Miracle-dz/UniFAR-FTUs huggingface dataset:
Improving hand hygiene adherence in an endoscopy unit

Background and study aims: Although hand hygiene is the most important measure in preventing infection transmission in healthcare settings, adherence to recommendations among healthcare workers is low. We implemented and assessed the impact of a World Health Organization-recommended educational intervention to improve hand hygiene adherence at the endoscopy unit of a Brazilian tertiary hospital. Patients and methods: Hand hygiene adherence and techniques used by healthcare workers of the endoscopy unit in the course of their duties were observed unobtrusively by four nurses from the infection control unit. Data were collected at every opportunity for hand hygiene. Evaluations were carried out before and 1 and 10 months after an educational intervention. The intervention consisted of task-orientated training sessions, with live demonstrations of the multitude of opportunities for hand hygiene and the appropriate techniques. In addition to assessing hand hygiene practices, we also evaluated staff knowledge through standardized questionnaires administered before and after the education intervention. Adherence was defined as hand hygiene/disinfection at an opportunity for hand hygiene. Results: Adherence improved from 21.4 % before the intervention to 63.3 % 1 month and 73.5 % 10 months after the educational intervention. Correct answers to the questionnaire were 82.1 % on pre-intervention test and 85.7 % on post-intervention test. Conclusion: Hand hygiene rates were low before the education intervention and improved significantly after it. Against expectations, adherence to hand hygiene practices had increased further at 10 months after the intervention, reinforcing the intervention’s positive impact.
Dualization and the access to occupational family‐friendly working‐time arrangements across Europe

This paper examines outsider’s relative access to occupational level family-friendly policies. I use data from the European Working Condition Survey of 2015 across 30 European countries examining worker’s access to two types of family-friendly working-time arrangements; flexitime, time off work for personal reasons. The paper focuses on women with care responsibilities given that their demands for family-friendly policies, as well as their outcomes have been shown to be distinct from other working population. In addition to the outsider definition used in the labour market dualization and occupational segmentation literature, i.e., low-skilled workers, those without a permanent contract, this paper also defines outsiders as those with job insecurity. The results of the analysis show a segmentation between workers in their access to family-friendly policies. Unlike statutory policies, occupational policies seem to be selectively provided mostly to workers where employers have a vested interest, i.e., insiders, resulting in a dualized system for most countries. However, rather than their contract status, the skill-level of the job/workers, and their perceived insecurity was found to be important. The results further shows that although Northern European and some continental European countries are those where family-friendly working-time arrangements are more readily available, it is here where the division between insiders and outsiders are the largest. The results of the paper contribute to the literature by showing a need to move beyond the national level when examining family-friendly policies, and to examine a more diverse definition of outsiders when examining dualization of working conditions.
Exploring Participatory Action Research as a Vehicle for Social Justice Training

Exploring Participatory Action Research as a Vehicle for Social Justice Training Susan E. Mao The field of counseling psychology has demonstrated a longstanding history to multiculturalism and social justice, which is reflected in the field’s professional standards of competence. Goodman et al. (2004) derived a set of social justice principles from feminist and multicultural counseling theories, which have served to guide counseling psychologists in social justice work. These six tenets include: ongoing self-examination, sharing power, giving voice, facilitating consciousness raising, building on strengths, and leaving clients with the tools to work toward social change. Graduate training has been identified as one essential component in the development of training social-justice oriented and competent counseling psychologists. Training programs have made attempts to address the training needs of the field of counseling psychology and its commitment to the development of social justice competencies in a variety of ways; however, there is lack of understanding regarding the efficacy of these approaches as well as an identified need for increased experiential training. Participatory Action Research (PAR) is an approach to research that has demonstrated potential as a tool for social justice training with its emphasis on collective participation, collaboration, empowerment, and positive social change. As such, the purpose of this study was to explore counseling psychology trainees’ experiences with PAR and the impact of these experiences on the development of social justice competencies. Data was collected through 12 semi-structured interviews with current and recently graduated doctoraland masters-level trainees in the field of counseling psychology. Participant narratives were transcribed and then analyzed using Consensual Qualitative Research (CQR). Results illustrated participants’ understanding of social justice and PAR, descriptions of PAR projects, personal reasons for engaging in PAR as well as expectations and challenging experiences related to PAR. Participants also discussed the impact of PAR on clinical training and professional practice, specifically related to the development of social justice competencies and the development of their own self-awareness and multicultural identity development. Personal meaning and value of PAR experiences for participants as well community members engaged in PAR are also presented. Implications of the findings, limitations, and suggestions for future research are discussed.
Digital control of synchronous buck converter with multi-mode for wide load range

