LLukas22/scidocs huggingface dataset:
Benefit assessment in Germany: implications for price discounts

BACKGROUND
The AMNOG regulation, introduced in 2011 in Germany, changed the game for new drugs. Now, the industry is required to submit a dossier to the GBA (the central decision body in the German sickness fund system) to show additional benefit. After granting the magnitude of the additional benefit by the GBA, the manufacturer is entitled to negotiate the reimbursement price with the GKV-SV (National Association of Statutory Health Insurance Funds). The reimbursement price is defined as a discount on the drug price at launch. As the price or discount negotiations between the manufacturers and the GKV-SV takes place behind closed doors, the factors influencing the results of the negotiation are not known.


OBJECTIVES
The aim of this evaluation is to identify factors influencing the results of the AMNOG price negotiation process.


METHODS
The analysis was based on a dataset containing detailed information on all assessments until the end of 2015. A descriptive analysis was followed by an econometric analysis of various potential factors (benefit rating, size of target population, deviating from appropriate comparative therapy and incorporation of HRQoL-data).


RESULTS
Until December 2015, manufacturers and the GKV-SV finalized 96 negotiations in 193 therapeutic areas, based on assessment conducted by the GBA. The GBA has granted an additional benefit to 100/193 drug innovations. Negotiated discount was significantly higher for those drugs without additional benefit (p = 0.030) and non-orphan drugs (p = 0.015). Smaller population size, no deviation from recommended appropriate comparative therapy and the incorporation of HRQoL-data were associated with a lower discount on the price at launch. However, neither a uni- nor the multivariate linear regression showed enough power to predict the final discount.


CONCLUSIONS
Although the AMNOG regulation implemented binding and strict rules for the benefit assessment itself, the outcome of the discount negotiations are still unpredictable. Obviously, negotiation tactics, the current political situation and soft factors seem to play a more influential role for the outcome of the negotiations than the five hard and known factors analyzed in this study. Further research is needed to evaluate additional factors.
Experience of families during cardiopulmonary resuscitation in a pediatric intensive care unit.

OBJECTIVES
Having parents present during cardiopulmonary resuscitation is becoming a common practice in pediatrics. This study aimed to determine parents' perception of the effects of their presence during the resuscitation efforts of their child and whether they would recommend the experience to other families.


METHODS
This study included parents or guardians of children who underwent cardiopulmonary resuscitation, and died at least 6 months before the interview. After telephone consent was obtained, a survey questionnaire was completed. The interviewees answered whether they were asked to be present, whether they had physical contact with their child, and whether the experience frightened them or gave them and their child comfort. The interviewees were asked to express their feelings about what was helpful to them and what could be done to improve the experience.


RESULTS
A total of 41 interviews were conducted, and responders were divided into 2 groups: 21 in the present group and 20 in the not-present group for cardiopulmonary resuscitation. Twelve (60%) of those in the not-present group believed that their presence would have comforted the child, and 50% (10 of 20) believed that it would have helped them accept the child's death. Of those in the present group, 67% (8 of 12) believed that touching their child brought comfort, 29% (6 of 21) felt scared during cardiopulmonary resuscitation, 71% (15 of 21) believed that their presence comforted their child, and 67% (14 of 21) believed that their presence helped them adjust to the loss of the child. The majority in both groups (63% [26 of 41]) would recommend being present during cardiopulmonary resuscitation.


CONCLUSIONS
This study supports encouraging family presence during cardiopulmonary resuscitation. The majority of parents who had been present and those who had not been present believed that all families should be given the option to be present.
Comparison between different feature extraction techniques for audio-visual speech recognition

The current audio-only speech recognition still lacks the expected robustness when the Signal to Noise Ratio (SNR) decreases. The video information is not affected by noise which makes it an ideal candidate for data fusion for speech recognition benefit. In the paper [1] the authors have shown that most of the techniques used for extraction of static visual features result in equivalent features or at least the most informative features exhibit this property. We argue that one of the main problems of existing methods is that the resulting features contain no information about the motion of the speaker’s lips. Therefore, in this paper we will analyze the importance of motion detection for speech recognition. For this we will first present the Lip Geometry Estimation(LGE) method for static feature extraction. This method combines an appearance based approach with a statistical based approach for extracting the shape of the mouth. The method was introduced in [2] and explored in detail in [3]. Further more, we introduce a second method based on a novel approach that captures the relevant motion information with respect to speech recognition by performing optical flow analysis on the contour of the speaker’s mouth. For completion, a middle way approach is also analyzed. This third method considers recovering the motion information by computing the first derivatives of the static visual features. All methods were tested and compared on a continuous speech recognizer for Dutch. The evaluation of these methods is done under different noise conditions. We show that the audio-video recognition based on the true motion features, namely obtained by performing optical flow analysis, outperforms the other settings in low SNR conditions.
Detecting Structural Similarities between XML Documents

In this paper we propose a technique for detecting the similarity in the structure of XML documents. The technique is based on the idea of representing the structure of an XML document as a time series in which each occurrence of a tag corresponds to a given impulse. By analyzing the frequencies of the corresponding Fourier transform, we can hence state the degree of similarity between documents. The efficiency and effectiveness of this approach are compelling when compared with traditional ones.
Prevalence of depression and its treatment in an elderly population: the Cache County study.

