Miracle-dz/UniFAR-FTUs huggingface dataset:
Disease management in healthcare organizations: results of in-depth interviews with disease management decision makers.

BACKGROUND Despite the widening use of disease management (DM) programs throughout the country, little is understood about the "state of DM" in healthcare systems and managed care organizations. OBJECTIVE To better characterize the range of users of DM in healthcare and to identify critical issues, both present and future, for DM. STUDY DESIGN Qualitative survey. PARTICIPANTS AND METHODS Forty-seven healthcare systems (n = 22) and managed care organizations (n = 25) were randomly selected. Decision makers were identified and interviewed between January 1, 2000, and March 31, 2000. We limited quantitative analysis to tabulations of suitable responses, without statistical testing. Responses were organized around 3 themes: models for DM, implementation strategies, and measurements of success. RESULTS Of 47 decision makers surveyed, 42 (89%) reported that their organizations currently have (75%) or are working to develop (14%) DM programs. Although the goals of DM programs were similar, organizations took a variety of approaches to achieving these ends. There were typically 3 steps in implementing a DM program: analysis of patient data, external analysis, and organizational analysis. Decision makers believed that DM programs had only achieved partial success in reaching the 2 main goals of improved quality of care and cost savings. CONCLUSIONS Given the variety of DM programs, there is a need to develop a classification scheme to allow for better comparison between programs. Further quantitative studies of decision makers' opinions would be helpful in developing programs and in designing necessary studies of patient management strategies.
Likelihood of starting dialysis after incident fistula creation.

BACKGROUND AND OBJECTIVES Guidelines promote early fistula creation to avoid central venous catheter use. This practice may lead to fistula creations in patients who never receive dialysis. The objective of this study was to estimate the risk of fistula nonuse with long-term follow-up. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS Administrative health data identified 1929 predialysis adults who had their first fistula creation between April of 2002 and March of 2006. Patients were followed for a minimum of 2 years or until they began dialysis, received a kidney transplant, or died. RESULTS The median follow-up times in patients who started dialysis, died without receiving dialysis, and remained in predialysis were 6.1, 11.5, and 38.7 months, respectively. Eighty-one percent of patients initiated dialysis; 9% of patients died without receiving dialysis, and 10% of patients remained predialysis. Forty percent of patients had their first fistula creation 3-12 months before initiating dialysis (the recommended window). Thirty percent were created within 90 days of starting dialysis; 30% were created more than 1 year before starting dialysis, and 10% were created more than 2 years before starting dialysis. Older patients, females, and patients with less comorbidity were not as likely to initiate dialysis after incident fistula creation. CONCLUSIONS Most patients who underwent fistula creation before starting dialysis eventually received dialysis with extended follow-up, but the risk was significantly modified by age, sex, and comorbidity. Many patients had fistula creations earlier or later than recommended.
Gene transfer mediated by stem cell grafts to treat CNS injury

Introduction: Stem cell transplantation holds promise for promoting anatomical repair and functional recovery after traumatic or ischemic injuries to the CNS. Harnessing stem cells with therapeutic genes of interest is regarded as an attractive approach to augment therapeutic benefits of stem cell grafts. Areas covered: The advantage of stem-cell-mediated gene transfer is the engraftibility of stem cells that can ensure a long-term and stable expression of therapeutic genes. In addition, stem-cell–gene interaction may synergistically amplify therapeutic benefits. Delivery of classical neurotrophic factor genes provided neuroprotective and pro-regenerative effects in various injury models. Some studies employed therapeutic genes targeting post-injury microenvironment to support endogenous repair. Recent trials of stem-cell-mediated transfer of nonclassical growth factors showed relatively novel biological effects. Combinatorial strategies seem to have the potential to improve therapeutic efficacy. Expert opinion: Future development of induced pluripotent stem cells and novel scaffolding biomaterials will greatly expedite the advances in ex vivo gene therapy to treat CNS injury. Before moving to a clinical stage, rigorous preclinical evaluations are needed to identify an optimal gene or gene combination in different injury settings. Improving the safety of viral vectors will be a critical prerequisite for the clinical translation.
The effects of age and skill level on knee musculature co-contraction during functional activities: a systematic review

