Miracle-dz/UniFAR-FTUs huggingface dataset:
On Goldilocks, care coordination, and palliative care: making it ‘just right’

data will be linked across the three audit work streams and will be analysed centrally. Reports with benchmarking against the national average will be provided for all participating practices, with higher level reports for commissioners and other organisations at a regional and national level. The practice reports will offer support for standardised coding of records and service improvement. Changes will be measured in repeat audit cycles. Whilst the collection of this database in England and Wales is itself a massive undertaking, the learning from Finland is that this is merely the beginning of a 5-year quality improvement programme. Within secondary care a peer review initiative is one option to drive improvements in care. For pulmonary rehabilitation programmes, an accreditation process is proposed which could drive up standards and assist commissioning of rehabilitation. One of the underlying principles of all such national audits is the open publication of data. This may be used to help patients and commissioners to understand the quality of services available. The Swedish and Finnish National studies have shown what can be accomplished if a national effort is made to collect good quality data and to use those data to support clinicians in improving the quality of care delivered to COPD patients. We now plan to collect a much bigger dataset in England and Wales and use this to drive a multi-faceted quality improvement programme on the care of our COPD patients. This is an opportunity for clinicians to deliver a long overdue UK national health improvement programme on a grand scale for a previously neglected group of people.
Wet Laws, Drinking Establishments, and Crime

Drawing on county-level data from Kansas for the period 1977-2011, we examine whether plausibly exogenous increases in the number of establishments licensed to sell alcohol by the drink are related to crime. During this period, 86 out of 105 counties in Kansas voted to legalize the sale of alcohol to the general public for on-premises consumption. These counties experienced substantial increases in the total number of drinking establishments (e.g., bars and restaurants). Using legalization as an instrument, this study is the first to provide estimates of the elasticity of crime with respect to drinking establishments. Specifically, we show that a 10 percent increase in drinking establishments is associated with a 3 to 4 percent increase in crime. Reduced-form estimates suggest that legalizing the sale of alcohol to the general public for onpremises consumption leads to a 10 to 12 percent increase in crime.
Statistical Characterization of Arctic Polar-Night Jet Oscillation Events

AbstractA novel diagnostic tool is presented, based on polar-cap temperature anomalies, for visualizing daily variability of the Arctic stratospheric polar vortex over multiple decades. This visualization illustrates the ubiquity of extended-time-scale recoveries from stratospheric sudden warmings, termed here polar-night jet oscillation (PJO) events. These are characterized by an anomalously warm polar lower stratosphere that persists for several months. Following the initial warming, a cold anomaly forms in the middle stratosphere, as does an anomalously high stratopause, both of which descend while the lower-stratospheric anomaly persists. These events are characterized in four datasets: Microwave Limb Sounder (MLS) temperature observations; the 40-yr ECMWF Re-Analysis (ERA-40) and Modern Era Retrospective Analysis for Research and Applications (MERRA) reanalyses; and an ensemble of three 150-yr simulations from the Canadian Middle Atmosphere Model. The statistics of PJO events in the model are found t.
A nanoscale secondary ion mass spectrometry study of dinoflagellate functional diversity in reef-building corals.

Nutritional interactions between corals and symbiotic dinoflagellate algae lie at the heart of the structural foundation of coral reefs. Whilst the genetic diversity of Symbiodinium has attracted particular interest because of its contribution to the sensitivity of corals to environmental changes and bleaching (i.e. disruption of coral-dinoflagellate symbiosis), very little is known about the in hospite metabolic capabilities of different Symbiodinium types. Using a combination of stable isotopic labelling and nanoscale secondary ion mass spectrometry (NanoSIMS), we investigated the ability of the intact symbiosis between the reef-building coral Isopora palifera, and Symbiodinium C or D types, to assimilate dissolved inorganic carbon (via photosynthesis) and nitrogen (as ammonium). Our results indicate that Symbiodinium types from two clades naturally associated with I. palifera possess different metabolic capabilities. The Symbiodinium C type fixed and passed significantly more carbon and nitrogen to its coral host than the D type. This study provides further insights into the metabolic plasticity among different Symbiodinium types in hospite and strengthens the evidence that the more temperature-tolerant Symbiodinium D type may be less metabolically beneficial for its coral host under non-stressful conditions.
Commitments to Save: A Field Experiment in Rural Malawi

