Miracle-dz/UniFAR-FTUs huggingface dataset:
Associations between nursing home performance and hospital 30‐day readmissions for acute myocardial infarction, heart failure and pneumonia at the healthcare community level in the United States

OBJECTIVES To evaluate community-specific nursing home performance with community-specific hospital 30-day readmissions for Medicare patients discharged with acute myocardial infarction, heart failure or pneumonia. DESIGN Cross-sectional study using 2009-2012 hospital risk-standardised 30-day readmission data for Medicare fee-for-service patients hospitalised for all three conditions and nursing home performance data from the Centers for Medicare & Medicaid Services Five-Star Quality Rating System. SETTING Medicare-certified nursing homes and acute care hospitals. PARTICIPANTS 12,542 nursing homes and 3,039 hospitals treating 30 or more Medicare fee-for-service patients for all three conditions across 2,032 hospital service areas in the United States. MEASUREMENTS Community-specific hospital 30-day risk-standardised readmission rates. Community-specific nursing home performance measures: health inspection, staffing, Registered Nurses and quality performance; and an aggregated performance score. Mixed-effects models evaluated associations between nursing home performance and hospital 30-day risk-standardised readmission rates for all three conditions. RESULTS The relationship between community-specific hospital risk-standardised readmission rates and community-specific overall nursing home performance was statistically significant for all three conditions. Increasing nursing home performance by one star resulted in decreases of 0.29% point (95% CI: 0.12-0.47), 0.78% point (95% CI: 0.60-0.95) and 0.46% point (95% CI: 0.33-0.59) of risk-standardised readmission rates for AMI, HF and pneumonia, respectively. Among the specific measures, higher performance in nursing home overall staffing and Registered Nurse staffing measures was statistically significantly associated with lower hospital readmission rates for all three conditions. Notable geographic variation in the community-specific nursing home performance was observed. CONCLUSION Community-specific nursing home performance is associated with community-specific hospital 30-day readmission rates for Medicare fee-for-service patients for acute myocardial infarction, heart failure or pneumonia. IMPLICATIONS FOR PRACTICE Coordinated care between hospitals and nursing homes is essential to reduce readmissions. Nursing homes can improve performance and reduce readmissions by increasing registered nursing homes. Further, communities can work together to create cross-continuum care teams comprised of hospitals, nursing homes, patients and their families, and other community-based service providers to reduce unplanned readmissions.
Immunostimulators induce granulocyte/macrophage colony-stimulating activity and block proliferation in a monocyte tumor cell line

Monocyte tumor cell line PU5-1.8 does not normally produce colony- stimulating activity (CSA) required by granulocyte and macrophage progenitors to proliferate and mature in agar. However, CSA is induced in the culture line by as little as 10 ng/ml endotoxic lipopolysaccharide (LPS), with maximum CSA production and release to the medium between 2 and 3 days of incubation. Derived lipid A, but not alkali-treated LPS, is also active. Induction requires RNA and protein synthesis, but is not blocked by mitomycin C or Colcemid. Other inducers of CSA include Mycobacterium Bacillus Calmette-Guerin, tuberculin protein preparation purified protein derivative, zymosan, and phorbol myristate. All inducing agents are specific inhibitors of the monocyte tumor cell proliferation in vitro. Latex beads, another macrophage-activating agent, are rapidly phagocytosed by PU5-1.8 cells, but neither inhibit growth nor induce CSA.
Measuring the Appropriate Outcomes for Better Decision-Making: A Framework to Guide the Analysis of Health Policy

Many existing economic evaluations of health policy recognize multidimensional outcomes and the importance of equally distributing the benefits, but do not to incorporate all relevant outcomes into a single comprehensive metric for cost-benefit analysis. The Organization for Economic Co-operation and Development’s (OECD’s) inclusive growth framework offers a novel approach for improved evaluation of policies which can address these concerns by aggregating societal outcomes in terms of income, life expectancy, unemployment rates and inequality into a single measure of living standards. We discuss the inclusive growth framework in the context of health policy and how it can be utilized by business leaders and policymakers to make superior policy decisions. Using an inclusive growth index of living standards developed by the OECD, we decompose growth in living standards (as defined by the OECD) due to increased life expectancy in Canada between 2000 and 2011 by cause of death and estimate the equivalent value of these reductions in mortality in terms of billions of dollars of income. We discuss factors underlying these reductions in mortality and suggest how they have been linked to policy. This exercise illustrates one way in which the inclusive growth framework can be used to evaluate the impacts of health policy.
Metabolic Issues Associated With Protease Inhibitors

