Miracle-dz/UniFAR-FTUs huggingface dataset:
Reclassification Risk in the Small Group Health Insurance Market

We evaluate reclassification risk in the small group health insurance market from a period before ACA community rating regulations. Using detailed individual-level data from a large insurer, we find a pass through of 16% from health risk to premiums with enrollee fixed effects, and 70% without fixed effects. The fixed effects estimates identify the extent to which the insurer passes through changes in risk to changes in premiums while the higher estimates without fixed effects may be due to more risk rating for new accounts. Our estimates control for selection into insurance take-up with a non-parametric selection model, using individual risk and industrial sector as exclusion restrictions. Our results are also robust to other possibilities, including potential measurement error of risk scores and slow pass through over time. We seek to explain why our fixed effects estimates are much closer to community rating than full experience rating. The limited pass through may be due to implicit “guaranteed renewability” contracts with one-sided pricing commitment on the part of the insurer, as our results are broadly consistent with the equilibrium pass through that would occur under these contracts. Our results cannot be explained by market power, search frictions, or slow pass through over time. We simulate the value that is generated by the insurer’s pricing policy relative to counterfactual pricing policies. The insurer’s policy generates 60% of the welfare gain from community rating relative to full experience rating. Even community rated plans generate substantial reclassification risk due to high out-of-pocket costs.
Historical observations contributing insights on etiopathogenesis of rheumatoid arthritis and role of rheumatoid factor

When studies on rheumatoid arthritis (RA) that were made many decades ago and could be considered “historical” in nature are analyzed in the context of recent observations, important insights on RA and on the function of rheumatoid factor (RF) become apparent. RF in the role of antibody to immune complexes (ICs) appears to be involved in activation of the complement system and in the production of chemotactic and inflammatory mediators, creating a condition that can be sustained and reinitiated. In the synovial cavity, a state of nonresolving inflammation is produced with the formation of citrullinated protein antigen–antibody complexes or other forms of ICs. This is followed by a second wave of IC production in the form of RF acting as antibody reactive with the initial ICs. Both of these processes are associated with complement consumption and production of inflammatory mediators. We present a model of an initiation phase of RA that might represent an example of repetitive formation of ICs and complement-mediated inflammation. Targeting therapy at this phase of RA to break the cycles of recurrent inflammation might be a novel approach to aid in further control of the disease.
Interaction of a Receptor Tyrosine Kinase, EGF-R, with Caveolins

Caveolin, a 21–24-kDa integral membrane protein, is a principal component of caveolae membranes. We and others have suggested that caveolin functions as a scaffolding protein to organize and concentrate certain caveolin-interacting signaling molecules within caveolae membranes. In this regard, it has been shown that a 20-amino acid membrane-proximal region of the cytosolic NH2-terminal domain of caveolin is sufficient to mediate the interaction of caveolin with signaling proteins, namely G-proteins, Src-like kinases, eNOS, and H-Ras. This caveolin-derived protein domain has been termed the caveolin-scaffolding domain. Binding of the caveolin-scaffolding domain functionally suppresses the activity of G-protein α subunits, eNOS, and Src-like kinases, suggesting that caveolin binding may also play a negative regulatory role in signal transduction. Here, we report the direct interaction of caveolin with a growth factor receptor, EGF-R, a known caveolae-associated receptor tyrosine kinase. Two consensus caveolin binding motifs have been previously defined using phage display technology. One of these motifs is present within the conserved kinase domains of most known receptor tyrosine kinases (termed region IX). We now show that this caveolin binding motif within the kinase domain of the EGF-R can mediate the interaction of the EGF-R with the scaffolding domains of caveolins 1 and 3 but not with caveolin 2. In addition, the scaffolding domains of caveolins 1 and 3 both functionally inhibit the autophosphorylation of the EGF-R kinasein vitro. Importantly, this caveolin-mediated inhibition of the EGF-R kinase could be prevented by the addition of an EGF-R-derived peptide that (i) contains a well conserved caveolin binding motif and (ii) is located within the kinase domain of the EGF-R and most known receptor tyrosine kinases. Similar results were obtained with protein kinase C, a serine/threonine kinase, suggesting that caveolin may function as a general kinase inhibitor. The implications of our results are discussed within the context of caveolae-mediated signal transduction. In this regard, caveolae-coupled signaling might explain how linear signaling pathways can branch and interconnect extensively, forming a signaling module or network.
Perceptions of death among adults with intellectual disability and awareness of their own mortality

