Miracle-dz/UniFAR-FTUs huggingface dataset:
Implications of metric choice for common applications of readmission metrics.

OBJECTIVE To quantify the differential impact on hospital performance of three readmission metrics: all-cause readmission (ACR), 3M Potential Preventable Readmission (PPR), and Centers for Medicare and Medicaid 30-day readmission (CMS). DATA SOURCES 2000-2009 California Office of Statewide Health Planning and Development Patient Discharge Data Nonpublic file. STUDY DESIGN We calculated 30-day readmission rates using three metrics, for three disease groups: heart failure (HF), acute myocardial infarction (AMI), and pneumonia. Using each metric, we calculated the absolute change and correlation between performance; the percent of hospitals remaining in extreme deciles and level of agreement; and differences in longitudinal performance. PRINCIPAL FINDINGS Average hospital rates for HF patients and the CMS metric were generally higher than for other conditions and metrics. Correlations between the ACR and CMS metrics were highest (r = 0.67-0.84). Rates calculated using the PPR and either ACR or CMS metrics were moderately correlated (r = 0.50-0.67). Between 47 and 75 percent of hospitals in an extreme decile according to one metric remained when using a different metric. Correlations among metrics were modest when measuring hospital longitudinal change. CONCLUSIONS Different approaches to computing readmissions can produce different hospital rankings and impact pay-for-performance. Careful consideration should be placed on readmission metric choice for these applications.
Metformin treatment lowers asymmetric dimethylarginine concentrations in patients with type 2 diabetes.

This study was initiated to see if plasma asymmetric dimethylarginine (ADMA) concentrations decreased in hyperglycemic patients with type 2 diabetes following metformin treatment, either as monotherapy or following its addition to sulfonylurea-treated patients. Fasting plasma glucose, dimethylarginine, and L-arginine concentrations were measured before and 3 months after the administration of a maximally effective dose of metformin to 31 patients with type 2 diabetes in poor glycemic control (fasting plasma concentrations > 9.7 mmol/L), while being treated with either diet (n = 16) or a maximal amount of a sulfonylurea compound (n = 15). Fasting plasma glucose concentration (mean +/- SEM) decreased to a similar degree (P <.01) in patients treated with either metformin alone (12.4 +/- 0.5 to 9.5 +/- 0.5 mmol/L) or when it was added to a sulfonylurea compound (14.1 +/- 0.5 to 10.6 +/- 0.9 mmol/L). The improvement in glycemic control was associated with similar decreases (P <.01) in ADMA concentrations in metformin (1.65 +/- 0.21 to 1.18 +/- 0.13 micromol/L) and sulfonylurea + metformin-treated patients (1.75 +/- 0.13 to 1.19 +/- 0.08 micromol/L). Plasma L-arginine concentrations were similar in the 2 groups at baseline and did not change in response to metformin. Thus, metformin treatment was associated with a favorable increase in the plasma L-arginine/ADMA ratio. These results provide the first evidence that plasma ADMA concentrations decrease in association with improved glycemic control in patients with type 2 diabetes and demonstrate that the magnitude of the change in metformin-treated patients was similar, irrespective of whether it was used as monotherapy or in combination with sulfonylurea treatment.
Determining activity monitor wear time: an influential decision rule.

BACKGROUND Accurately measuring physical activity (PA) with activity monitors requires sufficient monitor wear time which can be difficult to assess. Monitor sensitivity to movement and population characteristics (eg, children vs. adults) may dictate the duration of monitor inactivity indicative of nonwear. A standardized method for determining appropriate decision rules to identify wear time is needed. METHODS Several decision rules based on minimum durations of monitor inactivity (ie, 60, 90, 120, 150 minutes) to identify nonwear were applied to Stepwatch Activity Monitor data from 1064 adult bariatric surgical candidates. The frequency, pattern, and duration of resulting nonwear and wear periods were examined. Generalized Estimating Equations tested the effect of these decision rules on PA measures. RESULTS A 60-minute duration resulted in unreasonably large percentages of subjects with unlikely wear patterns [eg, ≥3 nonwear periods in a day (29.9%); ≥2 wear periods of less than an hour in a day (28.7%)]; 120 minutes appeared most reasonable. Wear time decision rules impacted PA measures. CONCLUSIONS The methods described in this paper can be used to determine appropriate instrument and population specific wear time decision rules. Recognizing monitor wear time is estimated, PA measures least affected by wear time are preferable.
Un modèle d’équilibre général dynamique pour une petite économie ouverte avec des effets Balassa-Samuelson

