Miracle-dz/UniFAR-FTUs huggingface dataset:
Who Should Lead a Healthcare Organization: MDs or MBAs?

EXECUTIVE SUMMARY Debates often arise about who is best suited to manage a healthcare organization. Therefore, we argue that an examination of the ability of healthcare organizations' chief executive officers (CEOs) to make strategic decisions is warranted. Is the most appropriate leader the medically educated CEO, whose training in patient care allows him or her to be most cognizant of the quality‐of‐care needs of the organization? Or is it the managerially educated CEO, whose training makes him or her most aware of the organization's financial needs? This article presents a study involving senior managers from two integrated healthcare organizations. The study revealed that no significant differences exist between medically educated and managerially educated senior managers in their ability to make strategic decisions that maximize the net income or the quality of care of the healthcare organization. The debate that pits the “MDs” against the “MBAs” is misdirected. Characteristics other than educational degree appear to have a stronger influence on a CEO's ability to make successful strategic decisions. Therefore, candidates' educational background should not play such an important role in the processes for selecting CEOs.
Recognition and Resistance in TEM β-Lactamase†

Developing antimicrobials that are less likely to engender resistance has become an important design criterion as more and more drugs fall victim to resistance mutations. One hypothesis is that the more closely an inhibitor resembles a substrate, the more difficult it will be to develop resistant mutations that can at once disfavor the inhibitor and still recognize the substrate. To investigate this hypothesis, 10 transition-state analogues, of greater or lesser similarity to substrates, were tested for inhibition of TEM-1 β-lactamase, the most widespread resistance enzyme to penicillin antibiotics. The inhibitors were also tested against four characteristic mutant enzymes: TEM-30, TEM-32, TEM-52, and TEM-64. The inhibitor most similar to the substrate, compound 10, was the most potent inhibitor of the WT enzyme, with a Ki value of 64 nM. Conversely, compound 10 was the most susceptible to the TEM-30 (R244S) mutant, for which inhibition dropped by over 100-fold. The other inhibitors were relatively imper.
Prevention of HIV/AIDS and other blood-borne diseases among injection drug users. A national survey on the regulation of syringes and needles.

We report the results of a survey of laws and regulations governing the sale and possession of needles and syringes in the United States and its territories and discuss legal and public health proposals to increase the availability of sterile syringes, as a human immunodeficiency virus (HIV) transmission prevention measure, for persons who continue to inject drugs. Every state, the District of Columbia (DC), and the Virgin Islands (VI) have enacted state or local laws or regulations that restrict the sale, distribution, or possession of syringes. Drug paraphernalia laws prohibiting the sale, distribution, and/or possession of syringes known to be used to introduce illicit drugs into the body exist in 47 states, DC, and VI. Syringe prescription laws prohibiting the sale, distribution, and possession of syringes without a valid medical prescription exist in 8 states and VI. Pharmacy regulations or practice guidelines restrict access to syringes in 23 states. We discuss the following legal and public health approaches to improve the availability of sterile syringes to prevent bloodborne disease among injection drug users: (1) clarify the legitimate medical purpose of sterile syringes for the prevention of HIV and other blood-borne infections; (2) modify drug paraphernalia laws to exclude syringes; (3) repeal syringe prescription laws; (4) repeal pharmacy regulations and practice guidelines restricting the sale of sterile syringes; (5) promote professional training of pharmacists, other health professionals, and law enforcement officers about the prevention of blood-borne infections; (6) permit local discretion in establishing syringe exchange programs; and (7) design community programs for safe syringe disposal.
[Adaptation of the Childhood Anxiety Sensitivity Index for Use in Turkey].