The longevity and aging process observed specifically in people with intellectual disability has been extensively studied, as has their experience of bereavement. Research concerning end of life and palliative care for this population remains limited, but is developing, notably in English-speaking countries. Not enough is known, however, about the personal relationship, which these people may have with death, the images they associate with it or how aware they are of their own ultimate end. This article deals with these issues, based on the study of 273 cases of adults with varying degrees of intellectual disability confronted with death as a result of the loss of a someone close or their developing their own life-threatening illness. Material was collected using questionnaires filled out by their professional carer-providers. 31 situations were then examined in detail and interviews conducted with the subjects, their families and carers. The results show that their perceptions of death are greater than might be expected. Nevertheless, more severe intellectual ability can induce unfinished or particular concepts of death and regardless of the level of disability, the emotional dimension can interfere with the way such events are perceived. Awareness of specific behaviors can help professionals and family members support the growing number of people with intellectual disability who must deal with bereavement or end-of-life situations.
SCUBA diving And mArine ConServAtion: CollABorAtion At two AUStrAliAn SUBtropiCAl deStinAtionS

reational activities. t wo New South Wales (NSW) volunteer underwater conservation groups [Solitary Islands Underwater research Group Inc. (SU rG) and Byron Underwater research Groups (BUrG)] were studied to characterize members’ motivations to assist with conservation in subtropi cal/temperate marine environments. t he collaboration between private and government organizations at two dive destinations was explored to reveal implications towards marine conservation outcomes. Primary motivations to engage in marine conservation programs were a desire to contribute to envi ronmental conservation and to increase personal knowledge and diving skill-base. t he volunteer work of these two underwater research groups builds on existing monitoring programs within local marine protected areas with benefits possible through collaboration at each diving destination.
Inventory and Characterization of Selected Deep Sea Fish Species as an Alternative Food Source from Southern Java Ocean and Western Sumatra Ocean, Indonesia

Sixteen selected deep-sea fish obtained from Southern Java Ocean and Western Sumatra Ocean was analyzed to determine its proximate, fatty acid and mineral composition. The moisture content was ranged from 64.38 to 86.04 %, ash from 0.17 to 0.69 %, the fat content was 1.54 - 13.30 % while the protein content varied from 15.84 to 23.60%. Among the fatty acids, oleic acid and palmitic acid was the dominant MUFA and SFA. Linoleic acid was the highest PUFA found at the selected deep-sea fish. Phospor was the highest macroelement concentration on selected deep-sea fish, followed by K, Ca, Mg and Iod, Fe and Zn among microelement. The trace concentration was found at Se microelement.
LANGUAGE AND DEMENTIA: SOCIOLINGUISTIC ASPECTS1

This review of sociolinguistic aspects of language and dementia focuses on studies that (1) examine naturally occurring language with attention to variation that relates to speakers' cognitive or sociocultural attributes or to dimensions of the communicative context, (2) provide a nuanced understanding of individuals with dementia or contexts of communication that may illuminate sociolinguistic analyses, or (3) call for sociolinguistic investigations to clarify or provide additional evidence for a particular finding outside of linguistics. Structured from the global to the local levels, the review begins with literature that frames the study of language and dementia from the societal or cultural perspective, focusing on public discourse relating to dementia and Alzheimer's disease. Studies that shed light on social activities and physical environments are addressed next as possible influences on the shape of the discourse. Finally, investigations of verbal and nonverbal aspects of discourse produced by and with individuals with dementia are reviewed. Ideas for future research are outlined along with a call for increased cross-disciplinary cooperation among researchers who work at the intersection of language, dementia, and society.
Electrical Performance of High Density 10 µm Diameter 20 µm Pitch Cu-Pillar with Chip to Wafer Assembly

Microbump-based interconnects with 20 µm pitch have been fabricated on 300 mm wafers using industrial tools. Good processes control enables to get narrow standard deviations for the microbumps height (0.2 µm) and diameter (0.4 µm). Assembly was studied with chip to wafer (CtW) test vehicles by either mass reflow (MR) or thermo-compression (TC) with or without non-conductive paste (NCP). MR and TC processes result in suitable CtW alignments without significant defects at bonding interface. TC NCP assembly suffers from larger misalignment and underfill entrapment, reducing top to bottom bonding section. Consequently, unit electrical resistance is lower for MR and TC processes with ~25 m ascribed to pure vertical link, than for TC NCP process exhibiting ~50 m vertical link with larger standard deviation (15 m versus 2 m). Intermetallic compounds have been studied and Ni3Sn4 proves to be the main contributor for electrical resistance in our configuration where SnAg is sandwiched between 2 Ni layers. Electrical yield measured on daisy chains is very good (close to or higher than 90%) for MR or TC, even on more than 20,000 interconnects. For TC NCP, electrical yield remains to be improved, particularly on large daisy chains. Finally, an original electrical test has been designed and successfully implemented to characterize top to bottom misalignment. These results are promising for future high performance computing products that would require 20 µm pitch microbumps.
Atherosclerotic risk factors and complications in patients with non-functioning adrenal adenomas treated with or without adrenalectomy: a long-term follow-up study.

