Miracle-dz/UniFAR-FTUs huggingface dataset:
Quasi-experimental Evidence of Physician Effects

Variation in health care utilization is large and exists both across geographic regions and across doctors in the same region. However, the literature is only just beginning to understand the drivers of such variation. Are doctors prescribing different care for the same types of patients or are patients different in ways unobservable to researchers? This paper estimates the share of variation in physician practice intensity that is due to doctor differences as opposed to patient differences. The quasi-experiment leverages changes in the referral network of primary care physicians resulting from specialist migrations and exits. Using Medicare claims data, I estimate that between 50% and 70% of variation is driven by doctor styles. I replicate the baseline results using an instrumental variables strategy, suggesting that identification is robust to the most-likely endogeneity threats. Higher or lower health care usage is not correlated with mortality or hospitalization rates, but higher initial utilization does lead to greater subsequent utilization. In contrast to past studies, I estimate the treatment effect of doctors, rather than the treatment effect of geographic regions. Since doctors are the key decision-makers in health care provision and since variation across doctors vastly exceeds variation across regions, understanding the causal effect of doctors is vital for understanding the sources of variation and for designing policies to reduce that variation. JEL Codes: H51, I1, I11 †Email: petertu@fas.harvard. edu. Department of Economics. Harvard University. I am indebted to the invaluable encouragement, support, and guidance of Nathan Hendren, David Cutler, and Anupam Jena. I also thank Jay Bhattacharya, Edward Glaeser, Brian Chen, David Choi, John Coglianese, Siddharth George, Heather Sarsons, Alex Segura, Nihar Shah, Chenzi Xu, and seminar participants at Harvard’s Public/Labor lunch and Health Economics seminar for their helpful questions and suggestions. 1http://scholar.harvard. edu/petertu
Reliability and Construct Validity of Knowledge, Attitude and Practice on Dengue Fever Prevention Questionnaire

Dengue fever is not just a disease but it is a worldwide phenomenon. Knowledge on dengue prevention is helpful to save life but a practice of knowledge among people to stop dengue fever is a lively issue among scholars. These viruses usually transmitted by Aedes aegypti and Aedes albopictus. The aim of this study was to assess the reliability and construct validity of Knowledge, attitude and practice of dengue fever prevention in Malaysia, especially in Perak state. A cross-sectional study and designed to validate the Knowledge, Attitude and Practice on dengue fever questionnaire in Perak Tengah District, Perak. Forty three items of the knowledge, attitude and practice questionnaire were designed based on the literature and expert opinions. The items on the questionnaire developed for this study were divided into four main sections which are demographic, knowledge, attitude and practice. Reliability was determined using Cronbach’s alpha for internal consistency where the construct validity was assessed using exploratory factor analysis using principal component with varimax rotation. The results indicate that the Cronbach’s alpha coefficients showed acceptable and satisfactory internal consistencies. Cronbach’s alpha coefficients for knowledge and practice were 0.968 and 0.790, respectively and therefore confirming the adequacy of the internal consistencies of these scales. However, the internal consistency for attitude scale was the lowest of the three domains (cronbach’s alpha = 0.638). The results of the validation study suggested that the KAP scales on dengue fever prevention are valid and reliable for assessing knowledge, attitude and practice in Malaysia especially in Perak state.
How Banks in China make Lending Decisions

Based on interviews conducted in four major Chinese cities, this paper examines the determinants of lending by state-owned commercial banks (SOCBs) to manufacturing firms in China. The conventional relationship banking and transaction lending theories helps explain at least part of the lender–borrower relationship in China. The perceived lending bias against non-state-owned enterprises could actually be reconciled as rational decision-making by SOCBs, partly due to the higher risk involved and/or high transaction costs in the risk evaluation of such lending. The existence of unofficial lending criteria at SOCBs nonetheless provides golden rent-seeking opportunities for unscrupulous bankers to exploit the regulatory loopholes for financial gain.
Wikis to facilitate patient participation in developing information leaflets: first experiences