OBJECTIVE Anxiety sensitivity (AS) refers to the fear of anxiety-related sensations. The aim of the present study is to investigate the validity and reliability of Childhood Anxiety Sensitivity Index (CASI) and adapting it into Turkish. METHOD The study group consisted of 328 healthy individuals whose age between 8-15 years old. All subjects included in the study ﬁlled out the Childhood Anxiety Sensitivity Index (CASI) and the State-Trait Anxiety Inventories for Children (STAI-C). RESULTS The CASI was found to be significantly related to both trait and state anxiety scores (r=0.42 and r=0.32, respectively). It had a high internal consistency (Cronbach a= 0.74) and good test-retest reliability (r= 0.77, p< 0.001). Explorotary factor analyses showed that the CASI is comprised of 6 lower-order factors. However, CASI subfactors was established according to literature as a three factor model: physical, cognitive and social. CONCLUSION According to the present study, the CASI Turkish version was shown to be a valid and a reliable scale.
Modulation of cytokine expression in mouse dendritic cell clones

Dendritic cells (DC) play an essential role in the induction of primary immune responses; however, very little information is available on cytokine production by DC. Here we determined the cytokine gene expression profile of two immortalized DC clones, CB1 and D2SC/1, both generated from mouse spleen but differing in their activation requirements. Among the cytokines tested, only transforming growth factor‐β1 was transcribed constitutively, but its production was detected only in D2SC/1 cells after treatment with granulocyte/macrophage colony‐stimulating factor (GM‐CSF). GM‐CSF also promoted transcription and synthesis of interleukin (IL)‐1β in CB1 cells that need pretreatment with GM‐CSF to present major histocompatibility complex class II‐restricted antigens efficiently in vitro. Lipopolysaccharide (LPS) up‐regulated gene expression and induced release of tumor necrosis factor‐α in both DC clones. In addition, LPS induced transcription of IL‐1α and both gene expression and synthesis of IL‐1β in D2SC/1 cells. Interferon‐γ was ineffective in inducing cytokine gene expression, although it augmented the antigen‐presentation capacity of DC. IL‐4, IL‐10 and IL‐12 mRNA were not induced by any of the tested stimuli. The results suggest that DC have a limited cytokine gene expression pattern compared to macrophages and are heterogenous in some functional properties.
Influence of Adjuvant Therapy in Cancer Survivors on Endothelial Function and Skeletal Muscle Deoxygenation

The cardiotoxic effects of adjuvant cancer treatments (i.e., chemotherapy and radiation treatment) have been well documented, but the effects on peripheral cardiovascular function are still unclear. We hypothesized that cancer survivors i) would have decreased resting endothelial function; and ii) altered muscle deoxygenation response during moderate intensity cycling exercise compared to cancer-free controls. A total of 8 cancer survivors (~70 months post-treatment) and 9 healthy controls completed a brachial artery FMD test, an index of endothelial-dependent dilation, followed by an incremental exercise test up to the ventilatory threshold (VT) on a cycle ergometer during which pulmonary V˙O2 and changes in near-infrared spectroscopy (NIRS)-derived microvascular tissue oxygenation (TOI), total hemoglobin concentration ([Hb]total), and muscle deoxygenation ([HHb] ≈ fractional O2 extraction) were measured. There were no significant differences in age, height, weight, and resting blood pressure between cancer survivors and control participants. Brachial artery FMD was similar between groups (P = 0.98). During exercise at the VT, TOI was similar between groups, but [Hb]total and [HHb] were significantly decreased in cancer survivors compared to controls (P < 0.01) The rate of change for TOI (ΔTOIΔ/V˙O2) and [HHb] (Δ[HHb]/ΔV˙O2) relative to ΔV˙O2 were decreased in cancer survivors compared to controls (P = 0.02 and P = 0.03 respectively). In cancer survivors, a decreased skeletal muscle microvascular function was observed during moderate intensity cycling exercise. These data suggest that adjuvant cancer therapies have an effect on the integrated relationship between O2 extraction, V˙O2 and O2 delivery during exercise.
Pediatric head and neck malignancies: US incidence and trends over 2 decades.

