Miracle-dz/UniFAR-FTUs huggingface dataset:
Impacts of rising health care costs on families with employment-based private insurance: a national analysis with state fixed effects.

BACKGROUND Given the rapid growth of health care costs, some experts were concerned with erosion of employment-based private insurance (EBPI). This empirical analysis aims to quantify the concern. METHODS Using the National Health Account, we generated a cost index to represent state-level annual cost growth. We merged it with the 1996-2003 Medical Expenditure Panel Survey. The unit of analysis is the family. We conducted both bivariate and multivariate logistic analyses. RESULTS The bivariate analysis found a significant inverse association between the cost index and the proportion of families receiving an offer of EBPI. The multivariate analysis showed that the cost index was significantly negatively associated with the likelihood of receiving an EBPI offer for the entire sample and for families in the first, second, and third quartiles of income distribution. The cost index was also significantly negatively associated with the proportion of families with EBPI for the entire year for each family member (EBPI-EYEM). The multivariate analysis confirmed significance of the relationship for the entire sample, and for families in the second and third quartiles of income distribution. Among the families with EBPI-EYEM, there was a positive relationship between the cost index and this group's likelihood of having out-of-pocket expenditures exceeding 10 percent of family income. The multivariate analysis confirmed significance of the relationship for the entire group and for families in the second and third quartiles of income distribution. CONCLUSIONS Rising health costs reduce EBPI availability and enrollment, and the financial protection provided by it, especially for middle-class families.
Influence of Acidic Residues and the Kink in the Active-site Helix on the Properties of the Disulfide Oxidoreductase DsbA*

The catalytic disulfide bond Cys30-Cys33 of the disulfide oxidoreductase DsbA from Escherichia coli is located at the amino terminus of an α-helix, which has a kink caused by insertion of a tripeptide (residues 38-40). The oxidative force of DsbA (E′0 = −125 mV) mainly results from the low pKa of 3.4 of its Cys30 thiol. To investigate the role of the kink and the electrostatic contribution of Glu37 and Glu38 to the redox properties of DsbA, we have characterized a series of DsbA variants (Δ38-40, Δ38-40/H41P, E37Q, E38Q, and E37Q/E38Q). In contrast to theoretical predictions, the redox potentials of the variants are almost unchanged, and the pKa values of Cys30 do not differ by more than 0.5 units from that of DsbA wild type. All variants show the same in vivo activity and dependence of redox potential on ionic strength as the wild type. The mutations have no influence on the polypeptide specificity of the protein, which is independent of the isoelectric point of the polypeptide substrate and most pronounced at acidic pH. We conclude that neither the kink in the active-site helix nor Glu37 and Glu38 are critical for the physical properties of DsbA.
A Pilot Surrogate Endpoint Biomarker Study of Celecoxib in Oral Premalignant Lesions

This study evaluated changes in prostaglandin E2 (PGE2) levels and related biomarkers in oral premalignant lesions (OPL) in response to celecoxib treatment. Twenty-two subjects were enrolled and treated with celecoxib. Pretreatment and 12-week biopsies were done. Subjects whose biopsy showed ≥30% decrease in PGE2 remained on celecoxib for a total of 12 months when repeat biopsy was done. Biopsies were examined to assess degree of dysplasia, DNA ploidy, and immunohistochemical expression of BCL2, pAKT-Ser473, Ki-67, and CD31 (microvessel density). In 18 paired biopsies available at baseline and 12 weeks, mean normalized PGE2 levels decreased by 38% (P = 0.002). After 12 months, PGE2 decreased by 31% (P = 0.340). Twelve biopsies (67%; P = 0.0129) showed improvement in degree of dysplasia after 12 weeks, and 8 of 11 biopsies (73%; P = 0.0703) continued to show an improvement in the degree of dysplasia after 12 months. Trends suggested down-modulation of cyclooxygenase-2 and Ki-67 in some tissues, increased pAKT-Ser473 expression, and an inverse relationship between PGE2 and BCL2 expression. This study documents the feasibility of measuring potential surrogate endpoint biomarkers of chemopreventive agent response in OPLs. Treatment with celecoxib in subjects with OPLs favorably modulates the primary mediator of cyclooxygenase-2 activity, PGE2, after 12 weeks.
True Microbiota Involved in Chronic Lung Infection of Cystic Fibrosis Patients Found by Culturing and 16S rRNA Gene Analysis

ABSTRACT Patients suffering from cystic fibrosis (CF) develop chronic lung infection. In this study, we investigated the microorganisms present in transplanted CF lungs (n = 5) by standard culturing and 16S rRNA gene analysis. A correspondence between culturing and the molecular methods was observed. In conclusion, standard culturing seems reliable for the identification of the dominating pathogens.
[The prevention of infection complicating acute necrotizing pancreatitis:an experimental study].