Objective: Although patients have gained a wealth of experienced based knowledge they are usually not involved in the development of patient information. We sought to determine the technical feasibility of wikis in generating dynamic patient information leaflets with participation from patients and healthcare professionals and identified barriers and facilitators for wiki use. Methods: An open wiki for patients receiving intrauterine inseminations and a closed wiki for patients receiving in vitro fertilization at one Dutch university clinic were used. Feasibility was assessed by analyzing logging data, content and users’ experiences and expectations. The latter were addressed by means of semi-structured interviews, which were also used to identify barriers and facilitators to wiki use. Results: Both patients and professionals worked on the information simultaneously, not hindered by time or location restrictions. The open IUI wiki was visited by 2957 and the closed IVF wiki by 424 users. About 28 barriers and 14 facilitators for using the wiki were identified. Conclusion: Wikis are promising tools to improve patient participation in the creation of patient information. Future projects should aim to increase active use of wikis by testing interventions based on the wide spectrum of barriers and should evaluate the quality of the content produced.
BENIGN RECURRENT HEMATURIA.

RECURRENT hematuria in the pediatric age group presents a problem with varying prognostic implications. Although recurrent hematuria in the pediatric patient is usually a manifestation of diseases that carry serious prognoses, we have encountered a group of patients in whom this symptom has a benign course and was not apparently associated with any of the known pathogenic etiologies. Gross hematuria may recur during the recovery period following acute glomerulonephritis of group A streptococcal etiology. Recurrent hematuria in this disease may be precipitated by streptococcal as well as nonstreptococcal upper respiratory infections.1 Such recurrences are limited in number and occur within a few months after the initial attack of acute glomerulonephritis. The good prognosis associated with group A streptococcal acute glomerulonephritis is not necessarily altered by these recurrences. However, the persistence of hematuria over a prolonged period of time should raise the possibility that one is dealing with acute exacerbations of
Effectiveness of two insecticides in controlling Ixodes dammini (Acari: Ixodidae) following an outbreak of Lyme disease in New Jersey.

Ixodes dammini Spielman, Clifford, Piesman & Corwin populations and rates of infection in these ticks by Borrelia burgdorferi (Johnson et al. 1984) at a military training facility in New Jersey were shown to be similar to those of other areas endemic for Lyme disease, following an outbreak in a U.S. Army Reserve Unit. Ground applications of carbaryl and diazinon directed against I. dammini adults reduced populations by 97.1 and 100%, respectively. Control persisted through the following spring. Reintroduction of subadult I. dammini into treated areas by animal hosts may necessitate repeated applications to large areas. Thus, usefulness of chemical control may be limited to areas where exposure to infected ticks is routine and avoidance is impractical.
Erythromycin is more effective than metoclopramide in the treatment of feed intolerance in critical illness*

Objective:This study aimed to a) compare the efficacy of metoclopramide and erythromycin in the treatment of feed intolerance in critical illness; and b) determine the effectiveness of “rescue” combination therapy in patients who fail monotherapy. Design:Randomized controlled trial. Setting:Level III mixed medical and surgical intensive care unit. Patients:Ninety mechanically ventilated, medical patients with feed-intolerance (gastric residual volume ≥250 mL). Interventions:Patients received either metoclopramide 10 mg intravenously four times daily (n = 45) or erythromycin 200 mg intravenously twice a day (n = 45) in a double-blind, randomized fashion. After the first dose, nasogastric feeding was commenced and 6-hourly nasogastric aspirates were performed. If a gastric residual volume ≥250 mL recurred on treatment, open-label, combination therapy was given. Patients were studied for 7 days. Successful feeding was defined as 6-hourly gastric residual volume <250 mL with a feeding rate ≥40 mL/hr. Measurements and Main Results:Demographic data, blood glucose levels, and use of inotropes, opioids, and benzodiazepines were similar between the two groups. After 24 hrs of treatment, both monotherapies reduced the mean gastric residual volume (metoclopramide, 830 ± 32 mL to 435 ± 30 mL, p < .0001; erythromycin, 798 ± 33 mL to 201 ± 19 mL, p < .0001) and improved the proportion of patients with successful feeding (metoclopramide = 62% and erythromycin = 87%). Treatment with erythromycin was more effective than metoclopramide, but the effectiveness of both treatments declined rapidly over time. In patients who failed monotherapy, rescue combination therapy was highly effective (day 1 = 92%) and maintained its effectiveness for the study duration (day 6 = 67%). High pretreatment gastric residual volume was associated with poor response to prokinetic therapy. Conclusions:In critical illness, erythromycin is more effective than metoclopramide in treating feed intolerance, but the rapid decline in effectiveness renders both treatments suboptimal. Rescue combination therapy is highly effective, and further study is required to examine its role as the first-line therapy.
Type of Inflammation Differentially Affects Expression of Interleukin 1β and 6, Tumor Necrosis Factor-α and Toll-Like Receptors in Subclinical Endometritis in Mares

