Miracle-dz/UniFAR-FTUs huggingface dataset:
Analysis of health utility data when some subjects attain the upper bound of 1: are Tobit and CLAD models appropriate?

BACKGROUND Health utility data often show an apparent truncation effect, where a proportion of individuals achieve the upper bound of 1. The Tobit model and censored least absolute deviations (CLAD) have both been used as analytic solutions to this apparent truncation effect. These models assume that the observed utilities are censored at 1, and hence that the true utility can be greater than 1.We aimed to examine whether the Tobit and CLAD models yielded acceptable results when this censoring assumption was not appropriate. METHODS Using health utility (captured through EQ5D) data from a diabetes study, we conducted a simulation to compare the performance of the Tobit, CLAD, ordinary least squares (OLS), two-part and latent class estimators in terms of their bias and estimated confidence intervals. We also illustrate the performance of semiparametric and nonparametric bootstrap methods. RESULTS When the true utility was conceptually bounded above at 1, the Tobit and CLAD estimators were both biased. The OLS estimator was asymptotically unbiased and, while the model-based and semiparametric bootstrap confidence intervals were too narrow, confidence intervals based on the robust standard errors or the nonparametric bootstrap were acceptable for sample sizes of 100 and larger. Two-part and latent class models also yielded unbiased estimates. CONCLUSIONS When the intention of the analysis is to inform an economic evaluation, and the utilities should be bounded above at 1, CLAD, and Tobit methods were biased. OLS coupled with robust standard errors or the nonparametric bootstrap is recommended as a simple and valid approach.
Factors determining convalescence after uncomplicated laparoscopic cholecystectomy.

HYPOTHESIS Detailed information on duration and limiting factors for convalescence after uncomplicated laparoscopic cholecystectomy is lacking. Duration of convalescence may be associated with patients' expectations, given recommendations, and postoperative complaints such as pain and fatigue. DESIGN Prospective, descriptive study. SETTING A university hospital. PATIENTS Two hundred consecutive patients who underwent uncomplicated elective laparoscopic cholecystectomy. INTERVENTION For sedentary, light, or moderate workload or main recreational activity, we recommended 2 days of postoperative convalescence; for strenuous workload or recreational activity, we recommended 1 week. MAIN OUTCOME MEASURES Duration and reasons for absence from work. RESULTS Convalescence from work (n = 85) and recreational activity (n = 198) was 6 days (range, 0-28 days) and 2 days (range, 0-24 days), respectively, in patients recommended for 2 days' convalescence. In patients recommended for 1 week of convalescence, convalescence from work (n = 25) was 10 days (range, 0-52 days), and convalescence from main recreational activity (n = 2), 8 days (range, 5-11 days). Among 87 patients who resumed work or activity later than recommended, pain was a contributory cause in 41 patients, fatigue in 35 patients, and convalescent period falling on a weekend in 26 patients, while 29 patients had arranged vacation or sick leave preoperatively. Preoperative expectation of convalescence and pain were independent contributory factors (P<.01) for convalescence from work for longer than 2 days in patients recommended for 2 days' convalescence. CONCLUSIONS The period of convalescence after uncomplicated laparoscopic cholecystectomy is about 1 week from work and 2 days from recreational activity when 2 days of convalescence is recommended. Improved pain relief and patient information may further reduce convalescence.
The effect of cold application and lavender oil inhalation in cardiac surgery patients undergoing chest tube removal

Post-surgical chest tube removal (CTR) is associated with a significant pain and discomfort for patients. Current treatment strategies for reducing CTR-associated pain and anxiety are limited and partially efficacious. To determine the effects of cold application, inhalation of lavender essential oil, and their combination on pain and anxiety during CTR was investigated. This randomized controlled open-label trial was conducted with 80 patients in the cardiac surgery intensive care unit who had a chest tube for duration of at least 24 hours after coronary artery bypass grafting (CABG). Patients were randomized (n=20 in each group) to receive cold application, aromatherapy with lavender oil, cold application in combination with lavender oil inhalation, or none of the above interventions (control group). The intensity and quality of pain and anxiety were evaluated using the visual analogue scale, short form and modified-McGill pain questionnaire (SFM-MPQ) and the Spielberger situational anxiety level inventory (STAII) scale, respectively. Patients in all treatment groups had significantly lower pain intensity and anxiety compared with the control group immediately, 5, 10 and 15 min after CTR. There was no statistically significant difference in the SFM-MPQ total scores between the intervention groups. With respect to anxiety score, there was a significantly reduced anxiety level immediately after CTR in the aromatherapy and cold-aromatherapy combination groups versus the cold application group. The present results suggested the efficacy of cold application and aromatherapy with lavender oil in reducing pain and anxiety associated with post-CABG CTR.
Minimization of Grid Current Distortion in Parallel-Connected Converters Through Carrier Interleaving

