The Impact of Social Services on the Utilization of Health Care Services

Indiana University-Purdue University Indianapolis (IUPUI)The unnecessary medical care causes a heavy financial burden for the patients themselves and the society, and they also negatively impact the quality of medical care. An estimated 13% to 27% of ED visits in the United States could be managed in physician offices, clinics, and urgent care centers, saving $4.4 billion annually, and 26 percent of hospitalizations were potentially avoidable at a cost of$5.6 billion in 2005. If we can help people become more aware of health care services, it could be a potentially effective way to reduce emergency service overuse. we focused on mental health service and social work service as intervention variable, preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem as outcomes to determine the impact of specific social service on utilization of specific health care service adjusting for other characteristics of patients (demographic and utilization history information). The data which involved 24074 patients was provided from and managed by the Regenstrief Institute. The date of having the specific service and the frequency of using the specific health care service per year from 2011 to 2014 for each patient was recorded as well as the baseline information including gender, age, race, primary care visit per year before 2011, ACG risk score at 2011, ED visit per year before 2011. For each of preventable ED visit, preventable ED visit due to mental health problem and hospitalization due to mental health problem, we fitted a multiple linear regression model to ascertain the effects of mental health service and social work service adjusted for the baseline information. There was a significant relationship between preventable ED visit & mental health service, hospitalization due to mental health problems & mental health service, as well as hospitalization due to mental health problems & social work service. We found that in most situation, social services were positively associated with health care service. But in the second model which described the impact of mental health service on utilization of hospitalization due to mental health problem, receiving one mental health service can reduce the utilization of hospitalization due to mental health problem, which is as our expectation. According to our study, appropriate amount of services appears helpful on reducing the overuse of ED and hospitalization due to mental health problem. However, people who overused ED or hospitalization in the past were also more likely to be frequent service users, and they tended to continue overuse ED or Incur more hospitalization. There is a group of people who overuse ED or hospitalization without having any service. ED or hospitalization may be their first choice because of their financial condition or other factors, which makes them have no interest to take services

Character Strengths, Strengths Use, Future Self-Continuity and Subjective Well-Being Among Chinese University Students

The study was designed to explore the relationships among character strengths, strengths use, future self-continuity and subjective well-being. A total of 225 undergraduates completed paper-and-pencil questionnaires assessing character strengths, strengths use, future self-continuity, and subjective well-being. Results suggested several character strengths were correlated with subjective well-being and the strongest correlations were found for hope, curiosity, zest, perseverance and love. All character strengths were significantly correlated with strengths use. Strengths use and future self-continuity were robustly correlated with subjective well-being. The mediation analysis showed that strengths use mediates the relationship between character strengths and subjective well-being, and specifically, the indirect effects of strengths use varies from different character strengths. The moderated mediator suggested that future self-continuity moderated the mediation of strengths use because future self-continuity moderates the effect of strengths use on subjective well-being. Furthermore, the indirect effect of strengths use was stronger with high level of future self-continuity than those with low level of future self-continuity. The present findings make a contribution to understand the underlying mechanisms involving in character strengths are associated with higher level of well-being. Additionally, the findings expand knowledge about future self-continuity and its relation to strengths use and subjective well-being among undergraduates, having significant implications in the educational context

Self-Actuated, Thermo-Responsive Hydrogel Valves for Lab on a Chip

An easy to fabricate, thermally-actuated, self-regulated hydrogel valve for flow control in pneumatically driven, microfluidic systems is described. This microvalve takes advantage of the properties of the hydrogel, poly(N-isopropylacrylamide), as well as the aqueous fluid itself to realize flow control. The valve was designed for use in a diagnostic system fabricated with polycarbonate and aimed at the detection of pathogens in oral fluids at the location of the sample collection. The paper describes the construction and characterization of the hydrogel valves and their application for flow control, sample and reagent metering, sample distribution into multiple analysis paths, and the sealing of a polymerase chain reaction (PCR) reactor to suppress bubble formation. The hydrogel-based flow control is electronically addressable, does not require any moving parts, introduces minimal dead volume, is leakage and contaminant free, and is biocompatible

A Supramolecular Catalyst Self-Assembled From Polyoxometalates and Cationic Pillar[5]arenes for the Room Temperature Oxidation of Aldehydes

