Miracle-dz/UniFAR-FTUs huggingface dataset:
Frequency of adverse events in patients with poor anticoagulation: a meta-analysis

Background: Patients taking anticoagulants orally over the long term have international normalized ratios (INRs) outside the individual therapeutic range more than one-third of the time. Improved anticoagulation control will reduce hemorrhagic and thromboembolic event rates. To gauge the potential effect of improved anticoagulation control, we undertook to determine the proportion of anticoagulant-associated events that occur when INRs are outside the therapeutic range. Methods: We conducted a meta-analysis of all studies that assigned hemorrhagic and thromboembolic events in patients taking anticoagulants to discrete INR ranges. We identified studies using the MEDLINE (1966–2006) and EMBASE (1980–2006) databases. We included studies reported in English if the majority of patients taking oral anticoagulants had an INR range with a lower limit between 1.8 and 2 and an upper limit between 3 and 3.5, and their INR at the time of the hemorrhagic or thromboembolic event was recorded. Results: The final analysis included results from 45 studies (23 that reported both hemorrhages and thromboemboli; 14 that reported hemorrhages only; and 8, thromboemboli only) involving a median of 208 patients (limits of interquartile range [25th–75th percentile] 131–523 subjects; total n = 71 065). Of these studies, 64% were conducted at community practices; the remainder, at anticoagulation clinics. About 69% of the studies were classed as having moderate or high quality. Overall, 44% (95% confidence interval [CI] 39%–49%) of hemorrhages occurred when INRs were above the therapeutic range, and 48% (95% CI 41%–55%) of thromboemboli took place when below it. The mean proportion of events that occurred while the patient's INR was outside the therapeutic range was greater for studies with a short mean follow-up (< 1 yr). Between-study heterogeneity was significant (p < 0.001). Interpretation: Improved anticoagulation control could decrease the likelihood of almost half of all anticoagulant-associated adverse events.
A review of the literature

The European strategy for growth has a twofold aim: to become an innovative union and to enhance labour flexibility. Yet, few have addressed the question of whether these two strategies are compatible or concurrent. Through a review of the literature, this article addresses this question by focusing on different types of labour flexibility (functional, contractual and financial), and two types of innovation outcomes: employee-driven innovation (EDI) and organizational innovativeness. Using insights from different research traditions, sound evidence is found for a positive relation between different forms of functional flexibility and both EDI and organizational innovation. This is nevertheless not so for contractual and financial flexibility. Indications are found that these types of labour flexibility are potentially negative for both EDI and organizational innovation. Yet, trends in the European labour market and EU backed policies do not focus on enhancing functional flexibility, but rather aim to increase contractual and financial flexibility.
Comment on “SUMO deconjugation is required for arsenic-triggered ubiquitylation of PML”

A switch in the SUMO isoforms conjugated to Lys65 in the oncoprotein PML-RARA is not required for its arsenic-induced degradation. Fasci et al. proposed that a SENP1-mediated switch from SUMO2 to SUMO1 conjugation on Lys65 in promyelocytic leukemia protein (PML) is required for arsenic-induced PML degradation, the basis for the antileukemic activity of arsenic. We found that PML or PML/RARA (retinoic acid receptor α) mutants that cannot be SUMO-conjugated on this specific site nevertheless underwent immediate arsenic-triggered SUMO modification. Moreover, these mutants were efficiently degraded in cells and even in vivo, demonstrating that SUMOylation of Lys65 was dispensable for arsenic response. The existence and putative role of a SUMO switch on PML should thus be reassessed.
Predictors of medication self-management skill in a low-literacy population

