Miracle-dz/UniFAR-FTUs huggingface dataset:
Impact of a health maintenance organization hospitalist system in academic pediatrics.

OBJECTIVE Hospitalist systems decrease length of stay (LOS) and cost for hospitalized adults. Whether hospitalist systems decrease LOS and cost for hospitalized children has not been conclusively established. We wanted to determine whether a health maintenance organization's (HMO's) implementation of a pediatric hospitalist system affected LOS, costs, mortality, readmission rate, follow-up rate, and parents' ratings of care. DESIGN Interrupted time-series study of general pediatric patients admitted to a freestanding pediatric teaching hospital from 1993 to 1998. The intervention group consisted of all patients admitted to a staff model not-for-profit HMO that began using hospitalists in October 1996. Patients in other HMOs and traditional insurance groups were studied for comparison. The main outcomes were mean LOS and inflation-adjusted costs. Other outcomes included parents' ratings of care and mortality, readmission, and follow-up rates. RESULTS Immediately after the introduction of the hospitalist system, mean LOS for staff model not-for-profit HMO fell 12% (0.3 days), and mean cost of hospitalization decreased 16% ($217) compared with prehospitalist levels. Parental ratings of care, initially somewhat low, improved substantially. Seven-day follow-up rates, mortality, and readmission rates did not change. Comparison groups experienced no concurrent improvements in LOS, cost, parental ratings, mortality, or readmission rates. CONCLUSIONS A pediatric hospitalist system within a staff-model HMO significantly improved LOS, cost, and parental ratings of care without affecting rates of posthospitalization follow-up. Additional studies are needed both to measure broader aspects of quality and to assess the impact of such a program on patients being cared for through other types of delivery and insurance systems.
CREB is necessary for synaptic maintenance and learning‐induced changes of the ampa receptor GluA1 subunit

The transcription factor cAMP response element binding protein (CREB) is a key protein implicated in memory, synaptic plasticity and structural plasticity in mammals. Whether CREB regulates the synaptic incorporation of hippocampal glutamatergic receptors under basal and learning‐induced conditions remains, however, mostly unknown. Using double‐transgenic mice conditionally expressing a dominant negative form of CREB (CREBS133A, mCREB), we analyzed how chronic loss of CREB function in adult hippocampal glutamatergic neurons impacts the levels of the AMPA and NMDA receptors subunits within the post‐synaptic densities (PSD). In basal (naïve) conditions, we report that inhibition of CREB function was associated with a specific reduction of the AMPAR subunit GluA1 and a proportional increase in its Ser845 phosphorylated form within the PSD. These molecular alterations correlated with a reduction in AMPA receptors mEPSC frequency, with a decrease in long‐term potentiation (LTP), and with an increase in long‐term depression (LTD). The basal levels other major synaptic proteins (GluA2/3, GluN1, GluN2A, and PSD95) within the PSD were not affected by CREB inhibition. Blocking CREB function also impaired contextual fear conditioning (CFC) and selectively blocked the CFC‐driven enhancement of GluA1 and its Ser845 phosphorylated form within the PSD, molecular changes normally observed in wild‐type mice. CFC‐driven enhancement of other synaptic proteins (GluA2/3, GluN1, GluN2A, and PSD95) within the PSD was not significantly perturbed by the loss of CREB function. These findings provide the first evidence that, in vivo, CREB is necessary for the specific maintenance of the GluA1 subunit within the PSD of hippocampal neurons in basal conditions and for its trafficking within the PSD during the occurrence of learning. © 2013 Wiley Periodicals, Inc.
Patterns of Failure Following Surgical Resection of Colorectal Cancer Liver Metastases: Rationale for a Multimodal Approach