Oxidizing aldehydes to generate carboxylic acids is a crucial reaction in nature and in chemical industry. The aldehyde oxidation, an easily achieved process in liver cells, is inert toward autoxidation in industrial production and difficultly achieved under enzymatic condition (in water, at pH 7, at room temperature). Herein, we prepared a supramolecular catalyst which are nanospheres assembled in aqueous media by chromium centered Anderson polyoxometalates Na3[CrMo6O18(OH)3] (namely, CrMo6) and cationic pillar[5]arenes (namely, P5A) with 10 positive charges which can be used as the phase transfer catalysts (PTCs). This supramolecular catalyst was exploited on aldehydes oxidation under enzymatic condition with relatively good conversion. Through DLS monitoring, the diameters of nanospheres were variable while changing the charge ratios of the ionic complexes (P5A-CrMo6), and it is probably because of the closer charge ratios causing the more compact assemblies. Also, the nano-morphologies were monitored by TEM and SEM, and the nanostructures were characterized by zeta potential, the X-ray energy-dispersive spectroscopy (EDS), elemental analysis

Absolute frequency measurements with a robust, transportable ^{40}Ca^{+} optical clock

We constructed a transportable 40Ca+ optical clock (with an estimated minimum systematic shift uncertainty of 1.3*10^(-17) and a stability of 5*10^(-15)/sqrt{tau} ) that can operate outside the laboratory. We transported it from the Innovation Academy for Precision Measurement Science and Technology, Chinese Academy of Sciences, Wuhan to the National Institute of Metrology, Beijing. The absolute frequency of the 729 nm clock transition was measured for up to 35 days by tracing its frequency to the second of International System of Units. Some improvements were implemented in the measurement process, such as the increased effective up-time of 91.3 % of the 40Ca+ optical clock over a 35-day-period, the reduced statistical uncertainty of the comparison between the optical clock and hydrogen maser, and the use of longer measurement times to reduce the uncertainty of the frequency traceability link. The absolute frequency measurement of the 40Ca+ optical clock yielded a value of 411042129776400.26 (13) Hz with an uncertainty of 3.2*10^(-16), which is reduced by a factor of 1.7 compared with our previous results. As a result of the increase in the operating rate of the optical clock, the accuracy of 35 days of absolute frequency measurement can be comparable to the best results of different institutions in the world based on different optical frequency measurements.Comment: 15 pages, 5 figure

UrbanGenoGAN: pioneering urban spatial planning using the synergistic integration of GAN, GA, and GIS

Introduction: Urban spatial planning is critical for the development of sustainable and livable cities. However, traditional planning methods often face challenges in handling complex planning scenarios and large-scale data.Methods: This paper introduces UrbanGenoGAN, a novel algorithm that integrates generative adversarial networks (GANs), genetic optimization algorithms (GOAs), and geographic information system (GIS) to address these challenges. Leveraging the generative power of GANs, the optimization capabilities of genetic algorithms, and the spatial analysis capabilities of GIS, UrbanGenoGAN is designed to generate optimized urban plans that cater to various urban planning challenges. Our methodology details the algorithm’s design and integration of its components, data collection and preprocessing, and the training and implementation processes.Results: Through rigorous evaluation metrics, comparative analysis with existing methodologies, and case studies, the proposed algorithm demonstrates significant improvement in urban planning outcomes. The research also explores the technical and practical considerations for implementing UrbanGenoGAN, including scalability, computational efficiency, data privacy, and ethical considerations.Discussion: The findings suggest that the integration of advanced machine learning and optimization techniques with spatial analysis offers a promising approach to enhancing decision-making in urban spatial planning. This work contributes to the growing field of AI applications in urban planning and paves the way for more efficient and sustainable urban development

Lack of Association Between DJ-1 Gene Promoter Polymorphism and the Risk of Parkinson’s Disease

