Miracle-dz/UniFAR-FTUs huggingface dataset:
Patient-Centered Medical Home Adoption: Lessons Learned and Implications for Health Care System Reform

Case studies of 8 primary care medical homes participating in a Massachusetts-based initiative were conducted to understand the approaches they used to operationalize medical home standards and associated barriers. All sites received their National Committee on Quality Assurance recognition as medical homes, yet varied considerably in how components were implemented. Despite this variation, they faced similar challenges to implementing and sustaining medical home standards. Variations and challenges strongly emerged in 4 areas: team-based care, scheduling and online access, identifying and managing high-risk patients, and organizing follow-up care. Our study offers insight into various pathways to medical home success, and notes areas for further study.
TERES - Tail Event Risk Expectile Based Shortfall

A flexible framework for the analysis of tail events is proposed. The framework contains tail moment measures that allow for Expected Shortfall (ES) estimation. Connecting the implied tail thickness of a family of distributions with the quantile and expectile estimation, a platform for risk assessment is provided. ES and implications for tail events under different distributional scenarios are investigated, particularly we discuss the implications of increased tail risk for mixture distributions. Empirical results from the US, German and UK stock markets, as well as for the selected currencies indicate that ES can be successfully estimated on a daily basis using a one-year time horizon across different risk levels.
The Information Content of Forward-Looking Statements in Corporate Filings—A Naïve Bayesian Machine Learning Approach

ABSTRACT This paper examines the information content of the forward-looking statements (FLS) in the Management Discussion and Analysis section (MD&A) of 10-K and 10-Q filings using a Naive Bayesian machine learning algorithm. I find that firms with better current performance, lower accruals, smaller size, lower market-to-book ratio, less return volatility, lower MD&A Fog index, and longer history tend to have more positive FLSs. The average tone of the FLS is positively associated with future earnings even after controlling for other determinants of future performance. The results also show that, despite increased regulations aimed at strengthening MD&A disclosures, there is no systematic change in the information content of MD&As over time. In addition, the tone in MD&As seems to mitigate the mispricing of accruals. When managers "warn" about the future performance implications of accruals (i.e., the MD&A tone is positive (negative) when accruals are negative (positive)), accruals are not associated with future returns. The tone measures based on three commonly used dictionaries (Diction, General Inquirer, and the Linguistic Inquiry and Word Count) do not positively predict future performance. This result suggests that these dictionaries might not work well for analyzing corporate filings. Copyright (c), University of Chicago on behalf of the Accounting Research Center, 2010.
Insufficient control of exercise intensity by heart rate monitoring in cardiac patients

Objectives: To test the reliability of heart rate (HR) recommendations for cardiac rehabilitation training obtained from different treadmill tests. Background: For training in cardiac rehabilitation, HR recommendations are derived from cardio-pulmonary tests. Exercise intensity is often controlled through self-monitoring HR by the cardiac patients. Design: Non-randomized clinical trial. Methods: 25 patients of a cardiac sports group (six women, 19 men, age 68.3 ± 5 years, height 171 ± 10 cm, weight 82 ± 12.8 kg) performed a stepwise increasing treadmill test according to a modified Stanford protocol (S) and a ramp treadmill test according to the Balke–Ware protocol (B) until volitional exhaustion. In 16 patients, HR was assessed with a HR monitor and compared with HR obtained by self-monitoring through pulse palpation during three training sessions. Results: Similar peak cardiopulmonary responses were obtained with the two exercise protocols of significantly (p < 0.001) different duration (S 22:05 ± 7:11 min, B 13:31 ± 4:20 min). During the training sessions, HR exceeded the upper HR limit set at 85% HRpeak in 15 patients and in nine patients, higher HRpeak than in the exercise tests was observed. Five participants did not accurately measure their HR by pulse palpation. Conclusions: All but one patient of the cardiac sports group did not adhere to the HR recommendations derived from incremental treadmill testing, most likely because volitional exhaustion occurred in both treadmill tests before maximal cardiopulmonary responses were reached. In about 30% of the patients, training intensity could not be controlled by self-monitoring because of inaccurate pulse palpation.
Role of the GlnK signal transduction protein in the regulation of nitrogen assimilation in Escherichia coli