OBJECTIVE Despite the increased prevalences of hypertension, type 2 diabetes mellitus (T2DM), hyperlipidemy, and obesity in patients with non-functioning adrenal adenomas (NFAAs), there is a paucity of data on long-term atherosclerotic morbidity as well as the long-term cardiovascular effects of adrenalectomy in these patients. DESIGN, PATIENTS, AND METHODS This retrospective study includes the results of baseline and follow-up investigations of 125 patients (29 males and 96 females; mean age 60.1 years) with NFAAs referred for endocrine evaluation between 1990 and 2001. Of the 125 patients, 47 underwent unilateral adrenalectomy, while 78 patients were followed conservatively. These patients were reinvestigated after a mean follow-up time of 9.1 (5-16) years in 2006, with special emphasis on laboratory and other atherosclerotic risk factors (ARF), vascular events, and interventions. RESULTS The prevalences of hypertension, impaired glucose tolerance or T2DM, hyperlipidemy, and obesity were 82, 43, 58, and 50%, and 89, 58, 82, and 50% at baseline and follow-up, respectively. None of the investigated ARF prevalences were different between patients treated and not treated with adrenalectomy, and between patients with and without subclinical Cushing's syndrome. The prevalences of angina pectoris, acute myocardial infarction, coronary, and peripheral arterial interventions or cerebrovascular stroke did not differ significantly between patients treated and not treated with adrenalectomy. CONCLUSION Our study confirms previous investigations reporting markedly increased prevalences of various ARF in patients with NFAAs. Adrenalectomy performed in these patients failed to decrease the prevalence of ARF and atherosclerotic morbidity.
Assessment of modified myocardial performance index in foetuses with growth restriction.

AIM To evaluate the modified myocardial performance index (Mod-MPI) in foetuses with growth restriction and compare this index with appropriate for gestational age foetuses. MATERIAL AND METHODS A prospective cross-sectional case-control study was conducted involving 76 singleton foetuses between 24 and 34 weeks of gestation divided into three groups (24 appropriate growth foetuses, 30 foetuses with estimated weight between the 3rd and 10th percentiles and 22 foetuses with estimated weight < 3rd percentile, according to the Hadlock table). The Mod-MPI was obtained in the plane of the four chamber view, and the spectral Doppler sample volume was placed in the lateral wall of the aorta, close to the mitral valve. Doppler of umbilical artery was normal in all cases. Analysis of variance (ANOVA) was used to compare the groups and the intra-class correlation coefficient (ICC) was used to assess intra- and inter-observer reproducibility. RESULTS The mean Mod-MPI in the groups of appropriate for gestational age, estimated weight between the 3rd and 10th percentiles, and estimated weight < 3rd percentile was 0.32 +/- 0.05, 0.35 +/- 0.05 and 0.36 +/- 0.06, respectively; there was no statistical difference between the groups (p = 0.072). There was good intra- and inter-observer reproducibility (ICC = 0.726 and 0.760, respectively). CONCLUSION Mod-MPI was not significantly different between foetuses appropriate for gestational age and those with growth restriction. Mod-MPI proved to be a feasible and reproducible technique.
Mental Health Issues Facing a Diverse Sample of College Students: Results from the College Student Mental Health Survey

Over the past 5 years there has been increased attention given to mental health issues on college and university campuses across the country. However, few research efforts have been conducted to systematically investigate the mental health of college students. The College Student Mental Health Survey was undertaken as a first step towards gaining a better understanding of the broad range of mental health issues that face the college student population. This exploratory study describes the mental health history and current distress and coping of 939 college students from a large Midwestern public university, with an approximate enrollment of 40,000 students. Implications for research, policy, and practice are discussed.
The effects of investigative utterances on Israeli children's reports of physical abuse

In investigative interviews concerned with allegations of sexual abuse, open-ended prompts by interviewers elicit more information than focused prompts. We attempted to explore these effects in investigations of physical abuse. Interviews with 50 children from 2 age groups (5–6-year-olds, 9–10-year-olds) who made subsequently substantiated allegations of physical abuse by their parents were subjected to detailed psycholinguistic analysis. The overall productivity (number of words spoken) and informativeness (number of details elicited) of these children were remarkably low. The children were also relatively unresponsive to the investigators' individual utterances, and many of the interviewers' utterances were nonsubstantive (15%). The interviewers were more likely than those included in studies of sexual abuse investigations to use open-ended as opposed to focused prompts. These open-ended utterances elicited significantly more words but not more details than focused prompts. Older children also provided .
Improved sampling and analysis of images in corneal confocal microscopy

