Miracle-dz/UniFAR-FTUs huggingface dataset:
Request Fulfillment in Office Practice: Antecedents and Relationship to Outcomes

Background: Patients communicate their desires and expectations largely by making requests. However, the antecedents and consequences of request fulfillment have received limited attention. Objective: To describe patient and physician characteristics associated with request fulfillment and to understand the consequences of request fulfillment and nonfulfillment on visit evaluations by patients and physicians, self-reported health care use, and health outcomes. Design: Data were gathered from patient and physician surveys administered at several points before and after problem-driven outpatient visits. Setting: The study was carried out in the office practices of 45 family practice, internal medicine, and cardiology physicians working either in a large multispecialty group practice or in a group-model health maintenance organization. Patients: Data were collected at the index visit from 909 patients (cooperation rate, 68%; net response rate, 32%). A telephone follow-up survey was administered to 887 (98%) of these patients 2 weeks after the visit. Measurements: Before the visit, patients provided ratings of their health concerns, physical functioning, role limitations, general health perceptions, and trust in the index physician. After the visit, patients reported on any request that they made, physician responses to these requests, and their satisfaction with care. At the 2-week follow-up evaluation, patients again reported on satisfaction, health concerns, health status, and self-reported postvisit health care use. Results: Patients reported making at least one request in 84% of encounters; requests for medical information, examination, and tests or procedures were most common. Four-fifths of patients who made at least one request reported complete fulfillment of all requests. Perceived request fulfillment was significantly lower among patients with relatively low pr-visit trust in the treating physician. Higher request fulfillment was predictive of more positive patient evaluations of care. Visits in which requests could not be completely fulfilled were rated by physicians as more demanding and less satisfying. Request fulfillment was also positively associated with fewer health concerns and greater symptom improvement at follow up. Nonfulfillment of patient requests did not predict postvisit health care use. Conclusions: Request fulfillment affects patient and physician satisfaction and perceptions of health outcomes. New approaches that efficiently recognize and respond to patient requests are needed.
Integrated information systems for electronic chemotherapy medication administration.

INTRODUCTION Chemotherapy administration is a highly complex and distributed task in both the inpatient and outpatient infusion center settings. The American Society of Clinical Oncology and the Oncology Nursing Society (ASCO/ONS) have developed standards that specify procedures and documentation requirements for safe chemotherapy administration. Yet paper-based approaches to medication administration have several disadvantages and do not provide any decision support for patient safety checks. Electronic medication administration that includes bar coding technology may provide additional safety checks, enable consistent documentation structure, and have additional downstream benefits. METHODS We describe the specialized configuration of clinical informatics systems for electronic chemotherapy medication administration. The system integrates the patient registration system, the inpatient order entry system, the pharmacy information system, the nursing documentation system, and the electronic health record. RESULTS We describe the process of deploying this infrastructure in the adult and pediatric inpatient oncology, hematology, and bone marrow transplant wards at Vanderbilt University Medical Center. We have successfully adapted the system for the oncology-specific documentation requirements detailed in the ASCO/ONS guidelines for chemotherapy administration. However, several limitations remain with regard to recording the day of treatment and dose number. CONCLUSION Overall, the configured systems facilitate compliance with the ASCO/ONS guidelines and improve the consistency of documentation and multidisciplinary team communication. Our success has prompted us to deploy this infrastructure in our outpatient chemotherapy infusion centers, a process that is currently underway and that will require a few unique considerations.
Circulating MKRN3 Levels Decline During Puberty in Healthy Boys.

CONTEXT Initiation and progression of puberty requires concerted action of hypothalamic activating and inhibiting factors. Recently, cases of familial central precocious puberty have been linked to loss-of-function mutations of makorin RING-finger protein 3 (MKRN3) indicating a pivotal inhibitory role of the protein on GnRH secretion. OBJECTIVE To investigate peripubertal circulating MKRN3 levels in healthy boys. DESIGN Population-based longitudinal study in healthy Danish boys. SETTING General community. PATIENTS OR OTHER PARTICIPANTS Healthy boys (n = 60) aged (median [range]) 9.3 (5.8-11.8) years at baseline followed for 6.0 (0.5-7.6) years (2006-2014) with blood sampling every 6 months. INTERVENTION None. MAIN OUTCOME MEASURES Serum levels of MKRN3: 623 samples, median (range) 12 (2-14) per boy. RESULTS MKRN3 levels declined before onset of puberty; the geometric mean (95% confidence interval) 5 years before onset of puberty vs last visit before onset of puberty was 216 (169-272) pg/mL vs 128 (118-139) pg/mL (P < .001), respectively. MKRN3 levels continued to decrease as puberty progressed. MKRN3 levels were not associated with age at onset of puberty. CONCLUSION Declining MKRN3 before pubertal onset support MKRN3 as an inhibitor of GnRH secretion during midchildhood.
Distinct glycan‐charged phosphodolichol carriers are required for the assembly of the pentasaccharide N‐linked to the Haloferax volcanii S‐layer glycoprotein

