Miracle-dz/UniFAR-FTUs huggingface dataset:
The Value of Relationships in Healthcare

I establish the economic relevance of long-term relationships between patients and doctors. Relationships determine where patients demand care and are moderately important for patients’ health. After a primary care physician’s (PCP’s) departure, patients’ preference for relationships leads to a less efficient provision of primary care, increasing both public and private costs. The effect is driven by relationships growing over time and plausibly containing health-specific information. I also find that managing clinics as teams minimizes patients’ reliance on a specific relationship. When a PCP moves 50 miles away, 53% of patients follow, providing a lower bound on patients’ valuation of relationships. *Department of Economics, University of Notre Dame. E-mail: asabety@nd.edu. JEL codes: I11, J24, J26, J63. This work was supported in part by the National Science Foundation Graduate Research Fellowship Program (Grant No. DGE1144152), the Alfred P. Sloan Foundation Pre-Doctoral Fellowship on the Economics of an Aging Workforce award from the NBER, and a Thomas Parry Research Fellowship award from the Integrated Benefits Institute. This project was also supported by grant number U19HS024072 from the Agency for Healthcare Research and Quality. The content is solely the responsibility of the author and does not necessarily represent the official views of the Agency for Healthcare Research and Quality. I am grateful for the extensive support and guidance of my advisers: David Cutler, Claudia Goldin, and Timothy Layton. Marcella Alsan, Michael Barnett, Alex Bartik, Savannah Bergquist, Samantha Burn, David Card, Michael Chernew, Moya Chin, Edward Glaeser, Colin Gray, Jonathan Gruber, Nir Hak, Ryan Hill, Robert Huckman, Anupam Jena, Ariella Kahn-Lang Spitzer, Lawrence Katz, Victoria Marone, Thomas McGuire, Michael McWilliams, Hannah Neprash, Dev Patel, Jonathan Roth, Mark Shepard, Niharika Singh, Gabriel Unger, Scott Walker, Melanie Wasserman, and Annetta Zhou as well as numerous seminar and conference participants provided unrivaled support, advice, and suggestions.
From Ergodic to Region- and Site-Specific Probabilistic Seismic Hazard Assessment: Method Development and Application at European and Middle Eastern Sites

The increasing numbers of recordings at individual sites allows quantification of empirical linear site-response adjustment factors (δS2S s ) from the ground motion prediction equation (GMPE) residuals. The δS2S s are then used to linearly scale the ergodic GMPE predictions to obtain site-specific ground motion predictions in a partially non-ergodic Probabilistic Seismic Hazard Assessment (PSHA). To address key statistical and conceptual issues in the current practice, we introduce a novel empirical region- and site-specific PSHA methodology wherein, (1) site-to-site variability (φS2S) is first estimated as a random-variance in a mixed-effects GMPE regression, (2) δS2S s at new sites with strong motion are estimated using the a priori φS2S, and (3) the GMPE site-specific single-site aleatory variability σ ss,s is replaced with a generic site-corrected aleatory variability σ0. Comparison of region- and site-specific hazard curves from our method against the traditional ergodic estimates at 225 sites in Europe and Middle East shows an approximate 50% difference in predicted ground motions over a range of hazard levels—a strong motivation to increase seismological monitoring of critical facilities and enrich regional ground motion data sets.
Biological Variation in Peripheral Inflammation and Oxidative Stress Biomarkers in Individuals with Gaucher Disease