BACKGROUND Recent reports have noted an increase in the overall incidence of pediatric cancer. OBJECTIVE To determine whether this trend is applicable to malignancies of the head and neck in children. DESIGN Using the National Cancer Institute's Surveillance, Epidemiology, and End Results tumor database, we determined the incidence of all cancers diagnosed from 1973 through 1996 in children younger than 19 years. This was compared with the incidence of head and neck malignancies within the same population. Rates were then determined for eight 3-year periods from 1973-1975 to 1994-1996 and adjusted by use of three 5-year age groups weighted by the 1970 US standard population. RESULTS A total of 24,960 malignancies diagnosed in children younger than 19 years were identified for the study period. From this group, 3050 tumors (12%) were located in the head and neck. The average annual rate of all cancer (number of malignancies per 100,000 person-years) in children younger than 15 years rose 25% from 11.22 (95% confidence interval [CI], 10.70-11.74) for 1973-1975 to 14.03 (95% CI, 13.46-14.60) for 1994-1996. Among malignancies of the head and neck, the incidence rate increased 35% from 1.10 (95% CI, 0.94-1.26) to 1.49 (95% CI, 1.30-1.68) during the same period. CONCLUSION The incidence of head and neck malignancies among children younger than 15 years in the United States from 1973 through 1996 increased at a greater rate than childhood cancer in general.
Phosphorylation and microtubule association of the Opitz syndrome protein mid-1 is regulated by protein phosphatase 2A via binding to the regulatory subunit α4

Opitz syndrome (OS) is a human genetic disease characterized by deformities such as cleft palate that are attributable to defects in embryonic development at the midline. Gene mapping has identified OS mutations within a protein called Mid1. Wild-type Mid1 predominantly colocalizes with microtubules, in contrast to mutant versions of Mid1 that appear clustered in the cytosol. Using yeast two-hybrid screening, we found that the α4-subunit of protein phosphatases 2A/4/6 binds Mid1. Epitope-tagged α4 coimmunoprecipitated endogenous or coexpressed Mid1 from COS7 cells, and this required only the conserved C-terminal region of α4. Localization of Mid1 and α4 was influenced by one another in transiently transfected cells. Mid1 could recruit α4 onto microtubules, and high levels of α4 could displace Mid1 into the cytosol. Metabolic 32P labeling of cells showed that Mid1 is a phosphoprotein, and coexpression of full-length α4 decreased Mid1 phosphorylation, indicative of a functional interaction. Association of green fluorescent protein–Mid1 with microtubules in living cells was perturbed by inhibitors of MAP kinase activation. The conclusion is that Mid1 association with microtubules, which seems important for normal midline development, is regulated by dynamic phosphorylation involving MAP kinase and protein phosphatase that is targeted specifically to Mid1 by α4. Human birth defects may result from environmental or genetic disruption of this regulatory cycle.
Prenatal diagnosis of trisomy 18 at the 10–14‐week ultrasound scan

A beneficial consequence of screening for trisomy 21 by a combination of maternal age and fetal nuchal translucency thickness (NT) at 1O–l4 weeks is the early diagnosis of trisomy 18. In a multicenter study of 91 091 singleton pregnancies there were 106 fetuses with trisomy 18 and (83% were identified by NT screening. Trisomy 18 was also associated with early onset intrauterine growth retardation, decreased fetal heart rate and the presence of exomphalos. Copyright © 1997 International Society of Ultrasound in Obstetrics and Gynecology
THE QUANTITATIVE ESTIMATION OF CEREBROSIDES IN NERVOUS TISSUE