This paper proposes digital frequency modulation control scheme of synchronous buck converter with boundary conduction mode and digital control strategy for high efficiency over wide load range. Synchronous converter, which can reduce conduction loss through diode, is preferred in high current application. However, this is inefficient at light load condition. Therefore, to achieve the high efficiency over wide range, multi-mode strategy is proposed using digital control. Modes are classified four types, from continuous conduction mode to boundary conduction mode, discontinuous conduction mode and pulse skipping mode as load decreases. The proposed method is implemented by TI's TMS320F28335 DSP chip. For the experimental verification, a 100W synchronous buck converter with 38V input and 20V/5A output is implemented.
Annuity Markets and Capital Accumulation

Abstract We examine how the absence of annuities in financial markets affects capital accumulation in a two-period overlapping generations model. Our findings indicate that the effect on capital is ambiguous in general equilibrium, because there are two competing mechanisms at work. On the one hand, the absence of annuities increases the price of old-age consumption relative to the price of early-life consumption. This induces a substitution effect that reduces saving and capital, and an income effect that has the opposite effect as households want to consume less when young, causing them to save more. On the other hand, accidental bequests originate from the assets of the deceased under missing annuity markets. The bequest received in early life always has a positive income effect on saving, but the bequest received in old age, conditional on survival, is effectively a partial annuity with both substitution and income effects. We find that when the desire to smooth consumption is high, the income effects dominate, so the capital stock always increases when annuity markets are missing. However, when the desire to smooth consumption is low, the substitution effects dominate, and the capital stock decreases with missing annuity markets.
Generation and Properties of Measles Virus Mutations Typically Associated with Subacute Sclerosing Panencephalitis a

Subacute sclerosing panencephalitis (SSPE), a very rare but lethal disease caused by measles viruses (MV) persisting in the human central nervous system (CNS) is characterized by lack of viral budding, reduced expression of the viral envelope proteins and spread of MV genomes through the CNS despite massive immune responses. The five major MV genes from several SSPE cases were cloned and sequenced, the two transmembrane envelope glycoproteins hemagglutinin (H) and fusion protein (F) were expressed and their maturation, cellular localization and functionality analyzed. We conclude that 1) mutations in the MV genes arise not only individually, by errors of the MV polymerase, but also in clusters as hypermutations, presumably due to RNA unwinding/modifying activity altering accidentally formed double-stranded RNA regions, 2) MVs spread in SSPE brains after clonal selection, 3) the MV matrix (M) gene is most heavily mutated and dispensable, 4) the two genes encoding envelope transmembrane proteins give rise to functional but altered proteins (typically F is heavily altered in its cytoplasmic domain), 5) H protein is transported poorly to the cell surface, 6) F and H proteins maintain tightly interdepending fusion functions, presumably to allow local cell fusion and MV ribonucleoprotein (RNP) spread through the CNS.
Leptin and leptin-binding activity in women with recurrent miscarriage: correlation with pregnancy outcome.

BACKGROUND Previous studies in humans and mice have suggested the importance of leptin in fetal growth. Recurrent miscarriage may be a result of abnormal placental and/or fetal development and therefore abnormal leptin levels may be associated with this form of pregnancy loss. METHODS Leptin and leptin-binding activity (LBA) were measured in blood obtained from women who had a history of recurrent miscarriage (n = 53) during weeks 5-6 and 7-8 of pregnancy, and the concentrations were correlated with subsequent pregnancy outcome. RESULTS Concentrations of leptin ranged from 1.4-62.8 ng/ml, but there was a strong correlation (r = 0.825, P < 0.001) between leptin values at weeks 5-6 and 7-8 in the same woman. Women who subsequently miscarried had significantly lower plasma leptin concentrations on both weeks 5-6 (13.34 +/- 2.1 ng/ml) (P < 0.05) and 7-8 (13.71 +/- 2.4 ng/ml) (P < 0.01) of pregnancy, than women who subsequently had a term birth (22.04 +/- 2.43 ng/ml week 5-6, 24.76 +/- 3.66 ng/ml week 7-8). LBA values ranged from 1-8.5% but there was no significant difference in LBA in blood obtained from women who subsequently miscarried or had a live birth. CONCLUSIONS The significantly lower concentrations of leptin in women who subsequently miscarried suggest that leptin may play a role in preventing miscarriage. However, as there was a considerable overlap between the values of leptin in women who subsequently miscarried, and those that had a live birth, these measurements are of limited use in the prediction of pregnancy outcome in these women.
Initial experience with an implantable hemodynamic monitor.

