Miracle-dz/UniFAR-FTUs huggingface dataset:
Pay for performance in the intensive care unit—Opportunity or threat?*

Objective:Ongoing evidence of poor-quality healthcare has stimulated the development of provider reimbursement schemes linked to the delivery of high-quality care. Our objective was to describe these programs and their potential implementation in intensive care units (ICUs). Sources:MEDLINE (2000–May, 2008) and personal files. Study Selection:We selected empirical studies, narrative and systematic reviews, and commentaries addressing pay-for-performance programs. Data Extraction:Using a narrative review format, we discuss the definition of pay-for-performance, describe current implementations, suggest challenges of applying these programs to the ICU setting, and discuss alternative quality improvement programs. Data Synthesis:The ICU will likely become a target for pay-for-performance plans, considering the high cost of care, development of ICU quality-of-care measures, and interest from healthcare regulators and funders. Existing plans applied outside the ICU have varied in the amount of financial incentive and targeted provider and quality measures. Evaluations are sparse. Implementation challenges specific to the ICU include selecting evidence-based and feasible quality of care measures, motivating the entire interdisciplinary team, integrating multifaceted behavior change strategies, and developing informatics infrastructure for timely audit and feedback. Other incentive-based alternatives to improve ICU quality of care include a “centers of excellence” approach (referral of patients to centers with excellent outcomes), public reporting of ICU outcomes, and payments to hospitals for participating in quality improvement programs. Conclusions:Participation in pay-for-performance programs is a potential opportunity for intensivists and ICU teams to improve outcomes for their patients in partnership with regulatory agencies and healthcare funders. Because many aspects of optimal design of these programs in ICUs are unknown, robust evaluations of their effect on healthcare quality should be integrated into any implementations.
Caring and Competency

The long-term crisis in nursing, particularly in acute care hospitals, is demonstrated in studies on negligence by the Institute of Medicine in To Err is Human: Building a Safer Health System 1and Crossing the Quality Chasm: A New Health System for the 21st Century. 2A review of the nursing literature reflects unclear definitions of competency and its component caring, and no single theory of competency has been adopted from the literature and used in the education of nurses. The American Nurses 2001 Code of Ethics does not resolve this confusion, because it does not correct the individual acts of nursing incompetencies in acute care hospitals. The author defines caring and competency by providing examples of what they are not in examining 200 actual cases of hospital nursing acts of incompetence by nursing discipline. None of these examples of imputed negligence was reported to the National Practitioner Data Bank because the “corporate shield” protected the nurses by not being named in the complaint nor named as part of the settlement against the hospital. A new model of the hospitalist, the nurse hospitalist, is presented to act as a daily teacher and facilitator for hospital nurses based on a curriculum of day-to-day examples of substandard patient care. This nurse specialist is an inpatient generalist advanced practice nurse who is employed by the hospital and reports to the chief nurse executive. The author proposes that this new model of the nurse hospitalist be devoted entirely to collaborating with nurse leaders, educators, charge nurses, and floor nurses throughout disciplines in advancing the competency of nursing. This daily proactive and prospective model of improving nursing performance in a facultative manner offers strategies to mitigate the limitations of the retrospective model of quality control. Total quality improvement practiced retroactively is ineffective. The author recommends no structural change in the institution but an educational agenda by the nurse hospitalist, with hospital administration to assist nurses in a new learning environment.
Light-Stimulated Inositol Phospholipid Turnover in Samanea saman Pulvini : Increased Levels of Diacylglycerol.

Leaflet movement in Samanea saman is driven by an endogenous circadian clock and by light. We are investigating whether the effects of light on leaflet movement are mediated by increased inositol phospholipid turnover. We demonstrated previously that irradiation of excised pulvini with 15 to 30 seconds of white light decreases the levels of phosphatidylinositol monophosphate and phosphatidylinositol bisphosphate and increases the levels of inositol phosphates. We now report that the diacylglycerol level increases after 30 seconds of white light but returns to below the control level after 10 minutes of white light.
Open Educational Practices and Attitudes to Openness across India: Reporting the Findings of the Open Education Research Hub Pan-India Survey.