This paper reports the results of a field experiment that randomly assigned smallholder cash crop farmers formal savings accounts. In collaboration with a microfinance institution in Malawi, the authors tested two primary treatments, offering either: 1)"ordinary"accounts, or 2) both ordinary and"commitment"accounts. Commitment accounts allowed customers to restrict access to their own funds until a future date of their choosing. A control group was not offered any account but was tracked alongside the treatment groups. Only the commitment treatment had statistically significant effects on subsequent outcomes. The effects were positive and large on deposits and withdrawals immediately prior to the next planting season, agricultural input use in that planting, crop sales from the subsequent harvest, and household expenditures in the period after harvest. Across the set of key outcomes, the commitment savings treatment had larger effects than the ordinary savings treatment. Additional evidence suggests that the positive impacts of commitment derive from keeping funds from being shared with one's social network.
Monitoring diabetic retinopathy in pregnancy: meeting the NICE guidelines

Editor, S ight-threatening diabetic retinopathy may develop during pregnancy despite good glycaemic control (Vestgaard et al. 2010); its timely detection and treatment are essential for preventing visual loss. The National Institute for Health and Clinical Excellence (NICE) recommended guidelines (NICE clinical guideline 63) for the management of diabetes during pregnancy in 2008 (Table 1). We aimed to compare screening diabetic retinopathy in pregnancy in our hospital to NICE guidelines, identify areas of concern and develop a strategy for improving care. A retrospective review of notes was done of all diabetic patients seen by the obstetricians at the Royal Berkshire Hospital. A baseline audit (January–December 2007, n = 36) assessed referrals for retinopathy screening, frequency of visits and ⁄or treatment and incidence of retinopathy. Changes were implemented (phase 1) and the service re-evaluated from June to November 2008, and following further changes (phase 2) from December 2008 to April 2009. Of note the NICE guidelines indicate photographic screening, however due to funding choices in our region beyond our control, the current system involves seeing pregnant diabetic patients in clinic. The changes we have implemented would also be applicable to a photographic screening service. Initial audit showed 19% of patients were being followed as recommended by NICE and a clear need to implement changes (Table 2). Phase 1 changes involved:
The adequacy of informed consent for placement of gastrostomy tubes.

BACKGROUND Gastrostomy tubes are placed commonly in patients with limited life expectancy. However, it is unclear whether the process of informed consent is adequate in these patients. This study examined the quality of informed consent in hospitalized patients undergoing placement of gastrostomy tubes. METHODS Retrospective review of the medical records of a cohort of 154 consecutive hospitalized adults undergoing placement of gastrostomy tubes in the context of chronic progressive illness, in the setting of a large community-teaching hospital. RESULTS The medical record documented a procedure-specific discussion of benefits and burdens of and alternatives to tube feeding in only 1 of 154 patients. Only 12 of 33 definitely or probably competent patients signed the hospital consent form; in the remaining 21, a surrogate decision-maker signed the form. The cumulative 1-year mortality for this cohort was 50%. CONCLUSIONS The quality of informed consent for placement of gastrostomy tubes was inadequate in a large community-teaching hospital. Indirect evidence from the literature suggests that these results are not unique to this institution. Physicians should become more familiar with the medical and ethical issues relevant to medically administered nutrition near the end of life, and institutions should develop procedures to improve the quality of decision-making for patients considering this intervention.
The Regional Distribution of Foreign Direct Investment in Thailand: A Partial Stock Adjustment Provincial-Level Model

This paper analyses Regional Foreign Direct Investment (FDI) in Thailand which is to identify using a panel dataset for 76 provinces over the period 1985-2012. The work is considered to develop a partial stock adjustment model which shows that there are some variations existing in the equilibrium FDI stocks of the regions of Thailand between 1985 and 2012, whereas it appears that there is a convergence among zones in each region of the country as can be seen in the deviation of actual FDI stock from equilibrium stock over time. A partial stock adjustment model is then developed following Chen and Kwan (2000) to help investigate the level of regional convergence in capital stocks arising from FDI. The model implies that investment authorities should implement policies to potentially FDI stocks either by production zones or clusters orientations.
Structure–function studies of Escherichia coli RnlA reveal a novel toxin structure involved in bacteriophage resistance

Escherichia coli RnlA–RnlB is a newly identified toxin–antitoxin (TA) system that plays a role in bacteriophage resistance. RnlA functions as a toxin with mRNA endoribonuclease activity and the cognate antitoxin RnlB inhibits RnlA toxicity in E. coli cells. Interestingly, T4 phage encodes the antitoxin Dmd, which acts against RnlA to promote its own propagation, suggesting that RnlA‐Dmd represents a novel TA system. Here, we have determined the crystal structure of RnlA refined to 2.10 Å. RnlA is composed of three independent domains: NTD (N‐terminal domain), NRD (N repeated domain) and DBD (Dmd‐binding domain), which is an organization not previously observed among known toxin structures. Small‐angle X‐ray scattering (SAXS) analysis revealed that RnlA forms a dimer in solution via interactions between the DBDs from both monomers. The in vitro and in vivo functional studies showed that among the three domains, only the DBD is responsible for recognition and inhibition by Dmd and subcellular location of RnlA. In particular, the helix located at the C‐terminus of DBD plays a vital role in binding Dmd. Our comprehensive studies reveal the key region responsible for RnlA toxicity and provide novel insights into its structure–function relationship.
Professional Service Firms and Total Quality Management:A Good Fit?