Pour rendre compte des chocs qui ont affecte l’economie Tunisienne durant les vingt dernieres annees, nous montrons dans un premier temps que des effets Balassa-Samuelson sont a l’oeuvre. Afin de reproduire les principaux faits stylises, le modele dynamique d’equilibre general bisectoriel (expose et abrite) construit comporte, dans un contexte de concurrence monopolistique, des negociations salariales en presence d’une parfaite mobilite intersectorielle du travail et des rigidites nominales sur les prix. Ce modele permet d’expliquer l’evolution du taux de change reel et des principaux agregats. La forte depreciation du taux de change reel en 1986-1988 peut etre reproduit e par un choc negatif de demande mondiale et par une moderation salariale durant le programme d’ajustement structurel. L’appreciation du taux de change reel qui a suivi serait pour sa part la consequence de gains de productivite dans le secteur expose et de la levee des quotas sur le textile.
Kinetics of Hypotension during 50 Sessions of Resistance and Aerobic Training in Hypertensive Patients: a Randomized Clinical Trial

Background Resistance and aerobic training are recommended as an adjunctive treatment for hypertension. However, the number of sessions required until the hypotensive effect of the exercise has stabilized has not been clearly established. Objective To establish the adaptive kinetics of the blood pressure (BP) responses as a function of time and type of training in hypertensive patients. Methods We recruited 69 patients with a mean age of 63.4 ± 2.1 years, randomized into one group of resistance training (n = 32) and another of aerobic training (n = 32). Anthropometric measurements were obtained, and one repetition maximum (1RM) testing was performed. BP was measured before each training session with a digital BP arm monitor. The 50 training sessions were categorized into quintiles. To compare the effect of BP reduction with both training methods, we used two-way analysis of covariance (ANCOVA) adjusted for the BP values obtained before the interventions. The differences between the moments were established by one-way analysis of variance (ANOVA). Results The reductions in systolic (SBP) and diastolic BP (DBP) were 6.9 mmHg and 5.3 mmHg, respectively, with resistance training and 16.5 mmHg and 11.6 mmHg, respectively, with aerobic training. The kinetics of the hypotensive response of the SBP showed significant reductions until the 20th session in both groups. Stabilization of the DBP occurred in the 20th session of resistance training and in the 10th session of aerobic training. Conclusion A total of 20 sessions of resistance or aerobic training are required to achieve the maximum benefits of BP reduction. The methods investigated yielded distinct adaptive kinetic patterns along the 50 sessions.
KNOWLEDGE, BARGAINING POWER, AND THE INSTABILITY OF INTERNATIONAL JOINT VENTURES

Although the high rate of instability of international joint ventures (IJVs) has been well documented, the underlying reasons for the instability need clarification. In this article, we develop a theoretical framework for instability of IJVs grounded in a bargaining power and dependence perspective. Instability is defined as a major change in partner relationship status that is unplanned and premature from one or both partners' perspectives. The core argument is that the instability of IJVs is associated with shifts in partner bargaining power. Shifts in the balance of bargaining power occur when partners of an IJV acquire sufficient knowledge and skills to eliminate a partner dependency and make the IJV bargain obsolete. Our primary focus is on the acquisition of local knowledge by the foreign partner and the impact that this acquisition of knowledge has on the stability of the IJV.
Evaluation of the ocular penetration of topical alpha-luminol (Galavit®/GVT®).