Two structurally similar but functionally distinct PII‐like proteins, PII and GlnK, regulate nitrogen assimilation in Escherichia coli. Studies with cells indicated that both PII (the glnB product) and GlnK (the glnK product) acted through the kinase/phosphatase NRII [NtrB, the glnL (ntrB ) product] to reduce transcription initiation from Ntr promoters, apparently by regulating the phosphorylation state of the transcriptional activator NRI∼P (NtrC∼P, the phosphorylated form of the glnG (ntrC ) product). Both GlnK and PII also acted through adenylyltransferase (ATase, the glnE product) to regulate the adenylylation state of glutamine synthetase (GS). The activity of both GlnK and PII was regulated by the signal‐transducing uridylyltransferase/uridylyl‐removing enzyme (UTase/UR, glnD product). Our experiments indicate that either PII or GlnK could effectively regulate ATase, but that PII was required for the efficient regulation of NRII required to prevent expression of glnA, which encodes GS. Yet, GlnK also participated in regulation of NRII. Although cells that lack either PII or GlnK grew well, cells lacking both of these proteins were defective for growth on nitrogen‐rich minimal media. This defect was alleviated by the loss of NRII, and was apparently due to unregulated expression of the Ntr regulon. Also, mutations in glnK, designated glnK *, were obtained as suppressors of the Ntr− phenotype of a double mutant lacking PII and the UTase/UR. These suppressors appeared to reduce, but not eliminate, the ability of GlnK to prevent Ntr gene expression by acting through NRII. We hypothesize that one role of GlnK is to regulate the expression of the level of NRI∼P during conditions of severe nitrogen starvation, and by so doing to contribute to the regulation of certain Ntr genes.
Stable isotopes confirm a coastal diet for critically endangered Mediterranean monk seals†

Understanding the ecology and behaviour of endangered species is essential for developing effective management and conservation strategies. We used stable isotope analysis to investigate the foraging behaviour of critically endangered Mediterranean monk seals (Monachus monachus) in Greece. We measured carbon and nitrogen isotope ratios (expressed as δ13C and δ15N values, respectively) derived from the hair of deceased adult and juvenile seals and the muscle of their known prey to quantify their diets. We tested the hypothesis that monk seals primarily foraged for prey that occupy coastal habitats in Greece. We compared isotope values from seal hair to their coastal and pelagic prey (after correcting all prey for isotopic discrimination) and used these isotopic data and a stable isotope mixing model to estimate the proportion of coastal and pelagic resources consumed by seals. As predicted, we found that seals had similar δ13C values as many coastal prey species and higher δ13C values than pelagic species; these results, in conjunction with mean dietary estimates (coastal=61 % vs. pelagic=39 %), suggest that seals have a diverse diet comprising prey from multiple trophic levels that primarily occupy the coast. Marine resource managers should consider using the results from this study to inform the future management of coastal habitats in Greece to protect Mediterranean monk seals.
Cutaneous Nerve Fibre Depletion in Vibration White Finger

Vibration white finger or hand-arm vibration syndrome is the episodic blanching of the fingers in response to cold occurring in those who work with hand held vibrating tools. Clinically the condition differs from primary Raynaud's phenomenon as persistent paraesthesiae and pain are common in the hands and arms and these occur independently from the ‘white attacks’. Symptoms can become severe enough to warrant a change of occupation. Industrial compensation may be awarded for vibration white finger but, at present, no simple or reliable objective diagnostic test is available. Calcitonin gene-related peptide (CGRP) is a neuropeptide with powerful vasodilator properties. A deficiency of immunoreactive CGRP nerve fibres has been previously demonstrated in the digital cutaneous microvasculature of patients with primary and secondary Raynaud's phenomenon with the distribution and quantity of other types of nerve fibres not being significantly altered. To determine if the innervation of the cutaneous microvasculature in vibration white finger was also abnormal skin biopsy samples from the fingers of 15 patients with vibration white finger, six healthy age matched controls who worked with vibrating machinery and 26 healthy age matched controls who were heavy manual workers without exposure to vibrating machinery were examined by immunohistochemistry. To try to correlate any histological abnormalities with clinical neurological deficit sensory nerve conduction studies have so far been performed in six patients with vibration white finger. There was a significant reduction in both the number of CGRP and protein gene product 9.5 (PGP) immunoreactive nerve fibres in the digital cutaneous biopsies from the patients with vibration white finger when compared to the biopsies from the heavy manual workers and the healthy workers exposed to vibration. The pattern of the loss of CGRP immunoreactive nerve fibres was similar to that described previously in Raynaud's phenomenon and may account for the episodic vasospasm seen in both conditions. PGP is a constitutive protein of all nerves therefore the reduced PGP immunostaining indicates generalized structural neuronal damage which could account for the persistent pain and paraesthesiae characteristic of vibration white finger. The nerve conduction studies revealed sensory nerve action potentials within the low range of normal in five patients with vibration white finger and mild median nerve compression in the remaining patient implying that the neuronal damage in the patients with vibration white finger is confined mainly to the small unmyelinated nerve fibres. The immunohistochemical findings may provide the basis for a diagnostic test for vibration white finger.
Hypoxia impairs the arousal response to external resistive loading and airway occlusion during sleep.