In recent years India has shown a growing appetite for open educational resources (OER) and open educational practices (OEP). Despite this, there is a paucity of research on OER use and impact, the extensiveness of OEP, and attitudes towards openness in India. This paper reports on research intended to help fill that knowledge gap by conducting a pan-India survey using many of the questions developed by the UK Open University’s Open Education Research Hub (OERH) for use in its OER impact research around the world (http://oerresearchhub.org/collaborative-research/instruments/). Delivered online, in English and Hindi, the pan-India survey is the biggest of its kind to have been conducted in India. Analysis of the collected data reveals extensive evidence of educators using OER to improve their teaching, and survey respondents’ common belief in the educational benefits of OER. In addition, despite encountering greater technical and structural barriers to OER use than those typically experienced by OERH survey respondents from the Global North, the pan-Indian survey respondents tend to show more engagement with OEP than their developed country peers, notably in terms of creating resources and publishing them on a Creative Commons (CC) license, and in adding comments to OER repositories. Accordingly, this paper presents an emergent model intended to better capture the rich contextual factors inhibiting and enabling OER use and OEP in the Global South. It must be acknowledged, however, that our findings relate to a fairly highly educated selection of educators, teacher-educators, students, education managers, academics, activists and policymakers. We therefore plan to expand on our model by conducting further research with a more diverse group of respondents, to include people facing technological, economic and societal barriers to using OER.
Yersinia enterocolitica Induces Apoptosis and Inhibits Surface Molecule Expression and Cytokine Production in Murine Dendritic Cells

ABSTRACT Yersinia enterocolitica evades innate immunity by expression of a variety of pathogenicity factors. Therefore, adaptive immunity including CD4+ T cells plays an important role in defense against Y. enterocolitica. We investigated whether Y. enterocolitica might target dendritic cells (DC) involved in adaptive T-cell responses. For this purpose, murine DC were infected with Y. enterocolitica wild-type and mutant strains prior to incubation with ovalbumin (OVA) as antigen and 5-(6)-carboxyfluorescein diacetate N-succinimidyl ester-labeled OVA-specific T cells from DO11.10 mice. While T-cell proliferation was partially affected by infection of DC with plasmid-cured and YopP-deficient Yersinia mutant strains, no T-cell proliferation occurred after infection of DC with wild-type Y. enterocolitica. Infection of DC with Y. enterocolitica wild type resulted in decreased up-regulation of major histocompatibility complex class II, CD54 (intercellular adhesion molecule 1), CD 80, and CD86 expression. Experiments with plasmid-cured Y. enterocolitica or a YopP-deficient mutant strain revealed that YopP accounts for inhibition of surface molecule expression. Wild-type Y. enterocolitica suppressed the release of KC, tumor necrosis factor alpha, interleukin-10 (IL-10), and IL-12 by DC, while infection of DC with plasmid-cured Y. enterocolitica or with the YopP-deficient mutant resulted in the production of these cytokines. Moreover, infection with wild-type Y. enterocolitica induced apoptosis in DC mediated by YopP. Apoptosis occurred despite translocation of NF-κB to the nucleus, as demonstrated by electromobility shift assays. Together, these data demonstrate that Y. enterocolitica targets functions of murine DC that are required for T-cell activation. This might contribute to evasion of adaptive immune responses by Y. enterocolitica.
Prescribing errors in hospital practice

