Miracle-dz/UniFAR-FTUs huggingface dataset:
Cost-effectiveness of endoscopic ultrasonography in the evaluation of proximal rectal cancer

OBJECTIVE:Clinical trials demonstrate the superiority of preoperative over postoperative radiotherapy (XRT) in diminishing rates of local recurrence of transmurally infiltrating (T3/4) rectal tumors. The dosage and cost of preoperative XRT are less than postoperative XRT. The economic and health impact of transrectal endoscopic ultrasound (EUS) on rectal cancer management has not been described. The aim of this study was to apply a decision analysis model to compare the cost-effectiveness of three staging strategies in the evaluation of nonmetastatic proximal rectal cancer: abdominal and pelvic CT versus abdominal CT plus EUS versus abdominal CT plus pelvic magnetic resonance imaging.METHODS:A decision model was designed using DATA Version 3.5 (TreeAge Software, Williamstown, MA), taking as entry criteria nonmetastatic proximal rectal cancer as determined by abdominal CT. In each arm, detection of transmural invasion prompted preoperative XRT. Baseline probabilities were varied through plausible ranges using sensitivity analysis. Cost inputs were based on Medicare professional plus facility fees. Endpoints were cost of treatment per patient and tumor recurrence-free rates. Cost-effectiveness (cost per prevention of local recurrence) and incremental cost-effectiveness ratios were calculated.RESULTS:For proximal rectal tumors, evaluation with abdominal CT plus EUS is the most cost-effective approach ($24,468/yr) compared with abdominal CT plus pelvic magnetic resonance imaging ($24,870) and CT alone ($26,076). Both the magnetic resonance imaging- and CT-only approaches were dominated (i.e., more costly and less effective). CONCLUSIONS:Abdominal CT plus EUS is the most cost-effective staging strategy for nonmetastatic proximal rectal cancer. Staging strategies incorporating EUS improve treatment allocation by achieving more accurate T staging, thereby optimizing the benefit of preoperative XRT to more advanced tumors.
Peripartum care of the cocaine‐abusing parturient: are we ready?

Cocaine abuse in the United States is widespread, affecting more than 30 million people. Nearly 90% of cocaine‐abusing women are of childbearing age. Cardiovascular complications of cocaine intoxication include dysrhythmias, ischemia and/or infarction, and account for most cocaine‐related deaths. Pregnancy enhances the cardiovascular toxicity of cocaine. While the epidemiology, pathophysiology, clinical symptomatology and implications on pregnancy of cocaine addiction in pregnancy have received significant attention over the past 25 years, far too little attention has been given to the therapeutic considerations and peripartum care of the cocaine‐abusing parturients. The timely treatment of acute cocaine‐induced cardiovascular toxicity in pregnancy is by far the best predictor of good maternal and fetal outcome. However, no specific treatment guidelines are currently available for cocaine‐induced cardiac dysrhythmias. This article discusses briefly several agents (and considers their mechanism of action) that have been proposed for the treatment of chest pain and other cardiovascular side‐effects of cocaine toxicity in pregnancy.
A post hoc analysis of the effect of nightly administration of eszopiclone and a selective serotonin reuptake inhibitor in patients with insomnia and anxious depression.

