Miracle-dz/UniFAR-FTUs huggingface dataset:
Measurement, Correlates, and Health Outcomes of Medication Adherence Among Seniors

OBJECTIVE To provide a comprehensive review of the literature on the measurement, correlates, and health outcomes of medication adherence among community-dwelling older adults. DATA SOURCES Searches of MEDLINE, PubMed, and International Pharmaceutical Abstracts databases for English-language literature (1966–December 2002) were conducted using one or more of the following terms: elderly, adherence/nonadherence, compliance/noncompliance, medication/drug, methodology/measurement, and hospitalization. STUDY SELECTION AND DATA EXTRACTION From the above search, studies of medication adherence in community-dwelling seniors were selected for review along with relevant publications from the reference lists of articles identified in the initial database search. DATA SYNTHESIS Although several methods are available for the assessment of adherence, accurate measurement continues to be difficult. The available evidence suggests that polypharmacy and poor patient–healthcare provider relationships (including the use of multiple providers) may be major determinants of nonadherence among older persons, with the impact of most sociodemographic factors being negligible. There is little consensus regarding other determinants of nonadherence. Relatively few high-quality investigations have examined the associations between nonadherence and subsequent health outcomes. Available data provide some support for increased health risks with nonadherence. However, interventions to improve adherence have seldom demonstrated positive effects on health outcomes. CONCLUSIONS There are few empirical data to support a simple systematic descriptor of the nonadherent patient. The inconsistencies across studies may be attributable, in part, to the inherent difficulties involved in the measurement of a behavioral risk factor such as nonadherence. Future research in this area would be strengthened by incorporation of detailed assessments of patient-reported reasons for nonadherence, the appropriateness of drug regimens, and the effect of nonadherence on health outcomes.
Construction and Characterization of an Effector Strain of Streptococcus mutans for Replacement Therapy of Dental Caries

ABSTRACT An effector strain has been constructed for use in the replacement therapy of dental caries. Recombinant DNA methods were used to make theStreptococcus mutans supercolonizing strain, JH1140, lactate dehydrogenase deficient by deleting virtually all of theldh open reading frame (ORF). To compensate for the resulting metabolic imbalance, a supplemental alcohol dehydrogenase activity was introduced by substituting the adhB ORF fromZymomonas mobilis in place of the deleted ldhORF. The resulting clone, BCS3-L1, was found to produce no detectable lactic acid during growth on a variety of carbon sources, and it produced significantly less total acid due to its increased production of ethanol and acetoin. BCS3-L1 was significantly less cariogenic than JH1140 in both gnotobiotic- and conventional-rodent models. It colonized the teeth of conventional rats as well as JH1140 in both aggressive-displacement and preemptive-colonization models. No gross or microscopic abnormalities of major organs were associated with oral colonization of rats with BCS3-L1 for 6 months. Acid-producing revertants of BCS3-L1 were not observed in samples taken from infected animals (reversion frequency, <10−3) or by screening cultures grown in vitro, where no revertants were observed among 105 colonies examined on pH indicator medium. The reduced pathogenic potential of BCS3-L1, its strong colonization potential, and its genetic stability suggest that this strain is well suited to serve as an effector strain in the replacement therapy of dental caries in humans.
THE “DARK SIDE” OF CREDIT DEFAULT SWAPS INITIATION: A CLOSE LOOK AT SOVEREIGN DEBT CRISES

We examine the effect of sovereign credit default swaps (CDS) trading initiation on the occurrence of sovereign debt crises (SDC). Estimations on a large sample of 141 countries for 1980–2013 reveal that, by affecting the fiscal stance, CDS initiation increases by around 1.5 percentage points on average the probability of SDC in countries with CDS compared to the other countries. This result holds for different robustness tests and is found to be stronger for developing countries, for countries with initial lower creditworthiness, and when the degrees of central bank independence and public sector transparency are low. Consequently, compared to existing work emphasizing favorable effects, CDS trading initiation is found to have adverse effects, by increasing the occurrence of SDC. These opposite effects should fuel the literature on measuring the consequences of CDS trading initiation, and its design and implementation from a policy perspective.
The Halloween Indicator: Everywhere and All the Time

