Miracle-dz/UniFAR-FTUs huggingface dataset:
The impact of leaving against medical advice on hospital resource utilization

AbstractOBJECTIVE: To assess the effect of hospital discharge against medical advice (AMA) on the interpretation of charges and length of stay attributable to alcoholism. DESIGN: Retrospective cohort. Three analytic strategies assessed the effect of having an alcohol-related diagnosis (ARD) on risk-adjusted utilization in multivariate regressions. Strategy 1 did not adjust for leaving AMA, strategy 2 adjusted for leaving AMA, and strategy 3 restricted the sample by excluding AMA discharges. SETTING: Acute care hospitals. PATIENTS: We studied 23,198 pneumonia hospitalizations in a statewide administrative database. MEASUREMENTS AND MAIN RESULTS: Among these admissions, 3.6% had an ARD, and 1.2% left AMA. In strategy 1 an ARD accounted for a $1,293 increase in risk-adjusted charges for a hospitalization compared with cases without an ARD (p=.012). ARD-attributable increases of $1,659 (p=.002) and $1,664 (p=.002) in strategies 2 and 3 respectively, represent significant 28% and 29% increases compared with strategy 1. Similarly, using strategy 1 an ARD accounted for a 0.6-day increase in risk-adjusted length of stay over cases without an ARD (p=.188). An increase of 1 day was seen using both strategies 2 and 3 (p=.044 and p=.027, respectively), representing significant 67% increases attributable to ARDs compared with strategy 1. CONCLUSIONS: Discharge AMA affects the interpretation of the relation between alcoholism and utilization. The ARD-attributable utilization was greater when analyses adjusted for or excluded AMA cases. Not accounting for leaving AMA resulted in an underestimation of the impact of alcoholism on resource utilization.
Adjuvant host-directed therapy with types 3 and 5 but not type 4 phosphodiesterase inhibitors shortens the duration of tuberculosis treatment.

BACKGROUND Shortening tuberculosis treatment could significantly improve patient adherence and decrease the development of drug resistance. Phosphodiesterase inhibitors (PDE-Is) have been shown to be beneficial in animal models of tuberculosis. We assessed the impact of PDE-Is on the duration of treatment in tuberculous mice. METHODS We analyzed the time to death in Mycobacterium tuberculosis-infected mice receiving type 4 PDE-Is (rolipram and cilomilast) and the impact on bacterial burden, time to clearance, and relapse when types 3 and 5 PDE-Is (cilostazol and sildenafil, respectively) and rolipram were added to the standard treatment. We investigated pharmacokinetic interactions between PDE-Is (cilostazol and sildenafil) and rifampin. RESULTS The type 4 PDE-Is rolipram and cilomilast accelerated the time to death in tuberculous mice. The addition of rolipram to standard tuberculosis treatment increased bacterial burden and did not decrease the time to bacterial clearance in the lung, while the addition of the cilostazol and sildenafil reduced the time to clearance by 1 month. Cilostazol and sildenafil did not have negative pharmacokinetic interactions with rifampin. CONCLUSIONS Type 4 PDE-Is may increase the severity of tuberculosis and should be carefully investigated for use in patients with latent or active tuberculosis. Cilostazol and sildenafil may benefit tuberculosis patients by shortening the duration of therapy.
Ankle Arthroscopy: I. Technique and Complications

&NA; Arthroscopic surgery of the ankle allows the direct visualization of all intra‐articular structures of the ankle without an arthrotomy or malleolar osteotomy. Technological advances and a thorough understanding of anatomy have resulted in an improved ability to perform diagnostic and operative arthroscopy of the ankle. The decreased morbidity and faster recovery times make it an appealing technique compared with open arthrotomy. A keen understanding of the anatomy of the foot and ankle is critical to safe performance of arthroscopic procedures and prevention of complications.
Prospective Study of the Impact of Thyroid Hormone Replacement on Objective Voice Parameters

