Miracle-dz/UniFAR-FTUs huggingface dataset:
What Prevents Quality Midwifery Care? A Systematic Mapping of Barriers in Low and Middle Income Countries from the Provider Perspective

Background Quality of care is essential for further progress in reducing maternal and newborn deaths. The integration of educated, trained, regulated and licensed midwives into the health system is associated with improved quality of care and sustained decreases in maternal and newborn mortality. To date, research on barriers to quality of care for women and newborns has not given due attention to the care provider’s perspective. This paper addresses this gap by presenting the findings of a systematic mapping of the literature of the social, economic and professional barriers preventing midwifery personnel in low and middle income countries (LMICs) from providing quality of care. Methods and Findings A systematic search of five electronic databases for literature published between January 1990 and August 2013. Eligible items included published and unpublished items in all languages. Items were screened against inclusion and exclusion criteria, yielding 82 items from 34 countries. 44% discussed countries or regions in Africa, 38% in Asia, and 5% in the Americas. Nearly half the articles were published since 2011. Data was extracted and presented in a narrative synthesis and tables. Items were organized into three categories; social; economic and professional barriers, based on an analytical framework. Barriers connected to the socially and culturally constructed context of childbirth, although least reported, appear instrumental in preventing quality midwifery care. Conclusions Significant social and cultural, economic and professional barriers can prevent the provision of quality midwifery care in LMICs. An analytical framework is proposed to show how the overlaps between the barriers reinforce each other, and that they arise from gender inequality. Links are made between burn out and moral distress, caused by the barriers, and poor quality care. Ongoing mechanisms to improve quality care will need to address the barriers from the midwifery provider perspective, as well as the underlying gender inequality.
The Structure of Federal Reserve Liabilities

Throughout the financial crisis and its aftermath from late 2008 through October 2014, the Federal Reserve used asset purchases as a potent tool of monetary policy? buying longer-term Treasury and mortgage-backed securities to provide economic stimulus beyond what traditional policy approaches could produce. Consequently, the size and composition of the Fed? s balance sheet changed significantly over this period.
Melatonin inhibits lipid peroxidation and stimulates the antioxidant status of diabetic rats

Although melatonin has been established as a free radical scavenger and antioxidant, its effects in diabetes have not been thoroughly investigated. The purpose of this study, therefore, was to investigate the effects of melatonin administration on lipid peroxidation and antioxidant status in streptozotocin (STZ)‐induced diabetes in rats. Concentrations of malondialdehyde (MDA) and reduced glutathione (GSH) in erythrocytes and activities of superoxide dismutase (SOD) and glutathione peroxidase (GSH‐Px) were compared in 3 groups of 10 rats each [control non‐diabetic rats (group I), untreated diabetic rats (group II) and diabetic rats treated with melatonin (group III)]. In the study groups, diabetes developed 3 days after intraperitoneal (i.p.) administration of a single 60‐mg/kg dose of STZ. Thereafter, while the rats in group II received no treatment, the rats in group III began to receive a 10‐mg/kg i.p. dose of melatonin per day. After 6 wk, the rats in groups II and III had significantly lower body weights and significantly higher blood glucose levels than the rats of group I (P<0.001 and P<0.001, respectively). There were no significant differences in body weight or blood glucose levels between groups II and III. MDA levels in untreated diabetic rats were higher than those in control group rats and in diabetic rats treated with melatonin (P<0.01 and P<0.05, respectively). However, MDA levels in diabetic rats treated with melatonin were not different from those of the control group. The GSH, GSH‐Px and SOD levels of untreated diabetic rats were significantly lower than those of the control group (P<0.02, P<0.002 and P<0.05, respectively). In group III, however, melatonin prevented decreases in the thiol antioxidant and the associated enzymes, and so these levels were not significantly different from those in the control group. These results confirm the presence of oxidative stress in STZ‐induced experimental diabetes and indicate the beneficial free radical‐scavenging and antioxidant properties of melatonin.
In Utero Exposure to Dichlorodiphenyltrichloroethane (DDT) and Dichlorodiphenyldichloroethylene (DDE) and Neurodevelopment Among Young Mexican American Children

