Miracle-dz/UniFAR-FTUs huggingface dataset:
Physician Reimbursement in Medicare Advantage Compared With Traditional Medicare and Commercial Health Insurance

Importance Nearly one-third of Medicare beneficiaries are enrolled in a Medicare Advantage (MA) plan, yet little is known about the prices that MA plans pay for physician services. Medicare Advantage insurers typically also sell commercial plans, and the extent to which MA physician reimbursement reflects traditional Medicare (TM) rates vs negotiated commercial prices is unclear. Objective To compare prices paid for physician and other health care services in MA, traditional Medicare, and commercial plans. Design, Setting, and Participants Retrospective analysis of claims data evaluating MA prices paid to physicians and for laboratory services and durable medical equipment between 2007 and 2012 in 348 US core-based statistical areas. The study population included all MA and commercial enrollees with a large national health insurer operating in both markets, as well as a 20% sample of TM beneficiaries. Exposures Enrollment in an MA plan. Main Outcomes and Measures Mean reimbursement paid to physicians, laboratories, and durable medical equipment suppliers for MA and commercial enrollees relative to TM rates for 11 Healthcare Common Procedure Coding Systems (HCPCS) codes spanning 7 sites of care. Results The sample consisted of 144 million claims. Physician reimbursement in MA was more strongly tied to TM rates than commercial prices, although MA plans tended to pay physicians less than TM. For a mid-level office visit with an established patient (Current Procedural Terminology [CPT] code 99213), the mean MA price was 96.9% (95% CI, 96.7%-97.2%) of TM. Across the common physician services we evaluated, mean MA reimbursement ranged from 91.3% of TM for cataract removal in an ambulatory surgery center (CPT 66984; 95% CI, 90.7%-91.9%) to 102.3% of TM for complex evaluation and management of a patient in the emergency department (CPT 99285; 95% CI, 102.1%-102.6%). However, for laboratory services and durable medical equipment, where commercial prices are lower than TM rates, MA plans take advantage of these lower commercial prices, ranging from 67.4% for a walker (HCPCS code E0143; 95% CI, 66.3%-68.5%) to 75.8% for a complete blood cell count (CPT 85025; 95% CI, 75.0%-76.6%). Conclusions and Relevance Traditional Medicare’s administratively set rates act as a strong anchor for physician reimbursement in the MA market, although MA plans succeed in negotiating lower prices for other health care services for which TM overpays. Reforms that transition the Medicare program toward some premium support models could substantially affect how physicians and other clinicians are paid.
Steroid receptors and response of ovarian cancer to hormones in vitro

Summary. Oestrogen receptor (ER) and progesterone receptor (PR) content and the response in vitro to tamoxifen (T), medroxyprogesterone acetate (MPA) and to a combination of the two hormones were determined in 21 epithelial ovarian carcinomas. The response was assessed by the level of adenosinetriphosphate in the cells. ER and PR were detected in 62% and 57%, respectively, with significant variations between the different histopathological cancer types. ER and PR predicted the response in vitro in 62% of the tumours exposed to the combined hormones, and in 38% and 33% of those exposed to T and MPA, respectively. The value of steroid‐receptor determinations in selecting the proper hormonal treatment in ovarian cancer is significantly reduced because of the high proportion of incorrect predictions.
Etk/Bmx Tyrosine Kinase Activates Pak1 and Regulates Tumorigenicity of Breast Cancer Cells*