A total of 45 patients, after surgical resection of colorectal liver cancer metastases, were retrospectively analyzed to define areas of failure, to identify some possible prognostic factors (site of primary, stage, site, number of metastases, preoperative carcinoembryonic antigen, differentiation of the primary, type of surgery), and to seek a new rationale for a multimodal approach. The median postoperative follow-up was 18 months (range: 4–45 months). Survival rate was calculated by the actuarial method, and statistical significance was tested by the Mantel-Haenszel test. Twenty-eight patients had a relapse. These recurrences were hepatic in 11 patients, extrahepatic (intra- and extra-abdominal) in 12 patients, and intra- and extrahepatic in five patients: The stage (classification of the Istituto Nazionale Tumori of Milan) was the most important parameter related to the overall recurrence rate (47% in stage I, 62% in stage II, and 81% in stage III) and to the overall and disease-free survival. Stage was significantly related to hepatic relapse but not to extrahepatic relapse. In stage I the failure rate of 18 months was similar in hepatic and extrahepatic relapses (one third to one fourth of the patients); in stages II and III the hepatic failure rate was always higher than the extrahepatic rate. These data indicate that surgery alone is an inadequate form of therapy in cases of colorectal cancer metastases of the liver, and an adjuvant therapy, including alternate regimens of intraperitoneal and systemic chemotherapy, should be considered.
Learning to Use In-Vehicle Technologies: Consumer Preferences and Effects on Understanding

Advanced Driver Assistance Systems (ADAS) have the potential to increase driver safety. However, driver misuse or failure to use ADAS could mitigate potential benefits. Appropriate training is one established method for encouraging proper use of technology. An online survey of 2364 respondents revealed significant differences between utilized and preferred methods for learning to use technologies. Drivers who learned through their preferred methods reported higher understanding and use of in-vehicle systems. Providing readily available methods of learning that align with learning preferences may improve safe use of ADAS.
The Blind Power: Power-Driven CEO Overconfidence and M&A Decision Making

The behavioral finance literature attributes failed M&amp;As to CEO overconfidence. We investigate the source of CEO overconfidence that leads to failed M&amp;As. Among various determinants of CEO overconfidence, we propose that power-led CEO overconfidence delivers undesirable consequences in corporate investments. Using CEO-level data, we find that CEO power increases the probability of a CEO being overconfident. We also show that power-driven overconfident CEOs tend to complete more deals regardless of circumstances, do stock acquisitions, and make value-destroying acquisitions, relative to non-overconfident CEOs. The results suggest that previous studies on M&amp;As by overconfident CEOs are mainly led by power-driven overconfident CEOs.
Corporate Tax Avoidance and Firm Value Discount

We analyze the valuation-tax avoidance relation and find there is, in fact, a market value discount for tax avoidance. We identify several channels for the adverse valuation effects of tax avoidance. Tax-avoiding firms that (i) lack foreign income, (ii) are financially constrained, and (iii) incur relatively high capital expenditures have lower valuations. A portfolio long the highest and short the lowest tax-avoiding firms has a significantly positive four-factor alpha, highlighting greater risk and thus lower valuation associated with tax avoidance. Our results are robust to a variety of tests, including several different tax avoidance measures.
Adherence and Morbidity Following Emergency Department Care Among Inner-City Children With Asthma

Objectives. To explore the utility of two measures, Risk for Nonadherence (RN) and Admitted Nonadherence (AN), developed in a national sample of children with chronic asthma, for predicting short-term morbidity among children following a pediatric emergency department (PED) visit for acute asthma and to compare verbal and self-completion of these measures. Design, Setting, and Participants. Prospective cohort study of children 3 to 11 years of age presenting to a PED with an acute asthma exacerbation. Caretakers were randomized to self-completion of a questionnaire assessing RN and AN or to verbally respond to the same questionnaire administered by a research assistant. Five asthma morbidity indicators were collected at 2, 4, and 8 weeks following discharge from the PED. Results. One hundred fifty-four patients were enrolled. There were no significant differences in asthma severity, RN, or AN, or the number of items missing on questionnaires between the self-completion and verbal administration groups. Patients with a RN score >4 had an adjusted odds of 3.67 (95% confidence interval [CI] 1.57–8.58) for waking >2 nights due to asthma symptoms. The adjusted odds of patients with any AN to report needing >4 days of rescue asthma medication was 3.16 (95% CI 1.37–7.26). Conclusion. RN and AN were both associated with morbidity indices following an acute asthma exacerbation and can identify children at risk for increased short-term morbidity regardless of the method of questionnaire administration. Assessment of RN and AN by self-administered questionnaire during an ED visit for asthma maybe feasible.
The prevalence and character of the muscularis mucosae of the human urinary bladder

