Miracle-dz/UniFAR-FTUs huggingface dataset:
Continuous professional development for GPs: experience from Denmark

Background and objectives Continuous professional development (CPD) for Danish general practitioners (GPs) is voluntary and based on funded accredited activities. There is an ongoing discussion on how to improve this current system by introducing mandatory elements. To inform this debate, we set out to identify GPs’ current use of CPD and to explore the motives behind their choices. Methods A mixed-methods study with a combined qualitative and quantitative approach was used. In 2012, two focus group interviews were conducted, followed up the same year by an online questionnaire sent to 1079 randomly chosen Danish GPs. Results Focus groups: CPD activities are chosen based on personal needs analysis, and in order to be professionally updated, to meet engaged colleagues and to prevent burnout. GPs also attend CPD to assess their own pre-existing level of competence. CPD activities need to be experienced as being both meaningful and relevant in order to have an impact. Questionnaire: The response rate was 686/1079 (63%). GPs spend on average 10.5 days per year on accredited, voluntary CPD activities. Workplace-related CPD activities and practice-based small group learning played a significant role. The main motivation for choice of CPD activities included academic interest, experience of patient-related problems in their own surgeries and medical topics where the GPs felt insufficiently confident. Conclusions Danish GPs are frequent users of voluntary accredited CPD. Their CPD choices are motivated by topics strengthening their professional capacity and preventing burnout. There would seem to be no need for a mandatory system.
Citizenship in the Gulf

On the one hand, numerous Arab commentators, including some Gulf intellectuals, have sought to encapsulate the key demand of the Arab uprisings as ‘a transition from being subjects to being citizens’. This captures a sense of a desired end to perceived passivity and a claim to becoming a different sort of political being, respected and with rights and dignity. On the other hand, Gulf governments have continued to define different de facto tiers of citizenship – determining who is entitled to which levels of economic benefits on the basis of ancestry, who is entitled to vote, whether women can pass citizenship on to their children, and in some cases, even stripping citizenship from dissidents perceived as being disloyal.
Wage Inequality and Return to Education in Indonesia: Quantile Regression Analysis

It is essential to the government to recognize the factors causing the increasing trend of income inequality in Indonesia since the Gini coefficient increased between 1996 and 2016. Moreover, wage inequality, which represented by high percentile and low percentile of income, also shows widening gap since 2003. This study focuses on the factors of wage inequality acceleration through the supply side approach that follows the Mincerian wage equation model. Specifically, this paper aims to investigate the association between the return to education and wage inequality in Indonesia. The quantile regression method is applied to compute the return on the investment at different points of the wage distribution. The main finding is that education contributes to an increasing wage inequality due to the significant variation in the rate of return to education in different quantile and as increasing wage dispersion within the same education. DOI: 10.15408/sjie.v7i1. 6071
Impact of Antimicrobial Stewardship Program on Vancomycin Use in a Pediatric Teaching Hospital

Background: Increasing rates of resistant gram-positive coccal infections led to an increased use of vancomycin. We evaluated the impact of implementing an Antimicrobial Stewardship Program on density of vancomycin use at a pediatric tertiary-care teaching hospital. Methods: An Antimicrobial Stewardship Program was implemented April 1, 2004. Indications for vancomycin use were incorporated as mandatory fields using the integrated computerized information system. An automated report of vancomycin prescriptions, doses, patient demographics, and microbiology data was reviewed by an infectious disease pharmacist Monday through Friday. Interventions were discussed with a pediatric infectious disease physician and real-time feedback provided to clinicians. Density of vancomycin use was evaluated by measuring the number of doses administered/1000 patient-days. Results: Density of vancomycin use declined overtime from 378 doses administered/1000 patient-days to 255 doses administered/1000 patient-days despite increasing rates of Staphylococcus aureus infected patients, and was not associated with increased use of other antibiotics with similar antimicrobial activity. Nonapproved vancomycin indications were selected in 28% of vancomycin doses administered. Of the 317 Antimicrobial Stewardship Program interventions performed, 190 qualified as vancomycin prescription errors, most commonly, vancomycin dosing and premature stop. After the implementation of the program, the rate of vancomycin prescription errors decreased. Conclusions: Implementation of an integrated Antimicrobial Stewardship Program using real-time evaluation and feedback to physicians, and optimization of the clinical informatics system, reduced vancomycin utilization and vancomycin prescribing errors, improving the quality of care and safety of hospitalized children in our institution.
Effects of Multimicronutrient Home Fortification on Anemia and Growth in Bhutanese Refugee Children