Low DJ-1 protein level caused by DJ-1 gene mutation leads to autosomal recessive Parkinson’s disease (PD) due to impaired antioxidative activity. In sporadic PD patients, although mutations were rarely found, lower DJ-1 protein level was also reported. Dysregulation of DJ-1 gene expression might contribute to low DJ-1 protein level. Since the promoter is the most important element to initiate gene expression, whether polymorphisms in the DJ-1 promoter result in the dysregulation of gene expression, thus leading to low protein level and causing PD, is worth exploring. The DJ-1 promoter region was sequenced in a Chinese cohort to evaluate possible links between DJ-1 promoter polymorphisms, PD risk and clinical phenotypes. Dual-luciferase reporter assay was conducted to evaluate the influence of promoter polymorphisms on DJ-1 transcriptional activity. Related information in an existing genome-wide association studies (GWAS) database were looked up, meta-analysis of the present study and other previous reports was conducted, and expression quantitative trait loci (eQTL) analysis was performed to further explore the association. Three single nucleotide polymorphisms (SNPs) (rs17523802, rs226249, and rs35675666) and one 18 bp deletion (rs200968609) were observed in our cohort. However, there was no significant association between the four detected genetic variations and the risk of PD either in allelic or genotype model, in single-point analysis or haplotype analysis. This was supported by the meta-analysis of this study and previous reports as well as that of GWAS database PDGene. Dual luciferase reporter assay suggested these promoter polymorphisms had no influence on DJ-1 transcriptive activity, which is consistent with the eQTL analysis results using the data from GTEx database. Thus, DJ-1 promoter polymorphisms may play little role in the dysregulation of DJ-1 expression and PD susceptibility in sporadic PD

Cotton WATs Modulate SA Biosynthesis and Local Lignin Deposition Participating in Plant Resistance Against Verticillium dahliae

Verticillium wilt, caused by Verticillium dahliae, seriously limits cotton production. It is difficult to control this pathogen damage mainly due to the complexity of the molecular mechanism of plant resistance to V. dahliae. Here, we identified three homologous cotton Walls Are Thin (WAT) genes, which were designated as GhWAT1, GhWAT2, and GhWAT3. The GhWATs were predominantly expressed in the roots, internodes, and hypocotyls and induced by infection with V. dahliae and treatment with indole-3-acetic acid (IAA) and salicylic acid (SA). GhWAT1-, GhWAT2-, or GhWAT3-silenced plants showed a comparable phenotype and level of resistance with control plants, but simultaneously silenced three GhWATs (GhWAT123-silenced), inhibited plant growth and increased plant resistance to V. dahliae, indicating that these genes were functionally redundant. In the GhWAT123-silenced plants, the expression of SA related genes was significantly upregulated compared with the control, resulting in an increase of SA level. Moreover, the histochemical analysis showed that xylem development was inhibited in GhWAT123-silenced plants compared with the control. However, lignin deposition increased in the xylem of the GhWAT123-silenced plants compared to the control, and there were higher expression levels of lignin synthesis- and lignifications-related genes in the GhWAT123-silenced plants. Collectively, the results showed that GhWATs in triple-silenced plants acts as negative regulators of plant resistance against V. dahliae. The potential mechanism of the WATs functioning in the plant defence can modulate the SA biosynthesis and lignin deposition in the xylem

Natural Coevolution of Tumor and Immunoenvironment in Glioblastoma.

Isocitrate dehydrogenase (IDH) wild-type glioblastoma (GBM) has a dismal prognosis. A better understanding of tumor evolution holds the key to developing more effective treatment. Here we study GBM\u27s natural evolutionary trajectory by using rare multifocal samples. We sequenced 61,062 single cells from eight multifocal IDH wild-type primary GBMs and defined a natural evolution signature (NES) of the tumor. We show that the NES significantly associates with the activation of transcription factors that regulate brain development, including MYBL2 and FOSL2. Hypoxia is involved in inducing NES transition potentially via activation of the HIF1A-FOSL2 axis. High-NES tumor cells could recruit and polarize bone marrow-derived macrophages through activation of the FOSL2-ANXA1-FPR1/3 axis. These polarized macrophages can efficiently suppress T-cell activity and accelerate NES transition in tumor cells. Moreover, the polarized macrophages could upregulate CCL2 to induce tumor cell migration. SIGNIFICANCE: GBM progression could be induced by hypoxia via the HIF1A-FOSL2 axis. Tumor-derived ANXA1 is associated with recruitment and polarization of bone marrow-derived macrophages to suppress the immunoenvironment. The polarized macrophages promote tumor cell NES transition and migration. This article is highlighted in the In This Issue feature, p. 2711