Objectives: To systematically review the current literature that relates the effects of age and skill level to motor control patterns of knee musculature co-contraction during functional movements. Methods: A search of electronic databases was performed with the search terms specifying co-contraction (cocontract*, co-contract*, coactive* or co-activ*). The search was focused on the effects age and/or skill level and were limited by the keywords of age or skill level (skill*) or experience (experi*). Results: The search yielded a total of six peer-reviewed manuscripts that met the search criteria and were included in the review. Conclusions: The relationship between adequate dynamic joint stability and efficient movement patterns are complex. Co-contraction related to age and skill development varies among studies due to technical and practical considerations. Adequate antagonistic co-contraction of hamstring musculature seems to be a component of all functional movements, possibly maintain dynamic knee stability and protect against excessive joint loads. Future investigations that further delineate the appropriate lower extremity agonist and antagonist relationships during dynamic tasks may help elucidate injury risk mechanisms in specific populations.
Long-range attraction between colloidal spheres at the air-water interface: the consequence of an irregular meniscus

Recent observations of charged colloidal particles trapped at the air-water interface revealed long-range interparticle attractive forces, not accounted for by the standard theories of colloidal interactions. We propose a mechanism for attraction which is based on nonuniform wetting causing an irregular shape of the particle meniscus. The excess water surface area created by these distortions can be minimized when two adjacent particles assume an optimum relative orientation and distance. Typically, for spheres with diameter of 1 &mgr;m at an interparticle distance of 2 &mgr;m, deviations from the ideal contact line by as little as 50 nm result in an interaction energy of the order of 10(4)kT. Roughness-induced capillarity explains the experimental findings, including the cluster dissolution caused by addition of detergent to the subphase and the formation of linear aggregates. This kind of interaction should also be of importance in particle-stabilized foams and emulsions.
Effect of ambient temperature on cardiovascular drift and maximal oxygen uptake.

PURPOSE This study tested the hypothesis that the magnitude of cardiovascular (CV) drift and decrease in maximal oxygen uptake (V[spacing dot above]O2max) would be greater at 35 degrees C than at 22 degrees C. METHODS The increase in HR and decrease in stroke volume (SV) between 15 and 45 min of cycling at 59.2 +/- 1.9% V[spacing dot above]O2max (CV drift) was measured in hot (HEAT, 35 degrees C) and cool (COOL, 22 degrees C) ambient temperatures in 10 endurance-trained men (age = 23 +/- 3 yr, V[spacing dot above]O2max = 64.7 +/- 8.7 mL.kg.min). V[spacing dot above]O2max was measured immediately after the 45 min of cycling and again under both ambient temperature conditions on separate days after 15 min of cycling. This design permitted assessment of V[spacing dot above]O2max between the same time points that CV drift occurred. Fluid to replace sweat losses was provided during all trials. RESULTS CV drift and the associated decrease in V[spacing dot above]O2max was greater (P < 0.05) in HEAT versus COOL. HR increased 11% (P < 0.05), SV decreased 11% (P < 0.05), and V[spacing dot above]O2max fell 15% (P < 0.05) between 15 and 45 min in HEAT, whereas HR and SV changed less (+2% and -2% for HR and SV, respectively, P < 0.05), and there was no significant decrease in V[spacing dot above]O2max (5%, P > 0.05) between 15 and 45 min in COOL. CONCLUSION These data demonstrate the magnitude of CV drift during prolonged submaximal exercise, and the accompanying decrease in V[spacing dot above]O2max measured immediately thereafter is greater in a hot than in a cool environment.
Macroeconomic determinants of stock market development in South Africa