Background Anemia remains a significant public health problem in refugee settings. Home fortification with micronutrient powders has been proposed as a feasible option to alleviate micronutrient deficiencies; its efficacy in reducing anemia in children aged 6 to 24 months has been demonstrated in several trials. Objective To evaluate the effectiveness of a large-scale micronutrient powder distribution program in reducing anemia prevalence and promoting growth in refugee children aged 6 to 59 months. Methods Four representative cross-sectional surveys were conducted 13 months before and 7, 14, and 26 months after initiation of the supplementation program. Data collected on children aged 6 to 59 months included hemoglobin concentration, anthropometric indicators, morbidity, feeding practices, and information on the micronutrient distribution program. The study had a pre—post design with no control group. Results The overall prevalence of anemia in children did not change significantly between baseline (43.3%) and endpoint (40.2%). The prevalence of moderate anemia decreased over the same period from 18.9% to 14.4% (p < .05). The levels of severe anemia were negligible (< 1%) in all surveys. The prevalence of stunting decreased significantly from 39.2% at baseline to 23.4% at endpoint (p < .001), a relative decrease of 40%. Reported coverage, use, and acceptance of micronutrient supplements remained consistently high throughout the study. Conclusions In the absence of a control group, changes in key outcomes should be interpreted with caution. The minor effect on hemoglobin status requires further investigation of underlying causes of anemia in this population. The large positive effect on linear growth may be a significant benefit of supplementation if confirmed by future studies.
Outline of a Proposal to Reform the Institutional Architecture of Money, Savings, and Credit to Reach a Financial Sustainability

The scope of this paper is to examine the complications raised by technical innovations in the financial field (fintech). The conclusion of this enquire is that the current institutional architecture cannot guarantee monetary and financial sustainability as long as Governments decide to reform it using the already available instruments (cryptocurrency, blockchain, algorithms) instead of leaving them free to operate or limiting their use as they are doing. The same goes for any tentative to restate bank credibility forecasting money and financial instability starting from big data treated with traditional econometric methods.
Financial Globalisation and Crisis Occurrence: Does Threshold Effect of Financial Development Matter?

This paper studies the relationship between financial globalisation and occurrence of crises according to the level of financial development condition. We demonstrate that economies with high level of financial sector development benefit more from financial integration than those with a lower one. More specifically, we will investigate the issues relevant to threshold effect of financial development on which capital flows changes effects sign on probability of crisis occurrence. We investigate the role of financial development in the relationship between capital flows and crisis occurrence probability for different groups of countries. Estimations are conducted with a panel data of 70 countries over the period 1984-2009 using fixed effects logit panel estimation. Empirical results support that capital movements can create bubble economy according to the level of domestic financial development. This implies that countries which are at an intermediate phase of financial development are the most vulnerable to crisis. Keywords: Financial development, Financial globalization, Financial crisis.
The politics of place identity in peri-urban environments. What role for productive farming landscapes? A case study of Wollondilly Shire, NSW, Australia