In Archaea, dolichol phosphates have been implicated as glycan carriers in the N‐glycosylation pathway, much like their eukaryal counterparts. To clarify this relation, highly sensitive liquid chromatography/mass spectrometry was employed to detect and characterize glycan‐charged phosphodolichols in the haloarchaeon Haloferax volcanii. It is reported that Hfx. volcanii contains a series of C55 and C60 dolichol phosphates presenting saturated isoprene subunits at the α and ω positions and sequentially modified with the first, second, third and methylated fourth sugar subunits comprising the first four subunits of the pentasaccharide N‐linked to the S‐layer glycoprotein, a reporter of N‐glycosylation. Moreover, when this glycan‐charged phosphodolichol pool was examined in cells deleted of agl genes encoding glycosyltransferases participating in N‐glycosylation and previously assigned roles in adding pentasaccharide residues one to four, the composition of the lipid‐linked glycans was perturbed in the identical manner as was S‐layer glycoprotein N‐glycosylation in these mutants. In contrast, the fifth sugar of the pentasaccharide, identified as mannose in this study, is added to a distinct dolichol phosphate carrier. This represents the first evidence that in Archaea, as in Eukarya, the oligosaccharides N‐linked to glycoproteins are sequentially assembled from glycans originating from distinct phosphodolichol carriers.
Serum protein electrophoresis in retired racing Greyhounds.

BACKGROUND Retired racing Greyhounds are becoming common as pets. Because of their unique physiology, results of routine laboratory tests are frequently outside the reference interval for dogs. Compared with other breeds, Greyhounds have low serum protein concentrations, but the concentrations of different serum protein fractions have not been reported. OBJECTIVES Our objectives were to evaluate the results of serum protein electrophoresis (SPE) in healthy, retired racing Greyhounds and compare them with a control group of age- and gender-matched non-Greyhound dogs. METHODS Agarose gel electrophoresis was done using a standard method; the gels were stained with amido black and scanned with a Cliniscan 2 densitometer (Helena Laboratories, Beaumont, TX, USA). Protein fractions were identified by visual inspection of the electrophoretogram. A Student's t-test assuming equal variances was used to compare the concentration of the different fractions between groups. RESULTS The concentrations of total protein, total globulins, and alpha-1-, alpha-2-, beta-1-, and beta-2-globulins were significantly lower and the albumin to globulin (A:G) ratio was significantly higher in Greyhounds than in non-Greyhound dogs (P < .05). There was no significant difference in albumin or gamma-globulin concentrations. CONCLUSIONS Low serum protein concentrations in Greyhounds are the result of low concentrations of a- and b-globulins. These results should be kept in mind when evaluating both healthy and sick Greyhounds. Additional studies are needed to identify the individual proteins associated with low alpha- and beta-globulin concentrations in Greyhounds.
Pentoxifylline does not Change Cerebral Blood Flow or Metabolism in the Dog

Pentoxifylline 0.3–30 mg/kg was given intravenously to six dogs under nitrous oxide anesthesia. Cerebral blood flow was measured with a sagittal sinus outflow technique, cerebral oxygen consumption was calculated from the a‐v difference, and metabolite levels were determined in biopsies of cerebral cortex. Pentoxifylline failed to influence cerebral blood flow or oxygen consumption. There was no increase in cerebral levels of phosphocreatine, ATP or total adenine nucleotides; the only significant effect was higher glucose levels in dogs given pentoxifylline (4.49±0.39μmol/g vs 2.21 ±0.18 μmol/g). The latter has previously been reported to be deleterious during cerebral ischemia. Pentoxifylline thus failed to have any significant influence upon cerebral blood flow or metabolism in the dog likely to be of benefit during cerebral hypoxia or ischemia.
Why patients consult when they cough: a comparison of consulting and non-consulting patients.

BACKGROUND Although it is the commonest symptom presented to general practitioners (GPs), little is known about why someone decides to consult with a cough. AIM To describe the illness behaviour of patients with a cough. METHOD Patients who had consulted a GP because of a cough, and a group of subjects who had recently had a cough but had not consulted, were interviewed in a qualitative study that investigated how they made sense of their illness. RESULTS Consulting patients understood their cough to be abnormally severe, whereas non-consulting subjects regarded their cough as 'normal' and mild. Consulting patients thought the cough would interfere with social roles and non-consulting subjects did not. The consulting patients were much more likely to be worried about the cough than the non-consulting subjects. In particular, half of the consulting patients were worried about their hearts, whereas the non-consulting subjects were not. The two groups did not distinguish bacteria from viruses, and did not differ in beliefs about the role of antibiotics that they thought were needed for severe coughs. Both groups had concerns about pollution. CONCLUSIONS For consulting patients, cough breached the taken for granted property' of health that the non-consulting subjects with a cough were able to maintain. Cough, for the consulting patients, was not a trivial illness.
Formoterol and Salmeterol in Partially Reversible Chronic Obstructive Pulmonary Disease: A Crossover, Placebo-Controlled Comparison of Onset and Duration of Action