OBJECTIVE To observe the effects of 5 intervention measures on infection complicating acute necrotizing pancreatitis (ANP) in dogs and rats. METHODS A lethal model of ANP was reproduced by infusion of artificial bile into the biliopancreatic duct. Animals were divided randomly into: ANP group (no treatment); Chinese medicine group ("Qing Yi Tang"); Bifidobacterium mixture group; purgation group (MgSO(4)); selective decontamination of the digestive tract (SDD) group; and somatostatin group. The pancreas and intestine were observed morphologically and tight junction on ileum epithelia was assessed on cryofracture replicas. Blood and/or tissue levels of DAO and D-lactic acid and uric contents of lactulose/mannitol (L/M), served as indicators of gut barrier function, were measured at various time points. Intestinal flora and incidence of bacterial translocation (BT) to organs were examined. RESULTS In early stage of ANP, mucosal and epithelial tight junction damage and flora disturbance occurred in the gut. In addition, the gut barrier function indicators deteriorated. The BT rates were as high as 78.6% (canine) and 59.5% (rat). Treatment with Chinese medicine markedly improved gut barrier function and reduced BT rate (32.1% - 37.0%). Having similar purgative response as Chinese medicine, MgSO4 did not show any beneficial effect on gut barrier protection and the incidence of BT was not reduced. In bifidobacterium mixture and SDD group, flora balance was preserved well and similar results as Chinese medicine were obtained. The BT rates of these two groups decreased to 33.9% and 33.3%, respectively. Somatostatin markedly blunted pancreatic tissue injury and ameliorated gut barrier damage during early phase of ANP. All intervention measures except for purgation also decreased mortalities (14.3% - 35.3%, compared with 58.8% of the no treatment group). CONCLUSIONS Treatment with Chinese medicine, bifidobacterium mixture, SDD and somatostatin attenuated gut barrier damage and BT after ANP, and could be used to prevent secondary infection after ANP, but purgation alone is not effective.
Characterization of the surface protein layers of the mosquito-pathogenic strains of Bacillus sphaericus

The protein surface layers on the cell walls of mosquito-pathogenic and nonpathogenic Bacillus sphaericus strains were studied by structural, biochemical, and serological methods. The surface structure of two representative insect-pathogenic strains had the form of a delicate linear array with a repeat interval of 5 nm. This was distinctly different from the tetragonal array of the P-1 strain in spacing and arrangement. The surface layers were composed of acidic glycoproteins with molecular weights ranging from approximately 133,000 to 155,000. Peptide mapping and serological analysis of the surface proteins revealed eight distinct groups among the pathogens. These groups were very similar to the groupings determined by flagellar-antigen serotyping and bacteriophage typing.
School Competition and Product Differentiation

Policies that encourage school competition in hopes of improving school quality are increasingly popular in both rich and poor countries. In this paper, I establish that schools may respond to increased competition by catering to wealthier students, at the expense of poorer students. I develop a model of school competition in the presence of differential information. If (1) the match between a school and a student affects learning, and (2) wealthier students’ enrollment decisions are more responsive to their match to schools, then schools cater more to the needs of wealthy students. Therefore, the entry of an additional school can reduce the quality of the match for poorer students. I show that the key mechanism of the theoretical model – that wealthier students are more responsive to their predicted test score gains when choosing schools – is consistent with the data by estimating a structural model of school choice in Pakistan. Exploiting the exit and entry of private schools and an instrumental variable that affects the cost of opening a private school, I find that competition increases private schools’ targeting of wealthy students and reduces their targeting of poor students. An additional private school in the market increases within-school inequality in yearly test score gains by 0.1 standard deviations. ∗Harvard University, Cambridge, MA, 02138, Contact: Natalie Bau@hks.harvard. edu. I gratefully acknowledge the support of the NSF Graduate Research Fellowship and the Harvard Inequality and Social Policy Fellowship. I am deeply indebted to my advisors, Chris Avery, Roland Fryer, Asim Khwaja, and Nathan Nunn for their guidance and encouragement. Alberto Abadie, Nava Ashraf, David Baqaee, Raj Chetty, Sarah Cohodes, Dave Deming, Glenn Ellison, James Feigenbaum, Rema Hanna, Nathan Hendren, Christopher Jencks, Larry Katz, Greg Lewis, Ariel Pakes, Rohini Pande, Martin Rotemberg, Doug Staiger, and Bryce Millett Steinberg also provided very helpful comments. I am also grateful to participants in the Harvard Development and Industrial Organization Workshops and the Labor and Fiscal Policy Lunch for their helpful comments.
Prevention of sevoflurane related emergence agitation in children undergoing adenotonsillectomy: A comparison of dexmedetomidine and propofol

