Miracle-dz/UniFAR-FTUs huggingface dataset:
Conflict and emotional exhaustion in obstetrician-gynaecologists: a national survey

Context Conflicts over treatment decisions have been linked to physicians' emotional states. Objective To measure the prevalence of emotional exhaustion and conflicts over treatment decisions among US obstetrician/gynaecologists (ob/gyns), and to examine the relationship between the two and the physician characteristics that predict each. Methods Mailed survey of a stratified random sample of 1800 US ob/gyn physicians. Criterion variables were levels of emotional exhaustion and frequency of conflict with colleagues and patients. Predictors included physicians' religious characteristics and self-perceived empathy. Results Response rate among eligible physicians was 66% (1154/1760). 36% of ob/gyns reported high levels of emotional exhaustion, and majorities reported conflict with colleagues (59%) and patients (61%). Those reporting conflict were much more likely to report emotional exhaustion (58% vs 29% who never conflict, OR, 95% CI 2.8, 1.6 to 4.8 for conflict with colleagues; 55% versus 26%, OR, 95% CI 2.2, 1.4 to 3.5 for conflict with patients). Physicians with lower self-perceived empathy were more likely to report physician-patient conflicts (65% vs 58% with higher empathy, OR, 95% CI 1.4, 1.0 to 1.9), as were female ob/gyns (66% vs 57% of males, OR, 95% CI 1.5, 1.1 to 2.0). Foreign-born physicians were less likely to report such conflicts (47% vs 64% of US born, OR, 95% CI 0.5, 0.4 to 0.8). Physicians' religious characteristics were not significantly associated with reporting conflict. Conclusions Conflicts over treatment decisions are associated with physicians' empathy, gender, immigration history and level of emotional exhaustion. With respect to the latter, conflict in the clinical encounter may represent an overlooked source or sign of burnout among ob/gyns.
Peripheral markers of oxidative stress in probable Alzheimer patients

The current research on Alzheimer's disease is mainly focused in the post‐mortem characterization of pathological and biochemical alterations in the brain. The finding of peripheral markers that could be associated with the changes observed in the Alzheimer's brain would be of interest in this field. The aim of the present study was to evaluate the state of different peripheral markers of oxidative stress in probable Alzheimer patients and compare them with a group of healthy individuals.
The evaluation of wafer thinning and singulating processes to enhance chip strength

For several kinds of advanced applications, such as RFID, telecommunication, portable electronics, or wearable electronics, the need of packaged semiconductor chip thick is getting thinner drastically. One representative technology is to embed an active device into an organic substrate by sequential build-up processes, for example, chip-in-polymer by IZM, chip-scale-module by Fujitsu, bumpless build-up layer by Intel, and chip-in-substrate package by ERSO/ITRI. However, reliability of an ultra-thin chip is decayed dramatically as the decay of chip thickness. This negative result of chip strength reduces the reliability of a semiconductor packages. In this paper, we want to get the optimal processes through the studies on wafer thinning and singulating respectively. As the aforementioned description, we did the sequential experiments on thinning and singulating to find out the optimal processing flow. In the wafer thinning study, the average chip strength of plasma dry etching is enhanced 40 to 50 percentages than standard backside grinding. Because DBG is a good solution for ultra-thin wafer processing, the effect on chip strength is also important in the study for the industry. It is enhanced about 10 percentages. On the other hand, the average chip strength of laser cutting is much lower than standard die dicing. Through the comparison of OM pictures of traditional dicing, DBG, and laser cutting, the chipping situations are observed clearly. DBG plus plasma etching does minimize the chipping to provide a more reliable chip. The study on wafer thinning and singulating processes is evaluated successfully in this paper. There are several methods generated and proved to enhance the strength of an ultra-thin chip. According to the results of the research, the novel, innovative, and leading-edge packaging technology can be realized via the more reliable ultra-thin chips.
Reproducibility and Validity of a Self-administered Food Frequency Questionnaire Used in the JACC Study

