Miracle-dz/UniFAR-FTUs huggingface dataset:
Stenotrophomonas maltophilia infection and colonization in the intensive care units of two community hospitals: A study of 143 patients.

STUDY OBJECTIVE To study the epidemiology of Stenotrophomonas maltophilia infections in the intensive care units (ICUs) of community general hospitals. DESIGN Retrospective chart review of 143 patients with cultures positive for S. maltophilia over a 2-year period. SETTING Intensive care units of 2 community general hospitals. RESULTS Patients with S. maltophilia infection or colonization were elderly (mean age 62.4 years), intubated for a mean of 11.8 days, and had a mean Acute Physiology and Chronic Health Evaluation II (APACHE II) score of 16.6. A tracheostomy was present in 22.4%, and underlying chronic respiratory disease and malignancy were found in 25.9% and 15.4%, respectively. Only 2 patients (1.4%) were neutropenic. Most isolates (89.5%) were from the respiratory tract and were part of a polymicrobial culture in 52. 5% of patients. Only a slightly higher APACHE II score (mean = 18.0, SD 7.8 vs mean = 15.6, SD 6.2, P = 0.052) differentiated patients with infection from those with colonization. All but 2 patients were exposed to antibiotics before their positive culture. Crude mortality rate was 41.3% overall and was significantly higher in those with an APACHE II score of 15 or more (48.8% vs 30.5%, P = 0. 028). CONCLUSION S. maltophilia is emerging as an important cause of nosocomial infection, especially pneumonia, in ICUs of community general hospitals. Patients tend to be elderly, intubated for a mean of about 12 days, have high APACHE II scores, and frequently have a tracheostomy or underlying chronic respiratory disease. In contrast to earlier reports, neutropenia and underlying malignancy are uncommon in our ICU population. We found prior antibiotic exposure was almost universal and similar to previous reports, but use of imipenem was much less common in our community hospital patients. Patients with a high APACHE II score should be considered infected rather than colonized, but differentiation of infection from colonization remains problematic. Isolation of S. maltophilia from a patient carries a crude mortality rate of 41.3%, and patients with an APACHE II score of 15 or more have a significantly higher mortality rate than those with lesser scores, approaching 50%. Trimethoprim-sulfamethoxazole (TMP-SMX) remains the drug of choice for infections caused by S. maltophilia.
Lean services: a systematic review

Purpose The purpose of this paper is to highlight the importance of Lean methodology through an exhaustive literature review, and its implications and application in the service industry right from its initiation in 1990s till date. Design/methodology/approach The paper summarises the evolution of Lean in services and has systematically classified the reviewed literature in four dimensions, namely time, publisher, region and content. Further under “time” dimension, the literature is classified into Pre-Lean era, Lean awareness era, Lean Exploration era and Lean implementation era. Under the “content” dimension, the categories include theoretical foundation, frameworks/models and application/case studies. Findings The analysis inferred; Lean is gaining roads in services, though the research is still at nascent stage. Lean is applicable in services though transfer of Lean manufacturing principles to services has certain limitations because of the characteristics of services. The need is to focus on process difference between services and manufacturing. Respect for people and employment engagement is critical to Lean in service. The authors identified the necessity to standardise the Lean service definition, principles, and tools and to develop guidelines for structured implementation in service industry. Research limitations/implications Though multiple databases have been taken-up but that does not assume that the literature presented in this paper is by any means comprehensive. Development of a standard model/framework for Lean services is critical for future research. Rigorous industry-specific studies, specifically in developing nations are another area for future research. Future studies could analyse the impact of join applications and possible links between Lean service and other approaches like TQM, Six Sigma, etc., with an aim of process improvement. Practical implications This paper would serve as a resource for Lean practitioners as well as researchers as a fundamental platform, contributing to Lean body of knowledge. Social implications Service industry has special significance to the society in large. Many services including governments, public interest services, non-profit organisations, healthcare, banking, consulting, etc., has a significant share across markets. Lean being a proven methodology for successful process improvements has to be looked at from a services perspective. This paper helps in such interest. Originality/value Publications reviewing the adoption of Lean in services is scarce in literature. This paper serves as an excellent resource for research on the subject and will facilitate academicians and practitioners to objectively understand Lean in service sector.
Urban-rural flows of physicians.