Background: Emergence agitation (EA) in children is increased after sevoflurane anesthesia. Propofol and dexmedetomidine have been used for prophylactic treatment with controversial results. The aim of the present study was to compare the effect of a single dose of propofol or dexmedetomidine prior to termination of sevoflurane-based anesthesia on the incidence and severity of EA in children. Methods: One hundred and twenty children, American Society of Anesthesiologists I-II, 2-6 years old undergoing adenotonsillectomy under sevoflurane based anesthesia were enrolled in the study. Children were randomly allocated to one of the three equal groups: (Group C) received 10 ml saline 0.9%, (Group P) received propofol 1 mg/kg or (group D) received dexmedetomidine 0.3 ug/kg-1. The study drugs were administered 5 min before the end of surgery. In post anesthesia care unit (PACU), the incidence of EA was assessed with Aonos four point scale and the severity of EA was assessed with pediatric anesthesia emergence delirium scale upon admission (T0), after 5 min (T5), 15 min (T15) and 30 min (T30). Extubation time, emergence time, duration of PACU stay and pain were assessed. Results: The incidence and severity of EA were lower in group P and group D compared to group C at T0, T5 and T15. The incidence and severity of EA in group P were significantly higher than group D at the same times. The incidence and severity of EA decreased significantly over time in all groups. The modified Children's Hospital of Eastern Ontario Pain Scale was significantly lower in group D compared to group C and group P. Conclusions: Dexmedetomidine 0.3 ug/kg1 was more effective than propofol 1 mg/kg in decreasing the incidence and severity of EA, when administered 5 min before the end of surgery in children undergoing adenotonsillectomy under sevoflurane anesthesia.
Motivation, Management, and Mastery

BACKGROUND: Clients with HIV infection have been conceptualized as a resilient population. Although a few researchers have documented resilience among clients with HIV infection, a theory of resilience in the context of HIV infection has not been developed. The purpose of this study was to describe the process by which resilience occurs for clients in the context of HIV infection. METHOD: Grounded theory methodology was used to sample and analyze data from 15 qualitative interviews with adults with HIV infection. Data were collected until saturation was reached. RESULTS: A theory, motivation, management, and mastery, a description of the process by which resilience occurs in the context of HIV infection, emerged from the data. CONCLUSION: Many clients living with HIV infection are resilient, despite the physical, psychological, and social challenges of this chronic illness. Nursing interventions to promote resilience among clients with HIV infection should be directed toward identification of client motivation factors and disease management strategies that may influence health outcomes of people living with HIV infection.
Knowledge Diffusion and Knowledge Transfer: Two Sides of the Medal

Understanding the way in which knowledge is technically produced and transferred, and how its diffusion path can be characterized is of fundamental importance for the performance of an economy. Although this fact seems to be plausible ex ante, the relevant literature so far has paid less attention investigating the microeconomic link between knowledge transfer and knowledge diffusion in a comprehensive approach. The aim of this paper is to highlight the link between knowledge transfer, knowledge diffusion and network effects in a stochastic environment, because the adoption decision of new knowledge should be treated as a stochastic event. For this reason, a new knowledge diffusion model in the line of Bass (1969) has been put forward, which integrates knowledge diffusion and knowledge transfer. The advantage of the proposed model is twofold. From a theoretical point of view, not only the so-called unimodal diffusion phenomena can be modelled, but also bimodal diffusion phenomena can be obtained. From an empirical point of view, the model which incorporates heteroscedastic errors and mean reverting behaviour can be theoretically estimated directly within a standard SUR context.
Segregation Analysis of Juvenile Diabetes Mellitus

