Miracle-dz/UniFAR-FTUs huggingface dataset:
Health Care Organizations and Policy Leadership: Perspectives on Nonsmoker-Only Hiring Policies

Purpose To explore employers’ decisions to base hiring policies on tobacco or nicotine use and community perspectives on such policies, and analyze the implications for organizational identity, community engagement, and health promotion. Method From 2013 to 2016, 11 executives from six health care organizations and one non-health-care organization with nonsmoker-only hiring policies were interviewed about why and how their policies were created and implemented, concerns about the policies, and perceptions of employee and public reactions. Focus groups were conducted with community members (n = 51) who lived in or near cities where participating employers were based, exploring participants’ opinions about why an employer would stop hiring smokers and their support (or not) for such a policy. Results Most employers excluded from employment those using all forms of nicotine. Several explained their adoption of the policy as a natural extension of a smoke-free campus and as consistent with their identity as health care organizations. They regarded the policy as promoting health. No employer mentioned engaging in a community dialogue before adopting the policy or reported efforts to track the policy’s impact on rejected applicants. Community members understood the cost-saving appeal of such policies, but most opposed them. They made few exceptions for health care organizations. Conclusions Policy decisions undertaken by health care organizations have influence beyond their immediate setting and may establish precedents that others follow. Nonsmoker-only hiring policies may fit with a health care organization’s institutional identity but may not be congruent with community values or promote public health.
Contests with Alternative Public‐Good Prizes

I study contests in which a society of players compete, by expending irreversible effort, over which one of alternative prizes to have awarded to them by the decision maker. The prizes are public goods and/or public bads for the players. The players choose their effort levels simultaneously and independently. I define each player's valuation spread as the difference between his valuations for the two public-good/public-bad prizes. I establish that he players' t equilibrium effort levels depend solely on their valuation spreads, and that the players never expend positive effort for both prizes in equilibrium. Further, I establish that, in equilibrium, only players with the widest positive valuation spread and players with the widest negative valuation spread expend positive effort. Finally, I establish that the equilibrium effort level expended for each prize and the equilibrium total effort level are determined only by the widest positive valuation spread and the widest negative valuation spread. JEL classification: D72, H41, C72
Exploring the benefits of adaptive sequential designs in time‐to‐event endpoint settings

Sequential analysis is frequently employed to address ethical and financial issues in clinical trials. Sequential analysis may be performed using standard group sequential designs, or, more recently, with adaptive designs that use estimates of treatment effect to modify the maximal statistical information to be collected. In the general setting in which statistical information and clinical trial costs are functions of the number of subjects used, it has yet to be established whether there is any major efficiency advantage to adaptive designs over traditional group sequential designs. In survival analysis, however, statistical information (and hence efficiency) is most closely related to the observed number of events, while trial costs still depend on the number of patients accrued. As the number of subjects may dominate the cost of a trial, an adaptive design that specifies a reduced maximal possible sample size when an extreme treatment effect has been observed may allow early termination of accrual and therefore a more cost‐efficient trial. We investigate and compare the tradeoffs between efficiency (as measured by average number of observed events required), power, and cost (a function of the number of subjects accrued and length of observation) for standard group sequential methods and an adaptive design that allows for early termination of accrual. We find that when certain trial design parameters are constrained, an adaptive approach to terminating subject accrual may improve upon the cost efficiency of a group sequential clinical trial investigating time‐to‐event endpoints. However, when the spectrum of group sequential designs considered is broadened, the advantage of the adaptive designs is less clear. Copyright © 2010 John Wiley & Sons, Ltd.
Improvement in A1C Levels and Diabetes Self-Management Activities Following a Nutrition and Diabetes Education Program in Older Adults