AbstractBACKGROUND: Patients’ ability to manage medications is critical to chronic disease control. Also known as medication management capacity (MMC), it includes the ability to correctly identify medications and describe how they should be taken. OBJECTIVE: To evaluate the effects of low literacy, medication regimen complexity, and sociodemographic characteristics on MMC. DESIGN: Cross-sectional analysis of enrollment data from participants in a randomized trial. PARTICIPANTS: Patients with coronary heart disease in an inner-city clinic. MEASUREMENTS: Medication management capacity was measured with the Drug Regimen Unassisted Grading Scale (DRUGS), which scores subjects’ ability to identify, open, describe the dose, and describe the timing of their medications. DRUGS overall and component scores were compared by literacy. Mini Mental State Exam score, regimen complexity (number of prescription medications), and sociodemographic characteristics. RESULTS: Most of the 152 participants were elderly (mean age 65.4 years), women (54.6%), and African American (94.1%). Approximately half (50.7%) had inadequate literacy skills, and 28.9% had marginal skills. In univariate analysis, MMC was significantly associated with literacy (P<.001), and this effect was driven by the ability to identify medications. In multivariable models, patients with inadequate literacy skills had 10 to 18 times the odds of being unable to identify all of their medications, compared with those with adequate literacy skills (P<.05). CONCLUSIONS: Adults with inadequate literacy skills have less ability to identify their medications. Techniques are needed to better educate low-literacy patients about their medications, as a potential strategy to enhance adherence.
Outage Probability Analysis of a Coded Cooperative OFDM System in Multipath Rayleigh Fading Channels

This paper considers a cooperative space-frequency (SF) coded OFDM system and evaluates its performance over quasi-static frequency selective Rayleigh fading channels. An expression for exact outage error probability is derived and its tight closed form lower bound is presented. The tightness of the lower bound is demonstrated through the Monte Carlo simulations. The asymptotic analysis indicates that the proposed protocol achieves full spatial and frequency diversities available in the cooperative communication system. The theoretical analysis of the proposed space-frequency coded cooperation protocol is further confirmed by computer simulations.
Effect of humic acid on survival, ionoregulation and hematology of the silver catfish, Rhamdia quelen (Siluriformes: Heptapteridae), exposed to different pHs

This study evaluates whether humic acid (HA; Aldrich) protects the silver catfish, Rhamdia quelen (Quoy & Gaimard, 1824), against exposure to acidic pH. Survival, levels of Na+, Cl- and K+ plasma, hematocrit, hemoglobin and erythrocyte morphometry were measured. Fish were exposed to 0, 10, 25 and 50 mg L 1 HA at four pH levels: 3.8, 4.0, 4.2 and 7.0 up to 96 hours. None of the fish exposed to pH 3.8 survived for 96 hours into the experiment, and survival of fish subjected to pH 4.0 decreased when HA concentration increased. Plasma Na+ levels decreased when pH was acidic, with no influence of HA, while Cl- levels declined at low pH with increased HA concentration. The levels of K+ at pH 4.0 and 4.2 increased without HA. Hematocrit and hemoglobin augmented under the effect of HA. At pH 4.0 and 4.2, erythrocytes of fish not exposed to HA were smaller, an effect that was partially offset by the presence of HA, since the values at pH 7.0 were higher. Although HA showed some positive effects changes in hematological and plasma K+a in silver catfish caused by exposure to acidic pH, the overall findings suggest that HA does not protect this species against acidic pH because it increased mortality and Cl- loss at pH 4.0.
Programmatic Supply and the Autonomy of US State Parties in 2008 and 2010

This paper examines the extent to which US state parties are autonomous from national party inﬂuence, evaluates how much state party autonomy varies across the USA, and examines possible explanations for this variance. We use newly collected party platform data from US state parties between 2008 and 2010 to examine the policy autonomy of state vis-à-vis national parties. In general, we ﬁnd that US state parties have more extreme policy positions than the national parties. We also ﬁnd signiﬁcant variance in the levels of autonomy across state parties and that Democratic state parties are more autonomous than Republican ones.
A Dynamic Model of U.S. Sugar-Related Markets: A Cointegrated Vector Autoregression Approach

The methods of the cointegrated vector autoregression (VAR) model are applied to monthly U.S. markets for sugar and for sugar-using markets for confectionary, soft drink, and bakery products. Primarily a methods paper, we apply Johansen and Juselius' advanced procedures to these markets for perhaps the first time, with focus on achievement of a statistically adequate model through analysis of a battery of advanced statistical diagnostic tests and on exploitation of the system's cointegration properties through rank restrictions, statistically supported hypotheses test restrictions, and inference. The VEC model results illuminate the estimates of crucial policy-relevant market parameters that drive these markets, as well as the dynamic nature of the relationships linking these sugar-based markets.
Pain Assessment in the Critically Ill Ventilated Adult: Validation of the Critical-Care Pain Observation Tool and Physiologic Indicators