OBJECTIVE. We investigated the relationship between prenatal exposure to dichlorodiphenyltrichloroethane (DDT) and dichlorodiphenyldichloroethylene (DDE) and neurodevelopment of Mexican farm-workers' children in California. METHODS. Participants from the Center for the Health Assessment of Mothers and Children of Salinas study, a birth cohort study, included 360 singletons with maternal serum measures of p,p′-DDT, o,p′-DDT, and p,p′-DDE. Psychomotor development and mental development were assessed with the Bayley Scales of Infant Development at 6, 12, and 24 months. RESULTS. We found a ∼2-point decrease in Psychomotor Developmental Index scores with each 10-fold increase in p,p′-DDT levels at 6 and 12 months (but not 24 months) and p,p′-DDE levels at 6 months only. We found no association with mental development at 6 months but a 2- to 3-point decrease in Mental Developmental Index scores for p,p′-DDT and o,p′-DDT at 12 and 24 months, corresponding to 7- to 10-point decreases across the exposure range. Even when mothers had substantial exposure, breastfeeding was usually associated positively with Bayley scale scores. CONCLUSIONS. Prenatal exposure to DDT, and to a lesser extent DDE, was associated with neurodevelopmental delays during early childhood, although breastfeeding was found to be beneficial even among women with high levels of exposure. Countries considering the use of DDT should weigh its benefit in eradicating malaria against the negative associations found in this first report on DDT and human neurodevelopment.
Are You Moving Up or Falling Short? An Inquiry of Skills-based Variation in Self-perceived Employability among Norwegian Employees

This article investigates how educational level, job-related skills and employers’ support for competence development jointly determine Norwegian employees’ expectations of maintaining employment and career advancement. The data were collected in 2010 and 2013, and they comprise a representative sample of Norwegian employees. In contrast to previous research on self-perceived employability, this study divides expectations of advancement and continued employment. The results show that these are different measures of labour market success. While education is significantly correlated with both measures, the employer’s support for competence development is important for expectations of career advancement, especially among the highly educated, whereas the job–skills match is most relevant for the expectation of maintaining employment.
Combined SSCP/heteroduplex analysis in the screening for PAX6 mutations.

We demonstrate the use of combined SSCP and heteroduplex analysis in the detection of PAX6 mutations using non-radioactive silver staining. A panel of aniridia patients was screened by this approach and we show that a greater number of mutations was detected than would have been found by running each technique alone. Six previously unreported aniridia mutations in PAX6 are also described.
Tracheobronchomalacia: Current Concepts and Controversies

Tracheobronchomalacia (TBM) results from weakness of the airway walls and/or supporting cartilage and affects both adult and pediatric populations. Diagnosing TBM is challenging because symptoms are nonspecific and overlap with those of other chronic respiratory disorders. Recent advances in multidetector computed tomography have facilitated the noninvasive diagnosis of TBM, and concurrent advances in management have improved clinical outcomes and created a need for greater awareness of the posttreatment appearance of the airways. This review discusses the physiology, histopathology, epidemiology, and clinical features of TBM; it also describes current methods of diagnosis, available therapies, and postoperative imaging evaluation.
Persistent and Selective Deficiency of CD4+ T Cell Immunity to Cytomegalovirus in Immunocompetent Young Children1

Healthy young children who acquire CMV have prolonged viral shedding into the urine and saliva, but whether this is attributable to limitations in viral-specific immune responses has not been explored. In this study, we found that otherwise immunocompetent young children after recent primary CMV infection accumulated markedly fewer CMV-specific CD4+ T cells that produced IFN-γ than did adults. These differences in CD4+ T cell function persisted for more than 1 year after viral acquisition, and did not apply to CMV-specific IFN-γ production by CD8+ T cells. The IFN-γ-producing CD4+ T cells of children or adults that were reactive with CMV Ags were mainly the CCR7low cell subset of memory (CD45R0highCD45RAlow) cells. The decreased IFN-γ response to CMV in children was selective, because their CCR7low memory CD4+ T cells and those of adults produced similar levels of this cytokine after stimulation with staphylococcal enterotoxin B superantigen. CD4+ T cells from children also had reduced CMV-specific IL-2 and CD154 (CD40 ligand) expression, suggesting an early blockade in the differentiation of viral-specific CD4+ T cells. Following CMV acquisition, children, but not adults, persistently shed virus in urine, and this was observable for at least 29 mo postinfection. Thus, CD4+ T cell-mediated immunity to CMV in humans is generated in an age-dependent manner, and may have a substantial role in controlling renal viral replication and urinary shedding.
Romania’s Euro Area Accession: The Question Is Under What Terms!

