Miracle-dz/UniFAR-FTUs huggingface dataset:
Routine use of Gen-Probe Amplified Mycobacterium Tuberculosis Direct (MTD) test for detection of Mycobacterium tuberculosis with smear-positive and smear-negative specimens.

SETTING Nucleic acid amplification tests, such as the Amplified Mycobacterium Tuberculosis Direct (MTD) Test, may improve early diagnosis of tuberculosis when used in combination with acid-fast bacilli smear examination with a similar turnaround time. OBJECTIVE To evaluate the routine use of MTD in respiratory and non-respiratory samples; to investigate the improvement of MTD specificity and positive predictive value by defining an equivocal zone for result interpretation. DESIGN MTD was performed according to the instructions supplied by the manufacturer. An equivocal zone was included for interpretation of results. Discordant results with culture were resolved by incorporating clinical data and multiple specimen analysis. RESULTS The overall sensitivities, specificities, and positive and negative predictive values for respiratory specimens (n = 3308) were 90.8, 99.9, 99.1, and 99.2%, respectively. With extra-pulmonary specimens (n = 1350) those values were 67.4, 99.9, 98.2, and 97.9%, respectively. By implementing an equivocal zone, the specificity and positive predictive value of MTD were improved (from 99.1% and 88.6% to 99.9% and 98.9% respectively) without significantly altering other performance characteristics. CONCLUSIONS Amplification assays cannot yet replace the conventional diagnostic techniques. Nevertheless, MTD is a reliable method for the direct detection of M. tuberculosis in clinical specimens. The number of false-positive results can be limited by defining an equivocal zone.
Did corporate governance mechanisms affect earnings management? Further evidence from GCC Islamic banks

Purpose - The aim of this paper is to examine the impact of corporate governance mechanisms on earnings management practice for a sample of GCC Islamic Banks using a new model of earnings management. Design/methodology/approach - First, we estimate discretionary accruals based on loan loss provisions DLLP using the procedure derived from Jones (1991) original model. Second, we run a multivariate regression model to check the linkage between corporate governance characteristics and discretionary loan loss provision. Finally we use an additional sensitivity check analysis to assess whether our results are robust to the estimation procedure and to other exogenous factors. Findings - Using as sample of 26 Islamic banks pertaining to the GCC region with a total of 223 firm-year observations and a nine year period (2004-2012), our results are conclusive and show that first, IBs with large Shariaa Board (SB) size manage less DLLP. Secondly, AAOIFI membership positively impacts earnings management through DLLP in IBs. Third, there is a negative relationship between boards of director’s independence the extent to which IBs manage DLLP. Fourth, the existence of block holders positively affects earnings management by IBs. Fifth, there is a negative relationship between audit committee meetings and DLLP. Finally, institutional ownership and bank size have no effect on earnings management through DLLPs. Research limitations/implications - In our research, we do not take into account all governance factors that are supposed to impact earnings management in Islamic banks. Future research should explore the impact of additional IBs governance structures including CEO bonus, experience, gender and the extent to which IBs use real earnings management with Murabaha, Mudaraba, Musharaka transactions. Practical implications - The paper is a very useful source of information that may provide relevant guidelines in helping the future development of corporate governance of IBs. As well as, the findings could prove to be useful for regulators since they are responsible for the acceptable level of corporate governance standards. Thus, they must consider strengthening governance mechanisms either through new legislation or stronger enforcement where earnings management is of such magnitude to that serious impedes information transparency and financial reporting quality of IBs. Originality/value - This study associates the corporate governance characteristics with earnings management by IBs. The study contributes to the growing body of literature on earnings management and corporate governance in IBs. It should be useful to researchers, regulators, investors, analysts and creditors as well as other players in the capital markets, as it presents a new and important aspect that needs to be accounted for when assessing the quality of IBs' accounting information in GCC countries.
Off-policy reinforcement learning with Gaussian processes