CONTEXT Physician supply is anticipated to fall short of national requirements over the next 20 years. Rural areas are likely to lose relatively more physicians. Policy makers must know how to anticipate what changes in distribution are likely to happen to better target policies. PURPOSE To determine whether there was a significant flow of physicians from urban to rural areas in recent years when the overall supply of physicians has been considered in balance with needs. METHODS Individual records from merged AMA Physician Masterfiles for 1981, 1986, 1991, 1996, 2001, and 2003 were used to track movements from urban to rural and rural to urban counties. Individual physician locations were tracked over 5-year intervals during the period 1981 to 2001, with an additional assessment for movements in 2001-2003. FINDINGS Approximately 25% of physicians moved across county boundaries in any given 5-year period but the relative distribution of urban-rural supply remained relatively stable. One third of all physicians remained in the same urban or rural practice location for most of their professional careers. There was a small net movement of physicians from urban to rural areas from 1981 to 2003. CONCLUSIONS The data show a net flow from urban to rural places, suggesting a geographic diffusion of physicians in response to economic forces. However, the small gain in rural areas may also be explained by programs that are intended to counter normal market pressures for urban concentrations of professionals. It is likely that in the face of an overall shortage, rural areas will lose physician supply relative to population.
Partisan Alignment and Political Corruption. Theory and Evidence from Spain Job Market Paper

I study the effect of partisan alignment between local and regional governments on political corruption. I estimate the effect by using rich panel data on three consecutive municipal and regional elections in Spain and also on corrupt practices carried out by local politicians. I find significantly more corruption in aligned municipalities. Partisan alignment increases corruption by 2.2 percentage points with respect to the 5.7% mean level of non-aligned municipalities. This effect is more pronounced among municipalities with i) more than 10,000 inhabitants, ii) a budget size above the mean level, iii) local and regional elections held on the same day and the regional government ruling the Autonomous Community with absolute majority and iv) the main right-wing party in the country ruling both government layers. The empirical results are consistent with a simple model of electoral accountability in which politicians in office have to decide between pleasing voters and extracting rents for their own benefit conditional on alignment. Specifically, the model highlights that corruption is an increasing function of the benefits of being aligned and the budget size, with a complementary response due to the interaction between both effects.
Final height and pubertal growth in Japanese patients with congenital hypothyroidism detected by neonatal screening

Aim: To investigate the final adult heights and pubertal growth patterns in Japanese patients with congenital hypothyroidism (CH) detected by neonatal screening. Methods: A retrospective chart review was conducted of female patients >15y of age (n= 18) and male patients > 18y of age (n= 9), who were detected by neonatal screening and kept on continuous thyroid hormone replacement therapy. Final height standard deviation scores (FHSDS) and target height standard deviation scores (THSDS) were determined. Parameters characterizing the pubertal growth process (such as age at onset of pubertal growth spurt and age at peak pubertal growth) were obtained from each patient's growth rate chart. Menarchial age was determined in each female patient by reviewing the medical record. The impact on FHSDS of the etiology of CH, the severity of CH, the time of initiation of therapy and the adequacy of treatment during the first year of life was assessed. Results: All patients had received initial thyroid hormone treatment no later than 50 d of age, and had reached their final height. The mean FHSDS for female and male patients were +0.17 ±0.99 and ‐0.03 ± 0.99, respectively. The mean FHSDS‐THSDS for female and male patients was +0.09 ± 0.77 and ‐0.19 ±0.53, respectively. No difference was seen in pubertal growth parameters for either gender compared with that of the reference population, except for a greater peak height velocity and pubertal height gain in male patients. The mean menarchial age was identical to that of the reference population. No significant relationship was found between the FHSDS and any of the factors investigated.
Two logics of governance in organizing public sector reform: The development of market competition and civic cooperation in Swedish local government 2000-2012