Euro area (EA) accession should mainly depend on the achievement of a critical mass of real and structural convergence, which should diminish the risks to operate in an incomplete monetary union. Accession would also be enhanced by reforms in the functioning of euro area institutions and policies which should deal with asymmetric shocks. We argue that the true stake of euro adoption in Romania should be neither “if” nor “when”, but “under what terms” and “how it will be done”. The essential prerequisite for real convergence is raising competitiveness. Our analysis shows common problems regarding competitiveness in new member states in terms of infrastructure, institutional development, business sophistication, innovation; it points out the scale of risks attached to a premature euro area accession. This accession does not require the achievement of the euro area average level of GDP/capita (in PPP terms). As we argue, one can imagine Romania’s accession after having achieved a minimum of 75% of euro area GDP/capita average and the fulfilment of a series of structural conditions against the backdrop of euro area reforms.
Predictive value of recent QuantiFERON conversion for tuberculosis disease in adolescents.

RATIONALE Conversions and reversions occur with IFN-γ release assay (IGRA) serial testing, as with the tuberculin skin test (TST). Recent TST conversion is associated with an established risk of developing tuberculosis (TB) disease, but the risk associated with recent IGRA conversions is unknown. OBJECTIVES To compare the incidence rate of TB disease after recent QuantiFERON TB Gold In-Tube (QFT) conversion compared with nonconverters. METHODS Adolescents with converted IGRA status (QFT converters [n = 534]) and randomly chosen adolescents whose IGRA status had remained negative over a period of 2 years (QFT nonconverters [n = 629]) were identified in a cohort study of TB infection and disease. Subsequent TB disease incidence was compared between the two groups. MEASUREMENTS AND MAIN RESULTS For QFT converters, the TB incidence rate (all cases) was 1.46 cases per 100 person-years (95% confidence interval [CI], 0.82-2.39), and the cumulative incidence was 2.8% (95% CI, 1.58-4.59). A significantly lower TB incidence rate (0.17 cases per 100 person-yr [95% CI, 0.02-0.62]) and cumulative incidence (0.32% [95% CI, 0.03-1.14]) was observed for QFT nonconverters. The incidence rate ratio was 8.54 (95% CI, 2.51-29.13) for all cases of TB and 9.1 (95% CI, 1.65-50.36) for protocol-defined TB. CONCLUSIONS Recent QFT conversion was indicative of an approximately eight fold higher risk of progression to TB disease (compared with nonconverters) within 2 years of conversion in a cohort of adolescents in a high-TB burden population.
A Triple Bottom Line Approach for Measuring Supply Chains Sustainability Using Data Envelopment Analysis

This paper deals with the issues faced by those who endeavor in measuring sustainability in supply chains (SC) by using a comprehensive approach. Elkington´s Triple Bottom Line (TBL) divide sustainability in three aspects: environmental (E), economic and social (E2S). Firms publish their business (including SC) sustainability impacts through Corporate Social Responsibility reports (CSR). According to Global Reporting Initiative (GRI), a CSR framework, reported information should be sufficiently accurate/detailed towards performance, but reports are rather qualitative. Fast fashion (FF) is a recent phenomenon of production/promotion of cheap/readily disposable clothes. Data Envelopment Analysis (DEA) is the adequate tool to identify best practices regarding sustainability (multidimensional) and supply chains in FF. To allow comparability and tackle lack of quantitative data, TBL clusters (output) are proposed: for each Disclosure, a three layers scoring scale: absence (1), qualitative only (2), 2nd layer plus quantitative (4). This work´s main contribution is the use of DEA as a powerful tool to measure sustainability in SC and the TBL clusters link all dimensions in an innovative way. Keywords: Data Envelopment Analysis, Sustainability, Supply Chains, Triple Bottom Line, Fast Fashion
Mannose 6-Phosphate/Insulin-like Growth Factor II Receptor Fails to Interact with G-proteins