A recent managerial trend is the move towards total quality management (TQM) in all economic sectors: manufacturing, service, public and now the professional services. Successful implementation of TQM requires that staff in adopting organizations change how they work and, in particular, how they relate to customers and co‐workers. However, professionals have several characteristics that make them difficult to manage. Examines some potential difficulties in the TQM approach as it applies to professional service firms, describes some successes and discusses some implementation issues.
Exchange relationships in financial services: marketing equities to institutions

London securities houses wish to improve equity securities marketing to institutional fund managers following major changes in the regulatory environments. There is a lacuna in the literature. Senior level respondents on both sides, from New York, London, Hong Kong and Toronto, participated in research to explore the nature of the marketing relationship. Results show that the industry is characterized by extensive technological development and increasing use of quantitative data but is driven by personal relationships. In addition to factors recognized in the literature (reciprocity, trust, comfort, reliability), these relationships are characterized by: long “development” lead time before pay‐off; consistent daily maintenance by seller; durability; personal relationships being the dominant factor; people being more important than the company they work for; independence from time, place, or distance barriers, important for the globalization of financial services; non‐transferability, the bond being between individuals, not organizations; and an independence from tangible evidence (contrary to industry expectations). Highlights managerial implications for the industry and presents guidelines for future research.
Software Piracy: Estimation of Lost Sales and the Impact on Software Diffusion

Software piracy by users has been identified as the worst problem facing the software industry today. Software piracy permits the shadow diffusion of a software parallel to its legal diffusion in the marketplace, increasing its user base over time. Because of this software shadow diffusion, a software firm loses potential profits, access to a significant proportion of the software user base, opportunities for cross-selling, and marketing its other products and new generations of the software. However, shadow diffusion may influence the legal diffusion of the software. Software pirates may influence potential software users to adopt the software, and some of these adopters may become buyers. A diffusion modeling approach is suggested to track shadow diffusion and the legal diffusion of a software over time. The approach enables management to estimate (1) the pirated adoptions over time and (2) the percentage of legal adoptions due to the influence of pirates. The modeling approach is applied to study the diffusion of two types of software (spreadsheets and word processors) in the United Kingdom. The results suggest that although six of every seven software users utilized pirated copies, these pirates were responsible for generating more than 80% of new software buyers, thereby significantly influencing the legal diffusion of the software. The implications of these results are discussed.
A phase I trial of immunostimulatory CpG 7909 oligodeoxynucleotide and 90yttrium ibritumomab tiuxetan radioimmunotherapy for relapsed B‐cell non‐Hodgkin lymphoma

Radioimmunotherapy (RIT) for relapsed indolent non‐Hodgkin lymphoma produces overall response rates (ORR) of 80% with mostly partial remissions. Synthetic CpG oligonucleotides change the phenotype of malignant B‐cells, are immunostimulatory, and can produce responses when injected intratumorally and combined with conventional radiation. In this phase I trial, we tested systemic administration of both CpG and RIT. Eligible patients had biopsy‐proven previously treated CD20+ B‐cell NHL and met criteria for RIT. Patients received rituximab 250 mg/m2 days 1,8, and 15; 111In‐ibritumomab tiuxetan days 1, 8; CpG 7909 days 6, 13, 20, 27; and 0.4 mCi/kg of 90Y‐ibritumomab tiuxetan day 15. The doses of CpG 7909 tested were 0.08, 0.16, 0.32 (six patients each) and 0.48 mg/kg (12 patients) IV over 2 hr without dose limiting toxicity. The ORR was 93% (28/30) with 63% (19/30) complete remission (CR); median progression free survival of 42.7 months (95% CI 18‐NR); and median duration of response (DR) of 35 months (4.6–76+). Correlative studies demonstrated a decrease in IL10 and TNFα, and an increase in IL1β, in response to therapy. CpG 7909 at a dose of 0.48 mg/kg is safe with standard RIT and produces a high CR rate and long DR; these results warrant confirmation. Am. J. Hematol. 88:589–593, 2013. © 2013 Wiley Periodicals, Inc.
Determinants of the Allocation of Funds Under the Capital Purchase Program

