Miracle-dz/UniFAR-FTUs huggingface dataset:
The effects of predetermined payment rates for Medicare home healthcare.

OBJECTIVE To assess the effects of an alternative method of paying home health agencies for services to Medicare beneficiaries, based on a demonstration program. DATA SOURCES/STUDY SETTING Primary and secondary data collected on participating home health agencies in five states and their patients during the three-year demonstration period. Primary data included patient surveys at discharge and six months later, and two rounds of interviews with executive staff of the agencies. Secondary data included agencies' Medicare cost reports, quality assurance reviews, Medicare claims data, demonstration claims data, demonstration patient intake forms, and plan of treatment forms. STUDY DESIGN The 47 agencies volunteering to participate in the demonstration were each randomly assigned to the treatment or control group. Treatment group agencies were paid a predetermined rate based on their inflation-adjusted cost per visit during the year preceding the demonstration; control group agencies were paid under Medicare's conventional cost reimbursement method. Demonstration impacts were estimated by comparing outcomes for the two groups of agencies and their respective patients, using regression models to control for any remaining differences. PRINCIPAL FINDINGS Agencies paid under prospective rate setting were slightly better at holding per-visit cost increases below inflation than were control group agencies. The change in payment method had no effect on agencies' volume of Medicare visits or quality of care, nor on patients' use of Medicare services or other formal or informal care services. CONCLUSION Changing from cost-based reimbursement to predetermined payment rates for Medicare home healthcare visits would not lead to large savings for the Medicare program, but would not increase costs to Medicare or adversely affect patients or their caregivers.
Histone Deacetylase Inhibitor Romidepsin Enhances Anti-Tumor Effect of Erlotinib in Non-small Cell Lung Cancer (NSCLC) Cell Lines

Introduction: Most epidermal growth factor receptor (EGFR) mutant non-small cell lung cancers (NSCLCs) are sensitive to EGFR tyrosine kinase inhibitors (TKIs) such as erlotinib or gefitinib, but many EGFR wild type NSCLCs are resistant to TKIs. In this study, we examined the effects of the histone deacetylase inhibitor, romidepsin, in combination with erlotinib, in NSCLC cell lines and xenografts. Methods: For in vitro studies, nine NSCLC cell lines with varying mutation status and histology were treated with erlotinib and romidepsin alone or in combination. 3-(4,5-dimethylthiazol-2-yl)-5-(3-carboxymethoxyphenyl)-2-(4-sulfophenyl)-2H-tetrazolium assays were performed to determine the concentration that inhibits 50% (IC50) value of each drug or the combination. For in vivo studies, NCI-H1299 xenografts were inoculated subcutaneously into athymic nude mice. Romidepsin and/or erlotinib were injected intraperitoneally after tumors developed and tumor sizes were measured. Results: We found that romidepsin increased the sensitivity of erlotinib synergistically in all nine NSCLC cell lines including EGFR and KRAS wild type cell lines, KRAS mutant cell lines, and TKI resistant EGFR mutant cell lines. This effect was partially due to enhanced apoptosis. Furthermore, cotreatment of erlotinib and romidepsin inhibited NCI-H1299 xenograft growth in athymic nude mice. Conclusions: These observations support a role for the combination of a histone deacetylase inhibitor and a TKI in the treatment of NSCLCs.
Mineralization of biphenyl and PCBs by the white rot fungus Phanerochaete chrysosporium

The white rot fungus Phanerochaete chrysosporium is unique in its ability to totally degrade a wide variety of recalcitrant pollutants. We have investigated the degradation of biphenyl and two model chlorinated biphenyls, 2,2′,4,4′‐tetrachlorobiphenyl and 2‐chlorobiphenyl by suspended cultures of P. chrysosporium grown under conditions that maximize the synthesis of lignin‐oxidizing enzymes. Radiolabeled biphenyl and 2′‐chlorobiphenyl added to cultures at concentrations in the range 260 nM to 8.8 μM were degraded extensively to CO2 within 30 days. In addition, from 40% to 60% of the recovered radioactivity was found in water‐soluble compounds. A correlation between the rate of degradation and the synthesis of ligninases or Mn‐dependent peroxidases could not be observed, indicating that yet unknown enzymatic system may be resonsible for the initial oxidation of PCBs. The more heavily chlorinated PCB congener, 2,2′,4,4′‐tetrachlorobiphenyl was converted to CO2 less readily; approximately 9% and 0.9% mineralization was observed in cultures incubated with 40 nM and 5.3 μM, respectively. Overall, our results indicate that P. chrysosporium is a promising organism for the treatment of wastes contaminatd with lightly and moderately chlorinated PCBs. © 1992 John Wiley & Sons, Inc.
Mechanism of action of mitoxantrone