Mares that fail to conceive or lose their embryos, without showing typical signs of clinical endometritis, should be suspected of subclinical endometritis (SE). In this study, the question was addressed: does SE fully activate selected mechanisms of innate immunity in mares? For this aim, expression of mRNAs for Toll-like Receptor 2 and 4 (TLR 2/4), interleukin 1β (IL-1β), interleukin 6 (IL-6) and tumor necrosis factor α (TNF) was examined in control mares versus either mares suffering from chronic endometritis (ChE) or subacute suppurative endometritis (SSE). The concentrations of IL-1β, IL-6 and TNF-α in supernatants from endometrial tissue cultures after 4 h incubation were measured using the enzyme immunoassay (EIA) method. Eighty-two warmblood mares, of known breeding history, were enrolled in this study. Based on histopathological assessment, mares were classified as suffering from ChE, SSE or as being healthy. In addition, immuno-localization of both TLR2 and TLR4 as well as TNF-α was investigated in the equine endometria. The mRNA expression of TLR2 (P < 0.01), IL-1β (P < 0.0001), IL-6 (P < 0.0001) and TLR4 and TNF (P < 0.05) was up-regulated in endometria of mares suffering from SSE compared with unaffected mares. Concentrations of IL-6 and TNF-α were increased only in mares exhibiting SSE, compared with unaffected (P < 0.01 for both) and ChE mares (P < 0.05 for both). Immuno-localization of TNF-α and TLRs was confirmed, both in unaffected and SE-affected endometria, and was present in the luminal and glandular epithelia and stromal cells. The severity of inflammation impacts the immune response and fosters activation of innate immunity mechanisms, as observed in the endometria of mares. The intracellular localization of TLRs and TNF-α in the endometria indicates a key role of endometrial epithelial and stromal cells in the immune response and inflammation.
Rat embryonic ectoderm as renal isograft.

Experimental results obtained many years ago revealed that during gastrulation (with the primitive streak and the mesoderm formation as distinct features) the early rodent embryo undergoes essential changes in its response to extrinsic teratogens (Russell & Russell, 1954; Wilson, 1954; Skreb, 1961; Skreb & Bijelic, 1962; Skreb & Frank, 1963). It has also been shown that the ultrastructural, histochemical and biosynthetic features of the embryo are subject to substantial changes during this period (Solter, Damjanov & Skreb, 1970, 1973; Dziadek & Adamson, 1978; Bode & Dziadek, 1979; Wartiovaara, Leivo & Vaheri, 1979; Jackson et al. 1981; Franke et al. 1982 a, b ). This suggests a restriction of developmental capacities (i.e. the loss of the capacity of regulation) in groups of embryonic cells at this developmental stage. According to the current concept, the initial cell population from which this restriction starts, resides within the embryonic ectoderm of the pregastrulation or preprimitive streak embryo (primitive or primary ectoderm).
Quantifying the Risk of Human Toxoplasma gondii Infection Due to Consumption of Domestically Produced Lamb in the United States.

