Miracle-dz/UniFAR-FTUs huggingface dataset:
Do Resource Utilization and Clinical Measures Still Vary Across Dialysis Chains After Controlling for the Local Practices of Facilities and Physicians?

Background:Because of adverse survival effects, anemia management and financial incentives to increase doses of erythropoiesis-stimulating agents (ESAs) have been controversial. Prior studies showed more aggressive anemia management in dialysis facilities owned by for-profit chains, but have been criticized for not accounting for practices of individual physicians and facilities. Objective:To improve understanding of how dialysis practices and resource utilization are influenced by physicians, facilities, and chains. Design:Mixed models with chain fixed effects and facility and physician random effects. Setting:Medicare hemodialysis patients in 2004. Participants:A total of 234,158 patients, 3995 facilities, 4838 physicians, and 7 chain classifications were included. Measurements:Spending per session for dialysis-related services billed separately from the dialysis treatment and for ESAs. Achievement of hematocrit (HCT) and urea reduction ratio (URR) targets. Results:Of the 4 largest for-profit chains, 3 had higher resource use than independents, with differences up to $17.92 higher ESA/session. Utilization was positively associated with achieving target HCT. Despite incurring lower costs, patients treated by a large nonprofit chain were as likely as patients of independents to achieve the HCT target. The largest chains were more likely than independents to achieve the URR target. Substantial variation occurred across physicians and facilities, and adjustment for chain only modestly decreased this variation. Limitation:Chains' methods of influencing practices were not directly observed. Conclusions:Chains appear to have the ability to implement protocols that shift practices, but not the ability to substantially reduce local variation. Assertions that chain effects found by earlier studies were spurious are not supported.
Internationalizing Higher Education (HE) in Vietnam: Insights from Higher Education leaders – an exploratory study

Purpose – The purpose of this paper is to increase knowledge of the key drivers, and challenges, of the internationalization of Higher Education (HE), especially in the transitioning economy of Vietnam. Design/methodology/approach – An exploratory qualitative research design used semi-structured interviews. Nine senior institutional leaders from five Vietnamese universities were interviewed. Thematic analysis, informed by the literature, was undertaken on English-translated transcripts. Findings – The findings shared senior HE leader perspectives on how internationalization of HE in Vietnam was being conceptualized and operationalized, as well as insights as to how these processes might be improved. Further research to monitor the success of internationalization processes in Vietnam, and beyond, is recommended. Research limitations/implications – This was an exploratory qualitative study including nine interviews with senior HE leaders from Vietnamese Universities. Exploratory findings only are shared. Or.
Successful transverse patterning in amnesia using semantic knowledge

We examined whether alternate systems compensate for deficient ones to process relations in amnesia. Transverse patterning (TP), a test of relating items to one another in memory, is reliably impaired in amnesia and has played a central role in testing hippocampal function. We facilitated successful TP in amnesia by providing familiar stimuli with semantically meaningful relationships. Tapping semantic knowledge allowed TP to be solved via extrahippocampal structures. Our work shows that by framing a situation as meaningful we can engage alternate neural systems to compensate for impairments. © 2007 Wiley‐Liss, Inc.
A Combination Antibiogram to Guide Empiric Therapy for Pseudomonas aeruginosa Infections. Year-to-Year Variation and Influence of Day of Hospitalization Isolation

Copyright: © 2016 Alnamnakani B, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. *Corresponding author: John A Bosso, PharmD, South Carolina College of Pharmacy, Charleston, USA, Tel: 843-792-8501; Fax: 843-792-1712; E-mail: bossoja@musc.edu
Reliability of prisoners' attitudes to their drinking behaviour

Synopsis A sample of male prisoners was examined by means of a questionnaire and subsequently by a structured interview. Control subjects who denied heavy drinking were used to study test-retest reliability of a group who admitted that drinking was a problem and a third group who admitted heavy drinking but denied problem drinking. Non-heavy drinkers and the heaviest drinkers are shown to be the most reliable and the intermediate group least reliable.
The development of a new computational model for the electromechanics of the human ventricular myocyte