Etk/Bmx, a member of the Tec family of nonreceptor protein-tyrosine kinases, is characterized by an N-terminal pleckstrin homology domain and has been shown to be a downstream effector of phosphatidylinositol 3-kinase. P21-activated kinase 1 (Pak1), another well characterized effector of phosphatidylinositol 3-kinase, has been implicated in the progression of breast cancer cells. In this study, we characterized the role of Etk in mammary development and tumorigenesis and explored the functional interactions between Etk and Pak1. We report that Etk expression is developmentally regulated in the mammary gland. Using transient transfection, coimmunoprecipitation and glutathioneS-transferase-pull down assays, we showed that Etk directly associates with Pak1 via its N-terminal pleckstrin homology domain and also phosphorylates Pak1 on tyrosine residues. The expression of wild-type Etk in a non-invasive human breast cancer MCF-7 cells significantly increased proliferation and anchorage-independent growth of epithelial cancer cells. Conversely, expression of kinase-inactive mutant Etk-KQ suppressed the proliferation, anchorage-independent growth, and tumorigenicity of human breast cancer MDA-MB435 cells. These results indicate that Pak1 is a target of Etk and that Etk controls the proliferation as well as the anchorage-independent and tumorigenic growth of mammary epithelial cancer cells.
Seven-Year Follow-Up of Peritoneal Dialysis Patients in Taiwan

Background There are no Taiwanese publications and only a few Asian publications on the long-term outcome of peritoneal dialysis (PD) patients. The aim of this study was to evaluate the outcome of PD patients in Taiwan during a 7-year follow-up period. Patients and Methods This study enrolled 67 patients (23 males, mean age 46.2 ± 14.5 years) on maintenance PD. We administered the Short-Form questionnaire on 30 September 1998 and recorded major events and outcomes until 30 September 2005. We compared differences in initial parameters between groups categorized by PD patient survival and PD technique survival. Causes of mortality and transfer to hemodialysis were determined. PD patient and PD technique survival rates were measured and risk factors for patient mortality and PD technique failure were analyzed. Results Those in patient survival or PD technique survival groups had lower mean age (p < 0.001 and 0.018 respectively) and higher serum albumin level (p = 0.015 and 0.041 respectively) compared to those that died or failed PD. The 7-year patient survival rate was 77% and the PD technique survival rate was 58%. The independent predictors for PD technique failure included lower Mental Component Summary scores [hazard ratio (HR) = 0.85, p = 0.031] and diabetes mellitus (HR = 4.63, p < 0.001), whereas lower serum albumin level (HR = 0.22, p = 0.031), lower Physical Component Summary scores (HR = 0.67, p = 0.047), and presence of diabetes mellitus (HR = 5.123, p = 0.009) were the independent predictors for patient mortality. Conclusion For our PD patients, both patient and technique survival rates are good. Better glycemic control, adequate nutrition, and enhancement of health-related quality of life are all of potential prognostic benefit.
Web-Based Evidence Based Practice Educational Intervention to Improve EBP Competence among BSN-Prepared Pediatric Bedside Nurses: A Mixed Methods Pilot Study.

The purpose of this pilot study was to assess and refine a Web-based EBP educational intervention focused on improving EBP competence in BSN-prepared pediatric bedside nurses, and to examine its feasibility, acceptability, and usability. Using a two-group experimental embedded mixed methods design, a convenience sample of 29 BSN-prepared nurses was recruited from a pediatric hospital in the Southeastern United States. Participants were randomized into an intervention (n=14) or attention control group (n=15) and both received approximately 2 hours of educational content. The intervention group (IG) reviewed the Web-based EBP module and the attention control group (ACG) reviewed a Webbased module on Munchausen’s Syndrome by Proxy. Quantitative data were collected online from both groups using the Evidence-Based Practice Beliefs (EBPB) scale and the adapted Fresno test for Pediatric Nurses. Qualitative data were collected via telephone interview. Data were collected online utilizing SurveyMonkey © technology. Quantitative analyses were conducted using parametric and non-parametric statistics, and effect size calculations. Qualitative data were analyzed using methods described by Creswell and Plano Clark (2011). Demographic characteristics of the two groups were similar. A comparison of the IG and ACG post-intervention indicated there was not a statistically significant difference in the groups on EBP competence. However, the mean of the IG was higher and the effect size estimate of Hedges’ g was small to borderline medium in magnitude. EBPB scale scores post-intervention were statistically significantly different with the IG demonstrating statistically significantly more positive beliefs about EBP. The estimated effect size for this difference was borderline medium in magnitude. Participants’ interview data supported the intervention as being moderately feasible, acceptable, and usable for improving EBP competence in BSN-prepared pediatric nurses. This study provides preliminary data on Web-based methodologies that can be helpful in improving EBP beliefs and EBP competence among pediatric bedside nurses.
Key organizational commitment antecedents for nurses, paramedical professionals and non-clinical staff.