Since the 1970s, local governments all over the world have been characterized by experimenting with public sector reform and innovation in order to increase bureaucratic effectiveness and public involvement. This paper examines how and why the growth and spread of NPM/privatization and civic reforms is shaped by two types of logics in the local government level. The analysis draws on the theory of institutional logics in relation to the impact of path dependency. The data stems from surveys performed with leading politicians, administrators and union representatives in 2004, 2008 and 2012 of all the 290 municipality level local governments in Sweden. The findings show that local governments implement these reforms in a logic-consistent behavior based on a delimited set of alternatives, founded on two contested principles of organization: competition and cooperation. The strength of cooperative reforms in local government is mainly explained by regional affiliation, while the growth of market privatization reforms rests on path dependency, based on experience from introducing privatization reform solutions in in the early 1990s in these local governments.
Multiple Intravesical Instillations of Low-Dose Resiniferatoxin in the Treatment of Refractory Interstitial Cystitis

Background: Current medications used in the treatment of interstitial cystitis (IC) have limited efficacy. This prospective study investigated the efficacy of multiple intravesical instillations of resiniferatoxin (RTX) at the concentration of 10 nM. Methods: Patients with proven IC previously treated with traditional medications for more than 6 months without clinical benefit were enrolled. They were excluded if bladder outlet obstruction or urinary tract infection was present. Intravesical instillation of low-dose RTX (10 nM) once weekly for 4 weeks was performed at the outpatient department. International Prostate Symptom Score (IPSS), 5-Point Pain Scale, and Quality of Life Index (QOL Index) were recorded. A videourodynamic study was done at baseline and 3 months after treatment. Results: The therapeutic results and urodynamic parameters were compared between baseline and 3 months. Thirteen patients, including 10 women and 3 men, were enrolled in this study. The mean duration of IC symptoms was 4.4 ± 2.5 years. The mean duration of active treatment was 15.3 ± 8.6 months. One female patient dropped out due to severe bladder pain after RTX instillation. Among the 12 patients who completed the study treatment, subjective assessment revealed that 2 had an excellent therapeutic result, 5 had an improved result and 5 remained unchanged from baseline. The overall satisfactory rate was 58.3%. IPSS, 5-Point Pain Scale, and QOL Index were significantly decreased after RTX treatment. There was no significant increase in mean functional bladder capacity or change in urodynamic parameters. No serious adverse event occurred after RTX treatment. Conclusions: This study suggests that multiple intravesical instillations of RTX at the concentration of 10 nM are effective in relieving lower urinary tract symptoms in patients with refractory IC. The treatment is tolerable and suitable for use on an outpatient clinic basis.
Btk/Tec kinases regulate sustained increases in intracellular Ca2+ following B‐cell receptor activation

Bruton's tyrosine kinase (Btk) is essential for B‐lineage development and represents an emerging family of non‐receptor tyrosine kinases implicated in signal transduction events initiated by a range of cell surface receptors. Increased dosage of Btk in normal B cells resulted in a striking enhancement of extracellular calcium influx following B‐cell antigen receptor (BCR) cross‐linking. Ectopic expression of Btk, or related Btk/Tec family kinases, restored deficient extracellular Ca2+ influx in a series of novel Btk‐deficient human B‐cell lines. Btk and phospholipase Cγ (PLCγ) co‐expression resulted in tyrosine phosphorylation of PLCγ and required the same Btk domains as those for Btk‐dependent calcium influx. Receptor‐dependent Btk activation led to enhanced peak inositol trisphosphate (IP3) generation and depletion of thapsigargin (Tg)‐sensitive intracellular calcium stores. These results suggest that Btk maintains increased intracellular calcium levels by controlling a Tg‐sensitive, IP3‐gated calcium store(s) that regulates store‐operated calcium entry. Overexpression of dominant‐negative Syk dramatically reduced the initial phase calcium response, demonstrating that Btk/Tec and Syk family kinases may exert distinct effects on calcium signaling. Finally, co‐cross‐linking of the BCR and the inhibitory receptor, FcγRIIb1, completely abrogated Btk‐dependent IP3 production and calcium store depletion. Together, these data demonstrate that Btk functions at a critical crossroads in the events controlling calcium signaling by regulating peak IP3 levels and calcium store depletion.
Quantifying Dehydration in the Fire Service Using Field Methods and Novel Devices