The lack of reliable biomarkers is a significant challenge impeding progress in orphan drug development. For appropriate interpretation of intervention-based results or for evaluating candidate biomarkers, other things being equal, lower variability in biomarker measurement would be helpful. However, variability in rare disease biomarkers is often poorly understood. Type 1 Gaucher disease (GD1) is one such rare lysosomal storage disorder. Oxidative stress and inflammation have been linked to the pathophysiology of GD1 and validated measures of these processes can provide predictive value for treatment success or disease progression. This study was undertaken to investigate and compare the extent of longitudinal biological variation over a three-month period for various blood-based oxidative stress and inflammation markers in participants with GD1 on stable standard-of-care therapy (N = 13), treatment-naïve participants with GD1 (N = 5), and in age- and gender-matched healthy volunteers (N = 18). We utilized Bland–Altman plots for visual comparison of the biological variability among the three measurements. We also report group-wise means and the percentage of coefficient of variation (%CV) for 15 biomarkers. Qualitatively, we show specific markers (IL-1Ra, IL-8, and MIP-1b) to be consistently altered in GD1, irrespective of therapy status, highlighting the need for adjunctive therapies that can target and modulate these biomarkers. This information can help guide the selection of candidate biomarkers for future intervention-based studies in GD1 patients.
Towards A Socioeconomic Model of Sleep Health among the Canadian Population: A Systematic Review of the Relationship between Age, Income, Employment, Education, Social Class, Socioeconomic Status and Sleep Disparities

A better understanding of the contribution of the socioeconomic status (SES) in sleep health could guide the development of population-based interventions aiming to reduce “the silent public health issue” that are sleep disturbances. PRISMA was employed to identify relevant studies having examined the association between social class, social capital, education, income/assets, occupation/employment status, neighborhood deprivation and sleep health. Sixteen cross-sectional and three longitudinal studies were selected, having sampled 226,029 participants aged from 2 months to 85 years old. Findings showed that: (1) sleep health disparities among children and adolescent are strongly correlated to parental socioeconomic indicators; (2) poor parental income, poor family SES and poor parental education are associated with higher sleep disturbances among children and adolescents; (3) lower education is a predictor of increased sleep disturbances for adults; (4) low SES is associated with high sleep disturbances in adults and old people and; (5) low income and full-time employment was significantly associated with short sleep among adults and old people. In conclusion, sleep health should be an important public health target. Such intervention would be beneficial for populational health, for all taxpayers and public administrations, which would see a reduction in absenteeism and productivity losses attributable to sleep-related health problems in the global economy.
Vegetation Dynamics under Rapid Urbanization in the Guangdong-Hong Kong-Macao Greater Bay Area Urban Agglomeration during the Past Two Decades

Detection of long-term vegetation dynamics is important for identifying vegetation improvement and degradation, especially for rapidly urbanizing regions with intensive land cover conversions. The Guangdong–Hong Kong–Macao Greater Bay Area (GBA) urban agglomeration has experienced rapid urbanization during the past decades with profound impacts on vegetation, so there is an urgent need to evaluate vegetation dynamics across land use/cover change (LUCC). Based on the normalized difference vegetation index (NDVI) during 2001–2020, we used coefficient of variation, Theil–Sen median trend analysis, and Hurst exponent to analyze the spatiotemporal change and future consistency of vegetation growth among the main LUCC in the GBA. Results demonstrated that low NDVI values with high fluctuations were mainly distributed in the central urban areas, whereas high NDVI values with low fluctuations were primarily located in the peripheral hilly mountains. The area-averaged NDVI showed an overall increasing trend at a rate of 0.0030 year−1, and areas with vegetation improvement (82.99%) were more than four times those with vegetation degradation (17.01%). The persistent forest and grassland and the regions converted from built-up to vegetation displayed the most obvious greening; NDVI in over 90% of these areas showed an increasing trend. In contrast, vegetation browning occurred in more than 60% of the regions converted from vegetation to built-up. Future vegetation change in most areas (91.37%) will continue the existing trends, and 80.06% of the GBA was predicted to develop in a benign direction, compared to 19.94% in a malignant direction. Our results contribute to in-depth understanding of vegetation dynamics during rapid urbanization in the GBA, which is crucial for vegetation conservation and land-use optimization.
Predictive Value of Nasal Nitric Oxide and Serum NOS2 Levels in the Efficacy of Subcutaneous Immunotherapy in Pediatric Patients with Allergic Rhinitis