BACKGROUND Measurement of intracardiac hemodynamic parameters has been limited to brief periods in the acute care setting. We developed and evaluated an implantable hemodynamic monitor that is capable of measuring chronic right ventricular oxygen saturation and pulmonary artery pressure. METHODS AND RESULTS The device consists of an electronic controller placed subcutaneously and two transvenous leads placed in the right ventricle (reflectance oximeter) and pulmonary artery (variable capacitance pressure sensor). Implantation was performed in 10 patients with severe left ventricular dysfunction. Average implant pulmonary artery pressures were systolic, 52 +/- 16 mm Hg; diastolic, 29 +/- 11 mm Hg; and mean, 40 +/- 12 mm Hg. The mean right ventricular oxygen saturation at implant was 51%. Provocative maneuvers, including postural changes, sublingual nitroglycerin, and bicycle exercise, demonstrated expected changes in measured oxygen saturation and pulmonary artery pressures over time. At follow-up of 0.5 to 15.5 months, there were no significant differences between pulmonary artery pressures or oxygen saturation values transmitted from the device and simultaneous measurement with balloon flotation catheters. Four of the pulmonary artery leads dislodged and three demonstrated sensor drift, whereas two of the oxygen saturation sensors failed. Four patients died and four received transplants. Pathological study did not demonstrate injury to the right ventricular outflow tract or pulmonic valve. CONCLUSIONS Chronic measurement of hemodynamic parameters in the outpatient setting with implantable sensor technology appears to be feasible. The devices are well tolerated without significant untoward effects, and the sensors generally function well over time, providing reliable information. Clinical usefulness remains to be established.
Porcupine-dependent wnt activity within the uterine epithelium is essential for fertility

Abstract The secretion of mammalian Wnt ligands within the cell is dependent on the activity of Porcupine, a gene located on the X-chromosome that encodes for a membrane-bound O-acyl transferase. Here, we report that postnatal ablation of Porcupine in the uterine luminal epithelium alone results in the decrease in endometrial gland number. Despite having uterine glands, mutant females are completely infertile. Epithelial ablation of Porcupine causes defects in timely apposition of the lumen, along with failure to respond to artificial decidual induction. Interestingly, progesterone supplementation was able to rescue the initiation of decidualization, but the decidua was not maintained and subsequently resorbed. Transcriptome analysis demonstrated that deletion of Porcupine in the epithelium resulted in the stromal dysregulation of members of the Wnt signaling pathway (Lef1, Wnt4, and Wnt16), dysregulation of receptors and ligands in the Notch signaling pathway (Notch1, Notch4, and Dll4) as well as Hoxa10. Our results demonstrate the crucial requirement of Wnt signaling in the epithelium for fertility and demonstrate that epithelial Wnts regulate stromal Wnt gene expression as well as regulating the expression of essential signaling factors and effectors required for successful embryo implantation. Summary Sentence Epithelial Porcupine is important for pregnancy.
Parenteral Plant Sterols and Intestinal Failure–associated Liver Disease in Neonates

Objectives: We prospectively evaluated incidence of prolonged (>28 days) parenteral nutrition (PN), associated complications, and significance of parenteral plant sterols (PS) in neonatal intestinal failure–associated liver disease (IFALD) compared with children. Methods: We recruited 28 neonates (mean age 50 days, range 28–126) and 11 children (6.9 y, 2.1–16.6) in all of Finland. Patients underwent repeated measurements of serum cholesterol, noncholesterol sterols, including PS, cholestanol and cholesterol precursors, and liver biochemistry during and 1 month after discontinuation of PN. Healthy matched neonates (n = 10) and children (n = 22) served as controls. Results: IFALD occurred more frequently among neonates (63%) than children (27%; P < 0.05). Ratios of serum PS, including stigmasterol, sitosterol, avenasterol, and campesterol, and total PS were increased among neonates compared with healthy controls and children on PN by 2- to 22- and 2- to 5-fold (P < 0.005), respectively. Neonates with IFALD had significantly higher ratios of serum PS and cholestanol compared with neonates without IFALD (P < 0.05). Total duration of PN associated with serum cholestanol, stigmasterol, avenasterol, alanine aminotransferase, and aspartate aminotransferase (r = 0.472–0.636, P < 0.05). Cholestanol and individual serum PS, excluding campesterol, reflected direct bilirubin (r = 0.529–0.688, P < 0.05). IFALD persisted after discontinuation of PN in 25% of neonates with 4.2- and 2.2-times higher ratios of serum stigmasterol and cholestanol compared with neonates without IFALD (P < 0.05). Conclusions: Frequent occurrence of IFALD among neonates on PN displays an association to duration of PN and markedly increased serum PS, especially stigmasterol, in comparison to healthy neonates and children on PN. Striking accumulation of parenteral PS may contribute to IFALD among neonates.
Limb lengthening combined with deformity correction in children with the Taylor Spatial Frame