ObjectivesUse of a valid behavioral measure for pain is highly recommended for critically ill, uncommunicative adults. The aim of this study was to validate the English version of the Critical-Care Pain Observation Tool (CPOT) and physiologic indicators [mean arterial pressure, heart rate, respiratory rate, and transcutaneous oxygen saturation (SpO2)] in critically ill ventilated adults. MethodsA total of 30 conscious and 25 unconscious patients in the intensive care unit participated in the study. Patients were assessed by staff nurses and research team members before, during, and 20 minutes after the 2 following procedures: (1) nociceptive procedure: turning, and (2) non-nociceptive procedure: taking noninvasive blood pressure (NIBP). Conscious ventilated patients provided self-report level of pain. ResultsInterrater reliability of the CPOT was supported with high intraclass correlation coefficients (0.80 to 0.93). Discriminant validity was supported with increases of the CPOT and physiologic indicators, and a decrease in SpO2 during turning, but remaining stable during NIBP. Conscious patients had higher CPOT scores during turning compared with unconscious patients. For criterion validity, the CPOT scores were correlated to the patients' self-reports of pain, whereas physiologic measures were not. Using a CPOT cutoff score of >3 yielded a sensitivity of 66.7% and a specificity of 83.3%. DiscussionThe CPOT is a reliable and valid tool to assess pain in critically ill adults. Behavioral indicators represent more valid information in pain assessment than physiologic indicators. Further research is needed to explore how specific critically ill populations (eg, head injury) react to a painful procedure.
Brand Loyalty, Generic Entry and Price Competition in Pharmaceuticals in the Quarter Century after the 1984 Waxman-Hatch Legislation

Abstract We examine market share and price trends in the quarter century since the 1984 Waxman-Hatch legislation. The generic share of US retail prescriptions has grown from 18.6% in 1984 to 74.5% in 2009, with a notable acceleration in recent years. Whereas in 1994 the generic price index fell from 100 to 65 in the 24 months following initial generic entry, in 2009 the comparable price index was 28. For the prescription drugs most commonly used by beneficiaries in Medicare Part D, rather than increasing by 25–28% as has been reported by the American Association of Retired Persons (focusing entirely on brand prices), we find that once one incorporates substitution to lower priced generics following patent expiration, average price per prescription fell by 21.3% from 2006–09. Finally, we find that the weighted mean reduction in pharmaceutical daily treatment cost across nine therapeutic areas equaled 35.1% at 24 months post-generic entry.
Expectations and the Stability Problem for Optimal Monetary Policies

A fundamentals based monetary policy rule, which would be the optimal monetary policy without commitment when private agents have perfectly rational expectations, is unstable if in fact these agents follow standard adaptive learning rules. This problem can be overcome if private expectations are observed and suitably incorporated into the policy maker's optimal rule. These strong results extend to the case in which there is simultaneous learning by the policy maker and the private agents. Our findings show the importance of conditioning policy appropriately, not just on fundamentals, but also directly on observed household and firm expectations.
Attentional functioning in fibromyalgia, rheumatoid arthritis, and musculoskeletal pain patients.

OBJECTIVES To investigate whether chronic pain patients have deficits in attentional functioning compared with pain-free controls, and whether fibromyalgia patients have larger deficits in attentional functioning compared with rheumatoid arthritis and musculoskeletal pain patients. METHODS Sixty patients (20 in each of 3 patient groups) and 20 pain-free controls completed measures assessing pain intensity, mood, pain-related disability, somatic awareness, and catastrophic thinking about pain. Attentional functioning was assessed using an age-standardized, ecologically valid test battery. Analyses were made of between-group differences. RESULTS Sixty percent of patients had at least one score in the clinical range of neuropsychological impairment, independent of demography and mood. Fibromyalgia patients were more anxious and somatically aware than rheumatoid arthritis or musculoskeletal pain patients, but did not show larger attentional deficits than other patient groups. CONCLUSION All 3 groups of chronic pain patients, regardless of diagnosis, had impaired cognitive functioning on an ecologically sensitive neuropsychological test of everyday attention.
Heterologous basic domain substitutions in the HIV‐1 Tat protein reveal an arginine‐rich motif required for transactivation.

