Miracle-dz/UniFAR-FTUs huggingface dataset:
Professional satisfaction and dissatisfaction of family physicians.

BACKGROUND Physicians' satisfaction with their professional life influences the quality of patient care they provide and helps to determine the number and type of students attracted to the various fields of medicine. In this study, we sought to delineate areas of satisfaction and dissatisfaction among family physicians. METHODS A self-administered questionnaire was sent to all physicians in the state of Pennsylvania who were included in the 1990 directory of the American Board of Family Practice (N = 1944). RESULTS Completed questionnaires were received from 1066 family physicians in full-time practice. Sixty-five percent were satisfied with their professional lives. Patient relationships, a sense of clinical competence, and their relationships with their partners were among the most satisfying aspects of practice for all family physicians. Problems identified included regulations by third-party payers and government agencies and the large amount of paperwork encountered in practice. There were significant (P < .001) differences in satisfaction between physicians in different practice arrangements. Significant differences between practice types were also found in the degree of dissatisfaction with third-party payers and government agencies, paperwork, isolation from other physicians, and the threat of a malpractice suit. CONCLUSIONS Almost two thirds of family physicians are satisfied with their general professional lives. Conversely, one third are not. Clear areas of satisfaction and dissatisfaction have been defined for family physicians in general as well as for family physicians in various practice environments. This information may be useful in the development of policy to structure a medical system that meets the needs of both patients and physicians.
A Geometric Proof of the Feigin-Frenkel Theorem

We reprove the theorem of Feigin and Frenkel relating the center of the critical level enveloping algebra of the Kac-Moody algebra for a semisimple Lie algebra to opers (which are certain de Rham local systems with extra structure) for the Langlands dual group. Our proof incorporates a construction of Beilinson and Drinfeld relating the Feigin-Frenkel isomorphism to (more classical) Langlands duality through the geometric Satake theorem.
Attitudes toward standardized data collection.

BACKGROUND AND PURPOSE Clinical databases will gain importance as physical therapists need to determine the effectiveness and justify the expense of treatment. Obstacles impeding participation in standardized data collection need to be identified and addressed to construct high-quality databases. SUBJECTS Subjects were clinicians involved in patient care in a multisite physical therapy/occupational therapy practice that had initiated a standardized data collection program. METHODS Questionnaires, asking about participation in the data collection project, were distributed to participating clinics. Factor analysis identified attitudes toward standardized data collection. Relationships between efforts to learn standardized methods, attitudes, clinic and clinician characteristics, and levels of participation in the project were investigated. RESULTS Most respondents (66%) had made some effort to learn the standardized procedures. Five attitudes were identified: inconvenience, acceptance of operational definitions, automation, paperwork, and training. CONCLUSION AND DISCUSSION Inconvenience of data collection and training in standardized methods need to be addressed to construct large, high-quality databases.
Predictors of sunburn among a NZ urban population in a cross‐sectional survey series (1999 to 2006)

In 1988, New Zealand initiated a SunSmart program, with the goal of reducing excessive UVR exposure and population skin cancer rates.1,2 A survey was implemented from 1994 to 2006 to monitor population sun exposure, sun protection and sunburn. No comprehensive analyses have accounted for concurrent weather conditions. A conceptual model of sunburn guided the analysis and reporting of these data.3 This study aims to report predictors of sunburn experience.
Sepsis and the Dendritic Cell

Sepsis is a syndrome of significant morbidity and mortality. Unlike the advances made in other diseases processes, improvements in outcome from sepsis, severe sepsis, and septic shock have been modest. Current research has altered our understanding of sepsis pathogenesis such that present models and definitions are still evolving. One relatively novel cell type, the dendritic cell, is the subject of much current investigation in sepsis. Although our present understanding of dendritic cell biology is incomplete, growing evidence supports the importance of this antigen-presenting cell in the normal and maladaptive responses to microbial invasion and tissue injury. A better understanding of this cell's basic biology as well as its potential as a therapeutic target will undoubtedly play increasing roles in the development of new strategies for the treatment of the septic patient.
The Mixed Embeddedness of Ethnic Entrepreneurs in a New Immigrant Gateway

In this research the concept of mixed embeddedness is used to analyze how economic and political opportunity structures and the group characteristics of Ethiopian and Bolivian immigrants have affected the establishment and development of their businesses in metropolitan Washington, DC. The study relies upon interviews, focus groups, census data, and mapping to assess the entrepreneurial activities of both groups. As a relatively new immigrant destination, metropolitan Washington lacks many of the institutional supports found in older gateway cities. Our findings show that Bolivians and Ethiopians entered into entrepreneurial activities due more to experiences of blocked mobility and labor market segmentation than due to ethnic enclave formation. In addition, their settlement and associations within particular jurisdictions in the region played a significant role in their social and economic integration as entrepreneurs. The study concludes with an assessment of mixed embeddedness as a valuable lens from which to understand entrepreneurship at the metropolitan scale.
Specific local cardiovascular changes of Nε-( carboxymethyl ) lysine , VEGF , and Smad 2 in the developing embryos coincide with maternal diabetes induced Congenital Heart Defects