STUDY OBJECTIVES Sustained hypoxia is a neurocognitive depressant, which has been shown to impair respiratory load sensation. Hypoxia has also been shown to impair arousal in animal models, but the effects of sustained hypoxia on arousal in humans have not been studied. The aim of this study was to assess the effects of sustained hypoxia on arousal from sleep in normal subjects. DESIGN Twelve normal male subjects (age, 24.3 +/- 1.2 years; body mass index, 24.8 +/- 1.4 kg/m2) were studied during stable stage 2 non-rapid eye movement sleep on 2 separate nights 1 week apart. SETTING Sleep physiology laboratory. PARTICIPANTS Normal healthy volunteers. INTERVENTIONS Arousal responses to external resistive loads (18 cm H2O x L(-1) x sec(-1)) and occlusions were compared during room-air breathing following sustained normoxia and isocapnic hypoxia (SaO2 approximately 85%). MEASUREMENTS AND RESULTS Time to arousal and minimum esophageal pressure preceding arousal were measured. Time to arousal was significantly increased following hypoxia compared with normoxia for resistive loads (24.6 + 4.4 seconds vs. 12.6 +/- 1.9 seconds, p = .007) but not occlusions. Minimum esophageal pressure prior to arousal was more negative following hypoxia for both external loads (-16.8 +/- 1.2 vs. -13.5 +/- 1.3 cm H2O, p = .035) and occlusions (-19.6 +/- 2.2 vs. -15.1 +/- 1.5 cm H2O, p = .029). CONCLUSIONS We conclude that sustained isocapnic hypoxia delays arousal to inspiratory loading during sleep and increases the respiratory arousal threshold. This has implications for disorders characterized by sustained nocturnal hypoxia, such as neuromuscular weakness, chronic obstructive pulmonary disease, obesity-hypoventilation syndrome, and severe obstructive sleep apnea.
Nowcasting: estimating developments in the risk of poverty and income distribution in 2013 and 2014

The at-risk-of-poverty rate is one of the three indicators used for monitoring progress towards the Europe 2020 poverty and social exclusion reduction target. Timeliness of this indicator is crucial for monitoring of the social situation and of the effectiveness of tax and benefit policies. However, partly due to the complexity of EU-SILC data collection, estimates of the number of people at risk of poverty are published with a significant delay. This paper extends and updates previous work on estimating (â€˜nowcastingâ€™) indicators of poverty risk using the tax-benefit microsimulation model EUROMOD. The modelâ€™s routines are enhanced with additional adjustments to the EU-SILC based input data in order to capture changes in the employment characteristics of the population since the data were collected. The nowcasting method is applied to seventeen EU Member States. AROP rates are estimated up to 2014 for ten countries and 2013 for the remaining seven countries. The performance of the method is assessed by comparing the predictions with actual EU-SILC indicators for the years for which the latter are available.
The Risk-Return Trade-Off in a Liberalized Emerging Stock Market: Evidence from Vietnam

ABSTRACT We empirically examine the risk-return trade-off in a liberalized emerging stock market: Vietnam during the period 2007–2014. We find that (1) neither realized idiosyncratic volatility nor conditional idiosyncratic volatility has been priced; (2) rational multifactor models could well explain the stock portfolio returns; (3) there is a flat trend for equal-weighted idiosyncratic volatility (IVOL), but a downward trend for market volatility. Our results indicate that the idiosyncratic risk plays an unimportant role in pricing stocks and that the systematic risks still dominate asset returns in emerging stock markets. Results imply that Vietnamese investors can get increased benefit from portfolio diversification.
The Effect of Full-Mouth Rehabilitation on Oral Health-Related Quality of Life for Children with Special Health Care Needs.