BACKGROUND
Previous estimates of the prevalence of geriatric depression have varied. There are few large population-based studies; most of these focused on individuals younger than 80 years. No US studies have been published since the advent of the newer antidepressant agents.


METHODS
In 1995 through 1996, as part of a large population study, we examined the current and lifetime prevalence of depressive disorders in 4,559 nondemented individuals aged 65 to 100 years. This sample represented 90% of the elderly population of Cache County, Utah. Using a modified version of the Diagnostic Interview Schedule, we ascertained past and present DSM-IV major depression, dysthymia, and subclinical depressive disorders. Medication use was determined through a structured interview and a "medicine chest inventory."


RESULTS
Point prevalence of major depression was estimated at 4.4% in women and 2.7% in men (P= .003). Other depressive syndromes were surprisingly uncommon (combined point prevalence, 1.6%). Among subjects with current major depression, 35.7% were taking an antidepressant (mostly selective serotonin reuptake inhibitors) and 27.4% a sedative/hypnotic. The current prevalence of major depression did not change appreciably with age. Estimated lifetime prevalence of major depression was 20.4% in women and 9.6% in men (P<.001), decreasing with age.


CONCLUSIONS
These estimates for prevalence of major depression are higher than those reported previously in North American studies. Treatment with antidepressants was more common than reported previously, but was still lacking in most individuals with major depression. The prevalence of subsyndromal depressive symptoms was low, possibly because of unusual characteristics of the population.
Wormhole attacks in wireless adhoc networks and their counter measurements: A survey

A Mobile Ad Hoc Network (MANET) is a self-organizing, infrastructure less, multi-hop network. The wireless and distributed nature of MANETs poses a great challenge to system security designers. Ad hoc networks are by nature very open to anyone. Their biggest advantage is also one of their biggest disadvantages: Anyone with the proper hardware and knowledge of the network topology and protocols can connect to the network. This allows potential attackers to infiltrate the network and carry out attacks on its participants with the purpose of stealing or altering information. A specific type of attack, the Wormhole attack does not require exploiting any nodes in the network and can interfere with the route establishment process. The entire routing system in MANET can even be brought down using the wormhole attack. This paper discusses the modes of wormholes, how wormholes disrupts routing in AODV, DSR, OLSR and then discusses the solutions and countermeasures on wormholes.
Effects of continuity of care by a primary midwife (caseload midwifery) on caesarean section rates in women of low obstetric risk: the COSMOS randomised controlled trial.

OBJECTIVE
To determine whether primary midwife care (caseload midwifery) decreases the caesarean section rate compared with standard maternity care.


DESIGN
Randomised controlled trial.


SETTING
Tertiary-care women's hospital in Melbourne, Australia.


POPULATION
A total of 2314 low-risk pregnant women.


METHODS
Women randomised to caseload received antenatal, intrapartum and postpartum care from a primary midwife with some care by 'back-up' midwives. Women randomised to standard care received either midwifery or obstetric-trainee care with varying levels of continuity, or community-based general practitioner care.


MAIN OUTCOME MEASURES



PRIMARY OUTCOME
caesarean birth. Secondary outcomes included instrumental vaginal births, analgesia, perineal trauma, induction of labour, infant admission to special/neonatal intensive care, gestational age, Apgar scores and birthweight.


RESULTS
In total 2314 women were randomised-1156 to caseload and 1158 to standard care. Women allocated to caseload were less likely to have a caesarean section (19.4% versus 24.9%; risk ratio [RR] 0.78; 95% CI 0.67-0.91; P = 0.001); more likely to have a spontaneous vaginal birth (63.0% versus 55.7%; RR 1.13; 95% CI 1.06-1.21; P < 0.001); less likely to have epidural analgesia (30.5% versus 34.6%; RR 0.88; 95% CI 0.79-0.996; P = 0.04) and less likely to have an episiotomy (23.1% versus 29.4%; RR 0.79; 95% CI 0.67-0.92; P = 0.003). Infants of women allocated to caseload were less likely to be admitted to special or neonatal intensive care (4.0% versus 6.4%; RR 0.63; 95% CI 0.44-0.90; P = 0.01). No infant outcomes favoured standard care.