This is an uncopyedited electronic version of an article accepted for publication in Diabetes. The American Diabetes Association, publisher of Diabetes, is not responsible for any errors or omissions in this version of the manuscript or any version derived from it by third parties. The definitive publisher-authenticated version will be available in a future issue of Diabetes in print and online at http://diabetes.diabetesjournals. org. Diabetes Publish Ahead of Print, published online February 2, 2009
Cerebellar granule cells cultured from adolescent rats express functional NMDA receptors: an in vitro model for studying the developing cerebellum

In the developing rat cerebellum functional NMDA receptors (NMDARs) expressing the NR2C subunit have been identified on or after postnatal day 19. We obtained primary cultured cells from 19‐ to 35‐day‐old rat cerebellum that expressed few oligodendrocytes or astrocytes. Cultured cells were immunoreactive for neuron‐specific proteins thus indicating a neuronal population. The primary neuron present was the granule cell as indicated by immunofluorescence for the GABAA alpha 6 subunit. Whole‐cell patch‐clamp experiments indicated that functional NMDARs were present. Functional characteristics of NMDARs expressed in cerebellar granule cells (CGCs) obtained from adolescent animals were similar to those previously reported for NMDARs expressed in CGCs obtained from neonatal rats. Cultured CGCs obtained from older animals contained NMDARs that were inhibited by EtOH and were less sensitive to the NR2B subunit‐specific antagonist Ro 25‐6981. Furthermore, NMDA‐induced currents were smaller than those observed in CGCs. Western blot analysis indicated the presence of the NMDA NR2A and NR2C subunits, but not the NR2B in cultures obtained from the adolescent rats. CGCs obtained from adolescent rats express functional NMDARs consistent with a developmental profile observed in vivo.
The role of tandem IS dimers in IS911 transposition

Using a combined in vivo and in vitro approach, we demonstrated that the transposition products generated by IS911 from a dimeric donor plasmid are different from those generated from a plasmid monomer. When carried by a monomeric plasmid donor, free IS911 transposon circles are generated by intra‐IS recombination in which one IS end undergoes attack by the other. These represent transposition intermediates that undergo integration using the abutted left (IRL) and right (IRR) ends of the element, the active IRR–IRL junction, to generate simple insertions. In contrast, the two IS911 copies carried by a dimeric donor plasmid not only underwent intra‐IS recombination to generate transposon circles but additionally participated in inter‐IS recombination. This also creates an active IRR–IRL junction by generating a head‐to‐tail IS tandem dimer ([IS]2) in which one of the original plasmid backbone copies is eliminated in the formation of the junction. Both transposon circles and IS tandem dimers are generated from an intermediate in which two transposon ends are retained by a single strand joint to generate a figure 8 molecule. Inter‐IS figure 8 molecules generated in vitro could be resolved into the [IS]2 form following introduction into a host strain by transformation. Resolution did not require IS911 transposase. The [IS]2 structure was stable in the absence of transposase but was highly unstable in its presence both in vivo and in vitro. Previous studies had demonstrated that the IRR–IRL junction promotes efficient intermolecular integration and intramolecular deletions both in vivo and in vitro. Integration of the [IS]2 derivative would result in a product that resembles a co‐integrate structure. It is also shown here that the IRR–IRL junction of the [IS]2 form and derivative structures can specifically target one of the other ends in an intramolecular transposition reaction to generate transposon circles in vitro. These results not only demonstrate that IS911 (and presumably other members of the IS3 family) is capable of generating a range of transposition products, it also provides a mechanistic framework which explains the formation and activity of such structures previously observed for several other unrelated IS elements. This behaviour is probably characteristic of a large number of IS elements.
Comparing face-to-face and electronic word-of-mouth in destination image formation: The case of Iran

Purpose The purpose of this paper is to address the following question: which type of word-of-mouth (WOM) communication, face-to-face vs electronic, has the stronger influence on destination image and attitude? Design/methodology/approach A multidimensional model is developed with eight constructs. After the validation of measurement scales, hypotheses are contrasted through structural modeling to test the model fit and estimate the model coefficients. The model was tested empirically using a sample of 678 tourists who had experience within the online tourist community, tripadvisor.com. Tourists were required to complete a survey regarding their information search from the virtual sharing platform and face-to-face communications. Findings The results of this study suggest that electronic WOM (eWOM) has a more powerful effect on destination image, attitude, and travel intention rather than face-to-face WOM. Originality/value This paper is one of the first to develop and empirically test a comparative model for information search behavior, namely, face-to-face WOM vs eWOM, and destination image/attitude in the context of tourism industry.
CUSUM Schemes for Monitoring Prespecified Changes in Linear Profiles