The binding of insulin-like growth factor II (IGF II) to the mannose 6-phosphate (M6P)/IGF II receptor has previously been reported to induce the activation of trimeric G proteins by functional coupling to a 14-amino acid region within the cytoplasmic receptor domain (Nishimoto, I., Murayama, Y., Katada, T., Ui, M., and Ogata, E.(1989) J. Biol. Chem. 264, 14029-14038). In the present study, we examined further the potential functional coupling of G-proteins with the human M6P/IGF II receptor and mutant receptors lacking the proposed G-protein activator sequence. IGF II treatment of mouse L-cells expressing either wild type or mutant M6P/IGF II receptors failed to attenuate the pertussis toxin-catalyzed modification of a 40-kDa protein or enhance GTPase activity. In broken L-cell membranes expressing wild type or mutant M6P/IGF II receptors, 30 nM IGF II also failed to affect the pertussis toxin substrate activity. By using phospholipid vesicles reconstituted with human wild type or mutant M6P/IGF II receptors and pertussis toxin-sensitive G-proteins, no stimulation of GTPS binding to or GTPase activity of G, G, or Gi/Go mixtures were observed in response to 1 μM IGF II. Furthermore, in vesicles containing purified wild type M6P/IGF II receptors and monomeric Gα or Gα and β dimers no effects of IGF II on GTPS binding could be detected. However, when vesicles reconstituted with M6P/IGF II receptors and G proteins were incubated with 100 μM mastoparan GTPS binding was stimulated and GTPase activity was increased significantly. These results indicate that the human M6P/IGF II receptor neither interacts with G-proteins in mouse L-cell membranes nor is coupled to G proteins in phospholipid vesicles. This study suggests strongly that the M6P/IGF II receptor does not function in transmembrane signaling in response to IGF II.
Seroprevalence of cytomegalovirus, Toxoplasma gondii, syphilis, and hepatitis B and C virus infections in a regional population seropositive for HIV infection.

OBJECTIVE To determine the prevalence of exposure to cytomegalovirus (CMV), Toxoplasma gondii, syphilis, hepatitis B virus (HBV) and hepatitis C virus (HCV) in a large, well characterized, regional population presenting for human immunodeficency virus (HIV) care. DESIGN Demographic and serological data compiled prospectively in a relational database used for routine patient care. Results were analyzed for statistically significant trends within demographic subpopulations known to be at risk of such infections. PATIENTS AND SETTING A total of 1274 persons with documented HIV infection in southern Alberta have sought medical care since 1985. Serological status to CMV, T gondii, syphilis, HBV and HCV infections were routinely requested as part of the initial assessment. All patients with serological results available were included in the analysis. RESULTS CMV infection was found in 84.1% of patients. A lower prevalence of CMV infection in those under 30 yeasr old (P<0.001), intravenous drug users (IVDUs) (P=0.001) and in patients with transfusion-acquired HIV (P<0.001) was seen. T gondii seropositivity was found in 10.6% of patients, with an increased risk of seropositivity in those born outside of Canada (P<0.001). Syphilis seropositivity was present in 5.1% of patients, with a higher prevalence in gay males (P=0.1). HBV carrier status was noted in 8.0% of patients, with males having an increased risk (P=0.025). Since 1990, there has been a 17.6% prevalence of HCV, predominantly in IVDUs (P<0.001). CONCLUSION Seroprevalence to common pathogens in HIV disease varies significantly among subpopulations, necessitating individual testing.
Chapter 9: Pragmatics and Discourse

Pragmatics studies the processes of language use, while discourse analysis is devoted to its product, i.e. discourse. Pragmatics can be understood in a narrow sense focussing on cognitive-inferential aspects of information processing, and it can be understood in a wider sense in which it also includes social aspects of interaction. In historical pragmatics, the former conceptualization lies behind work on pragmatic explanations in language change, while the latter conceptualization studies earlier language use from a social and interactional perspective, including such aspects as inserts (e.g. interjections and discourse markers), speech acts, and terms of address. Discourse, as the product of language use, can be seen as a stretch of conversation (dialogue) or as a domain of communication. In the former conceptualization, research focuses on the structural properties of the dialogue, and in the latter, it deals with the linguistic practices pertaining to particular fields of knowledge or interaction, e.g. courtroom discourse, the discourse of science, and news discourse.
[Species Diversity of Bifidobacteria in the Intestinal Microbiota Studied Using MALDI-TOF Mass-Spectrometry].