Twin studies (Joslin, Root, White, and Marble, 1952) and analyses of pooled family data (Pincus and White, 1934; Simpson, I962) provide evidence for a genetic aetiology of diabetes mellitus. The wide variation in the age at onset and in severity of the disease and the possibility that the disease is genetically heterogeneous present serious obstacles to establishing a mode of inheritance. Nevertheless, results of a number of studies have suggested that the disease is determined by a recessive gene at a single autosomal locus (Pincus and White, 1934; Steinberg and Wilder, I952; Post, I962). The techniques of segregation analysis can correct for biased ascertainment and sporadic cases (phenocopies, mutations, and other isolated events of non-segregational origin) in samples of families (Bailey, I95I; Morton, I958, I959). Under multiple selection, the segregation frequency and other pertinent genetic parameters may be estimated using maximum likelihood scores, provided that probands and ascertainments are counted for each sibship. From 233 families containing one or more juvenile diabetics, Simpson (I962) has published an unusually good collection of data that meets the requirements for segregation analysis. We have applied maximum likelihood segregation analysis to Simpson's data to test the hypothesis that diabetes mellitus is caused by a recessive gene at an autosomal locus. Our analysis is presented here.
The Scaffold Protein Muscle A-Kinase Anchoring Protein &bgr; Orchestrates Cardiac Myocyte Hypertrophic Signaling Required for the Development of Heart Failure

Background—Cardiac myocyte hypertrophy is regulated by an extensive intracellular signal transduction network. In vitro evidence suggests that the scaffold protein muscle A-kinase anchoring protein &bgr; (mAKAP&bgr;) serves as a nodal organizer of hypertrophic signaling. However, the relevance of mAKAP&bgr; signalosomes to pathological remodeling and heart failure in vivo remains unknown. Methods and Results—Using conditional, cardiac myocyte–specific gene deletion, we now demonstrate that mAKAP&bgr; expression in mice is important for the cardiac hypertrophy induced by pressure overload and catecholamine toxicity. mAKAP&bgr; targeting prevented the development of heart failure associated with long-term transverse aortic constriction, conferring a survival benefit. In contrast to 29% of control mice (n=24), only 6% of mAKAP&bgr; knockout mice (n=31) died in the 16 weeks of pressure overload (P=0.02). Accordingly, mAKAP&bgr; knockout inhibited myocardial apoptosis and the development of interstitial fibrosis, left atrial hypertrophy, and pulmonary edema. This improvement in cardiac status correlated with the attenuated activation of signaling pathways coordinated by the mAKAP&bgr; scaffold, including the decreased phosphorylation of protein kinase D1 and histone deacetylase 4 that we reveal to participate in a new mAKAP signaling module. Furthermore, mAKAP&bgr; knockout inhibited pathological gene expression directed by myocyte-enhancer factor-2 and nuclear factor of activated T-cell transcription factors that associate with the scaffold. Conclusions—mAKAP&bgr; orchestrates signaling that regulates pathological cardiac remodeling in mice. Targeting of the underlying physical architecture of signaling networks, including mAKAP&bgr; signalosome formation, may constitute an effective therapeutic strategy for the prevention and treatment of pathological remodeling and heart failure.
Antiproliferative Action of Xylopia aethiopica Fruit Extract on Human Cervical Cancer Cells

The anticancer potential of Xylopia aethiopica fruit extract (XAFE), and the mechanism of cell death it elicits, was investigated in various cell lines. Treatment with XAFE led to a dose‐dependent growth inhibition in most cell lines, with selective cytotoxicity towards cancer cells and particularly the human cervical cancer cell line C‐33A. In this study, apoptosis was confirmed by nuclear fragmentation and sub‐G0/G1 phase accumulation. The cell cycle was arrested at the G2/M phase with a decreased G0/G1 population. A semi‐quantitative gene expression study revealed dose‐dependent up‐regulation of p53 and p21 genes, and an increase in the Bax/Bcl‐2 ratio. These results indicate that XAFE could be a potential therapeutic agent against cancer since it inhibits cell proliferation, and induces apoptosis and cell cycle arrest in C‐33A cells. Copyright © 2011 John Wiley & Sons, Ltd.
Serologic survey of Eptesicus fuscus from Georgia, U.S.A. for Rickettsia and Borrelia and laboratory transmission of a Rickettsia by bat ticks