Background: In contrast to the well-known activity profile in asthma, the precise efficacy and optimum dose schedules of long-acting β2-agonists in chronic obstructive pulmonary disease (COPD) are not clear. Objective: In this study, we aimed to compare the onset and the duration of action of a single inhalation of formoterol and salmeterol in COPD patients having partially reversible airway obstruction. Methods: In a double-blind, randomized, crossover and placebo-controlled study design, the respiratory functions of 22 patients (mean age 57.3 ± 5.4 years) having mild to severe COPD (5 mild, 8 moderate and 9 severe) and partially reversible airway obstruction [mean baseline reversibility of forced expiratory volume in 1 s (FEV1) 19.3 ± 3.1%] were evaluated after inhalation of 12 μg formoterol and 50 μg salmeterol. Results: Regarding the onset of bronchodilator action, the mean absolute increase of 0.20 liters in FEV1 10 min after inhalation of formoterol was significantly higher than baseline and that of placebo (0.04 liters), whereas that of salmeterol (0.11 liters) did not reach statistical significance. At 20 min, both formoterol (0.25 liters) and salmeterol (0.20 liters) produced a significant increase in FEV1 compared with baseline and with that of placebo (0.04 liters). The peak bronchodilator effects occurring at 60 and 120 min following formoterol (0.39 liters) and salmeterol (0.40 liters) inhalation, respectively, were significantly higher than the corresponding levels of placebo (0.02 and –0.12 liters, respectively). Concerning the duration of action, the 12-hour values of both formoterol (0.25 liters) and salmeterol (0.22 liters) were significantly higher than that of placebo (–0.12 liters). The area under the curve values of FEV1 of formoterol (3.5 ± 1.3 l·h) and salmeterol (3.2 ± 1.2 l·h) averaged over 12 h were comparable and higher than placebo values (1.2 ± 0.5 l·h). After formoterol inhalation 2 patients experienced tremor and 1 had palpitation; 1 tremor and 1 headache attack were noted after salmeterol. For the pharmacologically predictable side effects, there was no difference between the drugs. Conclusions: In conclusion, this study revealed that a single dose of 12 μg formoterol and 50 μg salmeterol provided comparable bronchodilation within 12 h and had tolerable side effects in patients with mild to severe COPD having partially reversible airway obstruction.
Microanatomy of the Intrachoroidal Vasculature of the Lateral Ventricle

OBJECTIVE: Intraventricular surgery requires a detailed knowledge of the microanatomy of the choroid plexus vasculature. METHODS: Twenty choroid plexuses were microdissected, and two additional plexuses were prepared for microscopic examination. RESULTS: The choroid plexus was perfused primarily by the anterior choroidal artery (AChA) and the lateral posterior choroidal artery (LPChA). The AChA, which averaged 650 &mgr;m in diameter, most often (in 75% of cases) divided into the medial and lateral trunks, which averaged 450 &mgr;m in diameter. The medial trunk gave off the bush-like intrachoroidal branches, whereas the lateral trunk divided into the parallel arteries. The inferior LPChA was present in 50% of the hemispheres, both the inferior and superior LPChAs in 40%, and their common trunk in 10%. In 40%, the LPChA, which averaged 670 &mgr;m in diameter, divided into the terminal trunks, with a mean diameter of 490 &mgr;m. The anastomoses involving the trunks of the LPChA and other choroidal arteries averaged 310 &mgr;m in diameter. All primary intrachoroidal branches of the AChA and LPChA were divided into three groups. The parallel branches, which averaged from 220 to 230 &mgr;m in diameter, coursed along the lateral part of the choroid plexus. The tortuous glomus vessels, which averaged 310 &mgr;m in size, originated from the AChA (45%), the LPChA (15%), or both (40%). The bush-like vessels, with a mean diameter between 155 and 190 &mgr;m, ramified into smaller twigs, up to the intrachoroidal capillaries. CONCLUSION: The data obtained on the microanatomy of the intrachoroidal vasculature may have certain neurosurgical implications.
Motivational Attributions About Intimate Partner Violence Among Male and Female Perpetrators