PURPOSE The purpose of this paper is to develop a causal model that explains the antecedents and mediating factors predicting the organizational commitment of healthcare employees in different work roles. DESIGN/METHODOLOGY/APPROACH This study tests an integrative causal model that consists of a number of direct and indirect relationships for antecedents of organizational commitment. It is proposed that the relationship between job satisfaction and organizational commitment is best understood by focusing on the three interrelated facets of job satisfaction, i.e. satisfaction with career advancement, satisfaction with supervisor, and satisfaction with co-workers. However, the model also advances that these job satisfaction facets have different mediating effects for other antecedents of organizational commitment. FINDINGS The Structural Equation Modeling (SEM) path analysis showed that the job satisfaction facets of career advancement and satisfaction with supervisor had a direct impact on organizational commitment. Employee empowerment, job-motivating potential, effective leadership, acceptance by co-workers, role ambiguity and role conflict were also important determinants of organizational commitment. Interestingly, post hoc analyses showed that satisfaction with co-workers only had an indirect impact on organizational commitment. ORIGINALITY/VALUE While there has been extensive research on organizational commitment and its antecedents in healthcare organizations, most previous studies have been limited either to a single employee group or to a single time frame. This study proposes a practical causal model of antecedents of organizational commitment that tests relationships across time and across different healthcare employee groups.
Anti‐influenza virus activity of crude extract of Ribes nigrum L.

This experiment was designed to detect the antiviral activities of crude fruit extracts of wild Ribes nigrum L. (Kurokarin extract) against influenza virus types A and B. Kurokarin extract was prepared as follows: fruits of Ribes nigrum L. were heated at 50 °C in a heating tank, and then ground under anaerobic conditions. The extracts were centrifuged, and the supernatant fluid was filtered and sterilized by infrared rays. The crude extract was diluted with Eagle's minimum essential medium (MEM) and the solution was adjusted to a pH 7.2 with 0.1 N or 1 N NaOH. Proven anti‐influenza virus effects of the extracts were shown. The concentration of extract required to inhibit the plaque formation of both IVA and IVB by 50% (IC50) was 3.2 μg/mL. Both IVA and IVB were directly inactivated up to 99% by 10 μg/mL of the extract at pH 2.8, and 95% to 98% by this dose at pH 7.2. The growth of IVA in cells treated with 10 and 100 μg/mL of the extract for 6 h after infection was completely suppressed. Virus titres in culture fluids of the cells treated with 100 μg/mL of Kurokarin extract for 1 h at 8 to 9 h after infection, were completely suppressed, indicating that the extract inhibited the virus release from the infected cells. Copyright © 2003 John Wiley & Sons, Ltd.
Action of tritiated thymidine on the clonal growth of mammalian cells.

S>The effect of intracellular incorporation of tritiated thymidine (H/ sip 3/TDR) on mammalian cell cytology and survival has been investigated by the single-cell plating technique. A survival curve of HeLa S3 cells grown in medium containing H/sub 3/TDR has been constructed which demonstrates the lethal action of the radioisotope. At concentrations of 0.1 f UO/sub 2/ c/ml or greater, very few cells survive and continue to divide to form macroscopic colonies in the plate cultures. The lethal action of H/sup 3/TDR has been shown to be a function of both the dose and the specific activity. The cytological appearance of the cells is changed as a result of exposure to H/sup 3/TDR. Giant cell formation, loosely packed cells, and abortive colonial growth all indicate a radiation effect. No reversal of the killing effect could be demonstrated when H/sup 3/TDR- treated cells were grown over nonmultiplying, x-irradiated feeder cells. (auth)
It is Possible to Increase Skeletal Muscle Fibre Number in utero