Peri-urban farmlands in the Sydney basin are progressively being taken over by housing developments. In addition, the viability of peri-urban agricultural operations is undermined by the liberalisation of agriculture in Australia. Finally, the arrival of newcomers and the associated loss of the farmers’ central position in peri-urban communities lead to the emergence of competing discourse on the peri-urban. Due to these mutations, peri-urban Sydney, like many other peri-urban landscapes worldwide, has become a contested space, where different social groups develop conflicting representations of what the ‘identity’ of peri-urban areas is. This thesis examines, through a case study of Wollondilly Shire, how farmlands and farming activities are marginalised in the peri-urban and how this trend might be reversed. To do so, a holistic framework of the ‘politics of place/landscape identity’ was developed, offering a heuristic tool for understanding how hegemonic, resistant and emergent place identities are produced in the peri-urban landscape. Two hegemonic place identities were identified, both contributing (sometimes inadvertently) to the marginalisation of agricultural activities. The first identity proposes to accommodate housing development while preserving agricultural uses through the maintenance of a sharp distinction between city and country. However, in planning practices, this rationale is used to characterise housing development as ‘in place’ and agricultural activities as ‘out of place’. The second identity promotes the development of low-density residential development throughout the countryside, leading to a consideration of farming as a nuisance in the landscape. Furthermore, a resistant place identity defended by farmers was identified, which aimed at reasserting farmers’ legitimacy in the peri-urban landscape, by considering farmers as using the land appropriately. As of yet, this resistant place identity has not sparked collective action amongst farmers and, therefore, does not renegotiate their roles in the peri-urban. Rather, farmers have developed formal and informal arrangements with various stakeholders, as well as adaptive strategies at the farm scale, which might lead to a renegotiation of their role in the peri-urban. In the discussion, barriers that might prevent the renegotiation of the role of farming in the peri-urban are identified, as well as ways to address them. Levers for policy change that were identified include the need to renegotiate the meaning of the notion of viability and move beyond a spatial planning based on the city-country divide. Actions that could be taken by farmers and the civil society are also identified.
Speech Understanding with the CIS and the n-of-m Strategy in the MED-EL COMBI 40+ System

Speech tests have been performed on 6 subjects for comparing the standard 12-channel continuous interleaved sampling (CIS) strategy (CIS12), the 7-channel CIS strategy (CIS7) and the 7-of-12 strategy in the MED-EL COMBI 40+ system. An ABAB experimental design was used whereby each strategy was reversed and replicated. Speech tests were performed in quiet (vowels, consonants, monosyllables, sentences) and noise (sentences). Results showed that for vowels, CIS12 is significantly superior to CIS7, for consonants and sentences CIS12, CIS7 and 7-of-12 performed equally well, and that for monosyllables 7-of-12 is significantly superior to both CIS12 and CIS7. In addition, 7-of-12 is superior to CIS7 by almost the same amount as CIS12, but in this case the difference is not significant. Further, all strategies have been found to be equally robust in noise with respect to sentence understanding. The differences between CIS12 and 7-of-12 on the one hand and CIS7 on the other hand may be attributed to decreased spectral resolution of the latter. The fact that – in contrast to what has been reported for the SPEAK strategy – 7-of-12 is equally robust in noise as the CIS strategies is explained by the use of higher stimulation rates, wider frequency bands and a higher percentage of channels stimulated in each cycle.
Recording focal macular photopic negative response (PhNR) from monkeys.

PURPOSE To record the photopic negative response (PhNR) of the focal electroretinograms (ERGs) from the macula of monkeys and to study the properties of the focal macular PhNRs. METHODS Focal macular ERGs were recorded from five rhesus monkeys using a modified infrared fundus camera, in which a red stimulus spot on a blue illuminated background were incorporated. The effects of different stimulus intensities and durations presented on a steady blue background of 100 scot cd/m(2) on the focal macular PhNRs were investigated. Focal macular PhNRs were also recorded before and after an intravitreous injection of tetrodotoxin (TTX). RESULTS Focal ERG responses from a photocoagulated retinal site were recordable when the luminance of the red stimulus spot was <or=55 phot cd/m(2) and was presented on a steady blue background of 100 scot cd/m(2). The amplitude of the focal macular PhNR increased with increasing stimulus intensities and was larger than that of the b-wave at all stimulus intensities. The amplitude of the focal macular PhNR was largest at stimulus durations of 30 to 50 ms. An intravitreous injection of TTX essentially eliminated the focal macular PhNR. CONCLUSIONS It is possible to record focal macular PhNRs from monkeys by using a red stimulus spot on a blue background. Investigations of focal PhNRs can be a useful method of studying inner retinal function of local areas in normal and diseased retinas.
Collaborative team teaching