Given the widely acknowledged negative impact and pervasiveness of intimate partner violence (IPV), many have sought to discover why people perpetrate IPV. To this end, IPV risk factors have been extensively studied and attributions have recently received more attention. Evidence suggests males and females have similar attributions and both engage in IPV. Yet, IPV tactics and attribution rates appear to differ by perpetrator sex. This study explores whether males and females tend to attribute different reasons to their IPV, and whether these attributions help to distinguish among physical and psychological IPV tactics. The study tests three hypotheses: that IPV tactics and attributions will differ between females and males, that females and males will have similar latent constructs associated with types of attributions made about IPV, and that males and females will have different relationships among attribution factors and IPV tactics. This study is based on a cross-sectional survey of 5,035 18- to 25-year-old undergraduate university students in the Southeastern United States. Analyses used SPSS 20 to conduct basic and bivariate analyses, multiway frequency analysis, reliability analysis, and logistic regression, and MPlus 6.12 to conduct exploratory and confirmatory factor analysis. Overall, the results provide support for the three study hypotheses, although there was inconsistency in findings for the second hypothesis. The results suggest important practice and research implications, which are discussed. The study fills a gap in the limited literature on IPV perpetrator motivational attributions by presenting a nuanced analysis of an early measure of IPV attributions.
International Trade, Location and Wage Inequality in China

Models of economic geography predict that transportation costs directly affect demand for goods and the supply of intermediate inputs. One of the reasons that international trade is concentrated in the coastal provinces of China is that they have lower transportation costs in transporting goods to other countries than do provinces in the interior. This paper examines the relationship between the provincial wage rate and each province’s access to international markets, and to suppliers of intermediate inputs. A gravity equation is first estimated to construct these ‘market access’ and ‘supplier access’ variables. In the second stage, the effect of market access and supplier access on the wage rate is estimated. It is found that about one quarter of the provincial wage differences in the coastal provinces and 15 per cent of the wage differences in the interior provinces can be explained by these economic geography variables.
Pasteurellaceae isolated from tonsillar samples of commercially-reared American bison (Bison bison).

As commercial producers of American bison (Bison bison) become more numerous, concerns relative to bison health management increase. Since loss due to respiratory disease associated with Pasteurella and related Pasteurellaceae is a major concern for cattle producers, a study was conducted to determine what types of Pasteurellaceae are carried by bison to evaluate the potential of pneumonic pasteurellosis in bison herds where management practices are comparable to those used for cattle. Tonsillar biopsies, collected in May (n = 29) and August (n = 25) 1997 from 24- to 30-month-old bison bulls, at the time of slaughter were cultured for Pasteurellaceae. Pasteurella spp. were isolated from all the samples collected in May. These included isolates identified as P. haemolytica, trehalosi, testudinis, and multocida subsp. multocida a and multocida b. Actinobacillus spp. and Haemophilus somnus were also isolated from some samples. Pasteurella spp. , haemolytica, trehalosi, and multocida subsp. multocida a, multocida b and septica, plus 2 nonspeciated indole-positive biotypes, U2 and U16, were isolated from the second group of tonsil samples. Most of these organisms, including P. haemolytica, P. multocida subsp. , and H. somnus are associated with disease in domestic livestock and should be regarded as potential pathogens for bison, particularly in animals which become stressed by management practices commonly used with cattle such as herding, crowding, and shipping.
Daily vitamin K supplementation improves anticoagulant stability

Summary. Background: One of the causes of unstable anticoagulant control in patients using vitamin K antagonists is a fluctuating intake of vitamin K. Research suggests that patients with a low dietary intake of vitamin K have a less stable anticoagulant control than patients with a higher intake. Objectives: To study whether supplementation with a low daily dose of vitamin K improves anticoagulant control. Methods: We performed a double‐blind, randomized, placebo‐controlled trial. 200 patients of the Leiden anticoagulation clinic, who used the vitamin K antagonist phenprocoumon, were randomized to receive either adjusted‐dose phenprocoumon and 100 μg vitamin K once daily or adjusted‐dose phenprocoumon and a placebo. Treatment duration was 24 weeks. The primary outcome was the percentage of time the International Normalized Ratio was within the therapeutic range. Results: The time in the therapeutic range was 85.5% in the placebo group and 89.5% in the vitamin K group (adjusted difference 3.6%; 95% CI −0.8% to 8.0%). The time below the therapeutic range was 3.1% in the placebo group and 2.1% in the vitamin K group (adjusted difference −0.7%; 95% CI −2.5% to 1.1%) and the time above the therapeutic range was 11.4% in the placebo group and 8.5% in the vitamin K group (adjusted difference −2.9%; 95% CI −6.9% to 1.1%). The relative risk (RR) of a maximal stability in the vitamin K group compared to the placebo group was 1.8 (95%, CI 1.1–2.7). Conclusion: Supplementation of vitamin K antagonists with 100 μg vitamin K improves stability of anticoagulant therapy. Because the risk of side effects is inversely related to anticoagulant stability, such an improvement is likely to reduce the number of bleeding and thrombotic events.