PURPOSE Oxidative stress plays a major role in the pathogenesis of many neurodegenerative diseases. It has also been implicated as part of the pathogenic mechanisms in the development of glaucoma. Alpha-luminol has shown profound anti-inflammatory and antioxidant effects in both experimental animal and human clinical studies. The purpose of this pilot study was to investigate for the first time the ocular penetration of topical alpha-luminol. METHODS Nine animals were divided into three treated groups (three animals each; one drop OU/n = 18), each group receiving a different concentration of the eyedrop (0.5%, 1.5%, 2.5%). Aqueous humor and peripheral blood samples were obtained from each rabbit at three different timepoints (20 min, 4 h and 12 h). Samples were analyzed by means of high performance liquid chromatography and mass spectrometry; median values were compared. RESULTS Alpha-luminol was found in the aqueous humor in all treated groups at all timepoints. At the 2nd and 3rd timepoints (4 h and 12 h), aqueous humor levels decreased significantly (P < 0.05) for two of the three dosages tested and it was not detectable in some eyes. The highest aqueous humor concentration of the drug was 272 ng/mL after 20 min (0.0217% of one drop, 2.5% group). Alpha-luminol was found in the vitreous in two animals, one in the 1.5% and another in the 2.5% group (16.4 and 21.5 ng/mL, respectively), at 12 h. CONCLUSIONS Topically administered alpha-luminol readily penetrates into the anterior chamber and can penetrate into the vitreous chamber. Further investigation is warranted to better understand the intraocular pharmacokinetics of alpha-luminol.
Ultrastructural localisation and functional implications of Corticotropin releasing factor, Urocortin and their receptors in cerebellar neuronal development

In the cerebellum, climbing fibers containing corticotropin releasing factor (CRF) are crucial for the induction of long term depression at the Purkinje cell-parallel fiber synapse, a type of synaptic plasticity proposed as the cellular basis of learning. However, CRF expression commences at late embryonic stages, prior to the formation of any functional synapses. Prevailing thought leans towards the supposition of CRF, initially playing a role in establishing the cerebellar circuitry, with a shift in adulthood to that of a neuromodulator. In the present study, we detail the spatial and temporal distributional profile of CRF to further understand the possible roles of this peptide in the developing rat cerebellum. The study showed that the expression of CRF was not evenly distributed rather exhibiting inter - and intra-lobular heterogeneity, being localised in variable amounts in mossy fiber rosettes and climbing fiber terminal profiles from as early as postnatal day 3. In the posterior regions especially lobules IX and X, CRF labelling was more prominent in comparison to the central (V-VIII) and anterior lobules (I-IV). This disparate lobular distribution persisted through to adulthood. No cerebellar neurons were conclusively found to contain CRF. Furthermore, between postnatal days 6 to 9, in the posterior lobules, CRF labelling at the level of the Purkinje cell clearly showed the characteristic climbing fiber terminal arrangement related to the capuchon stage whereas in the anterior lobules, labelling is confined to the perisomatic profiles. These differences might signify that translocation of the climbing fibers from the Purkinje cell soma to its dendrite is not uniform for all climbing fibers with CRF possibly playing a facilitative role in this process. CRF immunoreactivity was also zonally arranged in sagittal bands across the molecular layer, these appearing as early as postnatal day 9 and persisting through to adulthood indicating that not all climbing fibers are immunoreactive. Since not all climbing fibers contain CRF, the process of long term depression and hence learning could possibly not be uniform across the cerebellum but be
Are Size and January Effects Related? Evidence from the Tunisian Stock Exchange

In this paper, we examine the existence of the size effect in the Tunisian stock exchange (TSE) overÂ the period January 2008 to December 2013 and we test the relationship between size Â and January effects. Thefindings reveal that there is a size effect in the TSE. However, we report that size and January effects are separateanomalies. More specifically, we document that average returns are found to increase with decreases in size.However, we find that small firms donâ€™t significantly outperform large firms in January.
Health Care