Objectives: Hypothyroidism has long been considered to have an impact on phonation. In this study, objective evaluation of vocal function in women with hypothyroidism was performed in order to characterize potential dysphonia; their subsequent response to thyroid hormone replacement was prospectively studied. It was hypothesized that thyroid hormone replacement therapy in this cohort would have an objectively measurable impact on vocal function. Methods: Prospective evaluation of objective voice parameters and concurrent determination of serum thyroid status was executed both before and after thyroid hormone replacement in a cohort of patients who had had total thyroidectomy. Objective voice parameters before and after treatment were compared. Results: Twenty-four female subjects were recruited over an 18-month period. After surgery, all subjects were hypothyroid (mean thyroid-stimulating hormone level, 81.38 mIU/L; range, 25.26 to 100.00 mIU/L) before replacement. After hormone therapy, their mean thyroid-stimulating hormone level dropped to 1.20 mIU/L (range, 0.28 to 3.83 mIU/L). The mean fundamental frequency significantly increased from a pretreatment average of 223.48 ± 36.10 Hz to 237.64 ± 38.81 Hz. Other measured voice parameters (jitter, shimmer, amplitude perturbation quotient, pitch perturbation quotient, noise-to-harmonics ratio, and maximum phonation time) were not affected. Conclusions: Thyroid hormone replacement therapy following total thyroidectomy has a measurable impact on mean fundamental frequency in female patients. The mechanism of this effect is not known.
A weather regime characterisation of Irish wind generation and electricity demand in winters 2009–11

Prolonged cold spells were experienced in Ireland in the winters of 2009–10 and 2010–11, and electricity demand was relatively high at these times, whilst wind generation capacity factors were low. Such situations can cause difficulties for an electricity system with a high dependence on wind energy. Studying the atmospheric conditions associated with these two winters offers insights into the large-scale drivers for cold, calm spells, and helps to evaluate if they are rare events over the long-term. The influence of particular atmospheric patterns on coincidental winter wind generation and weather-related electricity demand is investigated here, with a focus on blocking in the North Atlantic/European sector. The occurrences of such patterns in the 2009–10 and 2010–11 winters are examined, and 2010–11 in particular was found to be unusual in a long-term context. The results are discussed in terms of the relevance to long-term planning and investment in the electricity system.
Misperceptions in Intergroup Conflict

Two studies examined misperceptions of disagreement in partisan social conflicts, namely, in the debates over abortion (Study 1) and politics (Study 2). We observed that partisans tend to exaggerate differences of opinion with their adversaries. Further, we found that perceptions of disagreement were more pronounced for values that were central to the perceiver's own ideology than for values that were central to the ideology of the perceiver's adversaries. To the extent that partisans assumed disagreement concerning personally important values, they were also inaccurate in perceiving their adversaries' actual opinions. Discussion focuses on the cognitive mechanisms underlying misperceptions of disagreement and strategies for reducing inter- group conflict.
Memory Binding Test Predicts Incident Amnestic Mild Cognitive Impairment.

BACKGROUND The Memory Binding Test (MBT), previously known as Memory Capacity Test, has demonstrated discriminative validity for distinguishing persons with amnestic mild cognitive impairment (aMCI) and dementia from cognitively normal elderly. OBJECTIVE We aimed to assess the predictive validity of the MBT for incident aMCI. METHODS In a longitudinal, community-based study of adults aged 70+, we administered the MBT to 246 cognitively normal elderly adults at baseline and followed them annually. Based on previous work, a subtle reduction in memory binding at baseline was defined by a Total Items in the Paired (TIP) condition score of ≤22 on the MBT. Cox proportional hazards models were used to assess the predictive validity of the MBT for incident aMCI accounting for the effects of covariates. The hazard ratio of incident aMCI was also assessed for different prediction time windows ranging from 4 to 7 years of follow-up, separately. RESULTS Among 246 controls who were cognitively normal at baseline, 48 developed incident aMCI during follow-up. A baseline MBT reduction was associated with an increased risk for developing incident aMCI (hazard ratio (HR) = 2.44, 95% confidence interval: 1.30-4.56, p = 0.005). When varying the prediction window from 4-7 years, the MBT reduction remained significant for predicting incident aMCI (HR range: 2.33-3.12, p: 0.0007-0.04). CONCLUSION Persons with poor performance on the MBT are at significantly greater risk for developing incident aMCI. High hazard ratios up to seven years of follow-up suggest that the MBT is sensitive to early disease.
Sex-role congruence: Marital satisfaction and household division of labor