An off-policy Bayesian nonparameteric approximate reinforcement learning framework, termed as GPQ, that employs a Gaussian processes (GP) model of the value (Q) function is presented in both the batch and online settings. Sufficient conditions on GP hyperparameter selection are established to guarantee convergence of off-policy GPQ in the batch setting, and theoretical and practical extensions are provided for the online case. Empirical results demonstrate GPQ has competitive learning speed in addition to its convergence guarantees and its ability to automatically choose its own bases locations.
Economic evaluation of BST-CarGel as an adjunct to microfracture vs microfracture alone in knee cartilage surgery

Abstract Objectives: Knee cartilage damage is a common cause of referral for orthopedic surgery. Treatment aims to reduce pain and symptoms by repairing cartilage. Microfracture, the current standard of care, yields good short-term clinical outcomes; however, treatment might fail after 2–3 years. A Chitosan-Beta glycerolphosphate-based medical device (BST-CarGel) is used as an adjunct to microfracture and demonstrates improvements in quantity and quality of repaired tissue, potentially reducing the risk of treatment failure. This study aimed to establish the economic value of BST-CarGel vs microfracture alone in knee cartilage repair from the societal perspective, using Germany as the reference market. Methods: A decision tree with a 20-year time-horizon was constructed, in which undesirable clinical events were inferred following initial surgery. These events consisted of pain management, surgery, and total knee replacement. Clinical outcomes were taken from the pivotal clinical trial, supplemented by other literature. Data and assumptions were validated by a Delphi panel. All relevant resource use and costs for procedures and events were considered. Results: In a group of patients with all lesion sizes, the model inferred that BST-CarGel yields a positive return on investment at year 4 (with 20-year cumulative cost savings of €6448). Reducing the incremental risk of treatment failure gap between the device and microfracture by 25–50% does not alter this conclusion. Cost savings are greatest for patients with large lesions; results for patients with small lesions are more modest. Limitations: Clinical evidence for microfracture and other interventions varies in quality. Comparative long-term data are lacking. The comparison is limited to microfracture and looks only at costs without considering quality-of-life. Conclusion: BST-CarGel potentially represents a cost-saving alternative for patients with knee cartilage injury by reducing the risk of clinical events through regeneration of chondral tissue with hyaline characteristics. Since the burden of this condition is high, both to the patient and society, an effective and economically viable alternative is of importance.
Family physicians' opinions on the primary care documentation, coding, and billing system: a qualitative study from the residency research network of Texas.

BACKGROUND AND OBJECTIVES The study's aim was to deepen our understanding of family physicians' perceptions of the strengths and weaknesses of the widely used US documentation, coding, and billing rules for primary care evaluation and management (E/M) services. METHODS This study used in-depth, qualitative interviews of 32 family physicians in urban and rural, academic, and private practices. Interviews were initiated with a series of grand tour questions asking participants to give examples and personal narratives demonstrating cost efficiencies and cost inefficiencies relating to the E/M rules in their own practices. Investigators independently used an immersion-crystallization approach to analyze transcripts to search for unifying themes and subthemes until consensus among investigators was achieved. RESULTS The majority of participants reported that the documentation rules, coding rules, and common fees for procedures and preventive services were reasonable. The E/M documentation rules for all other visit types, however, were perceived by the participants as unnecessarily complicated and unclear. The existing codes did not describe the actual work for common clinic visits, which led to documenting and coding by heuristics and patterns. Participants reported inadequate payment for complex patients, multiple patient concerns in a single office visit, services requiring extra time beyond a standard office visit, non-face-to-face time, and others. The E/M rules created unintended negative consequences such as family physicians not accepting Medicare or Medicaid patients, inaccurate documentation, poor-quality care, and system inefficiencies such as unnecessary tests and referrals. CONCLUSIONS Family physicians expressed many problems and frustrations with the existing E/M documentation, coding, and billing rules and felt the system undervalued and unappreciated them for the complex and comprehensive care they provide. Findings of this study could inform improved guidelines for primary care documentation, coding, and billing.
Insights into the Tunnel Mechanism of Cholesteryl Ester Transfer Protein through All-atom Molecular Dynamics Simulations