Identical parallel-connected converters with unequal load sharing have unequal terminal voltages. The difference in terminal voltages is more pronounced in case of back-to-back connected converters, operated in power circulation mode for the purpose of endurance tests. In this paper, a synchronous reference-frame-based analysis is presented to estimate the grid current distortion in interleaved grid-connected converters with unequal terminal voltages. Influence of carrier interleaving angle on rms grid current ripple is studied theoretically as well as experimentally. Optimum interleaving angle to minimize the rms grid current ripple is investigated for different applications of parallel converters. The applications include unity power factor rectifiers, inverters for renewable energy sources, reactive power compensators, and circulating-power test setup used for thermal testing of high-power converters. Optimum interleaving angle is shown to be a strong function of the average of the modulation indices of the two converters, irrespective of the application. The findings are verified experimentally on two parallel-connected converters, with a circulating reactive power of up to 150 kVA between them.
Predictors of non-adherence to statins : A systematic review and meta-analysis

Background—Non-adherence to statins limits the benefits of this common medication. Individual studies assessing predictors of non-adherence have produced inconsistent results. Objective—The objective of this systematic review and meta-analysis was to identify reliable predictors of non-adherence to statins. Methods—Multiple databases, including Medline, EMBASE and Psychinfo, were searched to identify studies that evaluated predictors of non-adherence to statins. Studies were selected using a priori defined criteria, and each study was reviewed by 2 authors who abstracted data on study characteristics and outcomes. Relative risks were then pooled using an inverse-variance weighted random-effects model. Results—Twenty-two cohort studies met inclusion criteria. Age had a U-shaped association with adherence; the oldest (≥ 70 years) and youngest (< 50 years) had lower adherence than the middleaged (50–69 years). Women and those with lower incomes were more likely to be non-adherent than men [odds of non-adherence 1.07 (95% CI 1.04 – 1.11)] and those with higher income [odds of non-adherence 1.18 (95% CI 1.10 – 1.28)], respectively. A history of cardiovascular disease predicted better adherence to statins [odds of non-adherence 0.68 (95% CI 0.66–0.78)]. Similarly, a diagnosis of hypertension or diabetes was associated with better adherence. Although there were too few studies for quantitative pooling, increased lipid testing and lower out-of-pocket costs appeared to be associated with better adherence. There was substantial (I2 range 68.7–96.3%) heterogeneity between studies across factors. Conclusion—Several socio-demographic, medical, and healthcare utilization characteristics are associated with statin non-adherence. These factors may be useful guides for targeting statin adherence interventions. Disclosures: There are no conflicts to report. NIH Public Access Author Manuscript Ann Pharmacother. Author manuscript; available in PMC 2013 May 01. Published in final edited form as: Ann Pharmacother. 2010 September ; 44(9): 1410–1421. doi:10.1345/aph.1P150. N IH PA Athor M anscript N IH PA Athor M anscript N IH PA Athor M anscript
Response to early repeat celiotomy in horses after a surgical treatment of jejunal strangulation