Abstract This study examined the effects of a nutrition and diabetes education intervention on improving hemoglobin A1C levels, diabetes self-management activities, and A1C knowledge in congregate meal recipients in senior centers in north Georgia. Participants were a convenience sample and completed a pre-test, an educational intervention, and a post-test (N = 91, mean age = 73 years, 60% Caucasian, and 40% African American). Following the intervention, (1) A1C levels significantly decreased by 0.66 and 1.46% among those with pretest A1C of > 6.5% and > 8%, respectively (P ≤ 0.01); (2) compliance significantly increased following a healthful diet, following an eating plan, avoiding high fat foods, spacing carbohydrates, testing blood sugar as recommended by health care provider and inspecting shoes (P ≤ 0.05); (3) the number of A1C knowledge questions answered correctly increased from 42% to 65% (P < 0.0001); and (4) decreases in A1C among those with an initial A1C > 6.5% were correlated with increases in physical activity (P ≤ 0.05). This nutrition and diabetes intervention improved several aspects of the diabetes self-management activities and A1C knowledge, with concurrent decreases in A1C levels in older adults; however, additional interventions are needed to improve A1C levels, diabetes self-management activities, and A1C awareness in older adults.
Real Km-Synthesis via Generalized Popov Multipliers

In this paper, we refine our H¿ control designs presented at the 1990 and 1991 American Control Conference by introducing a new "real Km-Synthesis" technique involving the use of generalized Popov multipliers. Our multiplier technique substantially reduces, and in some cases may even eliminate altogether, the conservativeness associated with traditional Km-Synthesis solutions in which all uncertainties are treated as complex, even when they arise from real parameters such as the masses and spring constants in the benchmark problem. The design results demonstrate how this approach permits a very precise analysis of the intrinsic tradeoffs between robustness, performance and control energy requirements. Also included is an open-loop H¿ prefilter design that allows one to address the command response shaping issue.
Patients’ Experiences After Attempted Suicide: A Literature Review

The aim of this study has been to synthesize research on suicidal patients’ experiences of the suicide process. A literature search was performed in CINAHL, PubMed, and PsycINFO, and the analysis of the 15 articles covered was based on meta-synthesis. Patients experience a wide variety of feelings regarding their situation during the suicide process, and these exist on two levels: they relate to the different aspects of care that the patients receive and the patients’ need to communicate with others and regain hope. The patients in this study described the struggle to maintain hope when life became too difficult and their suffering despite a sense of security, and they sought to achieve emotional balance. A good understanding of how suicidal individuals live with and manage suicidal ideation, while maintaining hope is important for planning effective nursing care. Further research from the patient perspective is needed to further develop psychiatric care for people at risk of suicide.
CIN2 Is a Much Less Reproducible and Less Valid Diagnosis than CIN3: Results from a Histological Review of Population-Based Cervical Samples

Summary: We wished to compare the relative reproducibility and validity of cervical intraepithelial neoplasia (CIN) 2 and CIN3 diagnoses. In a population-based cohort study (1993-2001) of human papillomavirus (HPV) and cervical neoplasia in Costa Rica, we compared community pathologists' diagnoses with those of the 2 independent reviewers from the United States (total, n = 357). As measures of validity, we correlated primary and review diagnoses with HPV positivity and cytological interpretations. Two review pathologists agreed with 84% and 81%, respectively, of initial diagnoses of CIN3 compared with 13% and 31% of CIN2. The CIN3 diagnoses made by review pathologists were 94% oncogenic HPV positive, compared with 72% of CIN2 diagnoses. Eighty-one percent of CIN3 diagnoses versus 61% of CIN2 were correlated with high-grade cytological interpretations. The CIN3 is a substantially more reproducible diagnosis that can be validated more frequently with HPV tests and cytological interpretations than CIN2.
Classical simulation of infinite-size quantum lattice systems in two spatial dimensions.