Cholesteryl ester transfer protein (CETP) mediates cholesteryl ester (CE) transfer from the atheroprotective high density lipoprotein (HDL) cholesterol to the atherogenic low density lipoprotein cholesterol. In the past decade, this property has driven the development of CETP inhibitors, which have been evaluated in large scale clinical trials for treating cardiovascular diseases. Despite the pharmacological interest, little is known about the fundamental mechanism of CETP in CE transfer. Recent electron microscopy (EM) experiments have suggested a tunnel mechanism, and molecular dynamics simulations have shown that the flexible N-terminal distal end of CETP penetrates into the HDL surface and takes up a CE molecule through an open pore. However, it is not known whether a CE molecule can completely transfer through an entire CETP molecule. Here, we used all-atom molecular dynamics simulations to evaluate this possibility. The results showed that a hydrophobic tunnel inside CETP is sufficient to allow a CE molecule to completely transfer through the entire CETP within a predicted transfer time and at a rate comparable with those obtained through physiological measurements. Analyses of the detailed interactions revealed several residues that might be critical for CETP function, which may provide important clues for the effective development of CETP inhibitors and treatment of cardiovascular diseases.
High-risk HPV and survival in patients with oral and oropharyngeal squamous cell carcinoma – 5-year follow up of a population-based study

Abstract Conclusion: No statistically significant 5-year survival difference was seen in patients with oral and oropharyngeal squamous cell carcinoma (OOPSCC) between high-risk HPV-positive and -negative groups in this population-based study. Objectives: To see if the formerly observed higher risk for recurrence or second primary tumour (SPT) in high-risk HPV-positive patients with OOPSCC corresponds to worse survival. Methods: A total of 128 consecutive, previously untreated patients with OOPSCC, who were part of a population-based case-control study in southern Sweden during 2000–2004, were included. A mouthwash sample was collected and exfoliated cells were collected with cotton-tipped swabs from the tonsillar fossa and the tumour. Specimens were analysed for HPV DNA using nested polymerase chain reaction (PCR). Disease-specific survival (DSS) and DSS difference between HPV-negative and HPV-positive patients were calculated. The relationship between age, stage, high-risk HPV status and DSS was assessed. Oral and oropharyngeal tumours were assessed separately. Results: Mean DSS in months was 80.7/68.6 (high-risk HPV-negative/high-risk HPV-positive) for oral cavity tumours (p = 0.18) and 67.6/78.3 (high-risk HPV-negative/high-risk HPV-positive) for oropharyngeal tumours (p = 0.47). For oral cavity tumours, age, T status, N status and stage all showed significant differences in DSS. For oropharyngeal tumours, no significant difference regarding DSS was found.
Treatment of Depersonalization with Serotonin: Reuptake Blockers

Eight patients with depersonalization disorder or with depersonalization symptoms in association with obsessive-compulsive and panic disorders were treated with serotonin reuptake blockers. There was clinical overlap of depersonalization disorder with obsessive-compulsive disorder, and the co-occurrence of obsessive-compulsive and panic features with depersonalization in these patients was associated with a favorable treatment outcome. The chronicity of illness and lack of prior response to a variety of treatments in these patients highlights the positive outcome with this treatment. In addition, issues are raised regarding the current hierarchical exclusion of depersonalization disorder in the presence of obsessive-compulsive and panic disorders.
Activation pattern of the limbic system following spatial learning under stress