Mitoxantrone, a synthetic anthracenedione, was developed in the 1980s as a doxorubicin analogue in a program to find a cytotoxic agent with decreased cardiotoxicity compared with doxorubicin. It was approved by the FDA in 1987 for the treatment of adult acute myeloid leukemia and in 1996 for symptomatic hormone-refractory prostate cancer. In 2000, mitoxantrone was approved by the FDA for the treatment of worsening relapsing–remitting multiple sclerosis (MS), secondary progressive MS, and progressive-relapsing MS. Mitoxantrone is taken up rapidly by tissues, from which it is released slowly, and the terminal half-life ranges from 8.9 hours to 9 days. The highest concentrations of the drug are typically found in the thyroid, liver, and heart, and the drug persists in the body for as long as 272 days. Mitoxantrone is effective in reducing disease progression through a variety of different mechanisms of action. For example, it suppresses the proliferation of T cells, B cells, and macrophages. It impairs antigen presentation and decreases the secretion of proinflammatory cytokines. Mitoxantrone enhances T-cell suppressor function and inhibits B-cell function and antibody production. Finally, it inhibits macrophage-mediated myelin degradation. Compared with interferon betas, mitoxantrone has a broad range of actions and has effects on many different types of immune cells.
MEMS single-chip5×5 and 20×20 double-switch arrays for telecommunication networks

This paper reports on a microelectromechanical (MEMS) switch array with up to 20x20 double switches embedded and packaged on a single chip and utilized for automating main distribution frames in copper-wire telecommunication networks. The device includes 5x5 or 20x20 double-switches, allowing for an any-to-any interconnection of the specific input line to the specific output line. The switches are based on an electrostatic S-shaped film actuator with the switch contact moving between a top and a bottom electrode. The device is fabricated in two parts and is designed to be assembled using selective adhesive wafer bonding resulting in a wafer-scale package of the switch array. The packaged 5x5 switch arrays have a size of 6.7x6. 4mm2 and the 20x20 arrays are 14x10 mm2 large. The switch actuation voltages for closing/opening the switches averaged over an array were measured to be 21.2 V / 15.3 V for the 5x5 array and 93.2 V / 37.3 V for the 20x20 array. The total switch impedance varies on the 5x5 array between 0.126 Omega and 0.564 Omega at a measurement current of 1 mA. The average resistance of the switch contacts within the 5x5 array was determined to be 0.216 Omega with a standard deviation of 0.155 Omega.
New Leakage Mechanism and Dielectric Breakdown Layer Detection in Metal-Nanocrystal-Embedded Dual-Layer Memory Gate Stack

We study the dielectric breakdown (BD) behaviors in MOS capacitor structures with metal-nanocrystal (NC)-embedded dual-layer (SiO2/Al2O3) gate stack. Using a unique stressing methodology of inducing a BD path in one of the two dielectric layers, the effect of BD in the blocking or tunnel oxide is assessed. The first layer to BD is determined based on the physics underlying the Coulomb charging energy in relation to thermal energy gained by electrons at low voltage and in the very low temperature regime ranging from 11 K to 300 K. The established methodology to detect the BD layer in an NC-embedded dual-layer dielectric can be applied for any bilayered NC system, regardless of the thickness of the tunnel and blocking oxide layer. It is noted that BD in SiO2 leads to lateral charging/discharging among NCs, while, in Al2O3, it leads to spontaneous BD of bilayer gate stacks owing to high localized trap generation rate around the high-κ dielectric grain boundary and local electric field enhancement in the vicinity of metal NCs.
Apolipoprotein E and apolipoprotein D expression in a murine model of singlet oxygen-induced cerebral stroke.