Metabolic changes characteristically observed with HIV infection include low total and high-density lipoprotein (HDL) cholesterol and elevated triglycerides. Initiation of antiretroviral therapy (ART) may increase HDL but may also elevate low-density lipoprotein, very-low-density lipoprotein, and triglycerides as well as contribute to insulin resistance and morphologic changes (ie, visceral, breast, local fat accumulation, subcutaneous fat loss). This may result in a risk of cardiovascular disease substantially higher than among age- and sex-matched individuals in the general population. Cardiovascular risk calculators, such as the Framingham calculators, may underestimate risk in the setting of HIV and therapy. The degree of cardiovascular and metabolic risk can be managed with diet and lifestyle interventions and lipid-lowering pharmacotherapy, as in the general population. In addition, drug selection and treatment switching to agents with less impact on metabolic effects can reduce metabolic risk in HIV-positive individuals receiving ART.
Bile Acids as Regulators of Hepatic Lipid and Glucose Metabolism

Besides their well-established roles in dietary lipid absorption and cholesterol homeostasis, bile acids (BA) also act as metabolically active signaling molecules. The flux of reabsorbed BA undergoing enterohepatic circulation, arriving in the liver with the co-absorbed nutrients (e.g. glucose, lipids), provides a signal that coordinates hepatic triglyceride (TG), glucose and energy homeostasis. As signaling molecules with systemic endocrine functions, BA can activate protein kinases A and C as well as mitogen-activated protein kinase pathways. Additionally, they are ligands for a G-protein-coupled BA receptor (TGR5/Gpbar-1) and activate nuclear receptors such as farnesoid X receptor (FXR; NR1H4). FXR and its downstream targets play a key role in the control of hepatic de novo lipogenesis, very-low-density lipoprotein-TG export and plasma TG turnover. BA-activated FXR and signal transduction pathways are also involved in the regulation of hepatic gluconeogenesis, glycogen synthesis and insulin sensitivity. Via TGR5, BA are able to stimulate glucagon-like peptide-1 secretion in the small intestine and energy expenditure in brown adipose tissue and skeletal muscle. Dysregulation of BA transport and impaired BA receptor signaling may contribute to the pathogenesis of non-alcoholic fatty liver disease (NAFLD). Thus, BA transport and BA-controlled nuclear receptors and signaling pathways are promising drug targets for treatment of NAFLD. As such, FXR and/or TGR5 ligands have shown promising results in animal models of NAFLD and clinical pilot studies. Despite being a poor FXR and TGR5 ligand, ursodeoxycholic acid (UDCA) improves hepatic ER stress and insulin sensitivity. Notably, norUDCA, a side chain-shortened homologue of UDCA, improves fatty liver and atherosclerosis in Western diet-fed ApoE–/– mice. Collectively, these findings suggest that BA and targeting their receptor/signaling pathways may represent a promising approach to treat NAFLD and closely linked disorders such as obesity, diabetes, dyslipidemia and arteriosclerosis.
Habit Formation as a Resolution to the Equity Premium Puzzle: What Is in the Data, What Is Not

The consumption based asset pricing model of Lucas [14] defines a theoretical relationship between streams of consumption and equilibrium asset prices. Since data of both aggregate consumption and asset prices are available, the theory can be tested. Empirical tests of the Lucas model using standard time separable utility functions indicate mismatches between the theory and the data. For example, in the GMM (Generalized Method of Moments) estimation of Hansen and Singleton [9], overidentifying constraints implied by the model were rejected. Mehra and Prescott [16] demonstrated the difficulty of explaining a particular statistic: the theoretical expected equity premium (the yield differential between stocks and risk-free bonds) is much higher than the observed one if a standard utility function is used. They called the mismatch "the equity premium puzzle". To improve the performance of the model, several authors have relaxed the time-separability of preferences. In a stimulating paper, Constantinides [1] argued that the equity premium puzzle can be resolved through the assumption of "habit formation". The idea is that consumption in the past reduces utility in the present because it establishes habits. His model can match the observed mean and the variance of both the equity premium and the consumption growth rate. The match of the low moments is consistent with the bound tests of Heaton [11], Gallant, Hansen, and Tauchen [7], and Hansen and Jagannathan [10]. On the other hand, GMM estimations using monthly aggregate consumption of nondurable goods and leisure by Eichenbaum, Hansen, and Singleton [3], and that using consumption of nondurable goods and durable goods by Dunn and Singleton [2] and Eichenbaum and Hansen [4], showed that if current utility depends on current and past consumption, then current utility increases in past consumption, i.e., consumption has "local durability," the opposite of that implied by habit formation. A particularly strong result was obtained by Gallant and Tauchen [6]. They estimated a general form of utility functions with a general law of motion of data and found that the source of the time-non-separability is local durability. Since it is known that local durability
Generation of allo-antigen-specific induced Treg stabilized by vitamin C treatment and its application for prevention of acute graft versus host disease model