OBJECTIVE To determine the outcome after early repeat celiotomy in horses operated for jejunal strangulation. STUDY DESIGN Retrospective case series. ANIMALS Horses (n = 22) that underwent repeat celiotomy for postoperative reflux (POR) and/or postoperative colic (POC) that did not improve within 48 hours from onset after initial surgical treatment of strangulating jejunal lesions by jejunojejunostomy (n = 14) or no resection (n = 8). METHODS Medical records were reviewed for clinical signs, duration of signs before repeat surgery, surgical findings and treatment, and outcome. Survival was documented by phone call at long-term follow-up. The influence of POC and POR on timing of surgery were analyzed. Long-term survival was examined by Kaplan-Meier analyses. RESULTS Repeat celiotomy was performed at a median of 57 hours after initial surgery and 16.5 hours from onset of signs, and earlier in horses with POC compared with POR (P < .05). A total of 3/22 horses were euthanatized under anesthesia. A total of 9 of 11 horses with initial jejunojejunostomy required resection of the original anastomosis due to anastomotic complications. In 8 horses without resection, second surgery included resection (4) or decompression (4). Repeat celiotomy was successful in 13/16 horses with POR. Repeat celiotomy eliminated POC in all horses (n = 9). A total of 19 horses were recovered from anesthesia and all survived to discharge. Incisional infections were diagnosed in 13/17 horses where both surgeries were performed through the same ventral median approach, and hernias developed in 4/13 infected incisions. Median survival time was 90 months. CONCLUSION Repeat celiotomy can eliminate signs of POR and/or POC, and the additional surgery does not appear to aggravate POR. Criteria for repeat celiotomy in this study could provide guidelines for managing POC and POR after surgery for jejunal strangulation.
A nonlethal mutation in large T antigen of polyomavirus which affects viral DNA synthesis

A mutation in polyomavirus large T antigen which affects viral DNA synthesis was discovered in strain NG59RA (RA). The effect was most visible in nonpermissive cells. Although a substantial yield in DNA synthesis is normally observed in infections of Fischer rat cells when these are maintained at 33 degrees C (D.L. Hacker, K.H. Friderici, C. Priehs, S. Kalvonjian, and M.M. Fluck, p. 173-181, in R.E. Moses and W.C. Summers, ed., DNA Replication and Mutagenesis, 1988; D.L. Hacker and M.M. Fluck, Mol. Cell. Biol., in press), a 10- to 20-fold decrease in yield was obtained in infections with RA. The yield of free viral DNA in RA transformants was also strongly diminished, whether the transformants were maintained at 37 or 33 degrees C. A large reduction in the apparent number of integration sites, as well as a small reduction in the incidence of tandem integration of the viral genome, was observed in F-111 or FR-3T3 cells transformed by the mutant strain. This appears not to be directly related to the number of integration templates. A DNA fragment was identified which rescues these phenotypes. The fragment is located between the HindIII and NsiI restriction sites (nucleotides 1656 to 1910), a region which encodes only large T antigen. Sequence analysis of this region reveals a C-to-G transition at nucleotide 1791 which causes a proline-to-alanine change in the amino acid sequence of large T antigen. No other mutations have been previously reported in this region of large T antigen.
Large Individual Differences in Serum 25-Hydroxyvitamin D Response to Vitamin D Supplementation: Effects of Genetic Factors, Body Mass Index, and Baseline Concentration. Results from a Randomized Controlled Trial

Abstract The main aim of the study was to determine the influence of genetic factors on the serum 25-hydroxyvitamin D response to vitamin D supplementation. The main outcome measure was an increase in serum 25-hydroxyvitamin D after vitamin D supplementation. The patients are part of a randomized controlled trial in individuals with prediabetes assigned to 20 000 IU of vitamin D3 per week or placebo for 12 months. A total of 484 subjects were included in the analyses and genotyped for single nucleotide polymorphisms in the DBP, DHCR7, CYP2R1, and CYP24A1 genes. Single nucleotide polymorphisms from all 4 selected genes were significantly related to baseline serum 25-hydroxyvitamin D concentrations with differences between major and minor homozygote genotypes ranging from 4.4 to 19.2 nmol/l. In the subjects given vitamin D, those with genotypes with the highest baseline 25-hydroxyvitamin D concentration also had the highest 25-hydroxyvitamin D concentration after 12 months, and the increase (delta) in 25-hydroxyvitamin D was significantly related to 3 of the single nucleotide polymorphisms. The increase in serum 25-hydroxyvitamin D was also higher in lean vs. obese subjects, and higher in those with low baseline 25-hydroxyvitamin D concentrations. When combining these 3 factors in a linear regression model, the predicted (and observed) difference in 25-hydroxyvitamin D increase between high and low responders to the supplementation was approximately 60 nmol/l. In conclusion, due to genetic, body mass, and baseline 25-hydroxyvitamin D differences, there are huge individual variations in the serum 25-hydroxyvitamin D response to vitamin D supplementation that could be of clinical importance.
Highly Sensitive Phase-Front-Modulation Fiber Acoustic Sensor