BACKGROUND: A self-administered questionnaire on dietary habits used in the JACC Study contained a 40-item food frequency questionnaire (FFQ). Although more than 110 thousand subjects enrolled in JACC Study and responded to the FFQ, no validation study has been conducted to date. METHODS: Eighty-five volunteers among the cohort members completed 2 FFQs (FFQs 1&2) and 12-day weighed dietary records (WDR). The interval between the two FFQs was one year. During the one year, the subjects carried out a 3-consecutive-day WDR in each season. We tested the reproducibility by using two FFQs. Also, we tested the validity of the FFQ by using the 12-day WDR as a gold standard. RESULTS: The intake frequencies of the 2 FFQs often agreed, showing the Spearman correlation coefficients ranging from 0.42 (edible wild plants) to 0.86 (coffee). The Spearman correlation coefficients of the energy and nutrient intakes from FFQ2, and that of the 12-day WDR were 0.20(energy) to 0.46 (animal protein, potassium). After adjusting the energy intake, the correlation coefficients showed 0.21(fish fat) to 0.51(animal fat). When classifying the FFQ2 and WDR by quartiles and examining the degree of agreement between the two methods, we obtained its median 30%. CONCLUSIONS: The FFQ is suitable to deal with a large group of subjects. However, since the energy and the amount of nutrient intake from this FFQ can not show the overall dietary intake situation, the subjects’ dietary intake should be assessed by categories.
Subjective memory complaints with and without objective memory impairment: relationship with risk factors for dementia.

OBJECTIVE The authors investigated the frequency distribution of well-established risk factors for dementia--high plasma homocysteine and the apolipoprotein E epsilon4 allele (APOE epsilon4)--among older women with subjective memory complaints (SMC) but no cognitive impairment, and with mild cognitive impairment (MCI). METHODS This was a cross-sectional, community-based study. RESULTS Women with MCI had higher total plasma homocysteine than healthy-comparison subjects. There was also a nonsignificant excess of APOE epsilon4 carriers in the MCI than in the healthy group. Participants with SMC had higher depression and anxiety scores than healthy-comparison subjects, but did not differ from subjects in the healthy-comparison group in relation to their total plasma homocysteine and APOE epsilon4 distribution. CONCLUSIONS MCI seems to be more closely related to well-established risk factors for dementia than is SMC.
Positive mood enhances reward-related neural activity.

Although behavioral research has shown that positive mood leads to desired outcomes in nearly every major life domain, no studies have directly examined the effects of positive mood on the neural processes underlying reward-related affect and goal-directed behavior. To address this gap, participants in the present fMRI study experienced either a positive (n = 20) or neutral (n = 20) mood induction and subsequently completed a monetary incentive delay task that assessed reward and loss processing. Consistent with prediction, positive mood elevated activity specifically during reward anticipation in corticostriatal neural regions that have been implicated in reward processing and goal-directed behavior, including the nucleus accumbens, caudate, lateral orbitofrontal cortex and putamen, as well as related paralimbic regions, including the anterior insula and ventromedial prefrontal cortex. These effects were not observed during reward outcome, loss anticipation or loss outcome. Critically, this is the first study to report that positive mood enhances reward-related neural activity. Our findings have implications for uncovering the neural mechanisms by which positive mood enhances goal-directed behavior, understanding the malleability of reward-related neural activity, and developing targeted treatments for psychiatric disorders characterized by deficits in reward processing.
Executive Dysfunction in Patients with Obstructive Sleep Apnea Syndrome