Background Subcutaneous immunotherapy (SCIT) is an effective therapy for allergic rhinitis (AR), but some AR patients still do not benefit from it. Nasal nitric oxide (nNO) and inducible nitric oxide synthase (iNOS/NOS2) act important roles in AR. This study aims to explore the abilities of serum NOS2 and nNO in predicting the clinical efficacy of SCIT in AR patients. Methods We recruited 40 healthy controls (HCs) and 120 AR patients in this study. Serum NOS2 and nNO levels were compared between the two groups. In the AR group, patients underwent and finished 1-year of SCIT, and divided into the effective and ineffective groups, and the relationships between serum NOS2 and nNO levels and efficacy of SCIT were evaluated. Results The serum NOS2 and nNO levels were higher in AR patients than HCs. In the effective group, the serum NOS2 and nNO levels were increased than the ineffective group. ROC curves presented that a combination of serum NOS2 and nNO exhibited promising predictive ability in predicting the clinical efficacy of SCIT. Conclusions Serum NOS2 and nNO levels were enhanced in AR patients and might affect the efficacy of SCIT. The combined use of serum NOS2 and nNO levels could be a reliable and useful method for predicting the clinical efficacy of SCIT.
Vasoactive Effects of Chronic Treatment with Fructose and Slow-Releasing H2S Donor GYY-4137 in Spontaneously Hypertensive Rats: The Role of Nitroso and Sulfide Signalization

Increased fructose consumption induces metabolic-syndrome-like pathologies and modulates vasoactivity and the participation of nitric oxide (NO) and hydrogen sulfide (H2S). We investigated whether a slow-releasing H2S donor, GYY-4137, could exert beneficial activity in these conditions. We examined the effect of eight weeks of fructose intake on the blood pressure, biometric parameters, vasoactive responses, and NO and H2S pathways in fructose-fed spontaneously hypertensive rats with or without three weeks of GYY-4137 i.p. application. GYY-4137 reduced triacylglycerol levels and blood pressure, but not adiposity, and all were increased by fructose intake. Fructose intake generally enhanced endothelium-dependent vasorelaxation, decreased adrenergic contraction, and increased protein expression of interleukin-6 (IL-6), tumor necrosis factor alpha (TNFα), and concentration of conjugated dienes in the left ventricle (LV). Although GYY-4137 administration did not affect vasorelaxant responses, it restored disturbed contractility, LV oxidative damage and decreased protein expression of TNFα in fructose-fed rats. While the participation of endogenous H2S in vasoactive responses was not affected by fructose treatment, the expression of H2S-producing enzyme cystathionine β-synthase in the LV was increased, and the stimulation of the NO signaling pathway improved endothelial function in the mesenteric artery. On the other hand, chronic treatment with GYY-4137 increased the expression of H2S-producing enzyme cystathionine γ-lyase in the LV and stimulated the beneficial pro-relaxant and anti-contractile activity of endogenous H2S in thoracic aorta. Our results suggest that sulfide and nitroso signaling pathways could trigger compensatory vasoactive responses in hypertensive rats with metabolic disorder. A slow H2S-releasing donor could partially amend metabolic-related changes and trigger beneficial activity of endogenous H2S.
The cohomology of line bundles on Hopf manifolds

The purpose of the present paper is to give an elementary method for the computation of the cohomoloyg groups H(X, Ω(L)), (0<q<n) of an #-dimensional Hopf manifold X, (n>2), where Ω(L) denotes the sheaf of germs of holomorphic p-foτms with values in a holomorphic line bundle L on X. Ise [10] has given a solution of this problem for homogeneous Hopf manifolds. He makes strong use of the fact that any homogeneous Hopf manifold of dimension n is a fibre bundle over the complex projective space P. His main tools are knowledge of the cohomology groups Hq(Pn~1y Ω (L)) and the Leray spectral sequence. Our approach to Ise's problem is a generalization of a method used by Douady [4] to study the deformation of Hopf manifolds. We shall now describe the contents of this paper. Section 1 presents our method for the computation of the cohomology groups for flat line bundles and makes evident the dichotomy between Hopf manifolds of dimension n>2 and Hopf surfaces (n=2). Section 2 treats the case of Hopf manifolds of dimension n>2 and section 3 the case of Hopf surfaces. Generalizing a result of Kodaira [11] for Hopf surfaces we show in section 4 that all line bundles on an arbitrary Hopf manifold are flat. To this end we calculate first the Hodge numbers of these manifolds. The flatness of line bundles shows that the method introduced in section 1 applies to the general case. Applications to holomorphic vector bundles and foliations on Hopf manifolds will be published elsewhere. Acknowledgement: This paper is a part of the author's Ph.D. thesis [12] with Prof. A. Haefliger. My heartfelt thanks go to him for his help and encouragement.
Students’ experiences of using a writing-intense programme to facilitate critical thinking skills on an online clinical training platform: A pilot study