It is difficult to replicate the regular rate and rhythm described by Ilizarov while lengthening with the Taylor Spatial Frame. The purpose of the study was to examine whether this breach of Ilizarov's principles has any deleterious effect on the ability of children to make healthy regenerate bone. A retrospective case–control study was performed comparing pediatric patients undergoing primarily lengthening with Taylor Spatial Frame rings and struts, and patients undergoing lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Fifteen patients had primarily lengthening with Taylor Spatial Frame rings and struts, and six patients had lengthening with Taylor Spatial Frame rings and Ilizarov clickers. Statistically, there was no significant difference between the two groups in terms of age, latency, pre-operative bone length percentage, and average length gained. The lengthening index for the strut group (1.79 months/cm) was significantly different from the clicker group (1.33 months/cm) with P=0.012. For a pediatric patient with lower extremity long bone deformities in multiple planes, the Taylor Spatial Frame is an excellent option. However, the surgeon should anticipate a slightly longer duration of treatment with the Taylor Spatial Frame compared to Ilizarov frames and plan his/her fixation accordingly. For the straightforward lengthening of pediatric long bones without significant concomitant deformity, our results indicate that the Ilizarov method appears to be superior to the Taylor Spatial Frame struts and should still be considered the gold standard.
Characterization of picosecond pulse propagation in a microstrip line divider

Many extremely broad bandwidth circuit components have to be newly developed for practical applications of ultrashort electrical pulses. Theoretical and experimental investigations of the transmission properties of picosecond pulses through a microstrip line divider are reported. Full-wave analysis results in the frequency domain are incorporated into a Fourier transform algorithm for computer simulations of pulse propagation through a 3-dB microstrip line divider with a curved-line branching circuit pattern. Excellent agreement has been found between the theoretical predictions and the results of experimental measurements. <<ETX>>
Role of Public Expenditure in Economic Growth: Econometric Evidence from Kosovo 2002–2015

Abstract The aim of the study is to examine the impact of public expenditure on economic growth of Kosovo. Time series data span for the period of time 2002-2015. The structure of the econometric model is built on Keynesian theories and endogenous growth model. The model estimation is performed only after implementing the Augmented Dickey-Fuller (ADF) Unit Root test to estimate if time series are stationary. Several tests have been implemented to determine model validity. The model has met all the assumptions of statistical tests: error term residuals have a normal distribution (Jarque-Bera test), there is no auto-correlation between variables (Breusch-Godfrey Serial test), and error variances are constant, known as the principle of homoscedasticity (Breusch-Pagan-Godfrey test). Gross domestic product is used as a dependent variable in the model, while public expenditure (G), foreign direct investment (FDI), export (EXP) and total budget revenue (TrTax) are used as the endogenous variables. The study results have revealed that there is a positive and statistically significant effect of public expenditures and exports on economic growth. Total budget revenue has a positive impact on economic growth but this has not been proved to be statistically significant. The authors of the research have also found out that FDI is negative and statistically insignificant.
Post‐crisis reforms in banking: Regulators at the interface between domestic and international governance

Post-crisis international standards have been agreed on in certain areas of banking regulation, namely capital, liquidity, and resolution, but not others, namely bank structure – why? We articulate a two-step analytical framework that links the domestic and international levels of governance. In particular, we focus on the role of domestic regulators at the interface between the two levels. At the domestic level, regulators evaluate externalities and adjustment costs before engaging in cooperation at the international level. This analysis explains why regulators in the United States and the European Union act as pacesetters, foot-draggers, or fence-sitters in international standard setting; that is to say, why they promote, resist, or are neutral toward international financial standards. At the international level, we explain the outcome of international standard setting by considering the interaction of pacesetters and foot-draggers.
Comparative serum bactericidal activities of ceftizoxime and cefotaxime against intermediately penicillin-resistant Streptococcus pneumoniae

In a randomized crossover study involving 12 healthy volunteers, 1 g of ceftizoxime or cefotaxime was administered intravenously every 12 h for a total of three doses on two separate weekends. The duration of serum bactericidal titers (SBTs) greater than 1:2 and the time serum drug concentrations remained above the MIC (T > MIC) were determined against three clinical isolates of Streptococcus pneumoniae with intermediate resistance to penicillin. The duration of SBTs and T > MIC for both antimicrobial agents exceeded 50% of the dosing interval for all isolates. Ceftizoxime's T > MIC was statistically greater than that of cefotaxime, indicating that its longer half-life in serum (1.7 h) compared with that of cefotaxime (approximately 1 h) compensates for its slightly lower microbiologic activity against the penicillin-resistant pneumococci tested in this study.