ABSTRACT Bats and their ectoparasites are associated with bacterial agents of unknown pathogenicity. We tested sera from 56 Eptesicus fuscus from Georgia against Borrelia hermsii, Orientia tsutsugamushi, Rickettsia conorii, and Rickettsia rickettsii. We detected antibodies reactive against a relapsing fever Borrelia and spotted fever group Rickettsia in 3/56 and 1/56 bats, respectively. We attempted to culture Bartonella from the blood of these bats but were unsuccessful. In addition, we fed bat ticks, Carios kelleyi, infected with Rickettsia on a specific pathogen-free guinea pig. The guinea pig had a weak seroconversion to R. rickettsii with a peak titer of 1:32 starting on day 14. Rickettsia was not detected in any of the tissue samples from the guinea pig by molecular means. Our results indicate that E. fuscus is naturally exposed to both a spotted fever group Rickettsia and a relapsing fever group Borrelia. If these agents are transmitted by bat ticks, then people living in close proximity to bat ticks might be exposed.
Proteasomal inhibition causes the formation of protein aggregates containing a wide range of proteins, including nitrated proteins

Mutations in Cu,Zn‐superoxide dismutase (SOD‐1) are associated with some familial cases of amyotrophic lateral sclerosis (ALS), but it is not known how they result in cell death. We examined effects of overexpression of wild‐type SOD‐1 or the G37R or G85R mutations on the accumulation of ubiquitinated and nitrated proteins, and on loss of cell viability induced by the proteasome inhibitor, lactacystin. Wild‐type SOD‐1 had no effect on proteasomal activity, but the mutants decreased it somewhat. Treatment with lactacystin (1 µm) caused only limited cell viability loss, even though it induced a marked inhibition of proteasomal activities. However, viability loss due to apoptosis was substantial in response to lactacystin when cells were overexpressing a mutant SOD‐1. The frequency of cells showing immunoreactivity against ubiquitinated‐ or nitrated‐proteins was enhanced when wild‐type and mutant SOD‐1 s were overexpressed. Ubiquitinated or nitrated α‐tubulin, SOD‐1, α‐synuclein and 68K neurofilaments were observed in the aggregates. Similar aggregates were observed in cells overexpressing mutant parkin (Del3–5, T240R and Q311′X). The nitric oxide synthase inhibitor, l‐NAME, decreased viability loss and aggregation, suggesting that nitration of proteins may play an important role in aggregation and in the cell death accompanying it.
Octylcyanoacrylate Tissue Adhesive in the Repair of Pediatric Extremity Lacerations

Lacerations comprise a significant number of emergency department referrals for pediatric patients. Management of lacerations with sutures involves the use of needles and the injection of local anesthetic and represents a unique challenge in the wound management of an already distressed and frightened child. Octylcyanoacrylate, a new-generation, medical-grade tissue adhesive, has been found to be an effective alternative to replace skin sutures on virtually all facial lacerations and has been employed in low-skin tension wound management. Its use, however, has generally been avoided in the management of high-skin tension lacerations. Over the last 10 months, 32 children with high-skin tension (hand, feet, and over joints) lacerations were managed at our center by octylcyanoacrylate tissue adhesives. Skin closures and splints were applied to restrict movement of the affected area to overcome the limitation of adhesive application. Octylcyanoacrylate adhesive applied with optimal immobilization was found to be an effective method of skin closure in high-skin tension lacerations. Advantages of tissue adhesives for incision and laceration include quick application, excellent cosmetic results, patient preference, and cost effectiveness.
Internationalisation, intercultural communication and intercultural competence

This article assumes that the internationalization of higher education demands more elaborate pedagogical approaches to utilise the experiences of multiethnic student groups and to facilitate every student’s acquisition of intercultural competencies. Drawing from three internationalisation ideologies embedded in the educational discourse, it is argued that intercultural communication – as a field of study or a discipline – can play a key role in this endeavour. Twelve fields of consideration, when international educators work with students, are also identified.