We report the results of a histological evaluation of 335 consecutive autopsy specimens of apparently normal urinary bladder for the presence of a complete, partial or minimal muscularis mucosae. There were 164 females (49%) and 171 males (51%), ranging in age from 20 weeks of gestation to 102 years. A muscularis mucosae was present in 117 bladders (35%). The female to male ratio was 2:1, with 45% of female and 25% of male bladders containing a muscularis mucosae. The muscularis mucosae was complete in one case (1%), partial in 23 cases (6%) and minimal in 93 cases (28%). The occurrence of a partial or complete muscularis mucosae was ten times more likely in women than men. The presence of a muscularis mucosae in both women and men was not associated with any known disease process, nor was it related to patient age.
Implementation of a nation‐wide automated auditory brainstem response hearing screening programme in neonatal intensive care units

Aim: As part of a future national neonatal hearing screening programme in the Netherlands, automated auditory brainstem response (AABR) hearing screening was implemented in seven neonatal intensive care units (NICUs). The objective was to evaluate key outcomes of this programme: participation rate, first stage success rate, pass/referral rates, rescreening compliance, diagnostic referral rates, age of first diagnostic evaluation and prevalence of congenital hearing loss (CHL). Methods: This prospective cohort study collected data on 2513 survivors. NICU graduates with one or more risk factors according to the Joint Committee on Infant Hearing were included in a two‐stage AABR hearing screening programme. Conventional ABR was used to establish a diagnosis of CHL. Results: A total of 2513 newborns enrolled in the programme with a median gestational age of 31.6 (range 24–43) wk and a median birthweight of 1450 (range 510–4820) g. In 25 (1%) cases parents refused screening. Four out of 2513 newborns were initially lost; 2484 newborns have been tested initially. A final 98% participation rate (2465/2513) was obtained for the whole programme. After a median postmenstrual age at the first test of 33.7 (range 27–54) wk, a pass rate of 2284/2484 (92%) resulted at the first stage. The rescreening compliance after the first test was 92% (184/200). A referral rate for diagnostic ABR of 3.1% (77/2484) resulted. Of the 77 referrals 14 (18.2%) had normal screening thresholds, 15 (19.5%) had unilateral CHL and 48 (62.3%) had bilateral CHL. The prevalence of unilateral CHL was 0.6% (15/2484) and of bilateral CHL 1.9% (48/2484).
Reviewing the Literature of the Effect of Talent Management on Organizational Effectiveness

Talent management is a challenging ease concept in the business field, that has started to widespread among organizations locally and internationally, however, this aspect of management is completely related to the human being nature, therefore, a great cautious need to be considered when applying it through an organization especially in service-providing organizations. The purpose of this paper is to reviewing the literature and the impact of talent management on organizational effectiveness.
Finite-state Markov model for Rayleigh fading channels

We form a finite-state Markov channel model to represent Rayleigh fading channels. We develop and analyze a methodology to partition the received signal-to-noise ratio (SNR) into a finite number of states according to the time duration of each state. Each state corresponds to a different channel quality indicated by the bit-error rate (BER). The number of states and SNR partitions are determined by the fading speed of the channel. Computer simulations are performed to verify the accuracy of the model.
Machine Learning with Privacy by Knowledge Aggregation and Transfer

Machine learning relies on the availability of high-quality training data and— whether by its inherent nature, or by accident—this data will sometimes contain private information. When the model is to be published or made publicly accessible and the training data is not, it is important that the details of the sensitive training data cannot be inadvertently revealed by the model. This abstract presents a generally applicable approach to providing strong privacy guarantees for machine learning training data. The approach is based on combining, in a black-box fashion, multiple machine learning models trained with disjoint sensitive datasets, such as data for different users. Because they rely directly on sensitive data, these models are used only as “teachers” for a “student” machine learning model. However, when training the student, the teachers transfer only the labels upon which they all generally agree, via a noisy aggregation mechanism. The student has privacy properties that can be understood both intuitively (since no single teacher dictates the student’s training) and formally, in terms of differential privacy. These properties address “glass-box” attacks of the kind that arise if an adversary not only queries the student but also inspects its internal workings. The approach imposes only weak assumptions on how the teachers are trained. It applies to powerful, deep models, possibly with many layers and parameters. Our experiments demonstrate that the approach applies to real-world machine learning tasks, at a reasonable cost in accuracy, privacy, and software complexity.
ORIENTATION TO THE VERTICAL DURING WATER IMMERSION