Abstract Objective. This study reports measurements of hydration status among firefighters prior to training, documents changes in hydration status after prolonged firefighting training, and reports the utility of salivary measurements to assess changes in hydration in field environments. Methods. Nude body mass measurements as well as urinary and salivary measurements of hydration status were taken before and after approximately three hours of firefighting training activities. Initial hydration status was assessed via urinary and salivary measures. Changes in body mass and total body water were measured following firefighting activity and correlated with changes in urinary and salivary measures of hydration. Results. The most important findings of this study were that a high percentage of firefighters arrived at training in a significantly or seriously dehydrated state; that firefighters lost a significant amount of body mass because of firefighting operations; and that portable salivary osmolality measurements showed much stronger correlation with changes in hydration status after firefighting operations than standard urinary measurements did. Conclusions. Firefighters arriving in a dehydrated state are at risk for heat injuries and may be in a physically and/or psychologically compromised state at the outset of firefighter training. Even during cool autumn days with ample fluids available, firefighters experience dehydration during typical firefighting activities, so the ability to measure hydration status throughout such activities may be important. Our data suggest that quantification of changes in hydration status through salivary osmolality measurements may provide a viable field measurement tool for such activities.
Organisational Citizenship Behaviours: Definitions and Dimensions

Organisational citizenship behaviour (OCB) is an evolving concept concerning how and why people contribute positively to their organisations beyond defined work roles that have rapidly expanded in recent years. The study of OCB engages fundamental questions analysing the circumstances in which individuals “go the extra mile” in the workplace. This briefing reviews the literature to shed a light on the antecedents and enabling environments for OCB in order to improve employee and employer ability to maximise citizenship behaviour for mutual benefit.
Single room maternity care: the nursing response.

BACKGROUND The introduction of single room maternity care in the 1990s necessitated a new approach to nursing education and practice. A focus on perinatal nursing requires competence across the spectrum of labor, delivery, postpartum and newborn care. We sought to evaluate the nursing response to this change by comparing satisfaction with the workplace environment among single room maternity care nurses before and after they worked in the setting and among nurses working in traditional birth settings. METHODS Six months before the opening of a pilot seven-bed single room maternity care unit, nurses who planned to work in the new unit completed a survey about their satisfaction with aspects of their work environment. Three months after the new unit opened the survey was repeated with this study group and also by a sample of nurses working in the delivery and postpartum areas. RESULTS Responses indicated that single room maternity care nurses before and after working in the unit were significantly more satisfied with the physical setting, their ability to respond to patients' needs, their opportunity for teaching families, the nursing practice environment, peer support, and their perceived level of competency. They rated their satisfaction significantly higher than that of their colleagues in the traditional delivery and postpartum settings. CONCLUSIONS The positive transition to single room maternity care by obstetrical nurses was demonstrated by their improved overall satisfaction with the work environment. Evaluation of the nurses' responses to changes in health care delivery has important implications for justifying new clinical approaches and planning for future changes.
The Effect of Demographics on Investment Choice: An Empirical Study of Investors in Jammu