We use all available stock market indices for all 108 stock markets and for all time periods to study the „Halloween indicator‟ or „Sell in May‟-effect. In total 55,425 monthly observations over 319 years show winter returns – November through April are 4.52% (tvalue 9.69) higher than summer returns. The effect is increasing in strength: The average difference between November-April and May-October returns is 6.25% over the past 50 years. A Sell-in-May trading strategy beats the market more than 80% of the time over 5 year horizons. The data allows us to address a number of (methodological) issues that have been raised with respect to the effect.
Theaflavin, a black tea extract, is a novel anti-inflammatory compound

Objective:Tea has been around for centuries, and its medicinal properties have been purported in the literature but never fully confirmed. Interleukin-8 is a principle neutrophil chemoattractant and activator in humans. We determined the effects of theaflavin, a black tea-derived polyphenol, on tumor necrosis factor-&agr;-mediated expression of the interleukin-8 gene in A549 cells. Design:Prospective laboratory study. Setting:University laboratory. Subjects:A549 cells. Interventions:A549 cells were exposed to varying concentrations of theaflavin and analyzed for tumor necrosis factor-&agr;-mediated interleukin-8 gene expression. Measurements and Main Results:Theaflavin inhibited tumor necrosis factor-&agr;-mediated interleukin-8 gene expression, as measured by luciferase assay and Northern blot analysis, at concentrations of 10 and 30 &mgr;g/mL. This effect appears to primarily involve inhibition of interleukin-8 transcription because theaflavin inhibited tumor necrosis factor-&agr;-mediated activation of the interleukin-8 promoter in cells transiently transfected with an interleukin-8 promoter-luciferase reporter plasmid. In addition, theaflavin inhibited tumor necrosis factor-&agr;-mediated activation of I&kgr;B kinase and subsequent activation of the I&kgr;B-&agr;/nuclear factor-&kgr;B pathway. Theaflavin also significantly reduced tumor necrosis factor-&agr;-mediated DNA binding of activator protein-1. Conclusions:We conclude that theaflavin is a potent inhibitor of interleukin-8 gene expression in vitro. The proximal mechanism of this effect involves, in part, inhibition of I&kgr;B kinase activation and activator protein-1 pathway.
Attitude of Farmers towards Kisan Call Centres

The present study was conducted to measure the attitude of farmers in Kerala, India towards Kisan Call Centre (KCC). Kisan Call Centre provides free agricultural advisory services to every citizen involved in agriculture through a toll free number. One hundred and fifty farmers who have utilized the Kisan Call Centre service were selected from the database of KCC. The results showed that the respondents had moderately favourable attitude towards KCC followed by highly favourable attitude. The variables digital divide, temporal awareness on KCC, satisfaction towards KCC and utilization of KCC were found to have a positive correlation with the attitude of respondents towards KCC.
Self-Organizing Interval Type-2 Fuzzy Q-learning for reinforcement fuzzy control

This paper proposes a reinforcement fuzzy control method using Self-Organizing Interval Type-2 Fuzzy Q-learning (SOIT2FQ). The fuzzy rules are of zero-order Takagi-Sugeno-Kang (TSK) type and the antecedent part uses interval type-2 fuzzy sets in order to improve fuzzy controller robustness. There are no fuzzy rules initially. The SOIT2FQ generates all fuzzy rules during control process using an online rule generation algorithm. The consequent part of each generated fuzzy rule is selected from a predefined discrete set containing all candidate values. The SOIT2FQ selects the consequent candidate values according to their Q-values in order to obtain a successful interval type-2 fuzzy controller. The SOIT2FQ is applied to reinforcement truck-backing control problem in clean and noisy environments, where only two reinforcement signals “success” and “failure” are used for training. Simulations show effectiveness and efficiency of the SOIT2FQ. Comparisons with type-1 fuzzy controller verify the noise robustness ability of the SOIT2FQ-designed interval type-2 fuzzy controller.
Effect of omeprazole on concentrations of clarithromycin in plasma and gastric tissue at steady state