In this work we present a new electromechanical cardiac myocyte model tailored to reproduce the electrical and force generating activities of human ventricular myocytes. The model was created by coupling two existing models: the ten Tusscher electrophysiology model and the Rice myofilament mechanics model. The parameters of the new model were adjusted in order to replicate the available experimental data for human myocytes. The main challenges in this work were the strong feedbacks between the models, the high non-linearity of the models and mainly the lack of human data to make the adjustments.
A Combined Enrichment and Aptamer Pulldown Assay for Francisella tularensis Detection in Food and Environmental Matrices

Francisella tularensis, a Gram-negative bacterium and causative agent of tularemia, is categorized as a Class A select agent by the Centers for Disease Control and Prevention due to its ease of dissemination and ability to cause disease. Oropharyngeal and gastrointestinal tularemia may occur due to ingestion of contaminated food and water. Despite the concern to public health, little research is focused on F. tularensis detection in food and environmental matrices. Current diagnostics rely on host responses and amplification of F. tularensis genetic elements via Polymerase Chain Reaction; however, both tools are limited by development of an antibody response and limit of detection, respectively. During our investigation to develop an improved culture medium to aid F. tularensis diagnostics, we found enhanced F. tularensis growth using the spent culture filtrate. Addition of the spent culture filtrate allowed for increased detection of F. tularensis in mixed cultures of food and environmental matrices. Ultraperformance liquid chromatography (UPLC)/MS analysis identified several unique chemicals within the spent culture supernatant of which carnosine had a matching m/z ratio. Addition of 0.625 mg/mL of carnosine to conventional F. tularensis medium increased the growth of F. tularensis at low inoculums. In order to further enrich F. tularensis cells, we developed a DNA aptamer cocktail to physically separate F. tularensis from other bacteria present in food and environmental matrices. The combined enrichment steps resulted in a detection range of 1–106 CFU/mL (starting inoculums) in both soil and lettuce backgrounds. We propose that the two-step enrichment process may be utilized for easy field diagnostics and subtyping of suspected F. tularensis contamination as well as a tool to aid in basic research of F. tularensis ecology.
THE FINE STRUCTURE OF THE CERVICAL SPINAL CORD, VENTRAL ROOT AND BRACHIAL NERVES IN THE WOBBLER (wr) MOUSE

Much indirect evidence supports the prevailing concept that the wobbler mouse represents an inherited form of lower motor neuron degeneration, with resultant neurogenic muscular atrophy, due to an autosomal recessive gene (wr). This report, which emphasizes the fine structural changes in the wobbler mouse cervical spinal cord, ventral root and brachial nerves, both extends and modifies previously published data concerning the ultrastructural changes in this disorder. In addition to the more obvious neuronal cytoplasmic vacuolization known to occur, studies extended to a broader age range of wobbler mice have revealed neuronal alterations such as nonvacuolar dissolution of granular endoplasmic reticulum, proliferation of cytoplasmic microtubules and neurofilaments, proliferation of branched tubules resembling smooth endoplasmic reticulum, development of lipid droplets, and increased numbers of pleomorphic dense and lamellar cytoplasmic bodies. The spectrum of pathological changes in this murine form of motor neuron disease thus appears more complex and varied than has hitherto been appreciated, and may be relevant to the formulation of pathogenetic hypotheses.
A reinterpretation of the dimerization interface of the N‐terminal Domains of STATs

The crystal structures of the N‐terminal domain (N‐domain) and the core region of the STAT family of transcription factors have been determined previously. STATs can form cooperative higher order structures (tetramers or higher oligomers) while bound to DNA. The crystal packing in the STAT4 N‐domain crystal structure, determined at 1.5 Å resolution, suggests two alternate organizations of the N‐domain dimer. We now present the results of site directed mutagenesis of residues predicted to be involved at each dimer interface. Our results indicate that the dimer interface suggested earlier as being physiologically relevant is, in fact, unlikely to be so. Given the alternative model for the N‐domain dimer, the ability of the N‐domain to mediate interactions of two STAT dimers on DNA remains unchanged.
Do Youth Sports Prevent Pediatric Obesity? A Systematic Review and Commentary