Purpose The purpose of this paper is to examine the macroeconomic determinants of stock market development in South Africa during the period 1975–2015. Specifically, it examines the impact of banking sector development, economic growth, inflation rate, real interest rate and trade openness on the development of the South African stock market. Design/methodology/approach The author employs autoregressive distributed lag bounds testing procedure that allows the author to empirically investigate both the short- and long-run relationships between the stock market development and its determinants in the context of South Africa. In addition, the author also conducts a sensitivity analysis by accounting for the presence of structural breaks in the underlying series to check for the robustness of the estimation. Findings This paper confirms the findings by other studies that banking sector development and economic growth promote stock market development, while inflation rate and real interest rate inhibit stock market development. In addition, this paper finds an interesting result in the fact that trade openness has a negative impact on stock market development, which is different from the findings of many other studies. Originality/value Currently, while the theoretical and empirical literature presents diverse views on the relationship between each determinant and stock market development, no study has focussed on the South African stock market. Given the significant role that the South African stock market plays in Africa as measured by its market capitalisation and market capitalisation ratio, there is a need for a better understanding of the macroeconomic factors influencing its development.
Cost‐effectiveness of intraoperative facial nerve monitoring in middle ear or mastoid surgery

Objectives: Despite the utility of intraoperative facial nerve monitoring in reducing the risk of iatrogenic facial nerve injury during neurotologic surgery, its routine use during primary or revision surgery remains controversial. One of the major barriers to its acceptance is cost. This study evaluates the cost‐effectiveness of intraoperative facial nerve monitoring during middle ear or mastoid surgery. Research Design/Methods: A simple decision analytic cost‐effectiveness model and a societal approach were used to evaluate three cohorts of individuals who received (1) intraoperative facial nerve monitoring for both primary and revision middle ear or mastoid surgeries, or (2) facial nerve monitoring for revision surgeries only, or (3) no monitoring for any middle ear or mastoid surgeries. Results: Our results strongly favored the use of intraoperative facial nerve monitoring in all patients undergoing middle ear or mastoid surgery, adding about $222.73 to $528.00 to the total cost. The strategy to monitor primary and revision surgeries had the greatest effectiveness and lowest cost, with an average quality‐adjusted life‐year (QALY) of 45.68 at an average cost of $238. Facial nerve monitoring in revision patients only had similar QALYs (45.67) and higher costs ($292.1). Finally, the strategy not to monitor had the lowest QALY (45.65) and highest cost ($449.8). The analysis was robust across a wide range of changes in both costs and probabilities. Conclusions: Facial nerve monitoring is cost‐effective, and its routine use should be adopted to reduce the risk of iatrogenic facial nerve injury during otologic surgery.
The Relationship between Foreign Direct Investment, Electricity Consumption and Economic Growth in Vietnam

One of the prerequisites for the successful implementation of national industrialization and modernization is the synchronous development of fundamental industries. Electricity is a key industry that determines the success of other industries. The main purpose of this paper is to investigate the causal relationship between electricity consumption, foreign direct investment and economic growth in Vietnam during the period 1990-2015, by using Toda-Yamamoto approach and autoregressive distributed lag (ARDL) approach. The empirical results show strong statistical evidence that electricity consumption and foreign direct investment have positive impacts on economic growth in Vietnam in both short term and long term.
Do Universities Have a Role in the Education and Training of Teachers? An International analysis of policy and practice

The education of teachers has become a major concern in the development and improvement of education systems across the world. In most countries the responsibility for preparing teachers is held by the universities, which has helped raise the status of teaching. However teacher education has come under increasing criticism as overly theoretical and ineffective in addressing the practical needs of teachers within the classroom. This book addresses these concerns directly through a unique series of case studies by leading academics. The book suggests a number of key questions for universities to address in the education of teachers.
Modulation of the Renal Effects of Contrast Media by Endothelium‐Derived Nitric Oxide in the Rat