We report a new low-noise compact fiber acoustic sensor that implements a microfabricated silicon diaphragm with a π/2 phase step combined to a single-mode fiber to form a simple interferometric sensor head. Compared to high-sensitivity diaphragm-based fiber Fabry-Perot sensors, this sensor has a similar strain resolution, it operates over a much broad range of wavelengths (~±150 nm), its response depends very weakly on temperature and on the distance between the fiber and the diaphragm, and both microfabrication and assembly are simpler. A prototype sensor is reported with an average minimum detectable pressure as low as 5.4 μPa/√Hz between 1 and 30 kHz, in agreement with a theoretical model.
Influence of inoculum growth phase on microdilution susceptibility tests

Two types of commercially available microdilution trays were inoculated with log-phase cultures, stationary-phase cultures, and direct suspensions of 18- to 24-h colonies, with essentially comparable results. Direct pick-up of colonies was also tested with two Prompt inoculation systems (3M Co.); they were found to be convenient and reliable methods for standardizing inocula without preincubation in broth and without turbidity adjustment.
Pelvic organ prolapse surgery in the United States, 1997.

OBJECTIVE Our purpose was to describe the prevalence, regional rates and demographic characteristics, morbidity, and mortality of pelvic organ prolapse surgeries in the United States. STUDY DESIGN We used data from the 1997 National Hospital Discharge Survey and the 1997 National Census to calculate rates of pelvic organ prolapse surgeries by age, race, and regional trends. RESULTS In 1997, 225,964 women underwent surgery for prolapse (22.7 per 10,000 women). The mean age of these women was 54.6 years (+/-15.2). The South had the highest rate of surgery (29.3 per 10,000) and the Northeast had the lowest (16.1 per 10,000). The surgery rate for whites (19.6 per 10,000) was 3 times greater than that for African Americans (6.4 per 10,000). Although 16% of surgeries had complications, mortality was rare (0.03%). CONCLUSION Pelvic organ prolapse surgery is common. Regional and racial differences in rates of surgery may reflect physician practice, patient preferences, and gynecologic care utilization.
Epidémiologie, diagnostic et prise en charge de l'infection par le VIH-2 en Afrique de l'Ouest

Contexte : L’infection par le VIH-2 touche un a deux millions de personnes en Afrique de l’Ouest et sa prise en charge se heurte a de nombreuses difficultes. En plus des erreurs diagnostiques observees avec les tests VIH, la resistance intrinseque du VIH-2 aux Inhibiteurs non nucleosidiques de la transcriptase inverse et sa moindre sensibilite a certains inhibiteurs de protease, rendent complexe le traitement de l’infection. A cela vient s’ajouter l’absence de donnees sur la mortalite et la retention dans les soins,dans un contexte d’emergence de resistances aux differentes classes d’ARV. Methode : Le present travail de these, s’appuie sur la cohorte ouest africaine IeDEA-VIH-2 et la biotheque qui lui est rattachee, de meme que l’essai ANRS 12294 FIT-2, pour decrire les modalites diagnostiques, explorer la reponse therapeutique et decrire la mortalite et les perdus de vue, parmi les patients vivant avec le VIH-2 en Afrique de l’Ouest.Resultats : Un quart des patients VIH-2 ou doublement infectes, testes de novo avec les algorithmes nationaux, etaient en realite monoinfectes par le VIH-1. Les tests GenieIII et ImmunoCombII se sont averes etre de bons candidats pour un algorithme d’identification des patients VIH-2. Pour ce qui est du traitement, les patients vivant avec le VIH-2 initiaient principalement des regimes ARV a base d’IP boostes, avec une bonne reponse immunologique et virologique. Les regimes a base de trois INTI produisaient une reponse inferieure a celles des IP, tandis que les regimes a base d’IPnon booste produisaient une moins bonne reponse. Il existe chez les patients VIH-2,une mortalite sous traitement ARV qui etait precoce et elevee (5,2 /100 patient-annee),associee a l’anemie et a des CD4 bas (<100/mm3) a l’initiation des ARV. L’essai FIT-2 actuellement en cours permettra d’identifier les meilleures sequences d’initiation des regimes ARV disponibles dans les pays ouest africains. Conclusion De nombreuses questions restent encore en suspens concernant le VIH-2, les etudes epidemiologiques, immunologiques et genotypiques permettront d’ameliorer la prise en charge des patients VIH-2 vivant en Afrique de l’Ouest.
The effect of common genetic variation in 11β-hydroxysteroid dehydrogenase type 1 on hypothalamic-pituitary-adrenal axis activity and incident depression.