CONCLUSION
In settings with a relatively high baseline caesarean section rate, caseload midwifery for women at low obstetric risk in early pregnancy shows promise for reducing caesarean births.
Can early introduction of specialized palliative care limit intensive care, emergency and hospital admissions in patients with severe and very severe COPD? a randomized study

BACKGROUND
COPD is a progressive lung disorder with rates of mortality between 36-50%, within 2 years after admission for an acute exacerbation. While treatment with inhaled bronchodilators and steroids may partially relieve symptoms and oxygen therapy may prolong life, for many patients the course of the disease is one of inexorable decline. Very few palliative care intervention studies are available for this population. This trial seeks to determine the effectiveness of the introduction of specialized palliative care on hospital, intensive care unit and emergency admissions of patients with severe and very severe COPD.


METHODS/DESIGN
The study is a three year single centre, randomized controlled trial using a 2 arms parallel groups design conducted in a tertiary center (University Hospitals; Geneva). For the intervention group, an early palliative care consultation is added to standard care; the control group benefits from standard care only. Patients with COPD defined according to GOLD criteria with a stage III or IV disease and/or long term treatment with domiciliary oxygen and/or home mechanical ventilation and/or one or more hospital admissions in the previous year for an acute exacerbation are eligible to participate. Allocation concealment is achieved using randomisation by sealed envelopes. Our sample size of 90 patients/group gives the study a 80% power to detect a 20% decrease in intensive care unit and emergency admissions--the primary endpoint. All data regarding participants will be analysed by a researcher blinded to treatment allocation, according to the "Intention to treat" principle.


DISCUSSION
Given the trends toward aggressive and costly care near end-of-life among patients with COPD, a timely introduction of palliative care may limit unnecessary and burdensome personal and societal costs, and invasive approaches. The results of this study may provide directions for future palliative care interventions in this particular population.


TRIAL REGISTRATION
This trial has been registered at clinicaltrials.gov under NCT02223780.
A Compact CPW-Fed Monopole Antenna with a U-Shaped Strip and a Pair of L-Slits Ground for WLAN and WiMAX Applications

Abstract—A compact tri-band planar monopole antenna suitable for 2.4/5.2/5.8GHz WLAN and 3.5GHz WiMAX is presented. The antenna employs a U-shaped parasitic strip and a defect ground-plane structure. By inserting a U-shaped strip as a parasitic strip into a normal monopole which operates at lower band of the WLAN, one more resonance at the higher WLAN band comes out. A defect ground-plane composed of two symmetrical L-shaped slits leads to another resonance operating at WiMAX band. The proposed antenna has a compact size of 22 × 41 × 0.8mm3 and offers good radiation and reflection characteristics in the above frequency bands. The measured VSWR exhibits a good agreement with the simulated one. Detailed design steps, parametric studies and experimental results for the antenna are investigated in this paper.
Electrical stimulation and splinting were not clearly more effective than splinting alone for contracture management after acquired brain injury: a randomised trial.

QUESTION
Is electrical stimulation and splinting more effective than splinting alone for the management of wrist contracture following acquired brain injury?


DESIGN
A multi-centre randomised trial with concealed allocation, assessor blinding, and intention-to-treat analysis.


PARTICIPANTS
Thirty-six adults with first stroke or traumatic brain injury and mild to moderate wrist flexion contractures.


INTERVENTION
The experimental group received electrical stimulation to the wrist and finger extensor muscles for 1 hour a day over 4 weeks while the control group did not. Both groups wore a splint for 12 hours a day during this 4-week period.


OUTCOME MEASURES
The primary outcome was passive wrist extension measured with a 3Nm torque and with the fingers in extension. Secondary outcomes included passive wrist extension, wrist and finger extensor strength, wrist flexor spasticity, motor control of the hand, and Global Perceived Effect of Treatment, and perception of treatment credibility. Outcome measures were taken at baseline, at the end of the intervention period (4 weeks), and after a 2-week follow-up period (6 weeks).


RESULTS
At 4 and 6 weeks, the mean between-group difference (95% CI) for passive wrist extension was 7 degrees (-2 to 15) and -3 degrees (-13 to 7), respectively. Secondary outcomes were statistically non-significant or were of borderline statistical significance.


CONCLUSION
It is not clear whether electrical stimulation and splinting is more effective than splinting alone for the management of wrist contracture after acquired brain injury. Therapists' confidence in the efficacy of electrical stimulation for contracture management is not yet justified.
Xenophobia: A new pathology for a new South Africa?