We present an algorithm to simulate two-dimensional quantum lattice systems in the thermodynamic limit. Our approach builds on the projected entangled-pair state algorithm for finite lattice systems [F. Verstraete and J. I. Cirac, arxiv:cond-mat/0407066] and the infinite time-evolving block decimation algorithm for infinite one-dimensional lattice systems [G. Vidal, Phys. Rev. Lett. 98, 070201 (2007)10.1103/PhysRevLett.98. 070201]. The present algorithm allows for the computation of the ground state and the simulation of time evolution in infinite two-dimensional systems that are invariant under translations. We demonstrate its performance by obtaining the ground state of the quantum Ising model and analyzing its second order quantum phase transition.
Methicillin‐Resistant, Vancomycin‐Intermediate and Vancomycin‐Resistant Staphylococcus aureus Infections in Solid Organ Transplantation

Abbreviations: CA-MRSA, community-associated MRSA; CLSI, Clinical and Laboratory Standards Institute; EARSS, European Antimicrobial Resistance Surveillance System; HA-MRSA, healthcare-associated MRSA; HIV, human immunodeficiency virus; hVISA, heteroresistant VISA; ICU, intensive care unit; IDSA, Infectious Diseases Society of America; MALDI-TOF, matrix-assisted laser desorption ionization-time-offlight mass spectrometry; MIC, minimum inhibitory concentration; MRSA, methicillin-resistant S. aureus; MSSA, Methicillin-susceptible S. aureus; PCR, polymerase chain reaction; PNA-FISH, fluorescent in situ hybridization employing peptide nucleic acid probes; PVL, Panton-Valentine leukocidin; SSCmec, staphylococcal chromosome cassette mec; SSTIs, skin and soft-tissue infections; TMP-SMX, trimethoprimsulfamethoxazole; VISA, vancomycin-intermediate S. aureus; VRE, vancomycin-resistant enterococci; VRSA, vancomycin-resistant S. aureus.
Importance of communication influences on a highly collaborative task

Social interaction is a key driving force behind any team activity. Real time closely coupled interaction, where we quickly see the effect of our actions on others, is an important feature of social interaction. For example, smiling and returning a smile, shaking hands and passing a gift or business card are some of the most important interactions in the real world. Collaborative virtual environments (CVE) offer the potential for social interaction between geographically distributed groups. Closely coupled interaction is, however, very difficult in present CVE systems. This is because this medium lags behind real world communication in terms of representation, consistency and responsiveness. This paper takes a psychological perspective, describing how the primary forms of human communication in the real world map to those in the virtual. We discuss how each form of communication relates to the feeling of co-presence, giving real examples of behaviour observed in an example application, the virtual gazebo. We present detailed results from user evaluation, focusing on the perceived importance of these influences on collaboration.
An Inventory Optimization Model To Support Operating Room Schedules

Health care costs continue to rise at unprecedented rates in the United States. While past research has addressed optimal patient scheduling to improve the utilization of operating theater resources (physicians, specialized equipment, and operating rooms), little research has attempted to optimize material requirements and safety stocks to support these optimized schedules. Although classical inventory models can and should be used, additional considerations in hospital environments remain unaddressed. Based on our empirical observations, significant opportunities exist to reduce waste by improving the planning and coordination of materials and information in hospital operating theaters. To quantify these opportunities, we develop an analytic optimization framework for planning and executing material quantity preparation and placement decisions to support hospital operating theaters. Our model considers the non-stationary stochastic demand associated with block scheduling of surgical departments and a stochastic bill of materials, common in surgical treatments. Our approach is novel in that we formulate the stochastic decision problem exactly as a linear program by leveraging the convexity of the expected cost functions. The model is computationally efficient and flexible, allowing fast solutions and unique considerations for individual hospitals while considering uncertainty explicitly. We conduct a numerical study and sensitivity analysis to pinpoint the leverage points in the system for reducing inventory carrying and materials management costs. Surprisingly, reducing the uncertainty in the physician-determined bill of materials through standardization exhibited the greatest potential for savings.
A review of erlotinib – an oral, selective epidermal growth factor receptor tyrosine kinase inhibitor