Prescribing errors that occur in hospitals have been a source of concern for decades. This narrative review describes some of the recent work in this field. There is considerable heterogeneity in definitions and methods used in research on prescribing errors. There are three definitions that are used most frequently (one for prescribing errors specifically and two for the broader arena of medication errors), although many others have also been used. Research methods used focus primarily on investigating either the prescribing process (such as errors in the dose prescribed) or the outcomes for the patient (such as preventable adverse drug events). This complicates attempts to calculate the overall prevalence or incidence of errors. Errors have been reported in handwritten descriptions of almost 15% and with electronic prescribing of up to 8% of orders. Errors are more likely to be identified on admission to hospital than at any other time (usually failure to continue ongoing medication) and errors of dose occur most commonly throughout the patients' stay. Although there is evidence that electronic prescribing reduces the number of errors, new types of errors also occur. The literature on causes of error shows some commonality with both handwritten and electronic prescribing but there are also causes that are unique to each. A greater understanding of the prevalence of the complex causal pathways found and the differences between the pathways of minor and severe errors is necessary. Such an understanding would underpin theoretically‐based interventions to reduce the occurrence of prescribing errors.
A Proposed Framework of Audit Fees Determinants in Kurdistan Region

This paper examines the factors influencing the determinants of audit fees in the Kurdistan region/ Iraq. The major purpose is to develop a plausible proxy that can be beneficial in practical work. In order to do this, a prior related literature will be studied before the possible associated factors are analyzed and assessed. Furthermore, research questionnaire is distributed among experienced auditors, accountants and financial officers of client firms, and academics in the field. The hypotheses of this paper aim to investigate the significance of three major groups of factors which might considerably influence audit fees; audited firm attributes, auditor attributes, and market attributes. The results show that all three proposed categories of factors are significant and might be taken in consideration when audit fees are determined. Keywords: Audit fees, Auditee attributes, Auditor attributes, Market attributes.
Capacity Limitations in Memory for Visual Locations

This paper examines people's ability to make judgments which require them to know the relative positions of objects that are not simultaneously visible is examined. It has previously been shown that people can accurately perform such a task. The current experiments test the capacity limits for such tasks. Two experiments were conducted that required subjects to make spatial judgments based on sequences of points presented two at a time. It was shown that, whereas subjects can perform accurately when memory for a small number of dots (about four) is required, increasing the number of dots results in a radical reduction in performance. This argues against both the idea that spatial memory is based on a linguistic description and the idea that it is based on an image-like representation. Rather it appears that one can form an accurate representation of the spatial properties of a small number of objects.
Overexpression of Cyclooxygenase-2 and Transforming Growth Factor-Beta 1 is an Independent Predictor of Poor Virological Response to Interferon Therapy in Chronic HCV Genotype 4 Patients

Background/Aims: COX-2 and TGF-β1 are overexpressed in hepatitis C virus (HCV) infection and are related to hepatitis pathogenesis and hepatic fibrosis. The current study investigated the relationship between pretreatment COX-2 and TGF-β1 hepatic expression in HCV genotype 4 and the virological response to interferon therapy. Patients and Methods: Liver biopsies of 55 patients with HCV infection genotype 4 were selected together with 10 liver biopsies as control. The patients’ clinicopathological data were collected. Immunohistochemistry was done using anti-COX-2 and anti-TGF-β1 antibodies. Statistical tests were used to determine the association between both COX-2 and TGF-β1 expression in relation to clinicopathological parameters and response to interferon therapy. Results: COX-2 was upregulated especially in nonresponders and was an independent predictor of poor virological response. However, COX-2 showed no association with other clinicopathological features. TGF-β1 was upregulated and associated with nonresponders, histological activity, and fibrosis stage. There was no association between TGF-β1 and other clinicopathological features. There was an association between COX-2 and TGF-β1 immunoexpression. Conclusion: Overexpression of COX-2 and TGF-β1 is an independent predictor for poor outcome of interferon and ribavirin therapy and these might be useful markers for the response to treatment. Both molecules are associated together; however, their role during hepatitis treatment has to be clarified.
A new EDAC technique against soft errors based on pulse detectors

In this paper, a new technique is proposed in order to assure the reliability of digital circuits against single event upsets (SEUs) and multi-bit upsets (MBUs), which are a major concern in a radiation environment like space. This proposal reduces the area cost of triple modular redundancy (TMR), offering a similar protection level. In order to show the reliability and the area savings for this technique, it has been implemented using a commercial library to protect registers of different size. A software fault injection platform has been used in order to verify the reliability of the proposed technique.
Activation of SAPK/JNK by TNF Receptor 1 Through a Noncytotoxic TRAF2-Dependent Pathway