Sport is a promising setting for obesity prevention among youth, but little is known about whether it prevents obesity. We reviewed research comparing sport participants with nonparticipants on weight status, physical activity, and diet. Among 19 studies, we found no clear pattern of association between body weight and sport participation. Among 17 studies, we found that sport participants are more physically active than those who do not participate. We found seven studies that compared the diet of sport participants with non-participants. These studies reported that youth involved in sport were more likely to consume fruits, vegetables, and milk, and also more likely to eat fast food and drink sugar-sweetened beverages and consume more calories overall. It is unclear from these results whether sports programs, as currently offered, protect youth from becoming overweight or obese. Additional research may foster understanding about how sport, and youth sport settings, can help promote energy balance and healthy body weight.
A Structural Modelling Approach to Closed End Bond Funds

This thesis develops a model of closed end bond funds that helps us better understand a recent finding in the literature. In 2012 Elton et al. published an empirical study of closed end bond funds (CEBFs) and they suggested that the use of leverage in CEBFs could explain the fact that these funds had higher returns than those of comparable open end funds. This thesis provides a framework for estimating the impact of leverage on expected return and risk in this context. We use a Merton type approach to model both unlevered and levered CEBFs. The assets of a CEBF are primarily risky bonds. Each of these risky bonds can be analysed in terms of options under the Merton approach. We create an unlevered CEBF model by extending Merton's model to a multi-firm framework to represent a CEBF composed of several risky bonds. We then add leverage by assuming the CEBF issues debt. This permits us to model the securities of a levered closed end bond fund as compound options. The equity and debt of the CEBF can be decomposed into options on a portfolio of options. This framework enables us to compute the expected rate of return and standard deviation of an unlevered and levered CEBF. We obtain results that are comparable to those observed in Elton et al.
Studies on the immune protection to murine experimental brucellosis conferred by Brucella fractions. I. Positive role of immune serum.

Mouse inoculation with three different phenol-insoluble fractions extracted from Brucella melitensis (fractions 'PI', '4A' and '5') induces an acceleration of the blood clearance of i.v. inoculated live Brucella and a diminution of the rate of multiplication of the injected bacteria in the spleen. Preincubation of the challenge inoculum in immune serum or i.p. injections of immune serum confer a good specific protection to non-immunized hosts. The results observed with fractionated sera suggest that, not only antibodies, but also other serum constituents may participate in the protective activity of immune sera. This discussed in terms of the respective importance of humoral and cellular immunity to Brucella and of the choice of the best preparations for human or animal vaccination.
Relation between the external branch of the superior laryngeal nerve and the superior thyroid artery: a study in 101 nerves.

OBJECTIVE This paper aims to propose a protocol with the topographical relations of the ESLN and the superior thyroid artery in order to minimize the number of flaws in the proposals found in the literature. METHODS the cervical regions of 57 human cadavers from the Forensic Medicine Institute were dissected bilaterally, with photographic identification of the ESLNs and their relation to the superior thyroid artery. These data were used to propose the following classification: Type 1: unidentified ESLN; Type 2: the ESLN crosses the superior thyroid artery 1.5 cm above the upper pole of the thyroid gland; Type 3: the ESLN crosses the superior thyroid artery between 1 and 1.5 cm above the upper pole of the thyroid gland; Type 4: the ESLN crosses the superior thyroid artery less than 1cm above the upper pole of the thyroid gland; Type 5: the ESLN crosses lateral-medially below the upper pole of the thyroid gland. As a supplement, types 2, 3 and 4 received the subclassification: A - the ESLN was partially or totally enclosed in the perimuscular or intramuscular areolar connective tissue, in the inferior pharyngeal constrictor muscle, in more than half of its path after crossing the superior thyroid artery; B - the ESLN was not enclosed in either of these tissues. RESULTS Type 1, 11.88%; Type 2, 13.86%; Type 3, 34.65%; Type 4, 38.61%; Type 5, 0.99%. CONCLUSION the majority of the ESLN nearest to the upper pole of the gland (types 3 and 4) followed the perimuscular or intramuscular superficial connective tissue in the upper pole of the thyroid gland, which, in this study, disobliges the systematic identification of the nerve in thyroidectomies (p=0.075).
Gastric inhibitory polypeptide (GIP) stimulation by oral glucose in man.