Earlier investigations of marital satisfaction and household division of labor in dual-worker families have produced contradictory findings. The present research investigates the sex-role congruency of spouses and their attitudes toward autonomy for women and evaluates the impact of these variables on marital satisfaction and the division of labor in the home for single-worker and dual-worker families. This study examines household organization and the perceived level of marital well-being by focusing on the married couple as the unit of analysis. The amount of time that both spouses are involved in the work force and participate in household labor is investigated through reports from both the husband and wife, as are the measures of marital satisfaction. Fifty-eight husbands and wives completed a series of questionnaires and psychological scales that assessed demographic information, sex-role orientation, sex-role congruence, marital satisfaction, and household task performance. The findings of this investigation support earlier contentions of the importance of focusing on sex-role attitude congruency as a critical variable in marital research. iv The results of this study indicate that couples of the Modern Wife/Traditional Husband type have greater levels of marital dysfunction than couples of the opposite incongruent configuration. Additionally, Traditional/ Traditional couples are represented in the data as more husband dominated in the family decision-making process than families of the Modern/Modern type. The results also reveal that attitude toward autonomy for women, gender, and employment status of the wife are related to marital adjustment and division of labor in the home.
Constraints to Smallholder Tree Planting in the Northern Mountainous Regions of Viet Nam: A Need to Extend Technical Knowledge and Skills

ABSTRACT This paper presents a literature review and case study on constraints to smallholder's tree planting in northern mountainous areas of Viet Nam. It reveals that existing literature primarily highlights constraints within the ‘input domain’ that relates to inputs to tree system establishment such as land availability, or ‘output domain’ associated with market of tree system products, but sparsely report constraints within ‘knowledge domain’ namely knowledge in tree management practice. Our case study exploring farmer's perspectives also finds those related to input and output domain but identified lack of knowledge as the prime constraint, especially to poor farmers and ethnic minorities. We recommend that the dissemination of knowledge on tree system management, farmer's skill capacity building, and improvement in the national extension system as well as its linkage with research and education, be placed in the forefront of policy to sustainably expand and intensify tree planting in the country.
Nambara Shigeru (1889–1974): how a Japanese liberal conceptualized eternal peace, 1918–1951

Abstract Nambara Shigeru was a rara avis of Japanese liberal academics at hard times in that he survived difficult times without being punished by the oppressive government in the pre-war Japan and the occupation authorities in the immediate post-war Japan. He specialized in Western political philosophy especially in Immanuel Kant and Johann Gottlieb Fichte, known as proponents of German idealism and nationalism. His magnum opus was published, without being punished, in 1944, arguing that the Nazi politics was totally against the Western political tradition. In 1945–46, he made clear his opposition to the draft new Constitution in which the emperor be symbolic and the armed forces be abolished. In 1949–1950, he made clear his view that Japan, once Japan admitted to the United Nations, what would become Japanese Self-Defense Forces should donate portions to what would become United Nations Peace Keeping Operations. On the basis of his writings in the war period and the occupation period, comparisons of his positions with Roger Scruton, Vladislav Surkov, Yanaihara Tadao, Akamatsu Kaname, Nitobe Inazo, and Yanagida Kunio on such concepts as democracy promotion, national self-determination, peace keeping are attempted to see the extent to which the pent-up Wilsonian moment burst in the immediate post-war period.
The Use of the Revised Trauma Score as an Entry Criterion in Traumatic Hemorrhagic Shock Studies: Data from the DCLHb Clinical Trials