Abstract : In an effort to determine whether the utricle system within the ear might furnish a point of reference for the gravitational vertical, five subjects were immersed in water at a depth of either 18 or 25 feet and then rotated in a tucked position on a rod through 3, 4, or 5 revolutions. Rotation was terminated with the head in one of four positions. Upon termination of rotation, the subject was asked to point in the direction of the surface of the water, then to nod his head and correct the direction of pointing if necessary, and finally to swim toward the surface. There were errors in direction of the initial pointing of as much as 180 degrees. Errors were greatest with the head down or back and least with the head up or forward. Nodding the head was followed by consistent improvement in the pointing. It was concluded that the utricles are relatively inefficient as gravity sensors.
Adaptive Partial Differential Equation Observer for Battery State-of-Charge/State-of-Health Estimation Via an Electrochemical Model

This paper develops an adaptive partial differential equation (PDE) observer for battery state-of-charge (SOC) and state-of-health (SOH) estimation. Real-time state and parameter information enables operation near physical limits without compromising durability, thereby unlocking the full potential of battery energy storage. SOC/SOH estimation is technically challenging because battery dynamics are governed by electrochemical principles, mathematically modeled by PDEs. We cast this problem as a simultaneous state (SOC) and parameter (SOH) estimation design for a linear PDE with a nonlinear output mapping. Several new theoretical ideas are developed, integrated together, and tested. These include a backstepping PDE state estimator, a Pade-based parameter identifier, nonlinear parameter sensitivity analysis, and adaptive inversion of nonlinear output functions. The key novelty of this design is a combined SOC/SOH battery estimation algorithm that identifies physical system variables, from measurements of voltage and current only.
The relationship between testosterone and sexual function in depressed and healthy men.

AIM Men with Major Depressive Disorder (MDD) report high rates of sexual dysfunction, as do healthy males with low levels of testosterone. The objective of this study is to evaluate the effects of depression and low testosterone across various domains of sexual function. METHODS Untreated depressed males (N = 44) and age-matched healthy controls (N = 50) had blood samples drawn to determine morning levels of total testosterone (TT) and bioavailable testosterone (BT). In addition, questionnaires regarding depressive symptoms as well as sexual function were administered. MAIN OUTCOME MEASURES Sexual function outcomes were measured using the Sex Effects (SexFX) Scale and depression severity was assessed with the Hamilton Rating Scale for Depression-17 item (HAMD-17). RESULTS Using TT criteria, 27.9% of men were categorically defined as hypogonadal compared to 19.3% using BT criteria. Within both TT and BT hypogonadal groups, men with MDD had lower scores on all domains of sexual function compared to healthy controls with hypogonadism. Testosterone levels interacted with MDD status to affect orgasm and desire, although not arousal. Multiple linear regression analyses revealed that depression status was the main factor influencing sexual function. Hypogonadal status was not a predictor of sexual function in this sample, although age did play a minor role in the domain of arousal. CONCLUSION While testosterone levels appear to influence sexual function, specifically orgasm, the presence of MDD appears to be a stronger factor and has high predictive value for sexual outcomes.
A comparison of subcutaneous low-molecular-weight heparin with warfarin sodium for prophylaxis against deep-vein thrombosis after hip or knee implantation.