Aims: To clarify whether patients with obstructive sleep apnea syndrome (OSAS) have executive dysfunction, to identify the domains of executive function affected and to establish the severity of any dysfunction. Methods: A full-night polysomnography and a comprehensive neuropsychological assessment focusing on executive functions were conducted on 40 newly diagnosed OSAS patients and 20 healthy controls. The severity of dysfunction was analyzed using norm-referenced data. Results: All patients and controls were men. The groups did not differ statistically significantly in terms of age, education or intelligence quotient. Patients showed poorer performance than controls on the copy of the Rey-Osterrieth Complex Figure test, the Block Design, the Trails B of the Trail Making Test and the Intra-Extra Dimensional Set Shifting test. Based on the normative data, most OSAS patients performed at a normal level, but a few patients had either mild dysfunction (2.5–12.5%) or moderate to severe dysfunction (5–15%). Conclusions: OSAS patients have lower set-shifting and analysis/synthesis performance than healthy controls. According to the normative data, most patients in the present study had normal performance, but there were also a few patients with more serious deficits.
The homeobox gene Hesx1 is required in the anterior neural ectoderm for normal forebrain formation.

The homeobox gene Hesx1 is expressed in the anterior visceral endoderm (AVE), anterior axial mesendoderm (AME), and anterior neural ectoderm (ANE) during early mouse embryogenesis. Previous studies have shown that Hesx1 is essential for normal murine forebrain development. Hesx1 homozygous mutants showed variable forebrain truncations ranging from mild to severe lack of forebrain tissue. Here, we have investigated the requirement of Hesx1 in the AVE, AME, and ANE using chimeric and in situ hybridization analyses to understand better the nature of the forebrain defects. Chimeric embryos composed predominantly of Hesx1(+/+) cells developing within Hesx1(-/-) visceral endoderm showed no evident forebrain abnormalities. In contrast, injection of Hesx1(-/-) ES cells into wild-type blastocysts gave rise to chimeras with forebrain defects similar to those observed in the Hesx1(-/-) mutants. RNA in situ hybridization analysis showed that the AVE and AME markers Cerrl, Lim1, and Shh were normally expressed in 6.5- and 7.5-dpc Hesx1(-/-) mutants. Expression of the ANE markers Six3 and Rax/Rx was also unperturbed in the Hesx1(-/-) mutants from late gastrula to late headfold stages. However, transcripts for both genes were markedly reduced by the early somite stage, about 24 h after Hesx1 is first expressed in the ANE. Therefore, Hesx1 seems to be required autonomously in the ANE for normal forebrain formation.
A Life Course Approach to Immigrants’ Relocation: Linking Long- and Short-distance Mobility Sequences

This paper integrates life course principles to investigate interdependencies between residential, family and professional trajectories following an international migration, and enhance the more classic micro-economic explanations of foreign-born internal migration. Using retrospective data from the Swiss Household Panel survey, we follow foreign-born residents for a six-year period and analyse long- and short-distance mobility outcomes. By considering repeated migration in a multilevel framework, we tackle the question of whether successive migration is due to a short-term adjustment process or rather to a long-term phenomenon for a hypermobile segment of the population. The results corroborate important synchronicities between marriage, employment transitions and spatial outcomes, but fail to confirm the simultaneous process of childbirth and residential relocation. We conclude that successive long-distance and successive short-distance migration are confined to a selected segment of the population with high latent mobility propensity, while a long-short migration sequence rather results from a process of housing adjustment.
Blood vessel extraction with optic disc removal in retinal images

Automatic extraction of retinal blood vessels is an important issue for the diagnosis and the treatment of different retinal disorders. Most of the retinal images are of low contrast due to non-uniform illumination during acquisition process. Therefore, vessel extraction from unevenly illuminated retinal background is really a challenging task. To extract the vessels which lie in the optic disc region, the removal of the optic disc is also important. This paper proposes an algorithm for automatic blood vessel extraction and optic disc removal on poorly illuminated retinal images using curvelet transform, morphological operation, matched filtering and fuzzy entropy maximization. Curvelet transform is used to extract the finest details along the vessels since it can represent the lines, the edges, the curvatures, the missing and the imprecise boundary details efficiently. To remove the optic disc, the curvelet based edge enhanced image is first opened by a disk shaped structuring element which is then subtracted from the inverted histogram equalized image. Matched filtering intensifies the blood vessels' response in the enhanced image. The multiple threshold values for the maximum matched filter response that maximize the fuzzy entropy are considered to be the optimal thresholds to extract the different types of vessel silhouettes from the background. Differential Evolution algorithm is used to obtain the optimal combination of the fuzzy parameters. Performance evaluated on publicly available DRIVE database demonstrate that the present work outperforms the existing works for various types of vessels extraction and optic disc removal even from poorly illuminated retinal images.
31P NMR saturation transfer study of the creatine kinase reaction in human skeletal muscle at rest and during exercise