&NA; Touati C, Idee J‐M, Deray G, Santus R, Balut C, Beaufils H, Jouanneau C, Bourbouze R, Doucet D, Bonnemain B. Modulation of the renal effects of contrast media by endotheliumderived nitric oxide in the rat. Invest Radiol 1993;28:814‐820. rationale and objectives. A possible involvement of endothelium derived relaxing nitric oxide (NO) in the pathogenesis of iodinated contrast media (CM)‐induced nephrotoxicity was investigated in the rat. methods. Male rats (6 to 12 per group) were uninephrectomized. Six days later, the aorta was clamped above the renal artery and a low‐osmolar contrast medium (CM), ioxaglate, was injected (1 mL/min; 3 minutes) via an aortic puncture in the single remaining kidney. Contrast medium was injected with or without the NO‐synthase inhibitor L‐NAME (100 mg/kg intravenously [IV] 5 minutes before CM). One group received L‐Arginine, the physiological precursor of NO (100 mg/kg IV), 5 minutes before L‐NAME. Phenylephrine (300 &mgr;g/kg; 30 min) was used as a vasoconstrictive NO‐independent control. The effects of iohexol, another low‐osmolar CM, on creatinine clearance (CrCl) were also studied with and without pretreatment with L‐NAME. A control group was subjected to a 3‐minute renal ischemia only. Creatinine clearance and urinary N‐acetyl‐beta‐D‐glucosaminidase (NAG) excretion were determined before, and 24 and 48 hours after CM administration. Blinded histologic analysis was carried out after completion of the study. results. When administered alone, neither L‐NAME nor L‐arginine modified CrCl. Ioxaglate mildly but significantly decreased CrCl at 24 hours (−26.5% of preinjection value). This was similar to the effect observed in the control group subjected to ischemia only. When associated with L‐NAME, ioxaglate markedly decreased CrCl (−58 + 11% at 24 hours, P < .05 vs. ioxaglate alone). A similar interaction was noted in the case of iohexol. L‐NAME also markedly increased ioxaglate‐induced urinary NAG excretion. Phenylephrine had a similar impact on renal function. L‐arginine pretreatment reduced the increase in serum creatinine induced by L‐NAME + ioxaglate (68 + 17 &mgr;mol/L vs. 175 + 59 &mgr;mol/L for L‐NAME + ioxaglate; P < .05) and urinary NAG excretion. Ioxaglate alone induced only tubular epithelial vacuolization. When associated with L‐NAME, this CM induced tubular and vascular lesions, as well as necrosis in the outer medulla. Such histologic effects were clearly inhibited by L‐arginine. conclusion. These data indicate that L‐NAME, a specific inhibitor of NO‐synthase, and phenylephrine, accentuate the nephrotoxicity of CM in the rat. This is consistent with results from the literature showing that CM‐toxicity is enhanced by renal ischemia.
BP Network Based Mix Proportion Design of Self-Compacting Concrete

It was known that many parameters of raw materials, such as, strength of cement, mud content and modulus of fineness of river sand, maximum size of aggregate, content of' needle-like/sheet-like crushed stone, loss of ignition and fineness of fly ash, may exert significant influence on the theology and mechanical properties of self compacting concrete(SCC). It is a dream of researchers to identify the influencing degree of various factors on performance of SCC so as to obtain optimal properties. By virtue of BP neural network approach, this paper employed strength of cement, mud content and fineness modulus of fineness of river sand, maximum size of aggregate, content of needle-like/sheet-like crushed stone, loss of ignition and fineness of fly ash as the input parameters, and the corresponding optimized mix proportion as the output to describe the nonlinear relationship between them. And the orthogonal experiment was designed for the purpose of training and verification of network. The results demonstrated that the pre-trained BP neural network trained by orthogonal test data may employ to predict the optimal concrete mix proportion. This approach may replace some waste-time and heavy laboratory tests. In addition, such method may real-time optimize mixture proportion. of self-compacting concrete, which has great effect on the quality control of manufacturing self-compacting concrete.
Inflammation and neural signaling: etiologic mechanisms of the cancer treatment-related symptom cluster