Because of the characteristics of a system or process, several prespecified changes may happen in some statistical process control applications. Thus, one possible and challenging problem in profile monitoring is detecting changes away from the ‘normal’ profile toward one of several prespecified ‘bad’ profiles. In this article, to monitor the prespecified changes in linear profiles, two two‐sided cumulative sum (CUSUM) schemes are proposed based on Student's t‐statistic, which use two separate statistics and a single statistic, respectively. Simulation results show that the CUSUM scheme with a single statistic uniformly outperforms that with two separate statistics. Besides, both CUSUM schemes perform better than alternative methods in detecting small shifts in prespecified changes, and become comparable on detecting moderate or large shifts when the number of observations in each profile is large. To overcome the weakness in the proposed CUSUM methods, two modified CUSUM schemes are developed using z‐statistic and studied when the in‐control parameters are estimated. Simulation results indicate that the modified CUSUM chart with a single charting statistic slightly outperforms that with two separate statistics in terms of the average run length and its standard deviation. Finally, illustrative examples indicate that the CUSUM schemes are effective. Copyright © 2016 John Wiley & Sons, Ltd.
PEGylation and Multimerization of the Anti-p185HER-2 Single Chain Fv Fragment 4D5

A major goal in antibody design for cancer therapy is to tailor the pharmacokinetic properties of the molecule according to specific treatment requirements. Key parameters determining the pharmacokinetics of therapeutic antibodies are target specificity, affinity, stability, and size. Using the p185HER-2 (HER-2)-specific scFv 4D5 as model system, we analyzed how changes in molecular weight and valency independently affect antigen binding and tumor localization. By employing multimerization and PEGylation, four different antibody formats were generated and compared with the scFv 4D5. First, dimeric and tetrameric miniantibodies were constructed by fusion of self-associating, disulfide-linked peptides to the scFv 4D5. Second, we attached a 20-kDa PEG moiety to the monovalent scFv and to the divalent miniantibody at the respective C terminus. In all formats, serum stability and full binding reactivity of the scFv 4D5 were retained. Functional affinity, however, did change. An avidity increase was achieved by multimerization, whereas PEGylation resulted in a 5-fold decreased affinity. Nevertheless, the PEGylated monomer showed an 8.5-fold, and the PEGylated dimer even a 14.5-fold higher tumor accumulation than the corresponding scFv, 48 h post-injection, because of a significantly longer serum half-life. In comparison, the non-PEGylated bivalent and tetravalent miniantibodies showed only a moderate increase in tumor localization compared with the scFv, which correlated with the degree of multimerization. However, these non-PEGylated formats resulted in higher tumor-to-blood ratios. Both multimerization and PEGylation represent thus useful strategies to tailor the pharmacokinetic properties of therapeutic antibodies and their combined use can additively improve tumor targeting.
AN ANALYSIS OF HAPTOGLOBIN GENOTYPES AND RECOVERY FROM ANEURYSMAL SUBARACHNOID HEMORRHAGE