OBJECTIVE Patients with major depressive disorder (MDD) and significant anxiety are less responsive to antidepressants than those without anxiety. In this post hoc analysis of patients with insomnia and comorbid anxious depression, eszopiclone cotherapy with a selective serotonin reuptake inhibitor (SSRI) was compared with placebo cotherapy. METHOD Data were pooled from 2 randomized, double-blind, 8-week trials. One trial (conducted from January 2004 to October 2004) included patients with DSM-IV insomnia and comorbid MDD treated with fluoxetine concurrently with eszopiclone 3 mg/d or placebo. The other trial (conducted from July 2005 to April 2006) included patients with DSM-IV-TR insomnia and comorbid generalized anxiety disorder treated with escitalopram concurrently with eszopiclone 3 mg/d or placebo. Anxious depression was defined as a baseline 17-item Hamilton Depression Rating Scale (HDRS-17) score ≥ 14 (excluding insomnia items) and an anxiety/somatization factor score ≥ 7. Treatment group differences were determined for mean changes in HDRS-17 scores (with and without insomnia items), HDRS anxiety/somatization scores, and response and remission rates. Severity of insomnia was assessed by the Insomnia Severity Index (ISI). RESULTS In the combined dataset, 347 of 1,136 patients (30.5%) had insomnia and comorbid anxious depression. Significant improvements in insomnia were observed for eszopiclone cotherapy relative to placebo cotherapy (mean change from baseline on the ISI: -11.0 vs -7.8, respectively; P < .001). There were greater reductions in HDRS-17 scores at week 8 following cotherapy with eszopiclone compared with placebo when the insomnia items were included (mean change: -14.1 vs -11.2, respectively; P < .01) or excluded (-10.6 vs -8.9; P < .01), but not for anxiety/somatization (-4.3 vs -4.1; P = .23). Response rates were greater for eszopiclone cotherapy than for placebo cotherapy (55.6% vs 42.0%, respectively; P = .01; 50.0% vs 44.4% when insomnia items were removed; P = .3). Remission rates were not significantly different (32.6% vs 27.2%, respectively; P = .28). CONCLUSIONS In this post hoc analysis of patients with insomnia and comorbid anxious depression derived from 2 trials, 8 weeks of eszopiclone therapy coadministered with an SSRI resulted in significantly greater improvements in insomnia, significantly greater reductions in HDRS-17 total score, and significantly greater HDRS-17 response rates compared with placebo coadministration. There were no significant differences in response rates (when insomnia items were excluded) and remission rates, as well as in anxiety/somatization scores. Further research is warranted to determine whether these modest antidepressant effects can be replicated, and anxiolytic effects demonstrated, when evaluated in a prospective manner.
The effect of ball carrying method on sprint speed in rugby union football players

Different methods of ball carrying can be used when a player runs with the ball in rugby union. We examined how three methods of ball carrying influenced sprinting speed: using both hands, under the left arm and under the right arm. These methods were compared with running without the ball. Our aim was to determine which method of ball carrying optimizes sprinting speed. Altogether, 48 rugby union players (age 21±2 years, height 1.83±0.1 m, body mass 85.3±12 kg, body fat 14 ± 5%; mean±s) were recruited. The players performed twelve 30-m sprints in total (each player performed three trials under each of three methods of carrying the ball and sprinting without the ball). The design of the study was a form of Latin rectangle, balanced across the trial order for each of the methods and for pairwise combinations of the methods in blocks of four per trial. Each sprint consisted of a 10-m rolling start, followed by a 20-m timed section using electronic timing gates. Compared with sprinting 20 m without the ball (2.58±0.16 s), using both hands (2.62±0.16 s) led to a significantly slower time (P <0.05). Sprinting 20 m with the ball under the left arm (2.61±0.15 s) or under the right arm (2.60± 0.17 s) was significantly quicker than when using ‘both hands’ (P <0.05), and both these methods were significantly slower than when running without the ball (P <0.05). Accordingly, running with the ball in both hands led to the greatest decrement in sprinting performance, although carrying the ball under one arm also reduced the players' sprinting ability. Our results indicate that to gain a speed advantage players should carry the ball under one arm.
Anatomical and Morphometric Analysis of Accessory Infraorbital Foramen

Abstract The aim of the present study was to analyze the anatomical and morphometric variation in shape, frequency of occurrence, direction, and position of accessory infraorbital foramen (AIOF) in relation to infraorbital foramen (IOF) in cadaveric dry skulls to minimize clinical complications and aid in surgical maneuvering in the maxillofacial region and implementing the regional block anesthesia. The IOF is an important anatomical landmark in these surgical manipulations. Because there is limited literature available on AIOF, which transmits accessory branch of the infraorbital nerve, the present study was designed. In the current study, 45 human dry skulls and 20 disarticulated maxillae have been used irrespective of sex. The other parameters included measuring the distance of AIOF from anterior nasal spine, frontomaxillary suture, infraorbital margin, IOF, and zygomaticomaxillary suture. The transverse and vertical diameter of foramen was also noted. All these measurements were taken using a digital caliper. The result of our study reveals that the presence of AIOF is more on the right side compared with the left side. Because the presence of accessory infraorbital nerve needs to be taken care of during maxillofacial surgical interventions, knowledge regarding the presence of AIOF should be taken into consideration for preoperative evaluation.
National trends in bariatric surgery, 1996-2002.