Purpose of reviewCancer patients undergoing treatment with cytotoxic chemotherapeutic agents (CCAs) often experience a cluster of treatment-related symptoms, which include fatigue, loss of appetite, disturbed sleep, depressed mood, cognitive difficulties, and changes in body composition. This symptom cluster collectively referred to herein as cancer treatment-related symptoms (CTRSs) decrease quality of life, and physical and social functioning. The preclinical and clinical studies described in this review represent important progress in understanding potential underlying mechanisms of CTRS. Recent findingsRecent studies support a role for CCA-induced interleukin-1&bgr; (IL-1&bgr;) signaling in the cause of CTRS. CCAs may share a common ability to activate intracellular stress response pathways to trigger the synthesis, processing, and release of IL-1&bgr; from immune cells. Fatigue, sleep disturbance, and cognitive difficulties in cancer patients exposed to CCAs correlate with plasma levels of IL-6, IL-1 receptor antagonist, and soluble tumor necrosis factor receptor-I/II, surrogate markers of IL-1&bgr;-mediated central nervous system (CNS) inflammation. Additional preclinical work suggests IL-1&bgr;-mediated CNS inflammation may cause CTRS by altering hypothalamic and hippocampal functioning. SummaryAlthough additional research is necessary to further establish the link between CCA exposure, IL-1&bgr;-mediated inflammatory processes and CTRS, these data provide hints for future studies and therapeutic approaches in ameliorating these symptoms in cancer patients.
The distribution of weight-related risks among low-income women during the first postpartum year.

OBJECTIVE To describe the distribution of weight-related risks (weight retention and overweight/obese status) during the first postpartum year and determine if risk distributions differ by race/ethnicity, time, age, or parity. DESIGN Secondary analysis of a longitudinal data set from 1- to 3-days to 12-months postpartum. SETTING Initial recruitment was from a community hospital. PARTICIPANTS Two hundred and forty-seven (White, African American, or Hispanic) low-income women. RESULTS At 1- to 3-days postpartum weight-related risks were distributed as follows: 6.1% no risk, 17.0% significant postpartum weight retention, 12.1% overweight/obese, and 64.8% both weight-related risks; at 12 months, the distribution was 32.4%, 8.9%, 16.6%, and 42.1%, respectively. Distributions differed by race/ethnicity at 6-months (χ² =16.1, p=.013) and 12-months postpartum (χ² =19.7, p=.003). Having both weight-related risks (vs. not) at 12 months was 3.1 (odds ratio [OR]) times more likely (95% confidence interval [CI], 1.6, 6.2) for African American and 2.4 (OR) times more likely (95% CI[1.3, 4.6]) for Hispanic than White women. Having two risks decreased significantly only between 1 to 3 days and 6 weeks (p = .000). Maternal parity, but not age, was associated with weight-related risk distributions on four of five time points. CONCLUSION Despite changes in the weight-related risk distributions from 1- to 3-days to 6-weeks postpartum, the proportion of African American and Hispanic women with weight-related risk (especially having two weight-related risks) remains high at 12-months postpartum.
Epistemic Injustice and Nurse Moral Distress

The focus of this article is epistemic injustice as an underlying explanation for the lack of communication associated with moral distress in frontline nurses who provide end-of-life care. Improvements in interprofessional collaboration and communication in this challenging area of practice are needed, as supported by research on moral distress and related studies. Policy development that addresses interprofessional practice inclusive of all healthcare providers, particularly frontline nurses, in deliberations about end-of-life treatment deliberations and decisions is proposed.
Bacterial Sphingomyelinases and Phospholipases as Virulence Factors

SUMMARY Bacterial sphingomyelinases and phospholipases are a heterogeneous group of esterases which are usually surface associated or secreted by a wide variety of Gram-positive and Gram-negative bacteria. These enzymes hydrolyze sphingomyelin and glycerophospholipids, respectively, generating products identical to the ones produced by eukaryotic enzymes which play crucial roles in distinct physiological processes, including membrane dynamics, cellular signaling, migration, growth, and death. Several bacterial sphingomyelinases and phospholipases are essential for virulence of extracellular, facultative, or obligate intracellular pathogens, as these enzymes contribute to phagosomal escape or phagosomal maturation avoidance, favoring tissue colonization, infection establishment and progression, or immune response evasion. This work presents a classification proposal for bacterial sphingomyelinases and phospholipases that considers not only their enzymatic activities but also their structural aspects. An overview of the main physiopathological activities is provided for each enzyme type, as are examples in which inactivation of a sphingomyelinase- or a phospholipase-encoding gene impairs the virulence of a pathogen. The identification of sphingomyelinases and phospholipases important for bacterial pathogenesis and the development of inhibitors for these enzymes could generate candidate vaccines and therapeutic agents, which will diminish the impacts of the associated human and animal diseases.