UNLABELLED Toxoplasma gondii is a prevalent protozoan parasite worldwide. Human toxoplasmosis is responsible for considerable morbidity and mortality in the United States, and meat products have been identified as an important source of T. gondii infections in humans. The goal of this study was to develop a farm-to-table quantitative microbial risk assessment model to predict the public health burden in the United States associated with consumption of U.S. domestically produced lamb. T. gondii prevalence in market lambs was pooled from the 2011 National Animal Health Monitoring System survey, and the concentration of the infectious life stage (bradyzoites) was calculated in the developed model. A log-linear regression and an exponential doseresponse model were used to model the reduction of T. gondii during home cooking and to predict the probability of infection, respectively. The mean probability of infection per serving of lamb was estimated to be 1.5 cases per 100,000 servings, corresponding to ∼6,300 new infections per year in the U.S. POPULATION Based on the sensitivity analysis, we identified cooking as the most effective method to influence human health risk. This study provided a quantitative microbial risk assessment framework for T. gondii infection through consumption of lamb and quantified the infection risk and public health burden associated with lamb consumption.
Very low doses of direct intravenous iron in each session as maintenance therapy in hemodialysis patients

Abstract Background: Intravenous (IV) iron supplementation is widely used in hemodialysis (HD) patients to treat their periodic losses. However, the ideal dose and frequency is unknown. The goal of the study is to see if a 20 mg dose of iron IV at the end of each session of HD as iron maintenance is better than the iron prior therapy. We analyze the erythropoiesis activity (EA) and functional iron (FI) after four weeks of treatment. Methods: In 36 patients, we measure reticulocyte count and content of hemoglobin reticulocyte (CHr) as EA and FI markers, respectively, before and after the treatment. Before the study, 23 patients received another different therapy with IV iron as maintenance therapy. Results: Reticulocyte count: 49.7 ± 23.8 × 103 before and 47.2 ± 17.2 × 103 after the treatment (p= 0.51). The CHr: 34.8 ± 3.7 pg and 34.4 ± 3.5 pg, respectively, (p= 0.35), showing an excellent correlation with the other FI markers (serum iron r = 0.6; p = 0.001; saturation transferrin r = 0.49; p = 0.004); that is not shown with the serum ferritin (r = 0.23; p = 0.192) or the hepcidin levels (r = 0.22; p = 0.251). There was not a correlation between the C-Reactive Protein, reticulocyte count, and CHr. The 13 patients who did not receive the iron prior to the study showed high FI levels, but not an increased of the serum ferritin or the serum hepcidin levels. Conclusions: The administration of a small quantity of iron at the end of every HD session keeps the EA and the FI levels and allows reducing the iron overload administered and/or decreasing the iron stores markers in some patients.
Rational design of a humanized glucagon-like peptide-1 receptor agonist antibody.

Bovine antibody BLV1H12 possesses a unique "stalk-knob" architecture in its ultralong heavy chain CDR3, allowing substitutions of the "knob" domain with protein agonists to generate functional antibody chimeras. We have generated a humanized glucagon-like peptide-1 (GLP-1) receptor agonist antibody by first introducing a coiled-coil "stalk" into CDR3H of the antibody herceptin. Exendin-4 (Ex-4), a GLP-1 receptor agonist, was then fused to the engineered stalk with flexible linkers, and a Factor Xa cleavage site was inserted immediately in front of Ex-4 to allow release of the N-terminus of the fused peptide. The resulting clipped herceptin-Ex-4 fusion protein is more potent in vitro in activating GLP-1 receptors than the Ex-4 peptide. The clipped herceptin-Ex-4 has an extended plasma half-life of approximately four days and sustained control of blood glucose levels for more than a week in mice. This work provides a novel approach to the development of human or humanized agonist antibodies as therapeutics.
Peptic ulceration and ABO blood groups.

• The incidence of the four blood types O, A, B, and AB was studied in 1,301 patients with duodenal ulcer, 469 with gastric ulcer, and 69 patients with both gastric and duodenal ulcers. The three distributions so obtained were compared with the distribution found in a reference of 8,767 people without ulcers. Type O was more frequent among the ulcer patients than in the reference group, and calculations of probability showed that the association between type O and peptic ulcer was statistically significant. It was shown not to be secondary to any influences of sex, age, rhesus blood type, or occupation. Among a group of 529 patients who had histamine tests, however, the frequency of type O was significantly greater among those who reacted with an increase of free hydrochloric acid than among those in whom no increase of acid occurred.
Eribulin Mesylate in Pretreated Breast Cancer Patients: A Multicenter Retrospective Observational Study