Abstract Introduction The Revised Trauma Score (RTS) has been proposed as an entry criterion to identify patients with mid-range survival probability for traumatic hemorrhagic shock studies. Hypothesis/Problem Determination of which of four RTS strata (1-3.99, 2-4.99, 1-4.99, and 2-5.99) identifies patients with predicted and actual mortality rates near 50% for use as an entry criterion in traumatic hemorrhagic shock clinical trials. Methods Existing database analysis in which demographic and injury severity data from two prior international Diaspirin Cross-Linked Hemoglobin (DCLHb) clinical trials were used to identify an RTS range that could be an optimal entry criterion in order to find the population of trauma patients with mid-range predicted and actual mortality rates. Results Of 208 study patients, the mean age was 37 years, 65% sustained blunt trauma, 49% received DCLHb, and 57% came from the European Union study arm. The mean values were: ISS, 31 (SD = 18); RTS, 5.6 (SD = 1.8); and Glasgow Coma Scale (GCS), 10.4 (SD = 4.8). The mean TRISS-predicted mortality was 34% and the actual 28-day mortality was 35%. The initially proposed 1-3.99 RTS range (n = 41) had the highest predicted (79%) and actual (71%) mortality rates. The 2-5.99 RTS range (n = 79) had a 62% predicted and 53% actual mortality, and included 76% blunt trauma patients. Removal of GCS <5 patients from this RTS 2-5.99 subgroup caused a 48% further reduction in eligible patients, leaving 41 patients (20% of 208 total patients), 66% of whom sustained a blunt trauma injury. This subgroup had 54% predicted and 49% actual mortality rates. Receiver operator curve (ROC) analysis found the GCS to be as predictive of mortality as the RTS, both in the total patient population and in the RTS 2-5.99 subgroup. Conclusion The use of an RTS 2-5.99 inclusion criterion range identifies a traumatic hemorrhagic shock patient subgroup with predicted and actual mortality that approach the desired 50% rate. The exclusion of GCS <5 from this RTS 2-5.99 subgroup patients yields a smaller, more uniform patient subgroup whose mortality is more likely related to hemorrhagic shock than traumatic brain injury. Future studies should examine whether the RTS or other physiologic criteria such as the GCS score are most useful as traumatic hemorrhagic shock study entry criteria. Sloan EP, Koenigsberg M, Clark JM, Desai A. The use of the Revised Trauma Score as an entry criterion in traumatic hemorrhagic shock studies: data from the DCLHb clinical trials. Prehosp Disaster Med. 2012;27(4):1-15.
Rational screening of peroxisome proliferator-activated receptor-γ agonists from natural products: potential therapeutics for heart failure

Abstract Context: Peroxisome proliferator-activated receptor-γ (PPARγ) is a member of the nuclear hormone receptor superfamily of ligand-activated transcription factors. Activation of PPARγ pathway has been shown to enhance fatty acid oxidation, improve endothelial cell function, and decrease myocardial fibrosis in heart failure. Thus, the protein has been raised as an attractive target for heart failure therapy. Objective: This work attempted to discover new and potent PPARγ agonists from natural products using a synthetic strategy of computer virtual screening and transactivation reporter assay. Materials and methods: A large library of structurally diverse, drug-like natural products was compiled, from which those with unsatisfactory pharmacokinetic profile and/or structurally redundant compounds were excluded. The binding mode of remaining candidates to PPARγ ligand-binding domain (LBD) was computationally modelled using molecular docking and their relative binding potency was ranked by an empirical scoring scheme. Consequently, eight commercially available hits with top scores were selected and their biological activity was determined using a cell-based reporter-gene assay. Results: Four natural product compounds, namely ZINC13408172, ZINC4292805, ZINC44179 and ZINC901461, were identified to have high or moderate agonistic potency against human PPARγ with EC50 values of 0.084, 2.1, 0.35 and 5.6 μM, respectively, which are comparable to or even better than that of the approved PPARγ full agonists pioglitazone (EC50 = 0.16 μM) and rosiglitazone (EC50 = 0.034 μM). Hydrophobic interactions and van der Waals contacts are the primary chemical forces to stabilize the complex architecture of PPARγ LBD domain with these agonist ligands, while few hydrogen bonds, salt bridges and/or π-π stacking at the complex interfaces confer selectivity and specificity for the domain-agonist recognition. Discussion and conclusion: The integrated in vitro-in silico screening strategy can be successfully applied to rational discovery of biologically active compounds. The newly identified natural products with PPARγ agonistic potency are considered as promising lead scaffolds to develop novel chemical therapeutics for heart failure.
Anxiety Disorders in Bipolar I Mania: Prevalence, Effect on Illness Severity, and Treatment Implications

