Miracle-dz/UniFAR-FTUs huggingface dataset:
The effect of a patient's risk-taking attitude on the cost effectiveness of testing strategies in the evaluation of pulmonary lesions.

STUDY OBJECTIVES To assess the health and cost effects of a patient's risk-taking attitudes about diagnostic tests. DESIGN Cost-effectiveness analysis. SETTING Diagnostic testing strategies used in the evaluation of a patient with a radiographically detected lung lesion were evaluated. Strategies included combinations of sputum, fine-needle aspiration, bronchoscopy, thoracoscopy, and expectant management. PATIENTS Patient data were obtained from the Survival Epidemiology and End Results Program, MEDLINE search, National Center for Health Statistics, and the Universities of Iowa and Stanford, and Kaiser Permanente Hospital. INTERVENTIONS Different patient risk-taking attitudes were simulated using decision analysis. MEASUREMENTS Lifetime cost of medical care, life expectancy, and cost effectiveness. RESULTS The cost effectiveness of competing strategies depended on patient attitudes about taking risks. For a patient averse to expectantly waiting without definitive knowledge of whether cancer was or was not present, testing strategies using invasive procedures, such as thoracoscopy, were more cost effective. In contrast, for a patient who was identical except that he or she was averse to tests with higher morbidity and mortality, strategies that involved expectantly waiting, instead of more invasive tests, were more cost effective. Small changes in some risk-taking attitudes resulted in large changes in cost effectiveness. CONCLUSIONS Risk-taking attitudes influenced the cost effectiveness of testing strategies. Consideration of patient risk-taking attitudes in diagnostic testing appears warranted in setting clinical policies and making individual decisions.
Face detection with clustering, lda and NN

In this paper, we study neural network (NN) based face detection. The main purpose is to reduce the complexity of the NN detector and thus speedup training and detection through linear dimensionality reduction. Neither principle component analysis (PCA) nor linear discriminant analysis (LDA) is good for this purpose. PCA often reduces descriptive and discriminative information together. On the other hand, LDA maps all data into a (C - 1)-dimensional feature space, where C = 2 for face detection. Since face detection is highly non-linear, classification in 1-dimensional space is clearly not enough. In this paper, we propose a new method for face detection. In this method, the problem is first changed to a multi-class problem using clustering. A modified LDA (m-LDA) is then proposed to extract useful features. The NN is used to make the final decision. Here, m-LDA is used to minimize the within-cluster variance between all "face" clusters; and maximize the between-cluster variance between all "face" clusters and all "non-face" data points. The feature space so obtained has a dimensionality less than that of the original problem. To validate the proposed method, we conducted several experiments with four methods, namely the proposed method, NN, PCA+NN, and LDA+NN. Results show that the proposed method can provide lower false positive and false negative errors for test images.
Teduglutide in Crohn's disease

Introduction: The currently available medications for treatment of Crohn's disease (CD) include aminosalicylates, corticosteroids, antibiotics, immunomodulators and biologic agents (infliximab, certolizumab pegol, adalimumab and natalizumab). These agents target the immune and inflammatory pathways of CD, while there is a shortage of agents that target the barrier functions of the gut that are impaired in CD. Glucagon-like peptide 2 is an enterogastrone with strong trophic effects on the intestinal mucosa. Teduglutide, the analog of glucagon-like peptide has been already approved by the US Food and Drug Administration as a treatment of short bowel syndrome. This review discusses the potential use of teduglutide in patients with CD. Areas covered: As there has been only one randomized placebo controlled trial of teduglutide in CD, there is a shortage of data regarding the efficacy of this agent in CD. The literature search was performed using Medline database with the use of the following key words: teduglutide, glucagon-like peptide-2, CD and inflammatory bowel disease. Expert opinion: Based on available data, it can be concluded that this agent seems to be a promising medication in CD and further trials are required to define the place of teduglutide in treatment of CD.
Life cycle costs optimization for capital goods

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Anterior Segment Eye Assessment of Refractive Surgery Candidates in the Southeast of Iran.