ABSTRACT Gastric inhibitory polypeptide (GIP) was measured by a specific radioimmunoassay in 25 normal subjects who received 75 g of oral glucose or 25 g intravenously. Serum GIP levels increased in every subject after oral glucose ingestion. The mean fasting GIP was 319 ± 18 pg/ml and increased to a mean peak response of 747 ± 59 pg/ml between 15 and 60 min after oral glucose. In contrast, intravenous glucose did not significantly stimulate GIP release. We conclude that oral glucose is a potent stimulus for the enteric release of GIP.
The effect of inhalation aromatherapy on anxiety level of the patients in preoperative period

BACKGROUND: Anxiety is the one of the most common problems before the surgery. Its prevalence rate ranged from 11 to 80 percent in all the adult patients. Delay in wound healing and increasing use of narcotics and anesthetics are some of the other accompanying problems. Aromatherapy is one of the complementary medicine components. It is applied by special type of oil extracted from aromatic plants for medical objectives. This study aimed to investigate the effects of inhalation aromatherapy on anxiety level in preoperative patients. METHODS: This was a clinical study done on 72 patients candidate for heart and abdominal surgery admitted in Golestan and Imam Khomeini hospitals. The patients were selected according to our study objectives and inclusion criteria. Then, they were divided in two case and control groups. The Spielberger scale was used for evaluating the anxiety level. Twenty minute of inhalation with handkerchief containing lavandula was used in the case group and placebo also (water) in the control group. RESULTS: The average of anxiety level in inhalation aromatherapy group decreased from 51.00 to 38.61 from before to after the intervention. This average in the inhalation group with placebo was 50.67 before the intervention and decreased to 49.53 after the intervention. The results of independent t-test statistically showed a significant difference between the two groups after the intervention. CONCLUSIONS: The findings showed that inhalation aromatherapy was effective on reduction of anxiety level and this method can be applied as a complementary medicine on the clinic.
Physical functioning in older blacks: an exploratory study identifying psychosocial and clinical predictors.

OBJECTIVES The primary objective of this investigation was to examine the relationship between physical functioning and various clinical (pain intensity, pain locations, medications, comorbidities) and psychosocial (depression, locus of control) variables in a sample of older blacks. METHODS Data were collected from community-dwelling black adults (N=247), with a mean age of 69.4 +/- 9.4 years. Participants were recruited from several senior high-rise facilities located in an urban community in Baltimore, MD. A multivariate regression model was tested to determine the relationship between selected clinical, psychosocial and demographic characteristics, and physical functioning; and to assess the amount of unique variance in functional status accounted for by specific psychosocial, clinical and demographic indicators (independently and collectively). RESULTS It was established that reporting more depressive symptoms (beta=0.18, p<0.05), multiple pain locations (beta=0.25, p<0.01) and pain intensity (beta=0.30, p<0.01) was a significant indicator of physical impairment and accounted for 36% of its variation. CONCLUSION Identifying indicators of physical impairment is critical in providing baseline information on the functional well-being in older blacks. This emphasizes the need for further studies to rigorously examine the relationship between physical functioning, and clinical and psychosocial indicators within defined race and ethnic groups in order to develop data that provide meaningful comparisons between different race and ethnic groups.
Improving access to primary care: Eight case studies of introducing Advanced Access in England