Antigen-specific regulatory T cells (Tregs) possess the potential to reduce excess immune responses in autoimmune diseases, allergy, rejection after organ transplantation and graft-versus-host disease (GVHD) following hematopoietic stem cell transplantation. Although in vitro-expanded antigen-specific induced Tregs (iTregs) have been considered to be a promising therapeutic agent against such excessive immune reactions, the instability of iTregs after transfer is a fundamental problem in their clinical application. In this study, we searched for the optimal way to generate stable iTregs for the prevention of the murine GVHD model, in which conventional iTregs are reported to be inefficient. Allo-antigen-specific iTregs were generated by co-culturing naive T cells with allogenic dendritic cells in the presence of TGF-β and retinoic acid. By examining various agents and genes, we found that vitamin C stabilized Foxp3 expression most effectively in adoptively transferred iTregs under a GVHD environment. Vitamin C treatment caused active DNA demethylation specifically on the conserved non-coding sequence 2 (CNS2) enhancer of the Foxp3 gene locus in allo-antigen-specific iTregs and reduced iTreg conversion into pathogenic exFoxp3 cells. Vitamin C-treated iTregs suppressed GVHD symptoms more efficiently than untreated iTregs. Vitamin C also facilitated induction of a FOXP3high iTreg population from human naive T cells, which was very stable even in the presence of IL-6 in vitro. The treatment of vitamin C for iTreg promises innovative clinical application for adoptive Treg immunotherapy.
Infiltrating ductal / lobular carcinoma: an evaluation of prognostic factors in primary breast cancer.

During 1986-1987, 192 women aged 26-86 with invasive breast cancer were treated with radiotherapy, hormonotherapy, and chemotherapy and then underwent modified radical mastectomy or wide local excision at Luis Castelazo Ayala Hospital of Obstetrics and Gynecology of the Mexican Social Security Institute in Mexico City. At diagnosis, metastatic bone surveys and bone scans showed that no one had distant metastasis. The physicians used incisional biopsy to determine the type of breast carcinoma (infiltrating ductal carcinoma [IDC] and infiltrating lobular carcinoma [ILC]). The researchers aimed to identify prognostic factors in primary breast cancer. 156 patients (81.3%) and 36 patients (18.7%) had IDC and ILC, respectively. Among women with IDC, axillary nodes were involved in 23.5% of premenopausal women and in 23% of postmenopausal women. 83.8% of all patients with IDC and 52.3% of IDC patients aged at least 50 had clinical stage III disease. Among women with ILC, axillary nodes were involved in 19.4% of premenopausal women and in 19.4% of postmenopausal women. 70% of all patients with ILC and 84.6% of ILC patients aged at least 50 had clinical stage III disease. All the patients had advanced breast cancer (i.e., clinical stage II and III). Some tumors were only estrogen receptor types, while others were only progesterone receptor types. Some tumors were even both receptor types, while another category had neither steroid hormone receptor. Survival rates for metastatic and non-metastatic breast cancer was greater among postmenopausal women than premenopausal women (32.7% vs. 14.8% and 21.8% vs. 12.8% for ICD and 19.4% vs. 8.4% and 30.5% vs. 13.9% for ILC, respectively). These findings suggest that axillary node status, status of estrogen and progesterone receptors, and menstrual status were important prognostic factors of breast cancer.
Diseño organizativo y knowledge performance: Un estudio empírico