THE extensive research work in the physiological and pathological processes in which lipids are involved has increased the necessity for accurate micromethods for their quantitative estimation. BRANTE (1949) reviewed modern micromethods for the determination of the lipids in nervous tissue, and made a thorough investigation of the various factors which may influence them. Like most other investigators, BRANTE determined the cerebroside content only by estimating the reducing substances in a lipid extract before and after hydrolysis. From the important work of KLENK and collaborators (KLENK, 1941, 1942; KLENK and LANGERBEINS, 1941 ; SCHUWIRTH. 1940) we know that cerebrosides are not the only lipids containing carbohydrates in the central nervous system. They have isolated gangliosides from the brain and determined their amount in different nervous tissues. Besides these two glycolipids, a third has been described by ARSOVE, FOLCH, and MEATH (1951a). They named the new lipid strandin, but my preparations like DAWN'S (1952), showed that strandin consisted of gangliosides in a different physico-chemical state contaminated with low-molecular substances and mucopolysaccharides. CHATAGNON and CHATAGNON (1953, 1954) have suggested that sphingomyelin is also a part of the complex. BRANTE (1949) discussed the interference of gangliosides on the cerebroside values, and we (BRANTE and SVENNERHOLM, 1949, 1951) determined both total glycolipids and gangliosides in some foetuses. Other investigators (JOHNSON, MCNABB, and ROSSITER, 1950; CUMINGS, 1953; BLACKWOOD and CUMINGS, 1954) have neglected the gangliosides. Therefore the values for cerebrosides found in the current literature include gangliosides. EDGAR (1955) who has thoroughly discussed the problem, used the term glyco-sphingosides instead of cerebrosides. He has also made some estimations of both gangliosides and cerebrosides. Consequently, the carbohydrates in a lipid extract are derived from at least two lipid sources. But lipid extracts are contaminated to some extent with low-molecular substances, partly of carbohydrate nature. It is impossible to remove them completely by the methods generally used, i.e., precipitation of the lipids before extraction or re-extraction of a primary lipid extract. Generally, the error introduced by the contaminants is negligible i n the determination of glycolipids in adult nervous tissue, but this is not so in foetal tissue, where the amount of glycolipids is low and that of the contaminants is both relatively and absolutely higher. FOLCH, ASCOLI, LEES. MEATH, and LEBARON (1951b), however, succeeded in removing these substanccs by partition dialysis. By this procedure the gangliosides too are separated from the other lipids. It therefore appeared that it might be possible to use this method to separate cerebrosides from other substances containing carbohydrates.
Confessions and denials and the relationship with personality

Purpose. The main aim of the study was to examine the reasons and personality factors associated with confessions and denials. It was hypothesized that antisocial personality traits and active involvement in criminal behaviour would distinguish true confessors and true deniers from false confessors and false deniers. Method. The participants were 1,080 students in further education in Iceland. Each was asked about false admissions made to teachers and parents in the past, as well as about confessions or denials (true and false) made to the police during questioning, and the reasons for having responded in the way they did. The participants also completed questionnaires relating to offending, personality and self-esteem. Results. One-quarter (25%) of the participants stated that they had in the past been interrogated by the police in relation to a suspected offence, of whom 59% said they had confessed. A small minority of those interrogated (3.7%; 1% of the total sample) claimed to have made false confessions to the police, whereas 10% claimed to have made false confessions to teachers or parents. Males were signie cantly more likely to report false confessions than females. False confessions and false denials were signie cantly associated with antisocial personality traits, with Eysenck Personality Questionnaire Psychoticism being the single best predictor. Those participants who made true confessions and true denials were most normal in their personality. Conclusions. Personality is a signie cant predictor of who makes false confessions and false denials.
Mechanosensitive Afferent Units in the Lumbar Posterior Longitudinal Ligament

Study Design. The mechanosensitive afferent units in the lumbar posterior longitudinal ligament were investigated in an animal model using an electrophysiologic technique. Objectives. The objectives of this study were to identify the mechanosensitive receptive fields in the lumbar posterior longitudinal ligament and to investigate their distribution and characteristics. Summary of Background Data. The lumbar posterior longitudinal ligament has a nerve network originating from the sinuvertebral nerve. These fibers are thin, and most of their terminals are free nerve endings. Some immunohistochemical studies have indicated that they are immunoreactive to calcitonin gene-related peptide and/or substance P, suggesting a nociceptive function. Most of these studies investigated morphologic aspects, and there have been few studies employing electrophysiologic techniques to examine mechanosensitive units. Methods. We used 13 adult cats. They were anesthetized and then laminectomy was performed. The L5 and L6 dorsal rootlets were draped over a recording electrode. To investigate the receptive fields in the posterior longitudinal ligament, afferent impulses were evoked by mechanical stimulation with a glass probe. When the receptive fields were located, they were stimulated electrically to obtain conduction velocity and were stimulated with a set of 17 nylon filaments to determine their mechanical thresholds. Results. Thirteen units were identified in the lumbar posterior longitudinal ligament. The majority of the units were located around the intervertebral disc level of the posterior longitudinal ligament. The mean mechanical threshold was 47.04 ± 15.25 g. According to the conduction velocities of the units, 12 units were classified into Group III (0.5–2.5 m/sec) and one unit into Group IV (2.5–20 m/sec). Conclusion. Mechanosensitive units classified into Group III or Group IV and with a high mechanical threshold (>7.0 g) were thought to act as nociceptive units. All units identified in this study satisfied these criteria. Our result suggests that afferent fibers from the lumbar posterior longitudinal ligament have a principally nociceptive function.
Picoeukaryotic diversity and distribution in the subtropical-tropical South China Sea.