Background Coronavirus disease 2019 (COVID-19) and the subsequent lockdown altered traditional clinical training for speech language pathology students, thus forcing training institutions to implement innovative and responsive clinical training strategies in the midst of the pandemic. As such, a writing-intense programme was piloted in an online clinical training programme with second-year speech language pathology students. Objectives This study explored speech language pathology students’ experiences with a writing programme used during an online clinical training programme implemented during the COVID-19 pandemic. Method The study used a qualitative survey design. Purposive convenient sampling was used to recruit 29 second-year speech language pathology students. Online student reflections guided by 10 open-ended questions were used to elicit responses from students. Data were analysed using deductive thematic analysis. Results Findings revealed that the written component of the programme facilitated the acquisition of clinical knowledge and improved clinical processes of writing among students. Feedback that students received on their written tasks improved learning. The clinical component of the course enabled students to learn in a less stressful environment and helped them gain confidence in their knowledge and clinical skills. Connectivity challenges and the lack of motivation from some students negatively impacted the programme. Conclusion Using a writing programme to clinically train students can have positive effects in applying theory to clinical application because it affords students time to consolidate and process theory with practice as the jump from first year to second year can be cognitively taxing. A writing-intense programme can also improve students’ writing skills.
Prediction of Urinary Tract Infection in Neonates with Unexplained Indirect Hyperbilirubinemia

Background: Neonates with urinary tract infection (UTI) are susceptible to higher rates of morbidity and mortality, specifically when presented with hyperbilirubinemia. Screening for UTIs in jaundiced neonates is a cost-effective strategy. The aims of this study were to investigate the pattern of UTI (prevalence, etiology, and susceptible antimicrobial agents) in neonates admitted to the NICU with unexplained indirect hyperbilirubinemia, as well as to identify early predictors of UTI in order to reduce the present morbidity and long-term consequences in NICU patients. Methods: A cross-sectional hospital-based study that included 140 neonates diagnosed with unexplained indirect hyperbilirubinemia in the first 4 weeks of life. A questionnaire was applied to obtain demographic and clinical data. A number of laboratory parameters were assessed with clinical examination. Bacterial growth of 1 × 103 colony-forming units/mL of a single uropathogen was used to identify the existence of UTI. Multivariate analysis was used to identify the predicting factors of UTIs. Results: In the NICU group investigated, 25.7% of subjects had a culture-proved UTI. The most frequently isolated organism was Escherichia coli. Amikacin was the most common antibiotic that the isolates were susceptible to. In multivariable logistic regression analysis, a positive urine culture was statistically associated with an increase in WBCs (OR= 6.90, p= 0.001), pyuria (OR= 5.55, p= 0.001), small for gestational age (OR= 4.07, p= 0.021), prolonged phototherapy duration (OR= 3.50, p= 0.034), and the presence of obstetric complications (OR= 2.92, p= 0.001). Conclusion: UTI is substantially prevalent among neonates admitted to the NICU with unexplained indirect hyperbilirubinemia. The importance of routine UTI screening (urine culture) as part of the clinical assessment of unexplained hyperbilirubinemia was highlighted in this study, particularly in neonates with leukocytosis, pyuria, small for gestational age, prolonged phototherapy, and those born from mothers with a history of obstetric complications.
The Role of Nutrients and MCV on Stunting: A Case Study on Indonesian Early Teenagers