Behavioral finance is a nascent, but growing discipline, which studies investor's psychology while making financial decisions. The present study is based on the primary data collected from December, 2009 to March, 2010 in Jammu City. A sample of 120 respondents was taken. The results of the study reveal that there is an association of demographic profiles and personality type of the investor with investment choice. The differences among the different genders are found to be significant for provident funds, fixed deposits, and real estate. The females were found to be conservative while investing, whereas males were found to be aggressive. The investors in the lower age group do not prefer post office as an investment option, but the investors in the higher age group prefer post office as an investment avenue. Most of the investors preferred to consult their family members while making investment decisions and preferred to invest for 1 to 5 years. Most of the investors invest for the safety of money. They are not that concerned for the growth of the money or liquidity. There is no association of income, age, gender, occupation, education on the percentage of income an investor wants to save for the future requirements. There is also no association of age, gender, occupation, education with the appropriate investment period, but there is a significant relationship of income with the appropriate investment period.
Complementation of Human Papillomavirus Type 16 E6 and E7 by Jagged1-Specific Notch1-Phosphatidylinositol 3-Kinase Signaling Involves Pleiotropic Oncogenic Functions Independent of CBF1;Su(H);Lag-1 Activation

ABSTRACT We have analyzed the induction and role of phosphatidylinositol 3-kinase (PI3K) by Notch signaling in human papillomavirus (HPV)-derived cancers. Jagged1, in contrast to Delta1, is preferentially upregulated in human cervical tumors. Jagged1 and not Delta1 expression sustained in vivo tumors by HPV16 oncogenes in HaCaT cells. Further, Jagged1 expression correlates with the rapid induction of PI3K-mediated epithelial-mesenchymal transition in both HaCaT cells and a human cervical tumor-derived cell line, suggestive of Delta1;Serrate/Jagged;Lag2 ligand-specific roles. Microarray analysis and dominant-negatives reveal that Notch-PI3K oncogenic functions can be independent of CBF1;Su(H);Lag-1 activation and instead relies on Deltex1, an alternative Notch effector.
Fair and regulated spectrum allocation in licensed shared access networks

We propose a novel Licensed Shared Access (LSA) spectrum allocation framework in this paper. The spectrum is made available to the licensee mobile network operators (MNOs) at specific time instants, in a specific service area, and for a specific time period. We propose a spectrum allocation algorithm which aims at providing resources to the MNOs in such a way that they can utilize them to serve their users and the resource allocation is fair at the same time. We also introduce a penalty mechanism whose output is a reduced spectrum allocation for the MNOs which violate the LSA spectrum use regulations. Our proposed algorithms are evaluated numerically and our results show that we can both guarantee fairness in spectrum allocation and penalize the MNOs that misbehave in regards to the LSA spectrum usage limitations imposed by the incumbent.
Initial examination of the psychometric properties of the short Hebrew version of the Zarit Burden Interview

Objectives: Given the sharp increase in individuals with cognitive and physical impairments, the evaluation of burden has become common in both caregiving research and clinical practice. The Zarit Burden Interview (ZBI) is the first and one of the most commonly used measures of caregiver burden. This study examines the psychometric properties and factor structure of a Hebrew version of Bédard et al.'s [Bédard, M. , Molloy, D.W. , Squire, L. , Dubois, S. , Lever, J.A. , & O’Donnell, M. (2001). The Zarit Burden Interview: A new short version and screening version. The Gerontologist, 41, 652–657] short ZBI scale (ZBI-HS). Methods: A total of 148 primary caregivers of individuals with cognitive and/or physical impairments completed the ZBI-HS. The factor structure of the ZBI-HS was assessed using exploratory factor analysis (EFA) and concurrent validity was examined. Results: The EFA supported the two-factor structure as reported by Bédard et al. (2001). Concurrent validity was supported by the ZBI-HS negative association with caregivers’ well-being and positive association with caregivers’ distress over behavioral problems of care-recipients. Conclusion: These findings suggest that the short version of the ZBI-HS can be used as an effective tool for measuring caregiving burden.