The Tat protein coded by HIV‐1 is a unique eukaryotic transactivator. It activates gene expression from the viral LTR by its interaction with a nascent RNA element (TAR) located at the 5′ end of all HIV‐1 transcripts. Tat appears to bind to its target RNA structure in a highly sequence‐specific manner. The TAR‐binding activity of Tat has been localized in an Arg‐rich basic domain located between residues 49 and 57 of the Tat protein. We have carried out domain substitution studies with heterologous basic domains which are also implicated in RNA binding. Here, we report that a 19 or a 12 amino acid region from the N‐terminus of HTLV‐I Rex can functionally substitute for the Tat basic domain. In contrast, the Arg‐rich domains of the N gene products of bacteriophages lambda and 21 do not functionally substitute for the Tat basic domain. The positive and negative effects of various domain substitution mutants have facilitated identification of a consensus sequence (Arg/Lys‐X‐X‐Arg‐Arg‐X‐Arg‐Arg) in the basic domain required for Tat activity. Conversion of the functionally inactive basic domain of the lambda N protein to the consensus motif restored the transactivation function of the Tat‐N chimeric protein. Similarly, the Rex basic domain containing scrambled sequences unrelated or partially related to the consensus motif were either totally defective in transactivation or exhibited reduced activity. Our results further suggest that the activity of the core Arg motif may be enhanced by the presence of Gln or Asn within the basic domain. (ABSTRACT TRUNCATED AT 250 WORDS)
Identification of aminoglycoside resistance genes by Triplex PCR in Enterococcus spp. isolated from ICUs.

Early detection of antibiotic-resistant enterococci is an important part of patient treatment. Therefore, the aim of the present study was to evaluate the resistance patterns and simultaneously identify and characterise the resistance genes in Enterococcus spp. using a triplex polymerase chain reaction (PCR) method. In all, 150 consecutive Enterococcus spp were collected from several hospitals in Tehran (Iran) from January to December 2015. The Enterococcus species were identified by standard phenotypic/biochemical tests and PCR. The antimicrobial resistance patterns were determined using a disk diffusion method. The triplex PCR method was designed to identify gentamicin and other aminoglycoside resistance genes. Among the 150 Enterococcus specimens, 87 cases (58%) were Enterococcus faecalis, and 63 cases (42%) were Enterococcus faecium. The highest frequency of resistance was observed for tetracycline while the lowest was found for vancomycin. Among the identified samples, 56.9% contained the aac(6')-Ie-aph(2'')-Ia gene, 22.2% contained the aph(3')-IIIa gene, and 38.8% contained the ant(4')-? a gene. Eight percent of the isolates contained the three aminoglycoside resistance genes. Data analysis showed that there was a significant correlation between the phenotypic gentamicin resistance and the presence of the aminoglycoside resistance genes (18.9%, p <0.05), while the correlation between the phenotypic streptomycin resistance and the corresponding genes was not significant (2.8%, p ≥0.5). Nearly half of the identified Enterococcus strains had increased aminoglycoside resistance. The direct correlation between resistance genes, such as the aminoglycoside resistance factor, and phenotypic resistance was not significant (p > 0.05).
Different types of slowly conducting afferent units in cat skeletal muscle and tendon.

In chloralose‐anaesthetized cats, the impulse activity of single afferent units conducting at less than 30 m s‐1 and having receptive fields in the triceps surae muscle or the calcaneal tendon, was recorded from thin filaments of the dorsal roots L7 and S1. The receptive fields of the units were tested with a variety of graded natural stimuli (local pressure, stretch, contractions, temperature changes). In addition, the algesic agent bradykinin was injected into the receptive fields, but the sensitivity of the receptors to this substance was not used for classification purposes. Four types of receptors could be distinguished using the strongest response to innocuous natural stimulation as the criterion for characterizing a given ending: (a) nociceptors showing no response to innocuous forms of stimulation and requiring noxious (tissue‐threatening) stimuli to be clearly activated; (b) low‐threshold pressure‐sensitive receptors responding to innocuous indentation of the tissue but being relatively insensitive to stretch and contractions; (c) contraction‐sensitive receptors reaching high discharge frequencies during active contractions of moderate force and innocuous stretch, but being relatively insensitive to local pressure stimulation; (d) thermosensitive receptors responding strongly to small changes in temperature without reacting to innocuous mechanical stimulation. The possible involvement of the different receptor types in central nervous functions (nociception, mechanoreception, ergoreception, thermoregulation) is discussed.
IT Governance Implementation: the determinant factors