BACKGROUND Accumulating evidence suggests that hyperactivity of the hypothalamic-pituitary-adrenal axis (HPA axis) is involved in depression. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) converts inert cortisone to active cortisol and is implicated in HPA axis regulation in animal studies. The aim of our study was to identify polymorphisms in 11β-HSD1 gene (HSD11B1) with consistent associations with increased HPA axis activity and relate those polymorphisms to depression. METHODS Twelve single-nucleotide polymorphisms (SNPs), including 11 tagging SNPs, were selected using the HapMap database and genotyped in 4228 participants of the population-based Rotterdam Study. The outcome measures were salivary cortisol levels after awakening, 30 min later, at 1700 h, at bedtime, and plasma levels of androstenedione (in women only). SNPs that were significantly associated with cortisol as well as androstenedione levels were also related to incident depression. RESULTS rs11119328 was associated with higher cortisol saliva samples collected at bedtime as well as higher androstenedione levels (P value after correction for multiple testing: 0.01 and 0.04, respectively). Carriers of this polymorphism had an increased risk of an incident depression (hazard ratio 1.28, 95% confidence interval 1.03-1.59). Two other SNPs, which were in high linkage disequilibrium with rs11119328, were related to higher cortisol levels but not with androstenedione levels. CONCLUSIONS We identified one SNP, which was associated with increased salivary cortisol levels at nadir as well as higher androstenedione levels. Moreover, this SNP was also associated with a higher risk of an incident depression. This suggests that 11β-HSD1 is implicated in human HPA axis regulation and susceptibility to depression.
Pediatric Precursors of Adult Cardiovascular Disease: Noninvasive Assessment of Early Vascular Changes in Children and Adolescents

BACKGROUND. Until recently, our understanding of the childhood antecedents of adult cardiovascular disease was limited mainly to autopsy studies and pathologic findings in teens and young adults who died from accidental causes. Recent advances in the understanding of atherosclerosis and new technologies allowing detection of early events have made it possible to observe anatomic and physiologic evidence of cardiovascular disease in young adults and children. OBJECTIVES. The goal of this article was to introduce pediatricians to new methods for noninvasive measurement of cardiovascular disease and its precursors, to describe the potential application of these techniques in detecting childhood precursors of adult cardiovascular disease, and to summarize knowledge gained from this approach. METHODS. We conducted a computerized search of peer-reviewed articles listed in PubMed and Medline from 1980 to April 2006. We reviewed 63 and 84 articles from the adult and pediatric literature, respectively. RESULTS. Reviewing the research on childhood antecedents of adult cardiovascular disease is sobering. Vascular alterations in anatomy, physiology, mechanical properties, and proinflammatory and prothrombotic changes are present from a very early age of childhood and are associated with the risk factors common in adult cardiovascular disease. At the same time, this body of research supports the concept that the vascular impairment from childhood may improve over time with appropriate intervention. CONCLUSIONS. The measurement tools and concepts described in this article offer diagnostic and therapeutic opportunities for collaboration between clinical pediatricians and pediatric researchers. These partnerships will enable pediatricians to contribute in an effort to reduce the burdens of cardiovascular disease to individuals, families, and society.
Quality of life and psychosocial sequelae in children undergoing hematopoietic stem‐cell transplantation: A review

Abstract: This paper reviews the research published in the last 18 yr on QoL and psycho‐social sequelae in pediatric patients who have undergone HSCT. A corpus of 47 empirical studies was selected and is presented here. From this selection five main topics linked to psychological adjustment to HSCT emerged: QoL; psychological symptoms; cognitive sequelae; social adaptation; psycho‐social interventions for children. The information which emerged from the review of the literature is discussed with special attention to methodological issues. Directions for future research are proposed.