BACKGROUND Surgical therapy for the long-term treatment of obesity ("bariatric surgery") in individuals whose body mass index (calculated as weight in kilograms divided by the square of height in meters) is 40 or higher or in those who have significant obesity-related comorbidities and a body mass index of 35 or higher is one of few interventions shown to be effective. Many aspects of recent national bariatric surgery trends are unclear, including the ages of individuals undergoing such procedures and the economic burden borne by public vs private payers. HYPOTHESIS Population-adjusted rates of bariatric surgery are rapidly increasing and have economic implications that differ for private vs public payers. DESIGN AND SETTING We examined hospitalization and charge data from the Nationwide Inpatient Sample from 1996 through 2002, representative of national patterns for children and adults. We derived nationally weighted estimates of population-adjusted hospitalization rates and inflation-adjusted charges for bariatric surgery. We also examined the relative economic burden for public vs private payers for bariatric surgery discharges. RESULTS Population-adjusted rates of bariatric surgery in the overall sample increased more than 7-fold in the study period, from 3.5 per 100 000 US population in 1996 to 24.0 per 100 000 in 2002. During this period, among youth (<20 years old), rates increased from 0.23 per 100 000 to 0.73 per 100 000; and among elderly persons (>65 years old), rates increased from 0.30 per 100 000 to 1.69 per 100 000. The rate increased most dramatically among those aged 20 to 65 years, who composed 97% or more of bariatric surgery discharges annually. Increases in bariatric surgical volume corresponded with increasing economic consequences overall, exceeding USD $2 billion in annual charges by 2002 (mean, USD $29,107 per discharge). Since 2000, private payers have been charged for more than 80% of the national total; annual charges to Medicare and Medicaid have been comparatively modest, but each exceeded USD $100 million by 2002. CONCLUSIONS National rates of bariatric surgery have increased markedly among children and adults, with attendant economic consequences, principally for private insurers. This trend may reflect the dearth of effective primary care and preventive interventions to address the obesity epidemic.
Regulation of γ‐Aminobutyric Acid/Barbiturate Receptor‐Gated Chloride Ion Flux in Brain Vesicles by Phospholipase A2: Possible Role of Oxygen Radicals

Preincubation of brain membranes with phospholipase A2 (PLA2) has been shown previously to affect the binding characteristics of various recognition sites associated with the γ‐aminobutyric acid (GABA) receptor complex. In the present study, we have investigated the effects of PLA2 (from Naja naja siamensis venom) on the functional activity of the GABA receptor/chloride ion channel. PLA2 (0.001–0.02 U/mg protein) preincubation decreased pentobarbital‐induced 36Cl‐ efflux and musci‐mol‐induced 36Cl‐ uptake in rat cerebral cortical synaptoneurosomes. The effect of PLA2 was prevented by EGTA and two nonselective PLA2 inhibitors, mepacrine and bromophenacyl bromide. The removal of free fatty acids by addition of bovine serum albumin both prevented and reversed the effect of PLA2. Products of the catalytic activity of PLA2, such as the unsaturated free fatty acids, arachidonic and oleic acids, mimicked the effect of PLA2. However, the saturated fatty acid, palmitic acid, and lysophosphatidyl choline had no effect on pentobarbital‐induced 36Cl‐ efflux. Because unsaturated free fatty acids are highly susceptible to peroxidation by oxygen radicals, the role of oxygen radicals was investigated. Xanthine plus xanthine oxidase, a superoxide radical generating system, mimicked the effect of PLA2, whereas the superoxide radical scavenger, superoxide dismutase, diminished the effects of PLA2 and arachidonic acid on pentobarbital‐induced 36Cl‐ efflux. Similarly, the effect of PLA2 was also inhibited by methanol (1 mM), a scavenger of the hydroxyl radical, and by catalase. These data indicate that exogenously added PLA2 induces alterations in membrane phospholipids, possibly promoting the generation of oxygen radicals and fatty acid peroxides which can ultimately modulate GABA/barbitu‐rate receptor function in brain.
Comparative politics and quasi-rational markets