Background: Haptoglobin (Hp) binds hemoglobin (Hgb), thereby inhibiting free radical production. It is presumed that Hp 2-2 genotype is associated with worse functional outcome after aneurysmal subarachnoid hemorrhage (aSAH) related to the weaker affinity for Hgb binding, decreased clearance of hemoglobin from the site of hemorrhage, and an associated increase in secondary injury with the alpha-2 allele.Objective: The objective is to describe the relationship between Hp genotype and mortality and gross functional outcome after aSAH.Methods: A total sample of 268 subjects was narrowed down to a sample of 193 Caucasian subjects (due to differences in allele frequency distribution among races), age 18-75 with a diagnosis of aSAH, Fisher Grade greater than or equal to 2, DNA and outcome data available and without pre-existing chronic neurologic disease/deficit were enrolled into an ongoing study (NR004339). Demographic and medical condition variables were extracted from medical records. Modified Rankin Score (MRS) and Glasgow Outcome Score (GOS) were assessed at 3, 6, 12, and 24 months after aSAH. Data analysis included univariate analysis as well as multivariate logistic regression analysis, controlling for covariates including age, sex, and severity of hemorrhage (Fisher grade). Results: The sample was primarily female (n=138; 71.5%) and Caucasian (n=237; 88.4%) with a mean age of 54.45 years. This sample was further narrowed down to include only subjects of Caucasian race due to differences in allele frequency distribution among other races previously published in literature. Haptoglobin 2-2 genotype was significantly correlated with MRS at 3 months post aSAH during univariate analysis (p=.04) and at 3 months after controlling for covariates in the multivariate logistic regression analysis (p=.05). Univariate analysis produced a significant (p=.02) relationship between subjects whose genotypes yielded at least one alpha-2 allele and development of cerebral vasospasm (CV). Subjects whose genotypes had only one alpha-2 allele were significantly (p=.01) associated with Fisher grade. Fisher grade and Hunt and Hess score were both significantly associated with poor outcomes on MRS at all four time periods. Age was significantly (p=.01) correlated with Hp 1-1 and Hp 1-2 genotypes; specifically, these patients were younger than those with Hp 2-2 genotype. After controlling for covariates, Fisher grade was the only covariate that maintained significance in predicting outcomes after aSAH at all four time periods.Conclusions: Subjects whose genotypes contain at least one alpha-2 allele more often had poor outcomes on MRS at 3 months post aSAH and were more likely to develop CV. Additionally, haptoglobin genotype can be used as predictor of gross functional outcome when measured using MRS at 3 months after aSAH. The Fisher grading scale and Hunt and Hess scoring system are both significantly useful for predicting outcomes (GOS, MRS, mortality) at all four time periods after aSAH.
A targeted and adjuvanted nanocarrier lowers the effective dose of liposomal amphotericin B and enhances adaptive immunity in murine cutaneous leishmaniasis.

BACKGROUND Amphotericin B (AmB), the most effective drug against leishmaniasis, has serious toxicity. As Leishmania species are obligate intracellular parasites of antigen presenting cells (APC), an immunopotentiating APC-specific AmB nanocarrier would be ideally suited to reduce the drug dosage and regimen requirements in leishmaniasis treatment. Here, we report a nanocarrier that results in effective treatment shortening of cutaneous leishmaniasis in a mouse model, while also enhancing L. major specific T-cell immune responses in the infected host. METHODS We used a Pan-DR-binding epitope (PADRE)-derivatized-dendrimer (PDD), complexed with liposomal amphotericin B (LAmB) in an L. major mouse model and analyzed the therapeutic efficacy of low-dose PDD/LAmB vs full dose LAmB. RESULTS PDD was shown to escort LAmB to APCs in vivo, enhanced the drug efficacy by 83% and drug APC targeting by 10-fold and significantly reduced parasite burden and toxicity. Fortuitously, the PDD immunopotentiating effect significantly enhanced parasite-specific T-cell responses in immunocompetent infected mice. CONCLUSIONS PDD reduced the effective dose and toxicity of LAmB and resulted in elicitation of strong parasite specific T-cell responses. A reduced effective therapeutic dose was achieved by selective LAmB delivery to APC, bypassing bystander cells, reducing toxicity and inducing antiparasite immunity.
Retinal Astrocytic Hamartoma with Associated Macular Edema: Report of Spontaneous Resolution of Macular Edema as a Result of Increasing Hamartoma Calcification

The purpose of this article is to report a case of retinal astrocytic hamartoma with an associated macular edema and the spontaneous resolution of the latter due to an increase in hamartoma calcification over a seven-year follow-up period. Clinical examination, red-free and colour fundus photographs, fluorescein angiography, and optical coherence tomography were performed during a seven-year follow-up. We conclude that retinal astrocytic hamartomas may be associated with cystoid macular edema. In some cases, the CME may resolve due to an increase in tumor calacification. Whether the progressive calcification of the retinal mass represents an overall positive prognostic factor is still unknown and further histologic studies are certainly required.
Otomycosis—A continuing problem

Abstract The microbiology of 12, 174 symptomatic ears presenting over an eingt-year period to one hospital was examined in detail. 1, 061 cases of fungal infection were found. The incidence and pattern of these fungi and the accompanying bacteria, in case of mixed infection, do not appear to have been affected by the widespread use of powerful topically-applied autibiotic/steroid preparations over more than two decades. Otomycosis remains an uncommon, often overlooked but important cause of morbidity in a temperate climate.
The mediating effect of perceived usefulness towards tax service quality and the continuance usage intention of the filing system in Malaysia

This study examines the mediating effect of perceived usefulness on the relationship between tax service quality (correctness, response time, system support) and continuance usage intention of e-filing system in Malaysia. A total of 116 data was analysed using Partial Least Squared Method (PLS). The result showed that Perceived Usefulness has a partial mediating effect on the relationship between tax service quality (Correctness, Response Time) with the continuance usage intention and tax service quality (correctness) has significant positive relationship with continuance usage intention. Perceived usefulness was found to be the most important predictor of continuance usage intention