Anterior segment eye parameters are essential factors in diagnosis, screening and management of abnormal ocular conditions. Based on the previous studies, they might differ from one race or population to another. Sistan-and-Baluchestan province, the southeast of Iran, has special weather conditions and race, plus lack of research on these diagnostic factors. Hence, the objective of the present study was to assess anterior segment parameters using pentacam in this area. 800 eyes of subjects which had been referred to the Al-Zahra eye hospital of Zahedan, the capital city of the province, for corneal refractive surgery from October 2014 to March 2015 participated in this research. 95% confidence limits for mean of central corneal thickness, anterior chamber depth and volume were (536.02, 541.20), (3.13, 3.18) and (187.63, 192.58) respectively. Multiple linear regression models showed a lower mean central corneal thickness, and maximum/minimum of keratometry, for males than females, adjusting for age and spherical equivalent. Inversely, anterior chamber depth, and volume were more in males. In order to diagnosis and treating ocular diseases which have effect on retinal thickness, precisely specification of predictive factors is highly needed.
GABA immunoreactive neurons in rat visual cortex

An antiserum to γ‐aminobutyric acid (GABA) was used in a light and electron microscopic immunocytochemical study to determine the morphology and distribution of GABA‐containing neurons in the rat visual cortex and to ascertain whether all classes of nonpyramidal neurons in this cortex are GABAergic. The visual cortex used for light microscopy was prepared in such a way that the antibody penetrated completely through tissue sections, and in these sections large numbers of GABA immunoreactive neurons were apparent. The labeled neurons could be identified as being either multipolar, bitufted, bipolar, or horizontal neurons. In layers II through Via, GABA immunostained cells were distributed uniformly and accounted for approximately 15% of all neurons, but in layer I all neurons appeared to be immunostained.
Subtenon Block Compared to Intravenous Fentanyl for Perioperative Analgesia in Pediatric Cataract Surgery

BACKGROUND: General anesthesia with opioids provides good operative conditions for ocular surgery in children; however, postoperative pain management remains a significant problem. Regional anesthesia is commonly used as an adjunct to general anesthesia in children. We compared the efficacy and safety of subtenon block (SB) versus IV fentanyl for perioperative analgesia in pediatric cataract surgery. We hypothesized that perioperative analgesia using SB may reduce the requirement of postoperative rescue analgesia compared with fentanyl. METHODS: This was a prospective, randomized, controlled, double-blind trial. One hundred fourteen ASA I and II children (6 mo–6 yr) undergoing elective cataract surgery in one eye under general anesthesia were studied. Children were randomly allocated to one of the two groups, i.e., Group SB (n = 58) or Group F (n = 56) after securing the airway. Children in Group SB received SB with 0.06–0.08 mL/kg of 2% lidocaine and 0.5% bupivacaine (50:50) mixture and simultaneous 0.2 mL/kg normal saline IV, whereas children in Group F received 1 &mgr;g/kg (0.2 mL/kg of 5 &mgr;g/kg) of fentanyl IV and simultaneous subtenon injection with normal saline (0.06–0.08 mL/kg). Surgery started after 5 min of study drug administration. Postoperative assessment for pain, sedation, and nausea/vomiting was done at 0.5, 1, 2, 3, 4, and 24 h. The primary outcome was number of patients requiring rescue analgesia during the 24-h study period. Secondary outcomes assessed were pain and sedation scores, time to first rescue analgesia, incidence of occulocardiac reflex, and nausea/vomiting. RESULTS: The number of patients requiring rescue analgesia during the 24 h was significantly less in Group SB (n = 17/58, 29.3%) compared with Group F (n = 39/56, 69.6%, P < 0.001). The postoperative pain scores were statistically lower in Group SB at all time intervals. The median (range) time to first analgesic requirement was significantly prolonged in Group SB (16 [2–13] vs 4 [0.5–8.5] h in Group F) (P < 0.001). Sedation scores at ½ h were comparable, after which significantly more children were anxious or crying in Group F compared with Group SB in which more children were calm, sitting, or lying with eyes open and relaxed (P < 0.05). A significantly higher incidence of oculocardiac reflex was recorded in Group F versus Group SB (P = 0.019). No complication related to SB was noticed. CONCLUSIONS: SB is a safe and superior alternative to IV fentanyl for perioperative analgesia in pediatric cataract surgery.
Firm heterogeneity and FDI-related productivity spillovers: A theoretical investigation

ABSTRACT A number of existing empirical studies have attempted to estimate the foreign direct investment (FDI)-related productivity spillover effects to domestic firms in host economies using various methodologies and measures of FDI. This literature has produced mixed results. While some studies found positive spillovers, others reported zero or even negative spillovers. In this paper, using a model of firm heterogeneity, we provide a rigorous theoretical justification for the mixed findings. We show that FDI-related productivity spillover effects can be decomposed into a direct and an indirect effect. If the direct effect is positive then relatively less capable domestic firms that were not able to survive in the industry (before the arrival of foreign firms) can enter the industry, which decreases the average (expected) productivity of the industry. If this indirect effect is sufficiently strong then the overall impact of FDI on productivity of domestic firms can be zero or negative. Hence, irrespective of the type of FDI (vertical or horizontal) and control variables included in empirical models, one may find negative or zero spillover effects.
Antioxidant and antibacterial activities of flavonoid glycosides from Ficus exasperata Vahl-Holl (moraceae) leaves.