Importance of the field: The epidermal growth factor receptor (EGFR) is a cell surface receptor for EGF and transforming growth factor-alpha which is overexpressed by a number of human tumors. Erlotinib, developed by OSI Pharmaceuticals, is an oral selective EGFR tyrosine kinase inhibitor, the only drug of its class approved for the treatment of locally advanced non-small cell lung cancer (NSCLC) after failure of at least one previous chemotherapy regimen and for first-line treatment of advanced pancreatic cancer with gemcitabine. Areas covered in this review: Findings from major Phase III studies that led to the approval of erlotinib are summarized in this review. Key aspects of erlotinib clinical pharmacology, dosing in special populations (e.g., smokers), and toxicity are also reviewed. The article also outlines the results of all correlative studies that have been done in clinical trials of patients receiving erlotinib to identify biomarkers that predict response, such as rash, EGFR status of the tumor by immunohistochemistry and activating EGFR mutations. What will the reader gain: The reader will have an outline of the landmark trials leading to the approval of this drug and know which ongoing Phase III trials are expected to enhance the knowledge of this drug's activity. The reader will also understand the pharmacologic bases for the recent change in dosing guidelines of erlotinib, and the current knowledge of clinical and laboratory correlates that can serve as surrogates of response. Take home message: This is a well-tolerated oral biologic agent with two approved clinical indications. More studies to individualize therapy and optimize dosing are needed.
Dimensional profiles of male to female gender identity disorder: an exploratory research.

INTRODUCTION Male-to-Female Gender Identity Disorder (MtF GID) is a complex phenomenon that could be better evaluated by using a dimensional approach. AIM To explore the aggregation of clinical manifestations of MtF GID in order to identify meaningful variables describing the heterogeneity of the disorder. METHODS A consecutive series of 80 MtF GID subjects (mean age 37 +/- 10.3 years), referred to the Interdepartmental Center for Assistance Gender Identity Disorder of Florence and to other Italian centers from July 2008 to June 2009, was studied. Diagnosis was based on formal psychiatric classification criteria. Factor analysis was performed. MAIN OUTCOME MEASURES Several socio-demographic and clinical parameters were investigated. Patients were asked to complete the Bem Sex Role Inventory (BSRI, a self-rating scale to evaluate gender role) and Symptom Checklist-90 Revised (SCL-90-R, a self-rating scale to measure psychological state). RESULTS Factor analysis identified two dimensional factors: Factor 1 was associated with sexual orientation, and Factor 2 related to behavioral and psychological correlates of early GID development. No correlation was observed between the two factors. A positive correlation between Factor 2 and feminine BSRI score was found, along with a negative correlation between Factor 2 and undifferentiated BSRI score. Moreover, a significant association between SCL-90-R Phobic subscale score and Factor 2 was observed. A variety of other socio-demographic parameters and clinical features were associated with both factors. CONCLUSIONS Behavioral and psychological correlates of Factor 1 (sexual orientation) and Factor 2 (gender identity) do not constitute the framework of two separate clinical entities, but instead represent two dimensions of the complex MtF GID structure, which can be variably intertwined in the same subject. By using factor analysis, we offer a new approach capable of delineating a psychopathological and clinical profile of MtF GID patients.
A high‐performance liquid chromatography based strategy for rapid, sensitive sequencing of N‐linked oligosaccharide modifications to proteins in sodium dodecyl sulphate polyacrylamide electrophoresis gel bands

The majority of biologically active proteins are glycosylated, therefore any approach to proteomics which fails to address the analysis of oligosaccharides is necessarily incomplete. To appreciate the structure of a glycoprotein fully, to understand the roles for the attached oligosaccharides and to monitor disease associated changes it is necessary to visualise the sugars as well as the protein. To achieve this aim when biological samples are available at the low microgram level or less has involved increasing the sensitivity of the technology for glycan analysis. Since one protein may have many different oligosaccharides attached to it (glycoforms) this is a major technical challenge. CD59, for example, has over 100 different sugars at one N‐linked glycosylation site. Applications of recently developed technology suggest that it is now becoming realistic to extend the proteomics analysis of glycoproteins to include details of glycosylation. This is achieved by releasing the N‐glycans from the protein in a gel by optimised peptide‐N‐glycosidase F digestion. The released glycans are then tagged with the fluorophore, 2‐amino benzamide. The labelled glycan pools (containing 50–100 femtomoles of glycans) are resolved by predictive normal phase high performance liquid chromatography (HPLC) on an amide based column or by reverse phase HPLC on a C18 column. Preliminary structural assignments are confirmed by exoglycosidase array digestions of the entire glycan pool. Complementary matrix‐assisted laser desorption/ionization‐mass spectrometry, which requires 10–20 times as much sugar for a single run, can be used where there is sufficient material. This provides a composition analysis but not linkage information.
Podiatric physicians' perspectives on their role in promoting self-care in high-risk patients with diabetes.