Apolipoprotein E (apoE)-deficient mice exhibit neuronal abnormalities similar to those in Alzheimer's disease and enhanced sensitivity to stroke-associated injuries. Here, we show that apoE deficiency results in impaired microglia/macrophage recruitment and accumulation after cerebral infarct. Astrogliosis and apolipoprotein D (apoD) expression are unaffected, suggesting that the neurological abnormalities of apoE-deficient mice could be due to impaired microglia/macrophage recruitment/accumulation, which is important for the clearance of neurodegenerative products via reverse cholesterol transport. To our knowledge, the results presented herein provide the first experimental evidence that brain microglia/macrophage recruitment/accumulation is affected by apoE deficiency. The insights gained from this study should facilitate the elucidation of the role of apoE in neurological disorders such as dementia with stroke and Alzheimer's disease.
Experimental infections of pigs and mice with selected genotypes of Ascaris

Extending a previous investigation of the genotypic variability within Ascaris from humans and pigs, experimental infections of mice and pigs with selected genotypes of Ascaris were performed in the present study to explore possible host affiliation. Initial findings indicate that there is a significant difference in the ability of Ascaris eggs of genotype G1 (derived from human) and G3 (derived from pig) to infect and establish as larvae in mice and as adults in pigs, supporting the difference in the frequencies of the genotypes reported previously in natural Ascaris populations in pigs and humans in areas in China endemic for ascariasis.
[Treatment of uterine leiomyoma by two different doses of mifepristone].

OBJECTIVE To study the response of uterine leiomyoma to two different daily dosages of mifepristone. METHODS Prospective nonrandomized clinical trial on women with symptomatic uterine leiomyoma was conducted. Twenty-eight patients were treated with 10mg of mifepristone daily and fifteen patients with 20mg daily for 12 weeks, beginning on day 1 to 3 of the menstrual cycle. Volume changes of leiomyoma and uterus were measured with ultrasonography before treatment (as baseline) and monthly during the course of therapy. Blood samples for hemoglobin, liver and renal function were obtained monthly. RESULTS Ovarian acyclicity was induced in both groups of patients given different daily doses of mifepristone and dysmenorrhea and low abdominal pain disappeared. All symptoms and signs of anemia were resolved. The average hemoglobin level elevated 14-16g/L monthly. After 12 weeks of mifepristone treatment, the leiomyoma volume decreased to 41.4% of baseline in the 10mg daily dose group and 43.0% in the 20mg daily dose group. There was no significant difference between the two treatment groups; the side effects were similar. CONCLUSION Mifepristone of 10mg daily is considered to be a more ideal dosage for treatment. Mifepristone therapy is indicated in larger fibroids, and/or as preoperative medication for severely anemic patients and in perimenopausal patients with symptomatic fibroids.
Energy Demand Model for Residential Sector: A First Principles Approach

According to the U.S. Energy Information Administration (EIA), the residential sector accounts for one-third of the country's energy consumption. This number is steadily increasing, posing a challenge to energy regulators as well as suppliers. To manage the growing demand for energy, there is a need for energy system optimization, especially on the demand side. This paper uses a first principles approach to build a high-resolution energy demand model, which can be used as a test bed by academicians as well as policy makers for performing such optimizations. This framework generates activity-based, building-level, time-dependent demand profiles. The model associates appliance usage with each household activity and calculates energy consumption based on the appliance energy rating, the duration of the energy consuming activity, and the type of activity performed by each household member. It also accounts for shared activities among household members to avoid double counting. Additionally, passive energy consumptions such as space heating/cooling, lighting, etc., are measured. Finally, validation of the results obtained by this model against real-world data for Virginia is carried out. The results indicate that the modeling framework is robust and can be extended to other parts of the U.S. and beyond.
Can Monetary Policy Target on Asset Price? Evidence from Chinese Real Estate Market