BACKGROUND Ficus exasperata Vahl-Holl (Moraceae) leaves are used for infectious and inflammatory conditions in many West African Countries. However, there is need for more phytochemical studies to justify the ethnomedicinal uses of the plant. MATERIAL AND METHODS The crude 50% aqueous ethanolic extract of the leaves was partitioned successively between water and; n-hexane, ethyl acetate and n-butanol. The fractions were subjected to antimicrobial activity using agar diffusion test. n-Butanol fraction, which showed both antimicrobial and radical scavenging activities was subjected to repeated chromatographic fractionation on both silica and Sephadex LH-20 columns. Each stage of the purification was monitored by thin layer chromatographic diphenylpicryl hydrazyl autographic assay. Three compounds were isolated. The structures of the compounds were elucidated using spectroscopic methods, shift reagent studies, acid hydrolysis, and by comparison with literature data. RESULTS The compounds were identified as apigenin C-8 glucoside (1), isoquercitrin-6-O-4-hydroxybenzoate (2) and quercetin-3-O-β-rhamnoside (3). The solvent fractions and isolated compounds were found to inhibit the growth of Gram +ve organisms only. CONCLUSION These flavonoid glycosides are being reported in this plant species for the first time. Their weak in vitro antimicrobial activity suggest the flavonoids may be acting as pro-drug. The radical scavenging activity of the compounds may justify some of the ethnomedicinal uses of the plant as free radicals are implicated in the aetiology of many inflammatory diseases.
Proteasomes degrade proteins in focal subdomains of the human cell nucleus

The ubiquitin proteasome system plays a fundamental role in the regulation of cellular processes by degradation of endogenous proteins. Proteasomes are localized in both, the cytoplasm and the cell nucleus, however, little is known about nuclear proteolysis. Here, fluorogenic precursor substrates enabled detection of proteasomal activity in nucleoplasmic cell fractions (turnover 0.0541 μM/minute) and nuclei of living cells (turnover 0.0472 μM/minute). By contrast, cell fractions of nucleoli or nuclear envelopes did not contain proteasomal activity. Microinjection of ectopic fluorogenic protein DQ-ovalbumin revealed that proteasomal protein degradation occurs in distinct nucleoplasmic foci, which partially overlap with signature proteins of subnuclear domains, such as splicing speckles or promyelocytic leukemia bodies, ubiquitin, nucleoplasmic proteasomes and RNA polymerase II. Our results establish proteasomal proteolysis as an intrinsic function of the cell nucleus.
Serum erythropoietin levels in patients with sepsis and septic shock

Abstract: The role of the immune system in the control of the production of erythropoietin is still poorly understood. Herein, the levels of circulating immunoreactive erythropoietin, tumour necrosis factor α, interleukin‐1β and interleukin‐6 were determined in 10 septic patients for up to 4 d following the admission to an internal intensive care unit. The data show that the production of erythropoietin was not suppressed despite an increase in the levels of proinflammatory cytokines. Circulating erythropoietin and interleukin‐6 greatly increased in the 6 nonsurviving patients. The pattern of the serum erythropoietin level in the nonsurvivors resembled that of acute phase proteins and was independent of the blood haemoglobin concentration. Similar to interleukin 6, abnormally high serum erythropoietin levels appear to be a negative prognostic indicator in patients suffering from septic shock.
Validation of Equivalent Dynamic Model of Active Distribution Network Cell

Paper presents an equivalent model of an active distribution network cell (ADNC) with distributed generation for transmission system stability studies. The equivalent model of ADNC comprises a converter-connected generator and a composite load model in parallel. The gray-box approach was chosen as it enables inclusion of prior knowledge about the ADNC structure into the model development, hence making the model more physically relevant and intuitive than a black-box or white-box model. The dynamic equivalent model is presented in a seventh-order nonlinear quasi state space format, developed from the algebraic and differential equations describing assumed typical components of the ADNC. The developed equivalent model of ADNC was validated through small and large disturbance studies using the modified IEEE nine-bus transmission system model.
Participation in Risky Asset Markets and Propensity for Financial Planning: A Missing Link?