BACKGROUND Foot self-care is key in preventing morbidity in high-risk diabetic patients. Motivational interviewing (MI) is an approach to encourage behavior change by patients that can be used in medical settings. The goal was to explore how podiatric physicians promote self-care in such patients and whether they use MI techniques. METHODS We conducted a 19-question online survey of US-based practicing podiatric physicians. Most answers were on a 5-point scale. The MI index was the sum of answers to five relevant questions. RESULTS Of 843 podiatric physicians, 86% considered foot self-care to be very important for high-risk diabetic patients, and 90% felt that it was their role to discuss foot self-care with them; 49% felt that they had training and were successful in promoting behavior change, but most were definitely (38%) or possibly (46%) interested in learning more. Only 24% of respondents scored at least 15 of 20 on the MI index. Higher MI scores were associated with more face time and more time discussing foot self-care but were not related to podiatric physicians' age, sex, geographic location, percentage of time in surgery, or years in practice. Reported barriers to counseling were lack of reimbursed time and poor patient engagement. CONCLUSIONS Most podiatric physicians view self-care behavior among high-risk diabetic patients and their role in promoting it as very important; most feel already proficient, but only a few demonstrate MI skills; most are willing to learn more. Success in behavioral counseling, such as MI, is likely to require more time and may be encouraged by a move from fee-for-service to outcome-based reimbursement.
Immunisation of Sheep with Bovine Viral Diarrhoea Virus, E2 Protein Using a Freeze-Dried Hollow Silica Mesoporous Nanoparticle Formulation

Bovine viral diarrhoea virus 1 (BVDV-1) is arguably the most important viral disease of cattle. It is associated with reproductive, respiratory and chronic diseases in cattle across the world. In this study we have investigated the capacity of the major immunological determinant of BVDV-1, the E2 protein combined with hollow type mesoporous silica nanoparticles with surface amino functionalisation (HMSA), to stimulate immune responses in sheep. The current work also investigated the immunogenicity of the E2 nanoformulation before and after freeze-drying processes. The optimal excipient formulation for freeze-drying of the E2 nanoformulation was determined to be 5% trehalose and 1% glycine. This excipient formulation preserved both the E2 protein integrity and HMSA particle structure. Sheep were immunised three times at three week intervals by subcutaneous injection with 500 μg E2 adsorbed to 6.2 mg HMSA as either a non-freeze-dried or freeze-dried nanoformulation. The capacity of both nanovaccine formulations to generate humoral (antibody) and cell-mediated responses in sheep were compared to the responses in sheep immunisation with Opti-E2 (500 μg) together with the conventional adjuvant Quil-A (1 mg), a saponin from the Molina tree (Quillaja saponira). The level of the antibody responses detected to both the non-freeze-dried and freeze-dried Opti-E2/HMSA nanoformulations were similar to those obtained for Opti-E2 plus Quil-A, demonstrating the E2 nanoformulations were immunogenic in a large animal, and freeze-drying did not affect the immunogenicity of the E2 antigen. Importantly, it was demonstrated that the long term cell-mediated immune responses were detectable up to four months after immunisation. The cell-mediated immune responses were consistently high in all sheep immunised with the freeze-dried Opti-E2/HMSA nanovaccine formulation (>2,290 SFU/million cells) compared to the non-freeze-dried nanovaccine formulation (213–500 SFU/million cells). This study is the first to demonstrate that a freeze-dried silica mesoporous nanovaccine formulation gives balanced immune responses in a production animal.