organized into the first 2 competencies of the MLCF: Demonstrating Personal Qualities and Working With Others. Thirteen curricula (52%) aligned with leadership competency frameworks, and 12 (48%) did not appear to use a framework. Number of participants and target learner level varied widely, as did curricula duration, with fewer than half (n = 12, 48%) spanning more than 1 semester. Most curricula (n = 14, 56%) were elective, and many (n = 16, 64%) offered experiential learning. Most studies (n = 16, 64%) reported outcomes as student perception data. Conclusions The authors found wide variation in content of U.S. UME leadership development curricula, and few curricula aligned with an established leadership competency framework. The lack of professional consensus on the scope of medical leadership and how it should be taught thwarts effective incorporation of medical leadership training within UME.
Pipeline to the Physician Assistant Profession: A Look to the Future

Abstract: The current pipeline of physician assistant (PA) school applicants reflects the future workforce of the profession, which is why the admissions process with all its components and variables is so important. Many studies have shown that a workforce that represents the patients it cares for leads to improved health outcomes, especially among underrepresented minority populations. Yet, PA programs have made little progress over the past 2 decades in increasing the diversity of matriculants and graduates. As a profession, it is our collective responsibility to intentionally advance diversity, equity, and inclusion, and examining the admissions process would be the most logical place to start.
Phytocompounds and COVID‐19: Two years of knowledge

On 31 December 2019, the World Health Organization (WHO) formally reported the occurrence of ‘viral pneumonia’ in Wuhan, China. Since then, the disease, later identified as COVID-19 has affected millions of individuals worldwide. As of 9 January, over 304 million confirmed cases and over 5.4 million deaths have been reported globally (WHO, weekly epidemiological update). The present virtual issue represents an update of a previous online issue (https://onlinelibrary. wiley.com/doi/toc/10.1002/1099-1573.Plant-Compounds-for-COVID19, Adhikari et al., 2021; Ahmad, Rehman, Ahmad, & Alkharfy, 2020; Antonelli, Donelli, Maggini, & Firenzuoli, 2020; Bahrami, Kamalinejad, Latifi, Seif, & Dadmehr, 2020; Boozari & Hosseinzadeh, 2021; Brendler et al., 2021; Chrzanowski, Chrzanowska, & Grabo n, 2021; Cui, Xin, Tao, Mei, & Wang, 2021; Dave et al., 2020; Derosa, Maffioli, D'Angelo, & Di Pierro, 2021; Fakhri, Nouri, Moradi, & Farzaei, 2020; Ganguly & Bakhshi, 2020; Habtemariam et al., 2020; Haq et al., 2020; M. T. Islam et al., 2020; M. N. Islam et al., 2021; Kim et al., 2020; Lima, Brito, & da Cruz Nizer, 2021; Masiello, Novelli, Beffy, & Menegazzi, 2020; Omotuyi et al., 2021; Parida, Paul, & Chakravorty, 2020; Pawar & Pal, 2020; Rocha & de Assis, 2020; Roy et al., 2020; Thota, Balan, & Sivaramakrishnan, 2020; Tutunchi, Naeini, Ostadrahimi, & Hosseinzadeh-Attar, 2020; Upadhyay et al., 2020; F. Yang et al., 2020; Zahedipour et al., 2020; Zaman, Saqib, Ullah, Ayaz, & Ye, 2020; Q. Zhang et al., 2020) and covers the most significant discoveries published in Phytotherapy Research in the 2021 year. Below, a summary on the main findings are reported.
A new anti-vitiligo unsaturated fatty glycoside from Euphorbia humifusa Willd

Abstract A new unsaturated fatty glycoside Humionoactosides A, together with four known compounds were isolated from the whole plant of Euphorbia humifusa Willd. Their structures were identified by MS/MS, NMR and ECD spectroscopic analyses, and comparison with the literature data. All compounds were evaluated for the effect on melanogenesis and tyrosinase activity use B16 cells in vitro, and the results showed that compound 1 could significantly improve the formation of melanin (138.7%, 50 μM) and tyrosinase activity (137.2%, 50 μM) compared with the positive control 8-MOP (125.2%, 138.9%, 50 μM) in a dose-dependent manner. This is the first time that those compounds reported from Euphorbia humifusa Willd. with potential anti-vitiligo activity. Graphical Abstract
Predictors of Health Promotion Behaviors Among Working Adults at Risk for Metabolic Syndrome