Background: Eribulin was recently approved in patients progressing after being treated with anthracyclines and taxanes and after two or more chemotherapy lines for advanced disease. Objectives: This multicenter observational retrospective study was performed in order to evaluate activity and tolerability of eribulin in real-world patient population. Methods: 133 advanced breast cancer patients pretreated with ≥ 2 chemotherapy lines for metastatic disease were retrospectively enrolled in the observational trial in 11 italian cancer centres. Results: A median of 5 cycles of eribulin (range, 1-15) were administered. Twenty-eight partial responses were observed, for an overall response rate of 21.1% (95%CI,14.1-28.0). A stable disease was recorded in 57 patients (42.8%), and a clinical benefit (response or stable disease lasting ≥ six months) was observed in 51 patients (38.3%, 95%CI, 30.1-46.6). The subgroup analysis showed that a significant improvement in term of partial response and clinical benefit was achieved when eribulin was administered in HER-2 negative tumors (p=0.01 and p=0.004, respectively) and when it is given as third-line (p=0.09 and p=0.02, respectively). Toxicity was manageable; fatigue is the most common side effect observed, usually of low-grade, and clearly cumulative-dose related. Conclusions: In this retrospective, observational analysis eribulin confirmed its efficacy and manageable tolerability even in real-world population and in heavily pretreated patients.
Teenage smoking: A longitudinal analysis

This paper examines the binary recurrent outcome "teenage smoking" within a statistical modelling paradigm. The proposed statistical modelling relates smoking to a set of explanatory variables, which include subjective as well as objective measures. In order to assess the degree to which explanatory variables influence smoking, an adequate statistical model must handle the possibility that substantial variation between respondents will be due to omitted variables, multicollinearity and past behaviour. An earlier paper, using a secondary cross-sectional data source, concluded that an investigation of smoking needs to be based on longitudinal data using appropriate statistical modelling. The same data source provided observations on young adults over a period of 2 years. For comparison purposes, the same cross-sectional model was fitted to the longitudinal data. The results suggest there may be substantial heterogeneity due to omitted variables in the data and complex inter-relationships between observed explanatory variables leading to underestimation. Longitudinal data provide additional flexibility to control for omitted variables and are necessary to investigate dynamic social processes such as smoking. The results from our analysis suggest that the effects of variables reported in the literature on teenage smoking may be overestimated. For example, the role of peer pressure may not be as clear as it has been made out to be.
Comparison of Fusion Rates between Autologous Iliac Bone Graft and Calcium Sulfate with Laminectomy Bone Chips in Multilevel Posterolateral Spine Fusion

Multilevel lumbar fusion usually requires a large quantity of iliac crest bone graft but the supply is usually insufficient, so an alternative bone graft substitute for autograft is needed. This prospective study investigated the efficacy of calcium sulfate by comparing the fusion rates between the experimental material (calcium sulfate pellets with bone chips from laminectomy) and autologous iliac bone graft in long segment (three-or four-level) lumbar and lumbosacral posterolateral fusion. Forty-five patients with degenerative scoliosis or spondylolisthesis received multilevel spine fusion and decompression. The experimental material of calcium sulfate pellets with decompression bone chips was placed on the experimental side and the iliac crest bone graft was placed on the control side. The fusion status was assessed radiographically at three-month intervals, and solid fusion was defined as a clear continuous intertransverse bony bridge at all levels. The average follow-up period was 34.4 months. Twenty-nine (64.4%) patients showed solid fusion on the experimental side and 39 (86.7%) patients on the control side. The overall fusion rate was 86.7%. A statistically significant relation was found between the two sides with the Kappa coefficient of agreement of 0.436. Compared to the control side, the fusion rate of experimental side is significantly reduced (p = 0.014). The fusion ability of autograft is higher than the experimental material in multilevel lumbar posterolateral fusion. However, the overall fusion rate of calcium sulfate pellets is improved, compared with previously reported rates, which suggested that such material may be considered as an acceptable bone graft extender.