The paper analyzes how the traditional variables that define a firm’s organizational structure (formalization, complexity, and centralization) influence knowledge performance (the degree to which a firm generates knowledge and uses it to reach a competitive advantage). Three hypotheses are tested using a sample of 164 large Spanish firms. The results show that organizational complexity and centralization exert a positive and a negative influence, respectively, on knowledge performance, which confirms the two hypotheses related to these variables. However, the analysis reveals no empirical evidence to confirm the hypothesis that formalization and knowledge performance are related positively.
Effects of the ccd function of the F plasmid on bacterial growth

The ccd segment of the mini F plasmid containing the ccdA and ccdB genes controls the coordination between plasmid proliferation and cell physiology and fate. When the DNA replication of a thermosensitive-replication plasmid carrying the ccd segment of mini F is blocked, plasmid DNA molecules are progressively diluted through cell division until the copy number reaches 1 per cell. From this time on, there is little increase in the number of viable cells, although cells continue to divide, resulting in a mixed population of viable cells (mostly plasmid containing), nonviable but residually dividing cells, and nonviable nondividing cells. Results are presented suggesting that plasmid-containing cells are viable and continue to divide, whereas plasmid-free segregants are nonviable and form filaments after a few residual divisions, with DNA synthesis reduced or arrested in the filaments. Although the ccd functions are known to induce the SOS response when plasmid replication is blocked, the production of nonviable plasmid-free segregants is independent of the SOS cell division inhibition mechanism determined by the sfiA and sfiC genes.
Forensic Accounting - Potenziale von Big Data und Predictive Analytics im Rahmen der IT Governance

Die Informationstechnik stellt ein wertvolles Instrumentarium fur die Aufdeckung doloser Handlungen und die Prufung von Regeleinhaltungen im Rechnungswesen bereit. Mit der exponentiellen Zunahme relevanter Daten fur das Rechnungswesen, sowohl in strukturierter als auch wenig bis unstrukturierter Form, kommen bisherige Werkzeuge und Verfahren jedoch an ihre Grenzen in Bezug auf die Rechenzeit und Verarbeitungsmoglichkeit. Vor diesem Hintergrund bietet es sich an, zwei bisher nicht verbundene Felder miteinander zu verbinden, die Forensik im Rechnungswesen mit Big Data und Business Analytics. Der vorliegende Beitrag stellt die wesentlichen IT-Entwicklungen vor und diskutiert ihre Potentiale und Einsatzmoglichkeiten fur das Rechnungswesen und die IT-Governance. Des Weiteren wird ein Bezugsrahmen fur den Einsatz von Big Data und Predictive Analytics vorgestellt, der vor allem grosen Unternehmen mit Massendaten, Prufungsgesellschaften und Prufungsbehorden Hinweise auf eine prototypische Vorgehensweise der datengetriebenen forensischen Analyse bietet. 1 Ausgangssituation Forensic Accounting Die Wirtschaftskriminalitat in deutschen Unternehmen und der daraus entstehende monetare Schaden stellen hohe Risiken fur Organisationen dar [Pric11]. In Deutschland wurden im Jahr 2012 knapp 82.000 Falle doloser Handlungen mit einer kumulierten Schadenssumme von ca. 3,7 Mrd. Euro verzeichnet. Dolose Handlungen sind illegale Handlungen, welche durch vorsatzliche Tauschung, Verschleierung oder Vertrauensmissbrauch gekennzeichnet sind [Frei08]. Darunter fallen beispielsweise
Cytogenetic, spectral karyotyping, fluorescence in situ hybridization, and comparative genomic hybridization characterization of two new secondary leukemia cell lines with 5q deletions, and MYC and MLL amplification