OBJECTIVES Changes in oral health-related quality of life (OHRQoL) among 40 children with special health care needs (CSHCN) aged 5-14 years before and 12 months after full-mouth rehabilitation (FMR) under general anesthesia (GA) in two hospitals in Jeddah city were assessed. STUDY DESIGN The questionnaire was delivered to the parents/caregivers at baseline (pre-operative) and at the 12-month post-operative follow-up visit. Medical and dental histories and clinical findings were correlated accordingly. RESULTS The follow-up response rate was 87.5% with 35 children completing a 12-month follow-up visit. The age range was from 5 to 12 years with a mean of 7.3 ± 2.4 years. More than half of the study sample was boys (63%) in the 5-8 year age-group (69%). The impact on OHRQoL was reportedly negative before FMR under GA, with overall scores ranging from 12 to 68 and a mean of 43.34 ± 14.83. OHRQoL improved significantly in all aspects evaluated (P<0.05) following FMR under GA with overall scores ranging from 4 to 41 and a mean of 18.86 ± 8.54. CONCLUSIONS Treating CSHCN under GA, with 3-month recall visits for the patients, had a significant long-term effect on their OHRQoL extending up to 12 months postoperatively.
Upper limb joint muscle/tendon injury and anthropometric adaptations in French competitive tennis players

Abstract The purpose of this study was to examine the relationship between the upper limb anthropometric dimensions and a history of dominant upper limb injury in tennis players. Dominant and non-dominant wrist, forearm, elbow and arm circumferences, along with a history of dominant upper limb injuries, were assessed in 147 male and female players, assigned to four groups based on location of injury: wrist (n = 9), elbow (n = 25), shoulder (n = 14) and healthy players (n = 99). From anthropometric dimensions, bilateral differences in circumferences and in proportions were calculated. The wrist group presented a significant bilateral difference in arm circumference, and asymmetrical bilateral proportions between wrist and forearm, as well as between elbow and arm, compared to the healthy group (6.6 ± 3.1% vs. 4.9 ± 4.0%, P < 0.01; −3.6 ± 3.0% vs. −0.9 ± 2.9%, P < 0.05; and −2.2 ± 2.2% vs. 0.1 ± 3.4%, P < 0.05, respectively). The elbow group displayed asymmetrical bilateral proportions between forearm and arm compared to the healthy group (−0.4 ± 4.3% vs. 1.5 ± 4.0%, P < 0.01). The shoulder group showed significant bilateral difference in elbow circumference, and asymmetrical bilateral proportions between forearm and elbow when compared to the healthy group (5.8 ± 4.7% vs. 3.1 ± 4.8%, P < 0.05 and −1.7 ± 4.5% vs. 1.4 ± 4.3%, P < 0.01, respectively). These findings suggest that players with a history of injury at the upper limb joint present altered dominant upper limb proportions in comparison with the non-dominant side, and such asymmetrical proportions would appear to be specific to the location of injury. Further studies are needed to confirm the link between location of tennis injury and asymmetry in upper limb proportions using high-tech measurements in symptomatic tennis players.
Increased arterial stiffness in resistant hypertension is associated with inflammatory biomarkers

Abstract Background. Increased levels of inflammatory biomarkers such as interleukin-6 (IL-6), 10 (IL-10), 1β (IL-1β), tumor necrosis factor-α (TNF-α) high-sensitivity C-reactive protein (hs-CRP) are associated with arterial stiffness in hypertension. Indeed, resistant hypertension (RHTN) leads to unfavorable prognosis attributed to poor blood pressure (BP) control and target organ damage. This study evaluated the potential impact of inflammatory biomarkers on arterial stiffness in RHTN. Methods. In this cross-sectional study, 32 RHTN, 20 mild hypertensive (HTN) and 20 normotensive (NT) patients were subjected to office BP and arterial stiffness measurements assessed by pulse wave velocity (PWV). Inflammatory biomarkers were measured in plasma samples. Results. PWV was increased in RHTN compared with HTN and NT (p < 0.05). TNF-α levels were significantly higher in RHTN and HTN than NT patients. No differences in IL-6 levels were observed. RHTN patients had a higher frequency of subjects with increased levels of IL-10 and IL-1β compared with HTN and NT patients. Finally, IL-1β was independently associated with PWV (p < 0.001; R2 = 0.5; β = 0.077). Conclusion. RHTN subjects have higher levels of inflammatory cytokines (TNF-α, IL-1β and IL-10) as well as increased arterial stiffness, and detectable IL-1β levels are associated arterial stiffness. These findings suggest that inflammation plays a possible role in the pathophysiology of RHTN.
Status of prevalence study on multimorbidity of chronic disease in China: Systematic review