This study was conducted to determine (i) the effect of omeprazole on steady-state concentrations of clarithromycin and 14-(R)-hydroxyclarithromycin in plasma and gastric mucosa, (ii) the effect of clarithromycin on steady-state concentrations of omeprazole in plasma, and (iii) the effect of clarithromycin on the suppression of gastric acid secretion by omeprazole. Twenty healthy, Helicobacter pylori-negative male subjects completed this three-period, double-blind, randomized crossover study. In period 1, all subjects received 40 mg of omeprazole each morning for 6 days. Twenty-four-hour gastric pH monitoring took place on days -1 and 6. Pharmacokinetic sampling took place on day 6. In periods 2 and 3, subjects were randomly assigned to receive either 40 mg of omeprazole or omeprazole placebo daily for 6 days plus clarithromycin (500 mg) every 8 h for 5 days with a single 500-mg dose on day 6. Gastric tissue and mucus samples were obtained via endoscopy on day 5. Gastric pH monitoring and pharmacokinetic sampling took place on day 6. Two-week washout intervals separated the three study periods. Clarithromycin increased mean omeprazole area under the concentration-time curve from 0 to 24 h from 3.3 +/- 2.0 to 6.3 +/- 4.5 micrograms.h/ml (P < 0.05) and harmonic mean half-life from 1.2 to 1.6 h (P < 0.05) but did not significantly alter the effect of omeprazole on gastric pH. Mean clarithromycin area under the concentration-time curve from 0 to 8 h increased from 22.9 +/- 5.5 (placebo) to 26.4 +/- 5.7 micrograms.h/ml (omeprazole) (P < 0.05) when clarithromycin was administered with omeprazole. Analysis of variance revealed that mean concentrations of clarithromycin in tissue and mucus were statistically significantly higher when clarithromycin was given with omeprazole than when clarithromycin was given with placebo (P <0.001). Mean maximum observed concentrations of clarithromycin in the gastric fundus increased from 20.8 +/- 7.6 (placebo) to 24.3 +/- 6.4 micrograms/g (omeprazole), and those in the gastric mucous from 4.2 +/- 7.7 placebo to 39.3 +/- 32.8 micrograms/g (omeprazole). Similar increases were observed for the 14-(R)-hydroxyclarithromycin. These results show that omeprazole increases concentrations of clarithromycin in gastric tissue and mucus and may provide a mechanism for synergy between clarithromycin ad omeprazole that explains the excellent eradication of H. pylori seen in clinical trials.
Intima-Media Thickness and Arterial Distensibility in Behçet’s Disease

The etiology of Behçet’s disease, a systemic vasculitis, is unknown. Vascular involvement may be seen in 25% of patients with Behçet’s disease. Vasculitis make the prognosis of Behçet's disease severe. The aim of this study is to examine the structural and functional changes and relations of these changes with progression and prognosis of Behçet’s disease. For this purpose, 40 patients with Behçet’s disease and 40 healthy volunteer control subjects were analyzed, additionally patients with Behçet’s disease were divided into 2 subgroups as those with vascular complications and those without vascular complications. Intima-media thickness and arterial distensibility were measured in all subjects with carotid artery ultrasonography. Carotid artery distensibility was significantly lower in the patient group compared to the control group (0.67 ±0.2, 0.93 ±0.4, p<0.05), and carotid artery IMT was significantly higher (0.59 ±12, 0.80 ±0.11, p<0.05). A statistically significant increase in IMT has been detected (0.77 ±11, 0.86 ±11, p<0.05) in patients with Behçet’s disease with vascular involvement compared to patients with Behçet’s disease without vascular involvement, arterial distensibility in patients with vascular disease was similar with those who has no vascular disease (0.69 ±0.25, 0.63 ±0.25, p>0.05). There was a significant negative linear regression between arterial distensibility and systolic blood pressure (SBP) (B=-1x10-2, p<0.05), and a significant positive linear regression has also been found between IMT and SBP and diastolic blood pressure (DBP) and pulse pressure (PP) (B=6.8x10-3 for SBP, p<0.05, B=6.9x10-3 for DBP, p<0.05, B=6x10-3 for PP, p<0.05). As a result, IMT increases and AD decreases in patients with Behçet’s disease compared to results in the control group. Although more studies are required for this subject, use of noninvasive parameters such as IMT and AD, which reflect the structural and functional characteristics of vasculature, may be useful to define disease progression and subjects at high risk.
A Human Suppressor of c-Jun N-terminal Kinase 1 Activation by Tumor Necrosis Factor α*