In 1994, South Africa became a new nation. Born out of democratic elections and inaugurated as the 'Rainbow Nation' by Nelson Mandela, this 'new South Africa' represents a fundamental shift in the social, political and geographical landscapes of the past. Unity has replaced segregation, equality has replaced legislated racism and democracy has replaced apartheid, at least in terms of the law. Despite the transition from authoritarian rule to democracy, prejudice and violence continue to mark contemporary South Africa. Indeed, the shift in political power has brought about a range of new discriminatory practices and victims. One such victim is 'The Foreigner'. Emergent alongside a new-nation discourse, The Foreigner stands at a site where identity, racism and violent practice are reproduced. This paper interrogates the high levels of violence that are currently directed at foreigners, particularly African foreigners, in South Africa. It explores the term 'xenophobia' and various hypotheses about its causes. It also explores the ways in which xenophobia itself is depicted in the country. Portrayed as negative, abnormal and the antithesis of a healthy, normally functioning individual or society, xenophobia is read here as a new pathology for a 'new South Africa'. This chapter attempts to deconstruct such a representation by suggesting that xenophobia is implicit to the technologies of nation-building and is part of South Africa's culture of violence.
Recursive symmetries for geometrically complex and materially heterogeneous additive manufacturing

We present a generative method for the creation of geometrically complex andmaterially heterogeneous objects. By combining generative design and additive manufacturing, we demonstrate a unique formfinding approach and method for multi-material 3D printing. The method offers a fast, automated and controllable way to explore an expressive set of symmetrical, complex and colored objects, which makes it a useful tool for design exploration andprototyping.Wedescribe a recursive grammar for the generation of solid boundary surfacemodels suitable for a variety of design domains.We demonstrate the generation and digital fabrication ofwatertight 2-manifold polygonalmeshes, with feature-aligned topology that can be produced on a wide variety of 3D printers, as well as post-processed with traditional 3D modeling tools. To date, objects with intricate spatial patterns and complex heterogeneous material compositions generated by this method can only be produced through 3D printing. © 2016 Elsevier Ltd. All rights reserved.
Security-as-a-Service for Microservices-Based Cloud Applications

Microservice architecture allows different parts of an application to be developed, deployed and scaled independently, therefore becoming a trend for developing cloud applications. However, it comes with challenging security issues. First, the network complexity introduced by the large number of microservices greatly increases the difficulty in monitoring the security of the entire application. Second, microservices are often designed to completely trust each other, therefore compromise of a single microservice may bring down the entire application. The problems are only exacerbated by the cloud, since applications no longer have complete control over their networks. In this paper, we propose a design for security-as-a-service for microservices-based cloud applications. By adding a new API primitive FlowTap for the network hypervisor, we build a flexible monitoring and policy enforcement infrastructure for network traffic to secure cloud applications. We demonstrate the effectiveness of our solution by deploying the Bro network monitor using FlowTap. Results show that our solution is flexible enough to support various kinds of monitoring scenarios and policies and it incurs minimal overhead (~6%) for real world usage. As a result, cloud applications can leverage our solution to deploy network security monitors to flexibly detect and block threats both external and internal to their network.
Medication Adherence Interventions Improve Heart Failure Mortality and Readmission Rates: Systematic Review and Meta‐Analysis of Controlled Trials

BACKGROUND
Poor adherence to medications is a common problem among heart failure (HF) patients. Inadequate adherence leads to increased HF exacerbations, reduced physical function, and higher risk for hospital admission and death. Many interventions have been tested to improve adherence to HF medications, but the overall impact of such interventions on readmissions and mortality is unknown.


METHODS AND RESULTS
We conducted a comprehensive search and systematic review of intervention studies testing interventions to improve adherence to HF medications. Mortality and readmission outcome effect sizes (ESs) were calculated from the reported data. ESs were combined using random-effects model meta-analysis methods, because differences in true between-study effects were expected from variation in study populations and interventions. ES differences attributed to study design, sample, and intervention characteristics were assessed using moderator analyses when sufficient data were available. We assessed publication bias using funnel plots. Comprehensive searches yielded 6665 individual citations, which ultimately yielded 57 eligible studies. Overall, medication adherence interventions were found to significantly reduce mortality risk among HF patients (relative risk, 0.89; 95% CI, 0.81, 0.99), and decrease the odds for hospital readmission (odds ratio, 0.79; 95% CI, 0.71, 0.89). Heterogeneity was low. Moderator analyses did not detect differences in ES from common sources of potential study bias.


CONCLUSIONS
Interventions to improve medication adherence among HF patients have significant effects on reducing readmissions and decreasing mortality. Medication adherence should be addressed in regular follow-up visits with HF patients, and interventions to improve adherence should be a key part of HF self-care programs.