An academic career at Otago University is premised on the idea that we come pre-packaged for teaching, research and community service. In an ideal world this may be so, but in our experience as Māori academics in an applied professional department, this has not been the case for a number of reasons. Firstly, rather than come primarily through the academic system, the lecturing staff in our department come from an applied/professional background where most of us have worked as professional social or community workers. Therefore, our participation in the university system brings with it an enormous amount of practical experience in the fields we are teaching. However, it often lacks some of the key elements important to an academic institution. Developing the knowledge and skill base to undertake research, teaching and community service, especially when you consider professional development, promotion, remuneration and now PBRF, seems like an insurmountable task at times. Our approach has been to develop these things in a way that suits us culturally, personally and academically. Therefore, this paper will explore some of the reasons and subsequent implications for why we have chosen to work collaboratively and team teach all our papers. For the purposes of this paper we will discuss: ways of knowing; ways of viewing; complementarity of skills; experiential and knowledge bases; collegial relationships; and workload implications.
Endothelial Nitric Oxide Has Inhibitory Effects on Rhythmic Contractions in the Aortas of Sinoaortic Deafferented Rats

Sinoaortic deafferentation (SAD) is characterized by arterial pressure lability, without sustained hypertension. Although SAD rats did not become hypertensive, their isolated aortas exhibit RCs. We have investigated whether these RCs are influenced by endothelium. Aortic rings were placed in an organ chamber, and the frequency and amplitude of the RCs were measured in SAD rat aortas with intact and denuded endothelium. Moreover, the participation of endothelial NO and cGMP pathways on the RCs were analyzed through the use of such drugs as L-NAME, acetylcholine, ODQ, L-arginine, and oxyhemoglobin. Indomethacin was used to evaluate the influence of prostanoids on the RCs. Under phenylephrine stimulus, 100% of SAD rat aortas presented RCs, with higher frequency and amplitude in denuded endothelium (8.5 ± 0.50 cycles/2 min and 0.465 ± 0.05 g, respectively) compared with intact endothelium (4.5 ± 0.50 cycles/2 min and 0.311 ± 0.04 g, respectively). In intact-endothelium aortas, L-NAME, ODQ, and oxyhemoglobin raised the frequency and amplitude of the RCs to values similar to those found in denuded endothelium. L-arginine and indomethacin did not alter the RCs. In conclusion, SAD rat aortas present rhythmic contractions, which are negatively modulated by endothelial NO. Our results indicate that endothelium-derived NO (and not prostanoids), acting through the cGMP pathway, has an inhibitory effect on the oscillations.
Plateau potentials in alpha‐motoneurones induced by intravenous injection of L‐dopa and clonidine in the spinal cat.