Cytogenetic studies of patients with therapy‐induced acute myeloid leukemia (t‐AML) have demonstrated whole chromosome loss or q‐arm deletion of chromosomes 5 and/or 7 in a majority of cases. We have established two cell lines, SAML‐1 and SAML‐2, from two patients who developed t‐AML after radiation and chemotherapy for Hodgkin disease. In both cases, the leukemia cells contained 5q deletions. SAML‐1 has 58 chromosomes and numerous abnormalities, including der(1)(1qter→1p22::5q31→5qter), der(5)(5pter→5q22::1p22→1pter), +8, der(13)i(13)(q10)del(13)(q11q14.1), and t(10;11). Fluorescence in situ hybridization (FISH) with unique sequence probes for the 5q31 region showed loss of IL4, IL5, IRF1, and IL3, and translocation of IL9, DS5S89, EGR1, and CSFIR to 1p. SAML‐2 has 45 chromosomes, del(5)(q11.2q31) with a t(12;13)ins(12;5), leading to the proximity of IRF1 and RB1, and complex translocations of chromosomes 8 and 11, resulting in amplification of MYC and MLL. Comparative genomic hybridization and spectral karyotyping were consistent with the G‐banding karyotype and FISH analyses. Because a potential tumor suppressor(s) in the 5q31 region has yet to be identified, these cell lines should prove useful in the study of the mechanisms leading to the development of t‐AML. © 2003 Wiley‐Liss, Inc.
A Randomised, Double-Blinded, Placebo-Controlled Study of the Phosphodiesterase Type 5 Inhibitor Sildenafil for the Treatment of Preeclampsia

Objective: To determine if the phosphodiesterase type 5 inhibitor sildenafil prolongs pregnancy in women with preeclampsia. Methods: Women with preeclampsia at gestational ages 24–34 weeks were recruited from nine hospitals in the UK, and randomly assigned to sildenafil citrate or placebo. Medication was increased every 3 days from 20 mg three times daily (tid), to 40 mg, and 80 mg tid. The primary endpoint was prolongation of pregnancy from randomisation to delivery (days). Secondary endpoints were markers of maternal disease and cord pH at delivery and infant weight. Details of all adverse events were also collected. Plasma samples were taken to establish pharmacokinetic information. Data analysed on a modified intention to treat analysis. The study had a power of >95% to detect a difference of 5 days. Results: Of 35 women, 17 were allocated to sildenafil and 18 to placebo. There was no difference in time from randomisation to delivery in the two treatment groups, with a median time of 4 days (range 1–15) in the sildenafil group and 4.5 days (range 1–30) in the placebo group. Sildenafil achieved maximum drug concentrations of 48 ng/ml, 88 ng/ml, and 271 ng/ml after 3 days of 20 mg, 40 mg and 80 mg tid, respectively. Conclusion: We have safely conducted a clinical trial of a drug not routinely used during pregnancy. Sildenafil in the escalating dose regimen 20–80 mg tid was well tolerated, with no increase in maternal or fetal morbidity or mortality but did not prolong pregnancy duration in women with preeclampsia. (ClinicalTrials.gov number, NCT 00141310).
The legacy of power sharing in Kenya: literature challenges and research agenda’s invisibilities

Kenyan political elites signed a power-sharing agreement in February 2008 in the wake of the violent hostilities that swept the country following the irregularities of the hotly contested December 2007 general elections which left behind over a 1,000 dead and more than 600,000 IDPs in just over two months. Since the agreement was struck, a Government of National Unity composed of the two main contenders was put in place to halt the violence and set in motion a reform agenda to address the structural causes of violence. During its five-year run, the power sharing agreement was able to put forward a new Constitution (approved by popular referendum in August 2010) and held the next electoral process (in March 2013) by and large peacefully. Even though born in the realm of political science striving for political engineering in divided and multi-ethnic societies via democratic proportional inclusiveness, power sharing arrangements have been recurrent in the African continent since the end of the Cold War,1 particularly as a conflict resolution mechanism included in peace agreements. However, in both the democratic theory and the conflict resolution strands of research, literature on power sharing is almost exclusively derived from an elite-based and/or institutionally-driven analysis, neglecting bottom-up approaches and dynamics and failing to deliver a more comprehensive analysis on the impact of power sharing. Additionally, the lack of dialogue between sub-dimensions of the studies on power sharing has provided for yet little knowledge of its mediumand long-term consequences. Highlighting the findings of fieldwork done in Kenya during the March 2013 elections, this chapter intends to shed light on the dynamics of power-sharing agreement in Kenya. It argues that the aforementioned lack of dialogue between research and analytical agendas has been responsible for ‘blind spots’ in the literature that have been neglecting potentially influential actors and dynamics that could further the understanding of the limitations and potential consequences of power sharing arrangements. This chapter maps inconsistencies between the literature on power sharing theory and the practice of Kenyan power-sharing experience, using a diagnosis of the shortcomings of power-sharing literature to demonstrate the need for