Background: Comorbidity in bipolar disorder (BP) is common, of which anxiety disorder (AD) comorbidity has received recent attention. The aim of the present study was to find the prevalence of (current and lifetime) ADs in BP I with recent episode mania, its effect on illness severity and its treatment implications. This is unlike the convention of associating “anxiety” with depression. Here, the hierarchical diagnostic criterion of the DSM IV-TR was suspended for heuristic purpose. Materials and Methods: Consecutively admitted 102 consenting in-patients of bipolar mania were evaluated on Young Mania Rating Scale, Brief Psychiatric Rating Scale, and Hamilton Rating Scale for Anxiety, at baseline and after 45 days. When the patient became cooperative, Schedule for Affective Disorders and Schizophrenia - the lifetime version interview AD section, was conducted. Protocol for management of current acute state was kept flexible and naturalistic. All treatment details, historical bipolar illness and socio-demographic variables were collected from case record file and unstructured interview with patient and caregiver. Results: High prevalence of lifetime (70.2 percent) and moderate levels of current (29.6 percent) comorbid ADs were found. Comorbid lifetime AD was associated with more severe BP course (more past depressive episodes (P<0.001), less inter-episode recovery (P<0.01), and poorer response to acute phase treatment). Comorbid AD group needed more number of mood stabilizers for acute management (P<0.05). Conclusion: Findings illustrate the importance of this comorbidity having implications for psychiatric diagnostic systems.
Association Between Human Papillomavirus and Transitional Cell Carcinoma of the Bladder.

PURPOSE Bladder carcinoma is one of the most common malignancies in worldwide. Among several risk factors, Human Papilloma Virus (HPV) have been presumed to play a causative role in the etiology of bladder cell carcinoma. The aim of this study was to evaluate the involvement of HPV infection in biopsy specimens of patients with transitional cell carcinoma at the west of Iran. MATERIALS AND METHODS In this study, 97 biopsy specimens including 67 patients with transitional cell carcinoma (TCC) of bladder and 30 cases of control group with the mean age of 63 years were studied using immunohistochemistry to identify HPV. RESULTS 22.4% of patients with TCC of bladder and 3.3% of control group were positive for HPV with a meaningful relation (P=.019). The prevalence of HPV was 4.3 fold higher in men than women. Most TCC patients werebelonged to grades II and III. CONCLUSION Considering the higher incidence of HPV positivity in patients with TCC of bladder compared to control group, it seems to be a meaningful association between HPV infection and TCC of bladder, at least in the west of Iran.
Innovation in newly public firms: The influence of government grants, venture capital, and private equity

We investigate the influence of government grants, venture capital (VC), and private equity (PE) funding on innovation in newly public firms. We examine innovation inputs (R&D), innovation outputs (patents), and the quality thereof (patent citations). We contribute to understanding of the mechanisms between government grants and subsequent VC and PE funding and innovation. We find that grants encourage VC funding but not PE funding. Grants and VC/PE funding are generally complements regarding innovation except grants substitute for VC funding on innovation inputs. Furthermore, we observe that the firm-level heterogeneity of VC/PEs significantly influences innovation in portfolio companies. JEL Classification: G24, G32, L53, O31, O38
Post-Brexit immigration policy: reconciling public perceptions with economic evidence

Existing research shows consistently high levels of concern among people in the UK over the scale of immigration and its impact on jobs, wages and services. At the same time, that same body of research does not provide much in the way of detail about the nature of these concerns. This is partly because much of the data is from opinion polls which say little about the priorities and perspectives that underlie the aggregate numbers. Moreover, very little research has been carried out on what new immigration policies the British public would like to see once the UK leaves the EU and free movement ends. Our research for this report aims to fill these gaps by providing evidence about how people use and understand information about economic impacts of immigration, and what they might wish to see from new, post-Brexit, policies.