Health care is an enormously expensive, highly complex, universally used service that significantly affects economies and the quality of daily living. Service management, operations, and marketing scholars have much to offer to a critically important, intellectually challenging, but deeply troubled health care service sector. In this article, the authors use the opportunity they had to study at one of the world's most admired medical institutions— Mayo Clinic—as the basis for discussing the similarities and dissimilarities between health care and other services. The article takes the reader “inside” health care. The authors challenge service scholars to consider health care for their research activities and propose areas for future research.
Going to extremes: Family structure, children’s well-being, and social science

In this article I argue that public discussions of demographic issues are often conducted in a troubling pattern in which one extreme position is debated in relation to the opposite extreme. This pattern impedes our understanding of social problems and is a poor guide to sound public policies. To illustrate this thesis I use the case of social scientific research examining how children are affected by not living with two biological parents while they are growing up. Over the last decade, I maintain, most of the public, and even many social scientists, have been puzzled and poorly informed by this debate. In particular I consider Judith Wallerstein’s clinically based claims of the pervasive, profound harm caused by divorce and, at the other extreme, Judith Rich Harris s reading of behavioral genetics and evolutionary psychology, which leads her to dismiss the direct effects of divorce. Neither extreme gives a clear picture of the consequences of growing up in a single-parent family or a stepfamily.
Mitigating Adverse Selection in P2P Lending – Empirical Evidence from Prosper.com

This paper presents novel empirical evidence on the success of efforts by P2P lending platforms to limit adverse selection using a unique sample of 5,385 credit transactions on the internet platform Prosper.com. The results of our regressions on the probability of a credit bid’s successful funding show that all variables for which a significant influence on the probability of funding success could be found describe information which is verified by Prosper.com. Conversely, all non-verified variables do not possess any significant influence on the dependent variable thus confirming our hypothesis that the screening of potential borrowers is a major instrument in mitigating adverse selection in P2P lending and preventing the online market to collapse. Moreover, we find evidence confirming the proposition that the screening of potential borrowers by groups can help mitigate adverse selection. Group membership, however, does also seem to have a positive influence on the probability of a credit bid expiring, a novel finding of this study.
Up and Down the Blind Alley: Population Divergence with Scant Gene Flow in an Endangered Tropical Lineage of Andean Palms (Ceroxylon quindiuense Clade: Ceroxyloideae)

Given the geographical complexity of the Andes, species distributions hold interesting information regarding the history of isolation and gene flow across geographic barriers and ecological gradients. Moreover, current threats to the region’s enormous plant diversity pose an additional challenge to the understanding of these patterns. We explored the geographic structure of genetic diversity within the Ceroxylon quindiuense species complex (wax palms) at a regional scale, using a model-based approach to disentangle the historical mechanisms by which these species have dispersed over a range encompassing 17° of latitude in the tropical Andes. A total of 10 microsatellite loci were cross-amplified in 8 populations of the 3 species comprising the C. quindiuense complex. Analyses performed include estimates of molecular diversity and genetic structure, testing for genetic bottlenecks and an evaluation of the colonization scenario under approximate Bayesian computation. We showed that there was a geographical diversity gradient reflecting the orogenetic pattern of the northern Andes and its end at the cordilleras facing the Caribbean Sea. A general pattern of diversity suggests that the cordilleras of Colombia have served as historical recipients of gene flow occurring only scantly along the northern Andes. We provided evidence of important isolation between the largest populations of this complex, suggesting that both historical constraints to dispersal but also current anthropogenic effects might explain the high levels of population structuring. We provide a list of advisable measures for conservation stakeholders.
Functional gastrointestinal disorders in eating disorder patients: altered distribution and predictors using ROME III compared to ROME II criteria.