Based on the BEKK model and the GARCH mean-value equation model,this paper analyzes the volatility correlations among real estate price,money supply and economic growth,and examines the impact of various volatilities on economic growth.It has been found out that the volatility of real estate price and the comovement between real estate price and money supply have significant impacts on GDP growth rate,and furthermore lead to decline of GDP growth rate.The volatility of real estate price growth rate does not significantly affect economic growth rate volatility,while the co-movement between money supply and real estate price change sharply,and the co-movement between real estate growth rate and economic growth rate does not show significant influence on economic growth rate's volatility.The conclusion is that the volatility of real estate price should be controlled,but currently it is not necessary for the central bank to directly intervene in real estate price.
Tiny hand gesture recognition without localization via a deep convolutional network

Visual hand-gesture recognition is being increasingly desired for human-computer interaction interfaces. In many applications, hands only occupy about 10% of the image, whereas the most of it contains background, human face, and human body. Spatial localization of the hands in such scenarios could be a challenging task and ground truth bounding boxes need to be provided for training, which is usually not accessible. However, the location of the hand is not a requirement when the criteria is just the recognition of a gesture to command a consumer electronics device, such as mobiles phones and TVs. In this paper, a deep convolutional neural network is proposed to directly classify hand gestures in images without any segmentation or detection stage that could discard the irrelevant not-hand areas. The designed hand-gesture recognition network can classify seven sorts of hand gestures in a user-independent manner and on real time, achieving an accuracy of 97.1% in the dataset with simple backgrounds and 85.3% in the dataset with complex backgrounds.
Identification of squamous cell carcinoma associated proteins by proteomics and loss of beta tropomyosin expression in esophageal cancer.

AIM To assess the proteome of normal versus tumor tissue in squamous cell carcinoma of the esophagus (SCCE) in Iranian patients and compare our results with former reports by using proteomics. METHODS Protein was extracted from normal and tumor tissues. Two dimensional electrophoresis was carried out and spots with differential expression were identified with mass spectrometry. RNA extraction and RT-PCR along with immunodetection were performed. RESULTS Fourteen proteins were found whose expression levels differed in tumor compared to normal tissues. Mass spectrometric analysis resulted in the identification of beta-tropomyosin (TMbeta), myosin light chain 2 (and its isoform), myosin regulatory light chain 2, peroxyredoxin 2, annexin I and an unknown polypeptide as the down regulated polypeptides in tumor tissue. Heat shock protein 70 (HSP70), TPM4-ALK fusion oncoprotein 2, myosin light polypeptide 6, keratin I, GH16431p and calreticulin were the up-regulated polypeptides found in tumor tissue. Several of these proteins, such as TMbeta, HSP70, annexin I, calreticulin, TPM4-ALK and isoforms of myosins, have been well recognized in tumorigenesis of esophageal or other types of cancers. CONCLUSION Our study not only supports the involvement of some of the formerly reported proteins in SCCE but also introduces additional proteins found to be lost in SCCE, including TMbeta.
A pilot randomized clinical trial assessing the effect of cricoid pressure on risk of aspiration

Patients at risk for microaspiration during elective intubation often receive cricoid pressure in the hopes of mitigating such risk. However, there is scarce evidence to either support or reject this practice. The objective of this investigation was to assess the effect of cricoid pressure on microaspiration and to inform the potential feasibility of conducting a larger, more definitive clinical trial.
Coinhibitory receptors and CD8 T cell exhaustion in chronic infections

Purpose of reviewTo describe the recent data on the role of coinhibitory receptors, such as PD-1, Tim-3, CD160, as mediators of the ‘exhaustion’ of virus-specific CD8 T cells in chronic infections and particularly in HIV. Recent findingsExhaustion of chronic virus-specific CD8 T cells is a dynamic process characterized by altered differentiation, impaired function, and compromised proliferation/survival profile of these cells. This process is mediated by coinhibitory receptors expressed on the surface of virus-specific CD8 T cells and an orchestrated function of centrally connected pathways. Coexpression of several coinhibitory receptors characterizes severely exhausted virus-specific CD8 T cells. Several studies suggest a synergistic action, instead of a redundant role, of the different receptors. In-vivo manipulation of the coinhibitory network can rejuvenate exhausted virus-specific CD8 T cell responses and constrain replication of chronic viruses, including HIV. SummaryRevealing the molecular basis of virus-specific CD8 T cell exhaustion in chronic infections is critical for the understanding of the disease pathogenesis and the designing of novel vaccines aiming to enhance the cytolytic arm of the immune system. This is of particular interest for the development of immunotherapies in the context of a functional cure for HIV.
Results from a European Clinical Investigation of the Nucleus® Multichannel Auditory Brainstem Implant