1. Intracellular recordings were made from lumbar alpha‐motoneurones in unanaesthetized decerebrate acute spinal cats. The response of motoneurones to direct current pulse injection or synaptic excitation was investigated following intravenous injection of L‐beta‐3,4‐dihydroxyphenylalanine (L‐DOPA, 20‐120 mg/kg) alone, nialamide (10‐50 mg/kg) and L‐DOPA or clonidine (0.5‐1 mg/kg). 2. The response properties of motoneurones were tested with rectangular and triangular current waveforms. Before L‐DOPA treatment motoneuronal firing during a rectangular current pulse is characterized by an initial high firing frequency which rapidly decreases to a lower steady‐state firing which is maintained only for the duration of the pulse. Following administration of L‐DOPA an acceleration in firing frequency is apparent following the initial adaptation seen with rectangular current pulses. A transient after‐depolarization or an after‐discharge often followed the termination of the pulse. The frequency‐current relation in response to a triangular current injection changed from a clockwise to a counter‐clockwise hysteresis after L‐DOPA treatment (i.e. after L‐DOPA the firing frequency was higher for any given current during the descending phase than during the ascending phase of the triangular waveform). 3. Firing acceleration during and self‐sustained firing after rectangular current pulses and counter‐clockwise hysteresis of firing frequency with triangular current pulses are causally related to the presence of plateau potentials, which can be directly visualized after inactivation of the spikes. Plateau potentials in motoneurones could be generated by short‐lasting intracellular depolarizing current pulses or brief excitatory synaptic inputs and terminated by short‐lasting hyperpolarizing current pulses or brief inhibitory synaptic inputs. Plateau potentials were demonstrated in flexor and extensor motoneurones. 4. All bistable properties described in the preceding paragraphs following L‐DOPA administration could also be seen after administration of the alpha‐receptor agonist clonidine. 5. Slow rhythmic oscillations of the membrane potential (7.5‐10 Hz) were seen superimposed on plateau potentials in a few cells after administration of L‐DOPA and clonidine. The oscillations had an amplitude in the range 10‐20 mV and represent the expression of an intrinsic property of the motoneurone. 6. It is demonstrated that plateau potentials in the motoneurones contribute to the late long‐lasting reflexes observed in L‐DOPA‐treated spinal cats. 7. It is concluded that L‐DOPA (and clonidine) change the response properties of the motoneurones in an analogous way to 5‐hydroxy‐DL‐tryptophan (5‐HTP). (ABSTRACT TRUNCATED AT 400 WORDS)
In situ nucleic acid detection of human telomerase in intrahepatic cholangiocarcinoma and its preneoplastic lesion

Human telomerase, an enzyme associated with cellular immortality and tumorigenesis, is expressed by most malignant tumor cells. Human telomerase consists of human telomerase RNA (hTR) and telomerase protein components. One of the latter has been cloned and was termed telomerase‐associated protein 1 (TP1). Using anin situ hybridization method, expression of hTR and TP1 mRNA was surveyed in 20 cases of intrahepatic cholangiocarcinoma (ICC) (5 of them were associated with hepatolithiasis), 5 cases of hepatolithiasis alone and 6 normal livers. Biliary dysplasia, which is suspected as a preneoplastic lesion of ICC, was found in the biliary tree in all 5 ICC cases with hepatolithiasis and in 1 of 5 cases of hepatolithiasis alone. Normal colonic mucosa was used as positive control. In 17 (85%) of 20 ICC cases, hTR and TP1 mRNA were detected in carcinoma cells. There was no correlation between histological subtype of ICC and expression of hTR and TP1 mRNA. Biliary dysplasia was also positive for both RNA. These signals were mainly located in the cytoplasm of carcinoma and dysplastic cells, especially around their nuclei. The signals were homogeneously detected in the carcinoma, while their distribution was more or less heterogeneous in the dysplastic foci. These signals were not detected in nondysplastic biliary epithelia in hepatolithiasis and normal livers. It seems likely that almost all ICC acquired telomerase activities irrespective of histological subtype and more importantly that cellular immortalization has already occurred in biliary dysplasia and this lesion is already involved in the malignant progression of ICC.
Presenting News on Social Media

With the rising popularity of social media as news sources, a new common format element for presenting news has emerged: in addition to the classic headline, lead and picture, news organizations add a status message when they share their news articles on social media such as Twitter and Facebook. Based on media logic theory, we argue that the communication style of these messages is likely to be more interpersonal and subjective. To investigate this we used computational text analysis to compare status messages to headlines and leads, covering nine newspapers from the Netherlands and Flanders over a period of 2.5 years. We conclude that newspapers use status messages to add a subjective expression to news on social media, and call for research into how this takes shape and affects the audience.