The administration of porcine somatotropin (pST) to pregnant sows during early gestation (day 10 to 24) induced the formation of significantly more muscle fibres in the semitendinosus muscle of the fetuses, representing a higher growth capacity of skeletal muscle. The pST-treatment during late pregnancy (day 80 to 94) accelerated the development of the fetus resulting in higher body weights and advanced stage of maturity at birth.
A Four‐Stage Method of Age at Death Estimation for Use in the Subadult Rib Cortex *,†

Abstract: Age estimation in the subadult skeleton can be rather precise when the epiphyses and dentition are present, but incomplete or commingled remains still present a challenge. Histomorphometric age‐at‐death estimation methods developed for use on adults are based on the age‐associated accumulation of osteons. In the growing skeleton, there is a poor correlation between osteon numbers and age until the latter half of the second decade. As a result, there has been no histological aging method for use in subadults. The analysis of the rib cortex of 72 subadults ranging in age from 2 to 21 years has identified a series of developmental changes in the bone microstructure that can be used to estimate age. This qualitative method utilizes the systematic changes in rib cortical morphology to classify ribs into one of four age phases. This method can be applied to immature skeletons in forensic, archaeological, and paleontological contexts.
Cultural perspectives on diabetes in an Appalachian population.

OBJECTIVE To gain an understanding of cultural and socioeconomic forces that shape beliefs about diabetes and its self-management. METHODS Thirteen focus groups were conducted in community settings in West Virginia using a semistructured interview guide. RESULTS Diabetes is perceived as a relatively new disease. Self-management behaviors reflect a mixture of cultural beliefs and limited resources. Moral overtones stigmatize diabetes. CONCLUSIONS Understanding patients' illness experiences from within their cultural framework is important for successful community programming regarding chronic disease management.
The treatment of diabetic foot ulcers with uncultured, processed lipoaspirate cells: A pilot study

Human processed lipoaspirate (PLA) cells are relatively easy to obtain in large quantities without cell culture. The purpose of this study was to present the possibility of using uncultured PLA cell autografts for the treatment of diabetic ulcers. An in vitro study was designed initially to determine the effect of PLA cell autografts on the proliferation and collagen synthesis of diabetic fibroblasts (n=4). In a subsequent clinical study, 26 patients with diabetic foot ulcers were treated using PLA cell autografts. Control treatment was also performed in 26 patients. Eight weeks after treatment, the percentages of complete healing and mean healing times were compared. Cell proliferation and collagen synthesis in the PLA cell treatment group were 28 and 44% higher than that in the control group in vitro, respectively. Our clinical study showed that 100% of the PLA cell‐treated group and 62% of the control group achieved complete healing. The PLA cell treatment was also superior to the conventional method in terms of the healing time. No adverse events related to the study treatment occurred. Uncultured PLA cell autografts stimulate the activity of diabetic fibroblasts and may offer a simple and effective treatment for diabetic ulcers.
Does Lamotrigine Influence Valproate Concentrations?

The aim of this study is to investigate the effect of lamotrigine (LTG) on valproate (VPA) concentrations dependent on LTG dose, LTG concentration, and additional enzyme-inducing antiepileptic drugs (AED) as well. For this purpose the following patient groups were compared: VPA monotherapy, VPA + one enzyme-inducing AED, VPA + LTG, and VPA + LTG + one enzyme-inducing AED. A total of 400 serum concentrations from 372 patients were evaluated. Two or more serum samples from the same patient were considered only if the comedication had been changed. For statistical evaluation, regression analytical methods and an analysis of variance were performed. For the analysis of variance, the VPA serum concentration in relation to VPA dose:body weight (level:dose ratio, LDR) was calculated and compared for different drug combinations. The analysis of variance revealed a significant effect of enzyme-inducing comedication (as expected) and age on the VPA LDR. Patients on LTG had a slightly lower VPA LDR, but this effect was not statistically significant. In addition, nonlinear regression analysis confirmed that patients on enzyme-inducing AED (carbamazepine, phenytoin, phenobarbital, methsuximide) had significantly lower VPA concentrations. Patients on ethosuximide had slightly but not significantly lower VPA concentrations. Patients on LTG also had significantly lower VPA levels, but this effect was only minor (−7%) and most probably not of any clinical relevance. Furthermore, the regression analysis showed that the relationship between the VPA dose per body weight and the serum concentration deviates significantly from linearity. Children less than 6 years old had lower VPA levels than older children and adults on a comparable VPA dose per body weight. Gender had no significant influence on VPA serum concentration. In addition, a subgroup of 40 patients was analyzed to see whether changing the LTG dose influences VPA serum concentrations. It did not. Thus, the authors conclude that the effect of LTG on VPA concentrations is not of clinical relevance.
The role of the graft endothelium in transplant rejection: Evidence that endothelial activation may serve as a clinical marker for the development of chronic rejection