Tumor necrosis factor α (TNFα) has pleiotropic effects on cellular metabolism. One of the signaling paths from the TNFα receptor induces a stress-activated protein kinase cascade. Components within this TNFα kinase cascade include mitogen-activated protein kinase/extracellular signal-regulated kinase kinase kinase 1 (MEKK1) and stress-activated protein kinase/extracellular signal-regulated kinase kinase (SEK), which regulate the activity of c-Jun N-terminal kinase 1 (JNK1). Currently, molecules upstream of MEKK1 that link TNFα receptor to downstream kinases are not well understood. Besides TNFα, many other stimuli including several oncoproteins can activate JNK1. In most cases, the signaling cascade(s) leading from oncoproteins to JNK1 is poorly elucidated. We report here that the human T-cell lymphotrophic virus, type I (HTLV-I) oncoprotein, Tax, can activate JNK1. We isolated a novel human cell factor, G-protein pathway suppressor 2 (GPS2), by its ability to bind the HTLV-I oncoprotein, and we show that this factor can potently suppress Tax activation of JNK1. In trying to understand the mechanism of GPS2 activity, we found that it also suppressed TNFα activation of JNK1 but not TNFα activation of p38 kinase nor phorbol activation of extracellular signal-regulated kinase 2. Because GPS2 has minimal effect on MEKK1- or SEK-regulated JNK1 activity, it could act at a point between the TNFα receptor and MEKK1 in the initial step(s) of this kinase cascade. Alternatively, it is not excluded that GPS2 could work in a parallel pathway that leads from TNFα to JNK1. GPS2 represents a new molecule that could contribute important insights toward how cytokine- and oncoprotein-mediated signal transduction might converge.
Cancer patients' awareness about their diagnosis: a population-based study.

BACKGROUND The aim of the study was to evaluate Norwegian cancer patients' awareness of their prior cancer diagnosis in a general population-based study. METHODS A cross-sectional population-based study of cancer patients' responses to the index question: 'Do you have or have you had cancer? ' was carried out. We assessed correctness of the response in relation to cancer site, date of diagnosis, marital status, age and education. Smoking was chosen as a marker of health awareness. A total of 65,330 persons participated in the Nord-Trøndelag Health Survey (HUNT-II), performed in 1995-1997. The database of HUNT-II was merged with the Cancer Registry of Norway (CRN), thus identifying each of the 2983 (4 percent) participants with an invasive cancer diagnosis. RESULTS Excluding basal cell epithelioma, a total of 20 percent of the patients denied their prior cancer diagnosis. This group consisted mainly of men (54 percent) and those who were diagnosed as very young or as elderly. More smokers than non-smokers were unaware of their prior malignancy (24 percent versus 20 percent). CONCLUSIONS A 20 percent rate of patients who denied their former malignancy is surprisingly and unacceptably high. Disclosure of a cancer diagnosis should help the patient to develop increased health awareness. It should enable a person to report his or her former cancer diagnosis when necessary.
Developing an Internet- and Mobile-Based System to Measure Cigarette Use Among Pacific Islanders: An Ecological Momentary Assessment Study

Background Recent prevalence data indicates that Pacific Islanders living in the United States have disproportionately high smoking rates when compared to the general populace. However, little is known about the factors contributing to tobacco use in this at-risk population. Moreover, few studies have attempted to determine these factors utilizing technology-based assessment techniques. Objective The objective was to develop a customized Internet-based Ecological Momentary Assessment (EMA) system capable of measuring cigarette use among Pacific Islanders in Southern California. This system integrated the ubiquity of text messaging, the ease of use associated with mobile phone apps, the enhanced functionality offered by Internet-based Cell phone-optimized Assessment Techniques (ICAT), and the high survey completion rates exhibited by EMA studies that used electronic diaries. These features were tested in a feasibility study designed to assess whether Pacific Islanders would respond to this method of measurement and whether the data gathered would lead to novel insights regarding the intrapersonal, social, and ecological factors associated with cigarette use. Methods 20 young adult smokers in Southern California who self-identified as Pacific Islanders were recruited by 5 community-based organizations to take part in a 7-day EMA study. Participants selected six consecutive two-hour time blocks per day during which they would be willing to receive a text message linking them to an online survey formatted for Web-enabled mobile phones. Both automated reminders and community coaches were used to facilitate survey completion. Results 720 surveys were completed from 840 survey time blocks, representing a completion rate of 86%. After adjusting for gender, age, and nicotine dependence, feeling happy (P=<.001) or wanting a cigarette while drinking alcohol (P=<.001) were positively associated with cigarette use. Being at home (P=.02) or being around people who are not smoking (P=.01) were negatively associated with cigarette use. Conclusions The results of the feasibility study indicate that customized systems can be used to conduct technology-based assessments of tobacco use among Pacific Islanders. Such systems can foster high levels of survey completion and may lead to novel insights for future research and interventions.
Financial Imbalances, Crisis Probability and Monetary Policy in Norway