Interaction of the p55 tumor necrosis factor receptor 1 (TNF-R1)-associated signal transducer TRADD with FADD signals apoptosis, whereas the TNF receptor-associated factor 2 protein (TRAF2) is required for activation of the nuclear transcription factor nuclear factor kappa B. TNF-induced activation of the stress-activated protein kinase (SAPK) was shown to occur through a noncytotoxic TRAF2-dependent pathway. TRAF2 was both sufficient and necessary for activation of SAPK by TNF-R1; conversely, expression of a dominant-negative FADD mutant, which blocks apoptosis, did not interfere with SAPK activation. Therefore, SAPK activation occurs through a pathway that is not required for TNF-R1-induced apoptosis.
Obstacles in Business Process Management (BPM) Implementation and Adoption in SMEs

A business’s decision for utilizing a technology is based on reviewing the factors influencing this utilization and its advantages. Technology deployment greatly affects the way business is conducted, the optimality of resource utilization and Increase in the business’s competitive advantage. Factors influencing this utilization include various organizational, technological (innovation), environmental and individual characteristics. Characteristics of small and medium enterprises have a double-edged razor role in the effective utilization of business process management. These characteristics can create barriers in this utilization and become a great challenge in this issue. Other characteristics can ease this utilization and accelerate the adapting to the new system. This study, based on a mixed method approach, examines the main inhibiting factors in implementation of business process management. In the qualitative phase, these factors are identified through reviewing related research and interviewing experts of the field. Then, based on these findings, a questionnaire is designed. In the quantitative phase, data gathered from 122 samples from 28 businesses, active in Iranian e-retail sector and finally the identified factors were ranked based on their perceived importance by respondents.
What Google Can't Tell Us About Internet Auctions (and What it Can)

No initial public offering in the history of the United States capital markets has been as intensely discussed as the August 2004 offering of Class A Common Stock of Google, Inc. From the announcement of the IPO itself to the details of its innovative Internet auction to the post-IPO share price, the investing world has been continuously discussing Google for almost a year. One aspect of Google's IPO that received much attention before the offering was the fact that Google chose an online auction process as the mechanism to distribute its original IPO shares. In keeping with Google's nonconformist image, the founders of Google chose an IPO mechanism that is used only once or twice a year in the U.S. Many detractors of the traditional bookbuilding mechanism declared that the Google auction foreshadowed an upheaval in the cliquish investment banking industry. Although Google's auction was predicted to be the beginning of a trend, if anything, the auction process was blamed for low investor demand in the weeks leading up to the offering and a last-minute slash in the price range. In addition, in the year since the Google auction, only two other issuers have launched an online IPO. As observers of the intersection of the Internet and the securities markets, we are left to wonder whether the Google auction was a harbinger of change, a meaningless electronic blip, or even worse, a marketing event for the public relations-conscious issuer. This article analyzes this historic IPO and explores what important the Google IPO has for the campaign for online IPO auctions. Unfortunately, because Google was a unique issuer in many respects, both positive and negative, its offering cannot be used to herald an immediate sea change in the bookbuilding IPO market. However, Google's auction will only assist other issuers in negotiating with underwriters for alternative offering mechanisms.
Substrate induced radical formation in 4-hydroxybutyryl-CoA dehydratase 1 from Clostridium aminobutyricum 2 3