Abstract: In this review, we discuss the role of the allograft endothelium in the recruitment and activation of leukocytes during acute and chronic rejection. We discuss associations among endothelial activation responses, the expression of adhesion molecules, chemokines and chemokine receptors, and rejection; and we propose that endothelial vascular cellular adhesion molecule‐1 (VCAM‐1) may be used as a surrogate marker of acute rejection and allograft vasculopathy. In addition, we describe potential mechanistic interpretations of persistent endothelial cell (EC) expression of major histocompatibility complex (MHC) class II molecules in allorecognition. The graft endothelium may provide an antigen‐specific signal to transmigrating, previously activated, T cells and may induce B7 expression on locally transmigrating leukocytes to promote costimulation. Taken together, these functions of the EC provide it with a potent regulatory role in rejection and in the maintenance of T‐cell activation via the direct and/or the indirect pathways of allorecognition.
Multiplicity of abnormal promoter methylation in lung adenocarcinomas from smokers and never smokers

The prevalence of methylation of the p16, DAPK and RASSF1A genes was investigated in lung adenocarcinoma from smokers, former uranium miners and never smokers. The association between a common genetic alteration in adenocarcinoma, mutation of the K‐ras gene and methylation of these genes, as well as survival was examined. Adenocarcinomas from 157 smokers, 46 never smokers and 34 former uranium miners were evaluated for methylation of the p16, DAPK and RASSF1A genes using the methylation‐specific PCR assay. Comparisons were also made to prevalences of methylation of the MGMT gene and mutation of the K‐ras gene previously examined in these tumors. The prevalence of methylation for all genes was similar between adenocarcinomas from smokers and never smokers, although the prevalence for methylation of the p16 gene tended to be higher in smokers compared to never smokers. A significantly higher prevalence for p16 methylation was seen in central vs. peripheral lung tumors. At least 1 gene was methylated in 35% of stage I tumors, whereas 2 and ≥3 genes were methylated in 40% and 16% of tumors, respectively. Methylation of all genes was independent of K‐ras mutation, whereas methylation of the DAPK and RASSF1A genes was positively associated. Environmental tobacco smoke, the strongest lung cancer risk factor among never smokers, induces adenocarcinoma in part through inactivation of the p16, DAPK and RASSF1A genes. Adenocarcinomas may develop through 2 distinct processes: multiple gene inactivations through promoter hypermethylation and activation of the K‐ras gene. © 2004 Wiley‐Liss, Inc.
Identification of a Putative Receptor for Porcine Reproductive and Respiratory Syndrome Virus on Porcine Alveolar Macrophages

ABSTRACT To identify the receptor which may determine the macrophage tropism of porcine reproductive and respiratory syndrome virus (PRRSV), monoclonal antibodies (MAbs) against porcine alveolar macrophages (PAM) were produced. Two MAbs (41D3 and 41D5) which completely blocked PRRSV infection of PAM were further characterized. It was found that they reduce the attachment of PRRSV to PAM and immunoprecipitate a 210-kDa membrane protein from PAM. This protein was detected on the cell membranes of PAM but not of PRRSV-nonpermissive cells. A colocalization was found between the reactive sites of MAb 41D3 and PRRSV on PAM membranes. All PRRSV-infected cells in tissues of experimentally infected pigs reacted with MAb 41D3. Taken together, all these data suggest that the identified 210-kDa membrane protein is a putative receptor for PRRSV on porcine macrophages.