In the last 20 years, the use of IT by organizations has increased and ITG discipline is today a major concern. ITG has been recognized as a CIO top-10 issue for more than five years and has risen in priority between 2007 and 2009. Best practices and frameworks have been proposed in order to help organizations in ITG implementation. However, such practices and frameworks argue that the application of their practices depends on each organization context, but they don’t describe the different contexts and how the practices must be applied given the different contexts. Such fact calls for the identification and formalization of the determinant factors that can influence each ITG implementation which is not present in any framework. The researchers start the paper with a literature review to leverage such differentiator factors, herein called contingency factors, in order to provide a scientific viewpoint. Then, the researchers present the evaluation section with expert’s interviews in order to provide practitioner viewpoint. The researchers finalize the research with main contribution and future work section.
Design, fabrication, and measurements of an RF-MEMS-based self-similar reconfigurable antenna

Reconfigurability in an antenna system is a desired characteristic that has been the focus of much research in recent years. In this work, ohmic contact cantilever RF-MEMS switches are integrated with self-similar planar antennas to provide a reconfigurable antenna system that radiates similar patterns over a wide range of frequencies. The different issues encountered during the integration of the MEMS switches and the overall system design procedure are described herein. The final model radiates at three widely separated frequencies with very similar radiation patterns. The proposed concept can be extended to reconfigurable linear antenna arrays or to more complex antenna structures with large improvements in antenna performance.
MARKET-MAKING AND THE ASSESSMENT OF MARKET EFFICIENCY

IN ASSESSING the efficiency of a trading market, two criteria are relevant. ' First, can transactions take place in the market at relatively low cost? Second, are there opportunities for systematic profit as a result of serial correlation in price series? That is, are there market imperfections which prevent price from fully and immediately reflecting new information? These two criteria are applicable in evaluating a principal agent in organized trading markets-the market maker. They contrast, however, with the methods of evaluation currently used by the New York Stock Exchange and the Securities and Exchange Commission which focus on price continuity and price stabiliy and which may in fact tend to create inefficiency by causing price dependencies.2 This paper examines market-maker behavior. It argues that the chief cost of dealing with a market-maker is the difference between the theoretical but unobservable equilibrium price and the transaction price, rather than the bid-ask spread. A distinction is made between two types of trading, liquidity trading and information trading. The paper concludes that in both types of markets a competitive market-maker will perform more satisfactorily than a monopolistic market maker and that regulatory criteria are unnecessary. Organization follows these lines. Section II provides some background to the study of the market-maker. In Section III, price behavior in a market withough a market maker is discussed. Market-maker behavior in
Restriction-Fragment–Length Polymorphism in Insulin-Receptor Gene and Insulin Resistance in NIDDM

Restriction-enzyme analysis of genomic DNA from 52 White and Hispanic nondiabetic subjects and 51 subjects with non-insulin-dependent diabetes (NIDDM) was carried out with insulin-receptor cDNA probes. A polymorphic 5.8-kilobase SstI fragment was found in 12 (23.5%) of 51 NIDDM subjects but only in 4 (7.7%) of 52 nondiabetic control subjects. This association is significant by χ2-analysis (P < .05). Furthermore, the nondiabetic subjects with the polymorphism were found to have hyperinsulinemia and/or nondiagnostic glucose tolerance. The polymorphism is a genetic marker for a phenotype that is neither necessary nor, by itself, sufficient for NIDDM. Nevertheless, it may indicate that insulin resistance functionally related to an insulin-receptor gene polymorphism is the proximal cause of NIDDM in at least one subset of the population.