During 2008-09, as part of a wide-ranging rescue operation, the US Treasury poured capital infusions into a great many domestic financial institutions under the Capital Purchase Program (CPP), thus helping to avert a complete collapse of the US banking sector. In carrying out this effort, government regulators had to distinguish between those banks deserving of being bailed out and those that should be allowed to fail. The results of this study show that the CPP favored larger financial institutions whose potential failure represented higher degrees of systemic risk. This allocation of CPP funds was cost-effective from the point of view of taxpayers, as such banks reimbursed the government for their CPP bailouts sooner than expected. In contrast, smaller banks that were heavily into mortgage-backed securities, mortgages, and non-performing loans were less likely to be bailed out and, if they did receive CPP help, took longer to repurchase their shares from the Treasury. Several explanations of such allocation decisions are proposed in this paper, including adverse selection of the mortgage products kept on banks’ books and the Treasury’s approach to distinguishing between insolvent and temporarily illiquid institutions.
The financial crisis and global policy reforms

Introduction Given the profusion of papers on the financial crisis, the decision to write another requires some justification. I have accepted the commission for this one because it is designed to address an aspect of the problem that remains understudied, namely the design and coordination of global policy reforms. Scads have been written on reforming national financial markets. But the reach of financial markets and institutions is global. Although lip service has been paid to the need for global coordination of those national policies, progress remains halting. Whether in fact there will be a response justifying the label global policy reforms remains an open question. My analysis is in two parts corresponding to the two main explanations for the crisis. The first explanation sees the crisis as rooted in inadequate regulation and distorted incentives in financial markets. The second sees it as the result of a global savings glut that fueled an unsustainable credit boom in the United States. The debate between these two viewpoints  not so much their validity as the weight to be attached to them  will be played out in the history books. For present purposes I do not attempt to rank their importance. I simply assume the validity of both explanations and, by
Culturally Based Intervention Development: The Case of Latino Families Dealing With Schizophrenia

Objectives: This article describes the process of developing a culturally based family intervention for Spanish-speaking Latino families with a relative diagnosed with schizophrenia. Method: Our iterative intervention development process was guided by a cultural exchange framework and based on findings from an ethnographic study. We piloted this multifamily group 16-session intervention with 59 Latino families in a randomized control trial. Data were collected on family- and client-level outcomes, and poststudy focus groups were conducted with intervention participants. Results: Preliminary evidence indicates that the intervention is effective by increasing illness knowledge and reducing family burden. Conclusions: This work can provide a model for how to integrate cultural factors into psychosocial services and enhance interventions in real-world settings for culturally diverse populations.
Corporate Culture Dimensions Associated With Organizational Commitment: An Empirical Study

This study investigated the impact of corporate culture dimensions (empowerment, competence development, fair rewards and information sharing) on the affective, continuance, and normative organizational commitment in the banking sector in Kuwait. An empirical analysis was conducted across permanent, full-time and part-time employees (managers and non-managers) of five large private banks in Kuwait (n = 398). Both Exploratory Factor Analysis (EFA) and hierarchical regression analyses were used to draw the relationship between these variables. The results showed that sixty percent of variables confirmed previous studies and the remaining ones, surprisingly, were in conflict with previous studies due to some specific Kuwaiti cultural factors. Researchers are challenged to delve deeper into the complex relationship between variables since many of the studies have been conducted in Western societies; thus, the findings can be useful in future comparative studies. A replication of this study in other Arab countries with either the same corporate culture dimensions developed earlier or extended ones could reveal whether these results are country-specified or may be generalized to other countries.
How Prior Outcomes Affect Individual Investors' Subsequent Risk Taking

We present empirical evidence of how prior outcomes affect individual investors’ subsequent risk taking. Investors who experience big gains or big losses are likely to exit the stock market; however, investors remaining in the market increase their portfolio risk taking following losses. They replace stocks sold with new positions of a higher (lower) value following recent losses (gains), thereby leading to an increase (decrease) in overall stock portfolio risk taking. Our results are consistent with the predictions of consumption habit formation interacting with the disposition effect. Our results cannot be explained by information, simple rebalancing, the house money effect, or the break even effect.
Characteristics and Service Use of Medicaid Buy-In Participants with Higher Incomes: A Descriptive Analysis

This study examined the characteristics and service use of Medicaid Buy-In participants with higher incomes (above 250 percent of the federal poverty line), relative to participants with lower incomes. The study found higher-income participants were less likely to enroll in Medicare and more likely to be enrolled in third-party insurance. Service use for higher-income Buy-In participants concentrated on prescription drugs and durable medical equipment, and Medicaid expenditures for a selected set of services among higher-income participants were generally lower than expenditures for the same services among all Buy-In participants.