It is imperative to provide a more uniform method to improve the validity of prevalence studies on multimorbidity. However, the status of prevalence studies on multimorbidity of chronic disease is still yet to be confirmed in China. The objective of the present systematic review was to evaluate the variance across prevalence studies and to explore possible explanations for variations in China. Published literature was obtained from four databases. The studies that described the prevalence of multimorbidity on chronic disease based on the general population were considered. We assessed the risk of bias by a preplanned checklist referring to STROBE (Strengthening the Reporting of Observational Studies in Epidemiology). The heterogeneity among eligible studies was estimated by I2 statistic and P‐value using MetaAnalyst software. Nine studies were eligible for this systematic review. The prevalence of multimorbidity among the population aged 60 years or more ranged from 6.4% (95% CI 5.1–8.0) to 76.5% (95%CI 73.6–79.2). However, just two of nine studies could be judged as having a low risk of bias. It was shown that key items introducing the risk of bias included inconsistent sampling method, lacking of uniform measure indices and data source based on self‐report. Heterogeneity test showed I2 = 50% (P < 0.001), which showed there was substantial variation among individual studies. Therefore, only a narrative summary rather than meta‐analysis was carried out. Marked methodology heterogeneity exists among prevalence studies on multimorbidity. Suggested methodological aspects that should be considered in future studies include sampling method, measure indices of multimorbidity and data source. Geriatr Gerontol Int 2015; 15: 1–10.
Analytical & numerical modelings of elliptical superconducting filament magnetization

This paper deals with the two-dimensional computation of magnetization in an elliptic superconducting filament by using numerical and analytical methods. The numerical results are obtained from the finite element method and by using Bean's model. This model is well adapted for Low T/sub c/ superconductor studies. We observe the effect of the axis ratio and of the field angle to the magnetic moment per unit length at saturation, and also to the cycle of magnetization. Moreover, the current density and the distribution of the electromagnetic fields in the superconducting filament are also studied.
Identification of X-linked Inhibitor of Apoptosis-associated Factor-1 as an Interferon-stimulated Gene That Augments TRAIL Apo2L-induced Apoptosis*

In the course of gene array studies aimed at identifying IFN-stimulated genes associated with interferon β (IFN-β)-induced apoptosis, we identified X-linked inhibitor of apoptosis-associated factor-1 (XAF1) as a novel IFN-stimulated gene. XAF1 mRNA was up-regulated by IFN-α and IFN-β in all cells examined. However, IFNs induced high levels of XAF1 protein predominantly in cell lines sensitive to the proapoptotic effects of IFN-β. In apoptosis-resistant cells including WM164 melanoma, WM35 melanoma, U937 pro-monocytic leukemia, and HT1080 fibrosarcoma cells, XAF1 mRNA was strongly up-regulated but XAF1 protein was up-regulated only weakly or not at all. Tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) is a critical mediator of IFN-β-induced apoptosis, but most melanoma cell lines were resistant to recombinant TRAIL protein. For example, A375 melanoma cells were defective in TRAIL induction by IFN-β and were resistant to TRAIL-induced apoptosis. However, IFN-β pretreatment sensitized them to subsequent recombinant TRAIL-induced apoptosis. A375 cells expressing XAF1 constitutively were more sensitive to TRAIL-induced apoptosis compared with empty vector-transfected cells. The degree of sensitization by XAF1 was similar to that provided by IFN pretreatment and was correlated with the level of XAF1 expressed. Furthermore, the overexpression of the zinc-finger portion of XAF1 blocked IFN-dependent sensitization of A375 melanoma cells to the proapoptotic effects of TRAIL. These results suggested that IFN-dependent induction of XAF1 strongly influenced cellular sensitivity to the proapoptotic actions of TRAIL.