The creatine kinase reaction has been studied by 31P NMR in exercising human calf muscle. Quantitative analysis of high energy phosphates and saturation transfer study of the creatine kinase flux in the direction of ATP synthesis (Vfor) were performed at rest and during exercise. As expected, exercise induced a [PCr] decrease (from 28.5 ± 0.9 to 21.9 ± 1.5 mM, P < 0.01) matched by a P1, increase (from 4.5 ± 0.2 to 8.9 ± 1.8 mM,P = 0.06). pHi and [ATP] remained unchanged. Vfor did not change from rest (12.4 ± 0.9 mM s−1) to moderate exercise and decreased at the highest exercise level (8.4 ± 1.4 mM s−1, P = 0.006). This observation differs from the prediction of the creatine kinase rate equation, showing an increase in the flux with exercise intensity. Computations suggest that this discrepancy arises from metabolite compartmentalization and/or from the reaction kinetics of a dead end complex stabilized by planar anions.
Candidemia in a Tertiary Care Cancer Center: In Vitro Susceptibility and its Association with Outcome of Initial Antifungal Therapy

Since the 1990s, changing trends have been documented in species distribution and susceptibility to bloodstream infections caused by Candida species in cancer patients. However, few data are available regarding the association between in vitro antifungal susceptibility and outcome of candidemia in this patient population. We therefore evaluated the association of in vitro antifungal susceptibility and other risk factors with failure of initial antifungal therapy in cancer patients with candidemia. Candidemia cases in cancer patients from 1998 to 2001 (n = 144) were analyzed retrospectively along with their in vitro susceptibility to amphotericin B, fluconazole, and itraconazole (National Committee for Clinical and Laboratory Standards M27-A method). Patients were evaluable for outcome analysis if they received continuous unchanged therapy with either fluconazole or amphotericin B for ≥5 days. We excluded cases of mixed candidemia. In vitro susceptibility testing data of the first Candida bloodstream isolate were analyzed. Appropriate therapy was defined as that using an active in vitro antifungal for ≥5 days. For fluconazole susceptible-dose dependent Candida species, we defined appropriate therapy as a fluconazole dose of ≥600 mg/day. The Candida species distribution was 30%Candida albicans, 24%Candida glabrata, 23%Candida parapsilosis, 10%Candida krusei, 9%Candida tropicalis, and 3% other. Overall, amphotericin B was the most active agent in vitro, with only 3% of the isolates exhibiting resistance to it (>1 mg/L). Dose-dependent susceptibility to fluconazole and itraconazole was seen in 13% and 21% of the isolates, respectively, while resistance to fluconazole and itraconazole was seen in 13% and 26%, respectively.Eighty patients were evaluable for outcome analysis. In multivariate analysis, the following factors emerged as independent predictors of failure of initial antifungal therapy: leukemia (p = 0.01), bone marrow transplantation (p = 0.006), and intensive care unit stay at onset of infection (p = 0.02). Inappropriate antifungal therapy, as defined by daily dose and in vitro susceptibility, was not shown consistently to be a significant factor (it was significant in multivariate analysis, p = 0.04, but not in univariate analysis), indicating the complexity of the variables that influence the response to antifungal treatment in cancer patients with candidemia.
Dobutamine Stress Echo Is Superior to Exercise Stress Testing in Achieving Target Heart Rate among Patients on Beta Blockers