AIM To compare the prevalence of Functional gastrointestinal disorders (FGIDs) using ROME III and ROME II and to describe predictors of FGIDs among eating disorder (ED) patients. METHODS Two similar cohorts of female ED inpatients, aged 17-50 years, with no organic gastrointestinal or systemic disorders, completed either the ROME III (n = 100) or the ROME II (n = 160) questionnaire on admission for ED treatment. The two ROME cohorts were compared on continuous demographic variables (e.g., age, BMI) using Student's t-tests, and on categorical variables (e.g., ED diagnosis) using χ(2)-tests. The relationship between ED diagnostic subtypes and FGID categories was explored using χ(2)-tests. Age, BMI, and psychological and behavioural predictors of the common (prevalence greater than 20%) ROME III FGIDs were tested using logistic regression analyses. RESULTS The criteria for at least one FGID were fulfilled by 83% of the ROME III cohort, and 94% of the ROME II cohort. There were no significant differences in age, BMI, lowest ever BMI, ED diagnostic subtypes or ED-related quality of life (QOL) scores between ROME II and ROME III cohorts. The most prevalent FGIDs using ROME III were postprandial distress syndrome (PDS) (45%) and irritable bowel syndrome (IBS) (41%), followed by unspecified functional bowel disorders (U-FBD) (24%), and functional heartburn (FH) (22%). There was a 29% or 46% increase (depending on presence or absence of cyclic vomiting) in functional gastroduodenal disorders because of the introduction of PDS in ROME III compared to ROME II. There was a 35% decrease in functional bowel disorders (FBD) in Rome III (excluding U-FBD) compared to ROME II. The most significant predictor of PDS was starvation (P = 0.008). The predictor of FH (P = 0.021) and U-FBD (P = 0.007) was somatisation, and of IBS laxative use (P = 0.025). Age and BMI were not significant predictors. The addition of the 6-mo duration of symptoms requirement for a diagnosis in ROME III added precision to many FGIDs. CONCLUSION ROME III confers higher precision in diagnosing FGIDs but self-induced vomiting should be excluded from the diagnosis of cyclic vomiting. Psychological factors appear to be more influential in ROME II than ROME III.
Comparison of the beta-glucuronidase assay and the conventional method for identification of Escherichia coli on eosin-methylene blue agar.

The purpose of this study was to compare the IMViC (indole, methyl red, Voges-Proskauer and citrate utilization) tests with the beta-glucuronidase (GUD) assay for the identification of suspect Escherichia coli on Levine's eosin-methylene blue (EMB) agar. After testing 258 suspect E. coli colonies from raw meat and meat products, 163 and 44 were found to be E. coli and non-E. coli, respectively, by both methods. Nine isolates were IMViC positive (i.e., + + - - or - + - -) but GUD negative; among these isolates, six were confirmed to be E. coli by API 20E (bioMerieux, Marcy-I'Etoile, France) with the remaining three being non-E. coli. There were 42 isolates that were IMViC negative but GUD positive; among these isolates, seven were pure E. coli cultures, 33 were mixed cultures containing E. coli, and the remaining two were Proteus spp. The sensitivities for the identification of E. coli on EMB were 80.9% (169/209) and 97.1% (203/209), respectively, by the IMViC tests and GUD assay; whereas the specificities were 93.9% (46/49) and 95.9% (47/49), respectively, by the IMViC tests and GUD assay. It is proposed that the GUD assay can be an effective alternative to the conventional IMViC tests for the identification of suspect E. coli on EMB.
Dual-band tow layered printed antenna for 2.4/5GHz WLAN operation in the laptop computer

A novel dual-band two layered printed antenna for an internal laptop antenna for WLAN operation is presented. The antenna has a simple two layered structure consisting of a spiral strip. The proposed antenna has a low profile and can easily be fed by using a 50Ω microstrip line. It is believed that the size of the antenna is about the smallest among the existing internal laptop antennas for 2.4/5GHz WLAN operation. The antenna occupies a small area of 5mm×12mm on a combined FR4 and foam substrates. The simulated results are in good agreement with the measured results. Compact size, low cost, ease of fabrication and good radiation parameters respect to the previous designs are the most important advantages of the proposed antenna.