Introduction: Corneal confocal microscopy (CCM) is a noninvasive clinical method to analyse and quantify corneal nerve fibres in vivo. Although the CCM technique is in constant progress, there are methodological limitations in terms of sampling of images and objectivity of the nerve quantification. The aim of this study was to present a randomized sampling method of the CCM images and to develop an adjusted area‐dependent image analysis. Furthermore, a manual nerve fibre analysis method was compared to a fully automated method.
Necrotizing pneumonia due to clonally diverse Staphylococcus aureus strains producing Panton-Valentine leukocidin: the Czech experience

SUMMARY A prospective study (2007–2013) was undertaken to investigate clinical features and prognostic factors of necrotizing pneumonia caused by Staphylococcus aureus producing Panton–Valentine leukocidin (PVL) in the Czech Republic. Twelve cases of necrotizing pneumonia were detected in 12 patients (median age 25 years) without severe underlying disease. Eight cases occurred in December and January and the accumulation of cases in the winter months preceding the influenza season was statistically significant (P < 0·001). The course of pneumonia was very rapid, leading to early sepsis and/or septic shock in all but one patient. Seven patients died and mortality was fourfold higher in those patients presenting with primary pneumonia than with pneumonia complicating other staphylococcal/pyogenic infection elsewhere in the body. The S. aureus isolates displayed considerable genetic variability and were assigned to five lineages CC8 (n = 3), CC15 (n = 2), CC30 (n = 2), CC80 (n = 1), and CC121 (n = 3) and one was a singleton of ST154 (n = 1), all were reported to be associated with community-acquired infection. Four strains were methicillin resistant. The high case-fatality rate can only be reduced by improving the speed of diagnosis and a rapid test to detect S. aureus in the airways is needed.
On the formation of Hα line emission around classical T Tauri stars

We present radiative transfer models of the circumstellar environment of classical T Tauri stars, concentrating on the formation of the Hα emission. The wide variety of line profiles seen in observations are indicative of both inflow and outflow , and we therefore employ a circumstellar structure that includes both magnetospheri c accretion and a disc wind. We perform systematic investigations of the model parameters for the wind and the magnetosphere to search for possible geometrical and physical conditions which lead to the types of profiles seen in observations. We find that the hybrid models can repro duce the wide range of profile types seen in observations, and that the most common profile t ypes observed occupy a large volume of parameter space. Conversely, the most infrequently observed profile morphologies require a very specific set of models parameters. We find our mo del profiles are consistent with the canonical value of the mass-loss rate to mass-accretion rate ratio (� = 0.1) found in earlier magneto-hydrodynamic calculations and observations, but the models with 0.05 < � < 0.2 are still in accord with observed Hα profiles. We investigate the wind contribution to the line profile as a function of model parameters, and examine the rel iability of Hα as a mass accretion diagnostic. Finally, we examine the Hα spectroscopic classification used by Reipurth et. al, and discuss the basic physical conditions that are re quired to reproduce the profiles in each classified type.
Respiratory complications in the postanesthesia care unit: A review of pathophysiological mechanisms

Surgical, anesthetic and patient variables have been shown to impact pulmonary function in the postanesthesia period and contribute to complications in the postanesthesia care unit (PACU), with pulmonary atelectasis a common finding in more than 80% of anesthetized individuals. This comprehensive review discusses the major mechanisms causing deterioration of gas exchange in the immediate postoperative period; differential diagnosis of arterial hypoxemia in the PACU; preventive measures and treatment strategies for atelectasis; and the role of continuous positive airway pressure in the PACU.
Tissue plasminogen activator induces microglial inflammation via a noncatalytic molecular mechanism involving activation of mitogen‐activated protein kinases and Akt signaling pathways and AnnexinA2 and Galectin‐1 receptors

Inflammatory responses mediated by glial cells play a critical role in many pathological situations related to neurodegeneration such as Alzheimer's disease. Tissue plasminogen activator (tPA) is a serine protease which best‐known function is fibrinolysis, but it is also involved in many other physiological and pathological events as microglial activation. Here, we found that tPA is required for Aβ‐mediated microglial inflammatory response and tumor necrosis factor‐α release. We further investigated the molecular mechanism responsible for tPA‐mediated microglial activation. We found that tPA induces a catalytic‐independent rapid and sustained activation of extracellular signal‐regulated kinase (ERK)1/2, Jun N‐terminal kinase (JNK), Akt, and p38 signaling pathways. Inhibition of ERK1/2 and JNK resulted in a strong inhibition of microglial activation, whereas Akt inhibition led to increased inflammatory response, suggesting specific functions for each signaling pathway in the regulation of microglial activation. Furthermore, we demonstrated that AnnexinA2 and Galectin‐1 receptors are involved in tPA signaling and inflammatory response in glial cells. This study provides new evidences supporting that tPA plays a cytokine‐like role in glial activation by triggering receptor‐mediated intracellular signaling circuits and opens new therapeutic strategies for the treatment of neurological disorders in which neuroinflammation plays a pathogenic role. © 2011 Wiley Periodicals, Inc.