This study examines whether the association between financial literacy and participation in risky asset markets is robust to variation on a more innate level: the propensity for financial planning. I find that individuals’ propensity for financial planning is strongly positively related to stock market participation as well as membership in a voluntary workplace retirement savings scheme. This result holds when controlling for financial literacy and a range of demographic and control variables in a multivariate regression setting. Importantly, the positive association between financial literacy and risky asset market participation also persists, suggesting that these two variables operate through separate channels.
Very early tracheal extubation without predetermined criteria in a liver transplant recipient population

This study of all patients undergoing orthotopic liver transplantation (OLT) at our center between January 1997 and December 1999 evaluated the feasibility and safety of very early tracheal extubation without previous selection. Anesthetic management was the same in all cases, and tracheal extubation was performed on the basis of standardized criteria routinely adopted in operating rooms throughout the world, i.e., no residual curarization or anesthetic action, ability to swallow efficiently, and stable hemodynamics. One hundred sixty‐nine patients underwent 181 OLTs during the study period. Tracheal extubation was performed within 3 hours of surgery in 115 cases, 8 hours in 19 cases, and 8 to 24 hours in 10 cases. In 36 cases, artificial ventilation was required for more than 24 hours or weaning was not possible. One patient died of primary graft nonfunction within 24 hours and was excluded from the analysis. The feasibility of early extubation was influenced by the amount of intraoperative transfused blood; efficacy of kidney, cardiac, and pulmonary function; and presence of encephalopathy (P < .001). No correlation was found with age or pre‐OLT severity of hepatic disease, and the postoperative period was not compromised by early weaning. Very early extubation was feasible and safe in a large number of unselected transplant recipients, thus suggesting that the definition of early tracheal extubation should be changed from 8 to 3 hours after surgery.
Disease trajectories and ACT/RCPCH categories in paediatric palliative care

The objective of this study was to provide a preliminary description of trajectories of life-limiting conditions (LLCs) using qualitative experiential data. Semi-structured interviews were conducted with families of children with LLCs, selected to encompass all Association for Children’s Palliative Care (ACT)/Royal College of Paediatrics and Child Health (RCPCH) categories, using a schedule developed from focus groups of professionals. Thirty out of 76 families agreed to participate. Four of these were unsuitable. In nine out of 26 families, their child had died. In eight out of the 26, two individuals were interviewed. Twenty-four mothers, nine fathers, one sibling and two foster-carers were interviewed in total. The interview schedule was developed from data from four themed focus groups, comprising 25 professionals from 14 backgrounds. Thirty-four milestones in five phases were identified: Diagnosis, Loss of normality, Adjusting to new normality, Palliative phase and Death. Many milestones were common to all categories, suggesting that the ACT/RCPCH system encompasses related conditions. Others occurred in only some, suggesting trajectories in the categories are distinct. Significant themes emerging from qualitative data were: becoming expert in their child, concerns about service provision, information needs and relationships with health professionals. By presenting qualitative descriptive data regarding the lived experience of families of children with LLCs, this study provides preliminary evidence that the ACT/RCPCH categories are suitable tools for research and service development.
Loss of mobility and the patient burden of multiple sclerosis: expert opinion on relevance to daily clinical practice

Abstract Background: Walking impairment is one of the most visible and important manifestations of multiple sclerosis. MS Studies have consistently found that walking impairment occurs early during MS, and recent studies suggest that the greatest impact on socioeconomic outcomes occurs during the early stages of disability. Walking impairment is often perceived by the affected individual prior to its clinical manifestation, supporting the need for patient education and walking assessments that may be self-administered. Patient perceptions should lead to pre-emptive management strategies to maintain independence and delay the need for walking assistive devices or caregiving. Patient management should also include regular quantitative and qualitative assessments of walking by physicians or other clinicians, such as nurse practitioners, physician assistants, or physical therapists. Methods: PubMed searches retrieved recent studies (November 2008 to August 2013) evaluating the contribution of walking impairment to the burden of MS. Results: Several objective measures of walking are available, such as measures of walking speed (Timed 25-Foot Walk Test) and distance (2- or 6-Minute Walk); however, these measures may have practical considerations such as time and space. Patient-reported measures, which should have a low administration burden, include walking-specific (Multiple Sclerosis Walking Scale) and health-related quality-of-life outcome assessments. Conclusions: When used in tandem, patient-reported and objective measures can help monitor changes and facilitate patient–clinician discussions of problems, management strategies, and long-term goals related to walking impairment.