Little is known regarding the diversity and distribution of picoeukaryotes in the northwestern Pacific Ocean, although these organisms are vital components of their environment. Here, we used a culture-independent approach to assess the 18S rDNA diversity of picoeukaryotes at six sampling sites along a transcontinental section of the South China Sea. The Alveolata group comprised 58.6% of the clones and was mainly represented by the novel marine alveolates (MALV)-I (18.8%) and MALV-II (30.6%), corresponding to 66.5% of all operational taxonomic units. Sequences affiliated with seven clades of the novel marine stramenopiles (MAST) were widely distributed in different clone libraries. We report an entirely new group representing the deepest evolutionary branch of the Hacrobia; this finding suggests the existence of novel picoeukaryotes at a high taxonomic level. Many phylotypes could not be taxonomically assigned, indicating the presence of numerous previously unknown groups. Horizontally, picoeukaryotic assemblages in the coastal water characterized with the rare occurrence of MALV-I were distinct from offshore communities. Vertically, MAST-4 were mainly retrieved in surface waters; however, the Radiolaria (Rhizaria) were mainly detected in clone libraries from depths of 60 m. Our findings further emphasize the immense diversity of picoeukaryotes, especially in the subtropical-tropical northwestern Pacific Ocean.
Inhibitory influence of the dorsal nucleus of the lateral lemniscus on binaural responses in the rat's inferior colliculus

The contribution of the dorsal nucleus of the lateral lemniscus (DNLL) to binaural processing was examined by recording single-unit activity in the rat's inferior colliculus before, during, and after a reversible block of the excitatory activity in DNLL by local injection of kynurenic acid. Recordings were made from the central nucleus of the inferior colliculus with glass micropipettes filled with 3 M sodium acetate. Kynurenic acid (2 mM in Locke's solution) was injected into the DNLL through one side of a double-barreled glass pipette. The other side of the pipette was filled with Locke's solution for making control injections and recording neural activity. Pressure injection of 0.7–2.0 microliter of kynurenic acid resulted in the complete cessation of tone- evoked responses in DNLL for periods of 45 min to 1 hr. Tone bursts were delivered separately to the two ears through headphones fitted to the external auditory meatus. Binaural responses in the inferior colliculus were determined by comparing the effects of monaural and binaural stimulation. Attention was focused on neurons that were excited by contralateral stimulation and inhibited by ipsilateral stimulation. Interaural intensity difference (IID) functions were generated by holding contralateral sound pressure constant at 10 dB above threshold while increasing ipsilateral sound pressure level. Prior to kynurenic acid injection, ipsilateral stimulation caused a pronounced suppression of contralaterally evoked single-unit activity. Unilateral injection of kynurenic acid into DNLL reduced the strength of binaural suppression in the contralateral inferior colliculus. In every cell tested, the IID curve in inferior colliculus was shifted following contralateral DNLL injection. The IID curve returned to normal after recovery of neural activity in DNLL. In contrast, no effect was seen in the inferior colliculus ipsilateral to the kynurenic acid injection. The injection of Locke's solution into DNLL had no effect on IID curves in the inferior colliculus. These data suggest that the DNLL plays a role in binaural processing through an inhibitory influence on responses in the contralateral inferior colliculus.