We assess the strength of the impact of a monetary policy shock on financial crisis probability in Norway. Policy effects go via the interest rate impact on credit, house prices and banks’ wholesale funding. We find that the impact of a monetary policy shock on crisis probability is about 10 times larger than what previous studies suggest. The large impact is mostly due to a fall in property prices and banks’ wholesale funding in response to a contractionary monetary policy shock. In contrast, and in line with existing literature, there is a more limited contribution to reduced crisis probability from the impact of monetary policy on credit.
Thoracic Epidural Analgesia with Low Concentration of Bupivacaine Induces Thoracic and Lumbar Sympathetic Block: A Randomized, Double-blind Clinical Trial

Background:Clinical benefits of thoracic epidural anesthesia (TEA) are partly ascribed to thoracic sympathetic block. However, data regarding sympathetic activity during TEA are scarce and contradictory. This prospective, randomized, double-blind study evaluated the segmental propagation of sympathetic block after low-concentration, high-volume TEA using digital thermography. Methods:Twenty-four patients were included in the study. Thoracic epidural catheters were placed at a median insertion level of T8–T9. Patients were accommodated for 20 min to the room temperature of 23° ± 0.3°C. Skin temperature was recorded by digital thermography. After baseline measurement of heart rate, arterial pressure, and core body and skin temperature, 10 ml saline (control group) or 10 ml bupivacaine, 0.25% (TEA group), respectively, was administered epidurally. Five minutes (t5) and 20 min (t20) after baseline measurements, hemodynamic parameters and core body temperature were again measured, and sensory block was identified by loss of cold–warm discrimination. In the thumb, the toe, and each thoracic dermatome, difference from baseline temperature was calculated at t5 and t20. Data were analyzed by Mann–Whitney U test. Results:Baseline characteristics did not differ among groups. Median spread of sensory block at t20 was T5–L5. At both t5 and t20, skin temperature decreased more in the control group than in the TEA group in all thoracic dermatomes (P < 0.05). Toe temperature increased in the TEA group compared with the control group (P < 0.05), whereas thumb temperature remained unchanged. Conclusion:TEA with 10 ml bupivacaine, 0.25%, induced thoracic and lumbar sympathetic block that precedes and exceeds sensory block. Caudal limit of sympathetic block could not be demonstrated in this study.
Five Constants of Information Technology Adoption in Healthcare

The healthcare industry has developed a dependence on information technology (IT) for maintaining and improving both clinical and business operations. Whether IT is used for office automation or for reducing medical errors, there are five constants that routinely influence the successful integration of IT in healthcare. These constants are the proper use and maintenance of the IT budget, the role of supportive leadership, the use of project management, the process of implementation, and the significance of end user involvement. These constants challenge healthcare organizations to efficiently and effectively use their financial and human resources when adopting new IT. These constants also shape how the healthcare industry approaches the adoption and utilization of new IT. A collective understanding of these constants and their interrelationships will enable healthcare organizations to better integrate new IT and achieve organizational goals of developing a solid technological infrastructure to truly enhance the delivery of quality healthcare.
Strategic Lay Leadership Involvement in the Social Mission of a Western Ontario Denomination

Strategic Lay Leadership Involvement in the Social Mission of a Western Ontario Denomination by Isaac Osei-Akoto MBA, Eastern University, 1999 BA, University of Cape Coast, 1990 Dissertation Submitted in Partial Fulfilment of the Requirements for the Degree of Doctor of Philosophy Public Policy and Administration Walden University August 2017