Objective To examine the implementation of ‘Advanced Access’ as a means of improving access to primary care. Methods Qualitative case studies of eight English general practices undertaken as part of a mixed method study. Results There was considerable variation in the interpretation and implementation of Advanced Access. Practices claiming to operate this system often did not follow its key principles. Differences between practice access systems centred on the use of ‘same-day’ appointments. The association of Advanced Access with same-day appointment systems was problematic as it both created antagonism to, and diverged from, the Advanced Access model. Practice staff did not necessarily share the conceptualisation of demand that underpinned Advanced Access. Other policies and targets provided further incentives to diverge from the model and these factors were compounded by informal organizational behaviours, notably the exercise of discretion, which led to adaptation. Conclusion Advanced Access was diluted because it became confused with same-day appointment systems and other incentives and targets. Its guiding philosophy of ‘manageable demand’ appeared counter-intuitive to staff in the context of general practice, which made its implementation problematic. As a result, the system was adapted and modified.
The effect of water content on the ordered/disordered structures in starches.

(13)C cross-polarization magic angle spinning NMR has been used to study the ordered and disordered structures of starches with different water contents. The amorphous regions of starch have been shown to produce NMR patterns only if they are in a glassy state, the widths, positions, and areas of the peaks to some extent being dependent on the temperature and the water content of the starch. In the amorphous region, the peaks were all Gaussian in shape, while the peaks in the ordered regions had Lorentz profiles. Water contents in the range 10-50% did not influence the proportion of double helices in the starch. Decreasing the water content to 1-3%, however, resulted in a significant decrease in the proportion of double helices, the effect being greater in B- than in A-type starches. It is suggested that short-range order structures in starches (double helices) are stabilized by becoming part of long-range order structures (crystallites).
Pregnant Women's Current and Intended Cannabis Use in Relation to Their Views Toward Legalization and Knowledge of Potential Harm

Objectives: The objective of this study was to investigate pregnant women's current use of cannabis and their intended patterns of use with relation to their views on the legalization of cannabis and their knowledge of potential harms. Methods: A voluntary, anonymous survey regarding patterns of use of cannabis and views on legalization was distributed to a convenience sample of pregnant women presenting for prenatal care at an outpatient university clinic. Chi-square and Fischer's exact tests were used for analysis using STATA. Results: Of 306 surveys returned, 35% of women reported currently using cannabis at the time of diagnosis of pregnancy and 34% of those women continued to use. Seventy percent of respondents endorsed the belief that cannabis could be harmful to a pregnancy. Fifty-nine percent of respondents believed that cannabis should be legalized in some form and 10% reported that they would use cannabis more during pregnancy if it were legalized. Those who continued to use cannabis during pregnancy were less likely than those who quit to believe that cannabis use could be harmful during pregnancy (26% vs 75%, P < 0.001). The most common motivation for quitting cannabis use in pregnancy was to avoid being a bad example (74%); in comparison, only 27% of respondents listed a doctor's recommendation as a motivation to quit. Conclusions: Cannabis use during pregnancy is relatively common and persistent, despite knowledge of the potential risks of harm. Views toward legalization vary among pregnant women and may impact cannabis use during pregnancy. In a changing legal climate, there is a need for clear messaging on the effects of cannabis use during pregnancy.
Neutron sources in the Varian Clinac 2100C/2300C medical accelerator calculated by the EGS4 code.

The photoneutron yields produced in different components of the medical accelerator heads evaluated in these studies (24-MV Clinac 2500 and a Clinac 2100C/2300C running in the 10-MV, 15-MV, 18-MV and 20-MV modes) were calculated by the EGS4 Monte Carlo code using a modified version of the Combinatorial Geometry of MORSE-CG. Actual component dimensions and materials (i.e., targets, collimators, flattening filters, jaws and shielding for specific accelerator heads) were used in the geometric simulations. Calculated relative neutron yields in different components of a 24-MV Clinac 2500 were compared with the published measured data, and were found to agree to within +/-30%. Total neutron yields produced in the Clinac 2100/2300, as a function of primary electron energy and field size, are presented. A simplified Clinac 2100/2300C geometry is presented to calculate neutron yields, which were compared with those calculated by using the fully-described geometry.