ABSTRACT This article synthesises psychology, economics and political science theories that can explain market reaction to elections. In order to test the theories, we conduct event studies of the impact of elections on the interest rates on government bonds for 122 elections in 19 countries. The efficient market hypothesis states that rational markets immediately incorporate all information relevant to asset prices. According to psychology, human decision-making is quasi-rational. Market actors should be slow to accept evidence that conflicts with previously held opinions, leading them to under-react to new information. We show that markets under-react to elections and that under-reaction is greater in majoritarian countries because they provide more information to the market. Assuming fully rational markets underestimates the impact of elections and variations in impact across political systems. Most of the literature on market constraint assumes rational markets and may thus be underestimating the extent of market pressure in the aftermath of elections and its distribution across different types of electoral systems. Our results suggest that markets can calculate risk around elections, but are slow to do so, thereby suggesting that the role of uncertainty and the resort to heuristics is relatively minor.
The comparative and cost‐effectiveness of HPV‐based cervical cancer screening algorithms in El Salvador

Cervical cancer is the leading cause of cancer death among women in El Salvador. Utilizing data from the Cervical Cancer Prevention in El Salvador (CAPE) demonstration project, we assessed the health and economic impact of HPV‐based screening and two different algorithms for the management of women who test HPV‐positive, relative to existing Pap‐based screening. We calibrated a mathematical model of cervical cancer to epidemiologic data from El Salvador and compared three screening algorithms for women aged 30–65 years: (i) HPV screening every 5 years followed by referral to colposcopy for HPV‐positive women (Colposcopy Management [CM]); (ii) HPV screening every 5 years followed by treatment with cryotherapy for eligible HPV‐positive women (Screen and Treat [ST]); and (iii) Pap screening every 2 years followed by referral to colposcopy for Pap‐positive women (Pap). Potential harms and complications associated with overtreatment were not assessed. Under base case assumptions of 65% screening coverage, HPV‐based screening was more effective than Pap, reducing cancer risk by ∼60% (Pap: 50%). ST was the least costly strategy, and cost $2,040 per year of life saved. ST remained the most attractive strategy as visit compliance, costs, coverage, and test performance were varied. We conclude that a screen‐and‐treat algorithm within an HPV‐based screening program is very cost‐effective in El Salvador, with a cost‐effectiveness ratio below per capita GDP.
FuseMe: Classification of sMRI images by fusion of Deep CNNs in 2D+ε projections

The methods of Content-Based visual information indexing and retrieval penetrate into Healthcare and become popular in Computer-Aided Diagnosis. Multimedia in medical images means different imaging modalities, but also multiple views of the same physiological object, such as human brain. In this paper we propose1 a multi-projection fusion approach with CNNs for diagnostics of Alzheimer Disease. Instead of working with the whole brain volume, it fuses CNNs from each brain projection sagittal, coronal, and axial ingesting a 2D+ε limited volume we have previously proposed. Three binary classification tasks are considered separating Alzheimer Disease (AD) patients from Mild Cognitive Impairment (MCI) and Normal control Subject (NC). Two fusion methods on FC-layer and on the single-projection CNN output show better performances, up to 91% and show competitive results with the SOA using heavier algorithmic chains.
An SLC6 transporter of the novel B0,− system aids in absorption and detection of nutrient amino acids in Caenorhabditis elegans