3 Jin Zhang*, Peter Friedrich*, Antonio J. Pierik, Berta M. Martins, Wolfgang Buckel 4 5 Laboratorium für Mikrobiologie, Fachbereich Biologie and Synmikro, Philipps-Universität, 35032 6 Marburg, Germany; Max-Plank-Institut für terrestrische Mikrobiologie, 35043 Marburg; Institut 7 für Zytobiologie, Philipps-Universität, 35032 Marburg, Germany; Present address: Fachbereich 8 Chemie, Universität Kaiserslautern, 67663 Kaiserslautern, Germany; Institut für Biologie, 9 Strukturbiologie/Biochemie, Humboldt-Universität zu Berlin, 10099 Berlin, Germany. 10 11 Dedicated to Dr. Peter Willadsen (Brisbane, Australia) 12 * JZ and PF contributed equally to this work and are considered both as first authors. 13 Running head: Mechanism of 4-hydroxybutyryl-CoA dehydratase 14 Correspondence to: W. Buckel, Laboratorium für Mikrobiologie, Fachbereich Biologie, Karl-von15 Frisch-Straße 8, 35032 Marburg. Tel +49 6421 28 22088, Fax +49 6421 28 28979, Email: 16 buckel@staff.uni-marburg.de 17 18
Shady physiology revealed

somatic sex determination, can also be deployed as a patterning gene. Thus, the doublesex switch not only appears to be involved in the genetic control of female morphs, but expression of the doublesex protein in developing scale cells also correlates with the yellowish white rays found on the forewing of mimetic females. Loehlin and Carroll, in their accompanying commentary in the same issue of Nature on pages 172– 173 note that rather than simply indicating whether a specific tissue is male or female, doublesex expression is also elaborately regulated itself and shows tissue-specific expression in its own right. This means that doublesex is not only the female-limited switch gene but also a wing patterning gene. Finally, if a tightly linked cluster of genes (a supergene) is indeed only one albeit rather complicated gene, what exactly is recombination within a supergene? Loehlin and Carroll already noted that complex genes like doublesex probably carry a significant number of regulatory elements themselves and that any ‘recombinants’ within this supergene (although none have been noted for P. polytes by either Clarke and Sheppard or indeed Kunte et al.), or others, may be recombination events between different doublesex enhancers, that is, specifically correspond to recombinants within one gene rather than a set of clustered genes. Further, Kunte et al. also found an inversion polymorphism with breakpoints flanking the doublesex gene; however, it is not clear how different inversions might lock together different doublesex regulatory elements to drive different patterns of scale cell development. These results are similar to inversions around the P locus of Heliconius numata, which control the wide range of mimetic morphs associated with Mullerian mimicry (Joron et al., 2011). Significantly, many of these melanic mimicry examples, including P. polytes and H. numata, show dominance series amongst the different mimetic alleles with more melanic morphs being dominant over paler ones. If we now understand these to be alleles of a single gene (doublesex or P), then it may be easier to understand how such dominance series have evolved. Different inversions may therefore simply ‘lock together’ different enhancer elements and thus drive morph specific patterns of expression from different alleles of a single switch gene. This may also help to explain the famous ‘industrial’ melanism of the peppered moth, Biston betularia, where again darker forms are dominant over lighter ones and again melanism looks to be under control of a single locus at the equivalent chromosomal location to H. numata P (Van’t Hof et al., 2011). This very brief review of pigmentation and melanism in butterflies and moths therefore gives us two important ‘take-home messages’. First, pigmentation is about more than just ‘development’ and can in fact act as a major driver of natural selection. Second, and as a direct correlate to this, understanding the developmental heterochrony that underlies insect pigmentation is critical to our understanding of the molecular basis of natural selection itself.
DSP-Based Interleaved Buck Power Factor Corrector With Adaptive Slope Compensation

This paper introduces the adaptive slope compensation method into the digital clamping current control at various input voltages to improve the power factor (PF) and the total harmonic distortion (THD) of the universal input. The controller conducts a phase-management mechanism for various input voltages and load conditions to raise the circuit conversion efficiency. The optimal switching timing for one- and two-phase operations can be determined from the power loss distribution. A digital signal processor chip TMS320F28035 is used to implement the digital platform. A 300-W laboratory prototype with a universal line voltage 80-V dc output voltage is designed and tested to verify the feasibility. The values of efficiency from light load (10% of rated power) to full load at 115- and 230-V inputs are greater than 95%. PF values from medium to full load are greater than 0.94. Input current harmonics also meet the norm of IEC 61000-3-2 Class D.