BACKGROUND Deep-vein thrombosis is a potentially life-threatening complication of total hip or knee replacement. There are few data on the effectiveness and safety of warfarin as compared with low-molecular-weight heparin as prophylaxis against this problem. METHODS We therefore performed a randomized, double-blind trial in 1436 patients to evaluate the effectiveness and safety of low-molecular-weight heparin (given subcutaneously once daily) as compared with adjusted-dose warfarin to prevent venous thrombosis after hip or knee replacement. Treatment with the drugs was started postoperatively. The primary end point was deep-vein thrombosis as detected by contrast venography (performed a mean of 9.4 days after surgery in each group). RESULTS Among the 1207 patients with interpretable venograms, 231 of 617 patients (37.4 percent) in the warfarin group and 185 of 590 patients (31.4 percent) in the low-molecular-weight-heparin group had deep-vein thrombosis (P = 0.03). The reduction in risk with low-molecular-weight heparin as compared with warfarin was 16 percent, and the absolute difference in the incidence of venous thrombosis was 6 percent in favor of low-molecular-weight heparin (95 percent confidence interval, 0.8 to 11.4 percent). The incidence of major bleeding was 1.2 percent (9 of 721 patients) in the warfarin group and 2.8 percent (20 of 715 patients) in the low-molecular-weight-heparin group (P = 0.04), and the absolute difference was 1.5 percent in favor of warfarin (95 percent confidence interval, 0.1 to 3.0 percent). CONCLUSIONS Our data demonstrate that the small reduction in the incidence of venous thrombosis with low-molecular-weight heparin, as compared with warfarin, was offset by an increase in bleeding complications. Although the use of low-molecular-weight heparin is simpler, because it is administered subcutaneously without the need for monitoring, it may be more costly than warfarin. Warfarin is inexpensive, but the overall cost of its use is increased by the need to monitor the intensity of anticoagulation. At this time it is unclear which of these approaches is the most cost effective.
Prevalence and impact of fibromyalgia on function and quality of life in individuals from the general population: results from a nationwide study in Spain.

OBJECTIVE To estimate the prevalence of fibromyalgia (FM) and to compare some descriptive epidemiological and quality of life data between persons with and without FM criteria in a representative sample of the general Spanish population. METHODS Cross sectional study of 2,192 Spaniards aged 20 or above, selected by cluster sampling. Subjects were invited to a structured interview carried out by trained rheumatologists to ascertain various musculoskeletal disorders. The visit included screening and examination, validated instruments for measuring function (HAQ) and quality of life (SF-12) and questions about socio-demographic characteristics and musculoskeletal, mental, and other general symptoms. FM was suspected in subjects with widespread pain for more than three months. FM was defined by theAmerican College of Rheumatology classification criteria. All estimates are adjusted to sampling scheme. RESULTS The prevalence of FM in Spain is 2.4% (95% CI: 1.5-3.2). FM is significantly more frequent in women (4.2%) than in men (0.2%), with an OR for women of 22.5 (95%CI: 7.2- 69.9), mainly in the 40-49 years age interval. It is more frequent in rural (4.1%) than in urban settings (1.7%), with an OR for rural settings of 2.5 (95%CI: 1.03-5.9). FM is associated with a low educational level, to a low social class, and to self-reported depression. The scores in the HAQ and in the SF-12 were significantly lower in FM subjects, despite adjustment by covariates. CONCLUSION FM has a high prevalence in the general population. FM is associated to female gender, comorbidities, age between 40 and 59 years, and a rural setting. Persons fulfilling FM criteria show impaired functioning and quality of life.
Simian immunodeficiency virus displays complex patterns of RNA splicing

The human and simian immunodeficiency viruses encode at least six gene products that apparently serve regulatory functions. To evaluate the regulation of simian immunodeficiency virus gene expression at the level of RNA splicing, we used the polymerase chain reaction to amplify and clone cDNAs corresponding to a large array of mRNAs from infected cells. We identified mRNAs that used splice acceptor sites upstream of the initiator codons for tat, rev, vpr, nef, vif, and vpx, suggesting that these proteins may be expressed from different mRNAs. We also provide hybridization data suggesting that the same splice acceptor site may be used for both rev and env mRNAs. Furthermore, we isolated both tat and rev cDNAs that utilized three alternative splice acceptor sites at the start of coding exon 2, indicating that different versions of these proteins may be encoded. Finally, approximately 10 to 20% of simian immunodeficiency virus mRNAs spliced an intron from their untranslated 5' ends, and sequences contained within this intron constituted a portion of the tat-responsive TAR element. Thus, alternative pre-mRNA splicing adds a level of complexity to simian immunodeficiency virus expression, which may affect several levels of gene regulation.