SUMMARY Nutrient amino acid transporters (NATs) of solute carrier family 6 (SLC6) mediate uptake of essential amino acids in mammals and insects. Phylogenomic analysis of the Caenorhabditis elegans (Ce) SLC6 family identifies five genes paralogous to an insect-specific NAT subfamily. Here we cloned and characterized the first representative of the identified nematode-specific transporters, SNF-5. SNF-5 mediates broad spectrum cation-coupled transport of neutral amino acids with submillimolar affinities and stoichiometry of 1 AA:1 Na+, except for 1 l-Pro:2 Na+. Unexpectedly, it transports acidic l-Glu− and l-Asp− (1 AA−:3 Na+), revealing it to be the first member of a new B0,− system among characterized SLC6 transporters. This activity correlates with a unique positively charged His+ 377 in the substrate-binding pocket. snf-5 promoter-driven enhanced green fluorescent protein labels intestinal cells INT1-9 and three pairs of amphid sensory neurons: ASI, ADF and ASK. These cells are intimately involved in control of dauer diapause, development, metabolism and longevity. The snf-5 deletion mutants do not show apparent morphological disorders, but increase dauer formation while reducing dauer maintenance upon starvation. Overall, the present study characterized the first nematode-specific NAT and revealed important structural and functional aspects of this transporter. In addition to the predictable role in alimentary amino acid absorption, our results indicate possible neuronal roles of SNF-5 as an amino acid provider to specific neuronal functions, including sensing of amino acid availability.
Epidemiology of Trichomonas vaginalis and Human Papillomavirus Infection Detected by Real-Time PCR in Flanders

Objective: The goal of this cross-sectional laboratory-based study is to investigate the association between Trichomonas vaginalis (TV) and human papillomavirus (HPV) infections in cervical samples in Flanders. Setting: Liquid-based cervical cytology samples from unselected women, covering a population of 14–97 years of age (n = 62,636), and from professional sex workers of the region of Antwerp (n = 308), all residents of Flanders (North Belgium) and participating in cervical cancer screening, were assessed for the presence of TV and HPV. Methods: During 7 months in 2008, 62,944 consecutive liquid-based cytology cervical cancer screening samples were assessed for cytological abnormalities. All samples were tested by real-time quantitative PCR for the presence of TV as well as for low-risk HPV (lrHPV) types 6, 11, 53, 66 and 67, and high-risk HPV (hrHPV) types 16, 18, 31, 33, 35, 39, 45, 51, 52, 56, 58, 59, and 68. Association between TV and HPV infections with age, geographic area and occurrence of cytologic lesions were investigated. Results: The overall prevalence of TV in the general population in Flanders was 0.37%, with the highest prevalence in women aged 41–45 years (0.53%). HPV was detected in 15.1% of cervical samples and peaked in younger women of ages 21–25 years (26.8%). The prevalence of TV was higher in women with HPV infections as compared to women without HPV (0.61 vs. 0.33%, p < 0.0001). In women of suggestive foreign origin, TV prevalence was 4 times higher than in the probably autochthonous population (1.16 vs. 0.29%, p < 0.0001). Working in the sex industry had an increased risk of both HPV and TV when compared to other women (OR 8.6, 95% CI 4.4–16.9, p < 0.0001) and a higher rate of TV was also observed in urban regions, compared to rural areas (OR 1.7 (1.3–2.2), p = 0.0002). Conclusion: The prevalence of TV in Flanders is lower compared to data from the literature, whereas the prevalence of HPV infection is similar to that reported in other European countries with similar test systems. Both TV and HPV are sexually transmitted infections, but our prevalence data suggest that the epidemiology of HPV and TV are different in Flanders. Highest HPV prevalence is found in young women whereas TV is more frequent in older women. Although some epidemiological peculiarities of the society, such as promiscuity and import from overseas countries, can possibly account for the differences in epidemiology, the exact reasons remain to be elucidated in further studies.
Benign paroxysmal positioning vertigo: A long-term follow-up (6–17 years) of 125 patients

Conclusions. The study disclosed a few predictive factors for benign paroxysmal positioning vertigo (BPPV) recurrences, which are clinically relevant and essential for patient awareness of the often long-term course of the condition. Objectives. To determine the long-term recurrence rate of posterior canal BPPV after successful liberatory maneuvers. Methods. A retrospective self-evaluation questionnaire with a structured interview was conducted 6–17 years after assessment of the diagnosis in 125 patients. Results. The recurrence rate in patients with a mean follow-up of 10 years was 50%. Most recurrences (80%) were within the first year after treatment, irrespective of the liberatory maneuver applied. None of the patients observed a recurrence after a symptom-free period of 8 years. Recurrences were seen significantly more often in women (58% versus 39%). The recurrence rate of patients in the seventh decade was half that of those in the sixth decade (p=0.0009). A history of three or more BPPV attacks prior to treatment indicated a higher risk of impending multiple recurrences in about two-thirds of the patients.