Anatomical evidence suggests an interplay between the dorsal CA1 of the hippocampus (CA1), the basolateral amygdala (BLA) and the entorhinal cortex (EC), but their specific interactions in the context of emotional memory remain obscure. Here, we sought to elucidate the activation pattern in these areas following spatial learning under different stress conditions in the Morris water maze, using cAMP response element‐binding protein (CREB) activation as a marker. Stress levels were manipulated by maintaining the water maze at one of two different temperatures: lower stress (warm water) or higher stress (cold water). Three groups of animals were tested under each condition: a Learning group, trained in the water maze with a hidden escape platform; a No‐Platform group, subjected to the maze without an escape platform; and a Naïve group. To evaluate the quality of the spatial memory formed, we also tested long‐term memory retention of the initial location of the platform following an interference procedure (reversal training). In the CA1 and EC, we found different CREB activation patterns for the lower‐ and higher‐stress groups. By contrast, in the BLA a similar pattern of activation was detected under both stress levels. The data reveal a difference in the sensitivity of the memory to interference, with reversal training interference affecting the memory of the initial platform location only under the higher‐stress condition. The results suggest that stress‐dependent alterations in limbic system activation patterns underlie differences in the quality of the memory formed.
R&D Capabilities, Intellectual Property Strength and Choice of Equity Ownership in Cross‐Border Acquisitions: Evidence from BRICS Acquirers in Europe

The aim of the study is to investigate two relatively underexplored factors, namely, the R&D (research and development) capabilities of target firms and the strength of intellectual property (IP) institutions in target economies, that influences the choice of equity ownership in cross border acquisitions (CBAs) undertaken by multinational enterprises (MNEs) from BRICS (Brazil, Russia, India, China and South Africa) economies. They developed the key hypothesis on foreign market entry through CBAs by incorporating insights from transaction costs economics, the resource-based view and institutional theory to investigate the determinants of full versus partial equity ownership. Using logistic regression estimation methods to a sample of 111 CBA deals of BRICS MNEs in 22 European countries, it was found that BRICS MNEs were likely to pursue full rather than partial acquisition mode when target firms have high R&D capabilities. However, the greater the degree of strength of IP institutions in target economies and higher the target firms’ R&D capabilities, the more likely it is for BRICS MNEs to undertake partial, rather than, full acquisition mode. They provided interesting theoretical insights and managerial implications that might underlie some of the key findings on CBAs by emerging market MNEs.
Thrombocytosis and thrombocytopenia in childhood bacterial meningitis

To assess factors affecting the development of reactive thrombocytosis during bacterial meningitis, thrombocyte counts of 311 children with cerebrospinal fluid culture-positive bacterial meningitis were followed during hospitalization. Thrombocytosis (platelet counts >500x109/liter) was seen in 49% of the patients after the first week of tratment. Thrombocyte counts were higher in infants and in patients with long duration of illness before admission. Subdural effusion and cephalosporin therapy were associated with more pronounced thrombocytosis. We found no relation between thrombocytosis
Does P-Wave Dispersion Predict the Atrial Fibrillation Occurrence After Direct-Current Shock Therapy?

Supraventricular tachycardia attacks, including atrial fibrillation (AF), occur after both external and internal cardioversions. These attacks of atrial fibrillation after direct-current (DC) shock may be related to hemodynamic impairment, thromboembolic events, or enhanced electrical instability of the ventricular and atrial myocardium, especially in predisposed patients. In this study, the authors aimed to show the importance of P-wave dispersion (PWD), which lead the atrium to fibrillate, in predicting post-DC shock AF after external cardioversion. Thus physicians may be able to choose the patients with high risk for AF occurrence and apply some other therapeutic modalities to those patients. The authors identified 18 patients in whom an AF attack was induced by urgent or elective cardioversion for a ventricular tachycardia attack and compared these patients with a control group composed of 40 patients without AF in regard to some clinical, echocardiographic, and electrocardiographic parameters. Left atrial diameters were greater (4.3 ±0.3 vs 3.5 ±0.5 cm, p=0.001), left ventricular ejection fractions (LVEF) were lower (45.2 ±8.2 vs 54.9 ±7.5, p=0.001), the energy needed for successful cardioversion was higher (166.6 ±59.4 vs 80.8 ±51.6 J, p=0.001), and P max (135.2 ±7.4 vs 118.7 ±10.5 ms, p=0.001) and PWD (53.8 ±12.2 vs 23.8 ±9.5 ms, p=0.001) values were higher in patients with AF when compared to those without AF. Thus, the patients with higher PWD values had a greater risk for development of AF after a DC shock.
Simple open economy macro with comprehensive accounting a radical alternative to the Mundell Fleming model