Background Metabolic syndrome has a high global prevalence, affecting 26% of South Koreans. Lifestyle modifications have shown benefits in studies involving health behavior enhancement, specifically through workplace eating and exercise interventions. However, workplace interventions focusing on health behaviors have been inadequately explored. Objectives This study examined factors affecting health promotion behaviors of workers at high risk of metabolic syndrome by applying Theory of Planned Behavior constructs (attitude, subjective norm, perceived behavioral control, and intention). Methods This correlational cross-sectional study collected survey data from 164 hotel workers in South Korea. The study applied factor analysis and structural equation modeling for the data analysis. Results Analysis revealed five health promotion behaviors: exercise, making healthy food choices, avoiding fatty foods, eating a nutritious and balanced diet, and eating regular moderate meals. Participants were grouped as total participants, those with one risk factor, and those with two risk factors. In the “total” group, four behaviors were influenced by perceived behavioral control: exercise, making healthy food choices, eating a nutritious and balanced diet, and eating regular moderate meals. In the “one risk factor” group, intention and attitude influenced the eating regular moderate meals behavior, and two other behaviors were influenced by perceived behavioral control: exercise and eating a nutritious and balanced diet; in the “two risk factor” group, only perceived behavioral control directly affected exercise. Discussion Perceived behavioral control was a key predictor of health behaviors, and theory constructs partially explained behaviors. Perceived behavioral control influenced four behaviors and influenced exercise in all three groups. Also, theory constructs showed a greater effect on behaviors in the one risk factor group than in the two risk factor group, indicating that participants with one risk factor more effectively managed their behaviors on their own and with healthcare providers’ support. Occupational health providers should conduct early assessments of workers showing metabolic syndrome risk factors to identify their particular risks, intention, and behaviors. As the number of risk factors affects behaviors and perceived behavioral control primarily influences exercise, these findings should be incorporated in metabolic syndrome interventions.
Standardization and implementation of fluorescence molecular endoscopy in the clinic

Abstract. Significance: Near-infrared fluorescence molecular endoscopy (NIR-FME) is an innovative technique allowing for in vivo visualization of molecular processes in hollow organs. Despite its potential for clinical translation, NIR-FME still faces challenges, for example, the lack of consensus in performing quality control and standardization of procedures and systems. This may hamper the clinical approval of the technology by authorities and its acceptance by endoscopists. Until now, several clinical trials using NIR-FME have been performed. However, most of these trials had different study designs, making comparison difficult. Aim: We describe the need for standardization in NIR-FME, provide a pathway for setting up a standardized clinical study, and describe future perspectives for NIR-FME. Body: Standardization is challenging due to many parameters. Invariable parameters refer to the hardware specifications. Variable parameters refer to movement or tissue optical properties. Phantoms can be of aid when defining the influence of these variables or when standardizing a procedure. Conclusion: There is a need for standardization in NIR-FME and hurdles still need to be overcome before a widespread clinical implementation of NIR-FME can be realized. When these hurdles are overcome, clinical outcomes can be compared and systems can be benchmarked, enabling clinical implementation.
The Patient Pathway Review for Atrial Fibrillation

The care pathway for patients with atrial fibrillation (AF) is variable and this variability is explored in a patient pathway review. This review describes events that may take place for a patient with AF considering the “ideal” and the “real-world” pathway and attempts to rationalize them by considering the patient, clinician, health service, and societal perspective. In the “ideal” pathway, AF in a patient is either identify before or after stroke. The “real-world” pathway introduces the concepts that symptoms may influence patient decision-making to seek help, AF may be identified incidentally, and healthcare professionals may fail to identify AF. The management of AF includes no treatment or treatment such as stroke prevention, rate or rhythm control, and comorbidity management. The overall outcomes for patient depend on the presence of symptoms and response to therapies. The two major priorities for patients are symptomatic relief and avoidance of stroke. While most clinicians will find that initial AF management is not challenging but there may be incidental opportunities for earlier identification. From the healthcare service perspective, noncardiologists and cardiologists care for patients with AF, which results in much heterogeneity management. From the societal perspective, the burden of AF is significant resulting in substantial cost from hospitalizations and treatments. People with AF can take on different paths, which depend on factors related to the patient’s decision-making, clinical decision-making, and patient’s response to the treatment. A streamlined approach to a holistic and integrated care pathway approach to AF management is needed.