BACKGROUND: Many teenagers experience many nutritional problems, including anemia and stunting. The correlation between energy intake, protein, iron, and stunting with MCV levels in stunting adolescents in Jatinangor is not yet known. AIM: This study aims to analyze the correlation of energy intake, protein, iron, and stunting and MCV levels in stunting adolescents in Jatinangor. METHODS: This study was conducted with a cross-sectional design involving early adolescents aged 10-14 years in Jatinangor District as many as 41 people. Analysis of MCV levels was done by taking blood through veins. Stunting data were obtained based on WHO criteria with a value of z-score TB / U<- 2 SD and nutritional intake data including energy, protein, and iron obtained through 24-hour recall. To determine the intake of nutrients is done by interviewing with the method of 24 hours recall and FFQ. The data were analyzed with the Pearson Correlation Test. RESULTS: The correlation between energy intake and MCV levels was p=0.022 (r=0.356). Furthermore, the correlation of protein intake and MCV levels was p=0.257, and iron intake with MCV levels was p=0.301. Eventually, the stunting correlation test to MCV levels was p=0.006 (r=0.419). CONCLUSIONS: This study concludes that there is a correlation between energy intake and the value of the z-score TB / U index with MCV levels. There is no significant correlation between protein intake and iron intake with MCV levels in stunting adolescents in Jatinangor. There is a correlation between MCV and stunting levels, and there is no correlation between nutrient intake and stunting.
Identifying the dynamic characteristics of super tall buildings by multivariate empirical mode decomposition

In this study, multivariate empirical mode decomposition (MEMD) is used to evaluate the dynamic characteristics of super‐tall buildings. Two super‐tall buildings, including Milad Tower, which is located in Tehran, Iran, and Canton Tower, which is located in Guangzhou, China, are used as examples to estimate the capability of multivariate empirical mode decomposition for recognizing the dynamic characteristics of buildings. A method is suggested to extract the frequency of structures automatically. First, the best segment of required data, including acceleration response and wind speed is found, and then wavelet transform is used to eliminate the noise and find proper and wanted natural frequency. Finally, to investigate all signals, that is, acceleration responses of all channels simultaneously, MEMD is applied to identify the frequency of the filtered signals. The extracted frequencies are selected in the order of amplitude power of each mode for each intrinsic mode function (IMF). The obtained results are appropriate, corresponding to other studies. Hence, the proposed method can automatically select the accurate frequency of super‐tall buildings in less time duration by considering all required data simultaneously.
Saturated fluctuations in the laser radiation intensity in a turbulent medium

We develop an asymptotic theory of saturated fluctuations in the intensity of quasi-monochromatic radiation propagating over large distances in a turbulent medium with a power-law spectrum of refractive index fluctuations. We obtain an analytic expression for the correlation function of the intensity fluctuations for the case where the radiation starts out as a plane wave. We study the nature of the saturation of magnitude of the relative intensity fluctuations.
Association of Early Beta Human Chorionic Gonadotropin With Ischemic Placental Disease in Singleton Pregnancies After In Vitro Fertilization

Objectives: To evaluate whether an initial or two-day percent increase in serum beta-human chorionic gonadotropin (βhCG) is associated with ischemic placental disease (IPD) in singleton pregnancies after autologous or donor IVF. Study design: This was a secondary analysis of a retrospective cohort study of deliveries linked to IVF cycles at a single academic tertiary hospital and infertility treatment center. We included all patients (≥18 years old) who had a singleton live birth or intrauterine fetal demise (IUFD) resulting from either autologous fresh (n=1,347), autologous frozen (n=454), or donor (n=253) IVF cycles. Main outcome reassures: The primary outcome was a composite outcome of IPD or IUFD due to placental insufficiency. IPDs included preeclampsia, placental abruption, and small for gestational age (SGA). Results: Neither initial βhCG nor two-day percent increases in βhCG were associated with an increased risk of IPD for any type of IVF cycle. Initial and two-day percent increases in βhCG were significantly higher when comparing frozen with fresh IVF and donor with autologous IVF (all P≤0.01). Conclusions: Among singleton autologous and donor IVF cycles, the initial and two-day percent increase in serum βhCG were not associated with IPD or its components. However, significant βhCG differences existed by cycle type and oocyte source.