This paper presents a stock flow model of two economies (together comprising the whole world) which trade goods and financial assets with one another. The accounting framework, though comprehensive in its own terms, is very much simplified (it has interest rates without interest payments and exchange rate changes without changes in relative prices) so as to reach the main conclusions as simply and easily as possible. The paper is (a contrario) critical of attempts to deploy open economy models which only analyse the operations of a single economy, without regard to the responses of the rest of the world. In particular, the paper is critical of the influential Mundell-Fleming (M-F) model and finds that the characteristic M-F results are confuted once a full set of double entry accounts is used with all processes firmly located in historical time.
[Sex differences in brain stem auditory evoked potentials and P300 examination in patients with mild cognitive impairment and Alzheimer's disease].

OBJECTIVE To compare the sex differences on brain stem auditory evoked potentials (BAEP) and P300 in the elderly patients with mild cognitive impairment (MCI) and the patients with Alzheimer's disease (AD). METHODS Thirty-eight elderly patients with MCI, 26 cases of AD and 20 health controls (HC) were examined with BAEP, P300 . Sex difference of the variables was compared inter-and intra-groups. RESULTS Significant sex differences of BAEP were found in the latency period wave III, V of left side in the MCI group (P <0.01), in the latency period wave IV, V of left side in HC group (P<0.01), and no such differences were found in AD group. The females had longer latency period in P300 measurement than males in MCI group (P <0.01), but there were no significant differences within AD or HC groups. The males showed significant differences in wave I, II in left side between the MCI and AD groups. The males also showed significant difference in wave I, III approximate, equals V in left side, wave IV in right side between AD and HC groups, and so did the females in wave I approximate, equals V in both sides. The males had significant difference in the left wave III, IV and right wave I, IV, V between MCI and HC groups, and so did the females in right side wave I, II, V. In P300, longer latency waves were found in AD group than in MCI group. Both sexes showed significant differences in the latency of Fz, Cz, Pz between AD and HC groups, but no significant differences were found in the latency of Fz, Cz, Pz in the females between the MCI and HC groups. CONCLUSION Sex differences were found in the examination of both BAEP and P300 in MCI group, but not in AD group. The people of same sex have different expression of BAEP and P300 among MCI, AD and HC groups, suggesting the sex difference should be considered in the differential diagnosis.
Employment Status Persistence in the Japanese Labour Market

Abstract The growth of non-standard employment has become a cause for concern for policy-makers trying to boost output and keep unemployment low while also maintaining job security. This paper estimates a dynamic unobserved effects model using the Keio Household Panel Survey, an individual-level panel data set, to investigate the effects on future employment opportunities of employment in Japan’s non-standard employment and regular employment sectors. I find strong evidence of persistence within the labour market, suggesting that past employment experience has a significant impact on future labour market outcomes.
Antioxidant activities of cereal-legume mixed batters as influenced by process parameters during preparation of dhokla and idli, traditional steamed pancakes

Dhokla and idli are popular breakfast foods in India. The objective of the present study was to evaluate their antioxidative properties during different stages of preparation. The effects of fermentation on the enhancement of antioxidative activities were reflected by a higher total phenol content (TPC) in the fermented batters, which also displayed better antioxidative activities than their unfermented batters and steam-cooked products. Fermentation enhanced>2.5-fold TPC and>125% reducing activity. The fermented batters were better free-radical scavengers, which increased in a time and dose-dependent manner, than either the unfermented batters or their steamed products. There was significant enhancement of metal-chelating and lipid peroxidation inhibitory activities during fermentation. The TPCs of both dhokla and idli extracts were positively correlated with the respective values of other parameters, suggesting a possible role of phenolics in the extracts as the antioxidant. The data also revealed a strong correlation between any two of these five parameters tested.