BACKGROUND The members of genus Bifidobacterium represent a significant part of intestinal microbiota in adults and predominate in infants. Species repertoire of the intestinal bifidobacteria is known to be subjected to major changes with age; however, many details of this process are still to be elucidated. OBJECTIVE Our aim was to study the diversity of intestinal bifidobacteria and changes of their qualitative and quantitative composition characteristics during the process of growing up using MALDI-TOF mass-spectrometric analysis ofpure bacterial cultures. METHODS A cross-sectional study of bifidobacteria in the intestinal microbiota was performed in 93 healthy people of the ages from 1 month to 57 years. Strains were identified using Microflex LT MALDI-TOF MS, the confirmation was performed by 16S rRNA gene fragment sequencing. RESULTS 93% of isolated bifidobacterial strains were successfully identified using MALDI-TOF mass-spectrometry. At least two of the strains from each species were additionally identified by 16S rRNA gene fragment sequencing, in all of the cases the results were the same. It was shown that the total concentration of bifidobacteria decreases with age (p<0.001) as well as the frequency of isolation of Bifidobacterium bifidum (p=0.020) and Bifidobacterium breve (p<0.001), and the frequency of isolation of Bifidobacterium adolescentis, increases (p<0.001), representing the continuous process of transformation of microbiota. CONCLUSION The method of MALDI-TOF mass spectrometry demonstrated the ability to perform rapid and reliable identification of bifidobacteria that allowed the study of changes in the quantitative and qualitative characteristics of human microbiota in the process of growing up.
Qualitative case study methodology in nursing research: an integrative review.

AIM This paper is a report of an integrative review conducted to critically analyse the contemporary use of qualitative case study methodology in nursing research. BACKGROUND Increasing complexity in health care and increasing use of case study in nursing research support the need for current examination of this methodology. DATA SOURCES In 2007, a search for case study research (published 2005-2007) indexed in the CINAHL, MEDLINE, EMBASE, PsychINFO, Sociological Abstracts and SCOPUS databases was conducted. A sample of 42 case study research papers met the inclusion criteria. METHODS Whittemore and Knafl's integrative review method guided the analysis. RESULTS Confusion exists about the name, nature and use of case study. This methodology, including terminology and concepts, is often invisible in qualitative study titles and abstracts. Case study is an exclusive methodology and an adjunct to exploring particular aspects of phenomena under investigation in larger or mixed-methods studies. A high quality of case study exists in nursing research. CONCLUSION Judicious selection and diligent application of literature review methods promote the development of nursing science. Case study is becoming entrenched in the nursing research lexicon as a well-accepted methodology for studying phenomena in health and social care, and its growing use warrants continued appraisal to promote nursing knowledge development. Attention to all case study elements, process and publication is important in promoting authenticity, methodological quality and visibility.
Picasso: generating a covering set of protein family profiles

MOTIVATION Evolutionary classification leads to an economical description of protein sequence data because attributes of function and structure are inherited in protein families. This paper presents Picasso, a procedure for deriving a minimal set of protein family profiles that cover all known protein sequences. RESULTS Picasso starts from highly overlapping sequence neighbourhoods revealed by all-on-all pairwise Blast alignment. Overlaps are reduced by merging sequences or parts of sequences into multiple alignments. For maximum unification, the multiple alignments must reach into the twilight zone of sequence similarity. Sensitive and selective profile-profile comparison allows unification down to about 15% pairwise sequence identity. Families unified through a short conserved sequence motif are associated with multiple full-length alignments describing different subfamilies. Domains that are mobile modules are identified based on their association with different sets of neighbours. The result is 10000 unified domain families (excluding singletons) representing functionally related proteins and recovering classical prolific domain types in high numbers. The classification is useful, for example, in developing strategies for efficient database searching and for selecting targets to complete the map of all 3-D structures.