Objective This study was designed to investigate the perceptual benefits and potential risks of implanting the Nucleus® multichannel auditory brainstem implant. Design Between September 1992 and October 1997 a total of 27 subjects received a Nucleus 20- or 21-channel Auditory Brainstem Implant (ABI). All subjects involved in the trial had bilateral acoustic tumour as a result of neurofibromatosis type 2 (NF2) resulting in complete dysfunction of the VIIIth nerve. The study used each subject as their own control without a preoperative baseline because residual hearing, if existing, was destroyed at surgery by tumour removal. A battery of speech tests was conducted to evaluate each patient’s performance and communication abilities. Tests were conducted, where possible, in the auditory-only, visual-only, and auditory-visual conditions at 3 days postoperatively (baseline), at 3-mo intervals for the first year and every 12 mo thereafter. A subjective performance questionnaire was administered together with an extensive neurological examination at each test interval. Results 27 subjects involved in this trial were successfully implanted with a Nucleus ABI. One subject died 2 days postoperatively due to a lung embolism unrelated to the device. Twenty-six subjects underwent device activation and all but one patient received auditory sensation at initial stimulation (96.2%). On average 8.6 (±4.2) of the available 21 electrodes were used in the patients’ MAPs. Performance evaluation measures showed that the majority of users had access to auditory information such as environmental sound awareness together with stress and rhythm cues in speech that assist with lipreading. Although most subjects did not achieve any functional auditory-alone, open-set speech understanding, two subjects from this series (7.4%) did receive sufficient benefit to be able to use the ABI in conversation without lipreading. Conclusions Although the medical risks and surgical complexity associated with ABI device implantation are far greater than those for a cochlear implant, the clinical results from this trial show that the Nucleus multichannel ABI is capable of providing a significant patient benefit over risk ratio for subjects suffering loss of hearing due to bilateral retrocochlear lesions.
IL-13 mediates the recruitment of reserve cells for fusion during IGF-1-induced hypertrophy of human myotubes

Insulin-like growth factor-1 (IGF-1) has been shown to induce skeletal muscle hypertrophy, to prevent the loss of muscle mass with ageing and to improve the muscle phenotype of dystrophic mice. We previously developed a model of IGF-1-induced hypertrophy of human myotubes, in which hypertrophy was not only characterized by an increase in myotube size and myosin content but also by an increased recruitment of reserve cells for fusion. Here, we describe a new mechanism of IGF-1-induced hypertrophy by demonstrating that IGF-1 signals exclusively to myotubes but not to reserve cells, leading, under the control of the transcription factor NFATc2, to the secretion of IL-13 that will secondly recruit reserve cells for differentiation and fusion. In addition, we show that IGF-1 also signals to myotubes to stimulate protein metabolism via Akt by (1) activating the mTOR-p70S6K-S6 pathway and inhibiting GSK-3β, both involved in the control of protein translation, and (2) inhibiting the Foxo1–atrogin-1 protein degradation pathway.
Prevalence of dyslipidemia among adult diabetic patients with overt diabetic nephropathy in Anambra state south-east Nigeria.

BACKGROUND Dyslipidemia has been identified as a risk factor for the development and progression of diabetic renal disease. OBJECTIVE This study was done to determine the prevalence of dyslipidemia among diabetic patients with overt nephropathy. MATERIALS AND METHODS A total of 72 diabetic patients with overt diabetic nephropathy and 36 age- and sex-matched normoalbuminuric diabetic patients were studied. Their fasting lipid profile, fasting blood sugar, and renal function tests were evaluated. RESULTS Total serum cholesterol and serum triglycerides were significantly higher in patients with overt diabetic nephropathy compared to the controls; 66.7% and 62.5% versus 36.1% and 30.6%, respectively ( P = 0.003 and 0.002, respectively). CONCLUSIONS Diabetic patients with overt diabetic nephropathy have significant dyslipidemia and aggressive lipid lowering in these patients may retard their progression to end-stage renal disease.