Published guidelines recommend continuing β-adrenergic receptor blockade in patients undergoing stress testing. We evaluated the role of pharmacological versus exercise stress testing in achieving target heart rate (THR) among patients on β-adrenergic blockade. We compared data from 140 patients who underwent dobutamine stress echo (DSE) and 143 patients who underwent exercise treadmill testing (ETT). In both groups, β-adrenergic blocker was continued at the time of stress testing. Overall, patients undergoing DSE achieved THR more frequently than ETT. With β-adrenergic blockade, DSE patients met THR more frequently than ETT patients (p < 0.001). Without β-adrenergic blockade, there was no difference between either modality in achieving THR. In both DSE and ETT patients, absence of β-adrenergic blockade increased the odds of achieving THR [odds ratio (OR): 2.46, p = 0.042 and OR: 7.44, p < 0.001, respectively]. Atropine use with DSE increased the odds of achieving THR (OR: 3.76, p = 0.006). In conclusion, pharmacological stress testing appears to be superior to exercise stress testing in achieving THR among patients on β-adrenergic blockade.
Finance and Employment Formalization: Evidence from Mexico's ENIGH, 2000-2016

We study the relationship between financial constraints and employment formalization by exploiting heterogeneity in the industry-level degree of financial dependence, in the spirit of Rajan and Zingales (1998). This dependence, and variation in aggregate credit, lets us measure industry-level financial slack, and estimate its effects on employment formality. We find formality among young workers increases, which is consistent with a model of informal firms that grow and formalize with financial resources, thus becoming more productive. However, we find that financial slack, apparently, decreases formality among older, experienced workers, which is consistent with a model of capital-constrained formal employees that turn into entrepreneurs when financial conditions improve. Descriptive statistics on formality, as well as regression estimates conditioning by age and schooling provide a detailed map of the differential effects of finance on formality.
Austrian and mainstream economics : how do they differ?

In the account of Kay (2011, 2012), in the years following the 2008 crash, the reputation of economists and their science suffered and as a result was diminished due to the global economic crisis1. Economics was accused of being unable to predict the crisis and policy makers felt misguided by formal economic models, which Kay criticized heavily. During the prolonged recessions and stagnations both in the U.S. and in various European countries, policy makers were not given clear, consistent advice by economists. There was no consensus on what to do regarding the conduct of monetary and fiscal policy or how to reform broader economic institutions like the labor market (see Krugman 2009, Boaz 2009, Cochrane 2011 or Levine 2009). In the words of Krugman (2012, p. 108) “at the decisive moment, when what we really needed was clarity, economists presented a cacophony of views, undermining rather than reinforcing the case for action”. Baily (2009) suggests that there was no agreement either as to how far economic theory influenced the practice of policy making and, therefore, how much it can be blamed for the crisis. Nevertheless, this multifaceted lack of consensus seemed almost identical to that of the 1930s, which might give the impression that there has been no major progress in (macro) economics since then. As a matter of fact, Skidelsky (2010 [2009], p. 11) sees “economics as a fundamentally regressive discipline, its regressive nature disguised by increasingly sophisticated mathematics and statistics”. In that situation, one might be tempted to look more closely at what heterodox schools of economic thought, particularly those that do not use sophisticated mathematics and statistics, might offer to solve the problem, especially given the fact that according to “The Economist” (2011), “they have thrived on the back of massive disillusion with mainstream
International Debt Shifting: The Value-Maximizing Mix of Internal and External Debt

Abstract We study the capital structure of multinationals and expand previous theory by incorporating international debt tax shield effects from both internal and external capital markets. We show that: (i) multinationals’ firm value is maximized if both internal and external debt are used to save tax; (ii) the use of internal and external debt is independent of each other; and (iii) multinationals have a tax advantage over domestic firms, which cannot shift debt across international borders. We test our model using a large panel of German multinationals and find that internal and external debt shifting are of about equal importance.