Miracle-dz/UniFAR-FTUs huggingface dataset:
Do Physician-based or Hospital-based Provider Service Networks Better Control Medicaid Expenditures?

In a recent demonstration project, Florida Medicaid enrollees were required to pick a managed care plan that was either a Health Maintenance Organization (HMO) or a Provider Service Network (PSN). PSNs are a form of managed care very similar to Accountable Care Organizations (ACOs) that provides health care services directly through a provider or network of organizations to a defined population without a “middle man” such as a third party insurance company and health plan. There are two types of PSNs: Physician-based PSNs and Healthcare system-based PSNs. Physician-based PSNs are created and controlled by physicians groups. Healthcare system-based PSNs are based on safety net hospitals and their outpatient clinics. Health system-based PSNs are integrated delivery systems, which are organizations that combine healthcare providers into one organization and may provide more efficient care with lower cost of care due to economies of scale. The objective of this study was to examine the differences in healthcare expenditures by enrollees in physician-based and health system-based PSNs. Using a difference in difference approach our study found that compared to enrollees in physician-based PSNs, enrollees in health system-based PSNs lowered expenditures to a greater extent over time compared to physician-based PSNs. Findings from this study provide important information to states considering implementing alternative delivery models to control Medicaid costs.
Comparing effects of Beractant and Poractant alfa in decreasing mortality rate due to respiratory distress syndrome in premature infants

Background: Exogenous natural and synthetic surfactants is a rescue treatment for respiratory distress syndrome (RDS). The goals of the study were to compare the clinical response and side-effects of two frequently used surfactants, poractant alfa (Curosurf) and beractant (Survanta), for the treatment of respiratory distress syndrome in preterm infants. Methods: This clinical trial study was performed during a two-year period in the Neonatal Intensive Care Unit of Ghaem Hospital in Mashhad, Iran. Sample size calculated by a 95% confidence and power of 80, included 104 premature neonates, 74 in survanta and 30 in curosurf groups. The level of statistical significance was considered to be Results: There were no statistically significant differences between the infants treated by survanta or cursurf groups regarding their mean gestational age (30.58 Vs. 29.00 weeks) and birth weight (1388 Vs. 1330 g), (p=0.3) There were also no significant differences between the two groups regarding incidences of broncho- pulmonary dysplasia (BPD) (40.5% Vs. 40%), intraventricular hemorrhage (IVH) grades III/IV (13.5% Vs. 13.3%), pneumothorax (both 20%), patent ductus arteriosus (PDA) (28/3% Vs. 20%) or death (28% Vs. 26.6%) on the 28th day postpartum. Conclusion: This study showed that survanta and curosurf had similar therapeutic effects in the treatment of neonatal respiratory distress syndrome.
Effect of chemotherapy and radiotherapy on red blood cells and haemoglobin in cancer patients

Cells are the building blocks of living things. Cancer grows out of normal cells in the body. Cancer is the uncontrolled growth of abnormal cells in the body. Numerous patient, disease and treatment related factors contribute to the low level of red blood cells (RBCs) and haemoglobin (Hb). Cancer-related anemia described as a cytokine-mediated disorder of erythropoiesis. It reduces the ability of the bone marrow to increase pr oduction of red blood cells in response to the loss of red blood cells. The present study was conducted to compare the effects of chemotherapy and radiotherapy on the RBCs count and Hb level in different types of cancer patients. A total of 80 blood sample s from control and cancer patients were collected and processed for RBCs count and Hb level. Hematological analyzer Medononic 620was used for RBCs count and Hb level. The instrument was a fully automated hematology analyzer. Medononic 620 was designed to measure up to 20 parameters using whole blood from an open inlet, closed tubes, micro pipettes 20 microliter or pre -diluted blood. Significant difference was found in RBCs count as 4.5 +0.4 value was found in normal and 4.1+0.7 was in cancer patients. On other hand, there was also decreased Hb level in cancer patients with 11.0+2.3 value as compared to normal samples where it was 12.6+1.1. It was concluded that cancer treatments such as chemotherapy and radiation therapy can result in decreased R BCs count and Hb level. Low Hb levels can result in immune- compromised body of the cancer patient. Erythropoietin (EPO) can be suggested to the patients during cancer treatment especially in case of chemotherapy and radiotherapy to maintain the RBCs count and Hb levels.
Prevalence of Escherichia coli in milk and different milk products sold under market conditions at Lahore.

Milk and milkproducts are an important part of our diet. Quality of food counts much forhuman health, especially in developing countries where proper hygienicfacilities are not practiced. In the present study 120 samples (60 from areasof better sanitation and 60 from those of poor sanitation) of milk anddifferent milk products like Rasgulla, Gulabjamun, Barfi, Khoa and Dahi werescreened for the comparative analysis of presence, absence and abundance ofEscherichia coli. An overall 54% samples were contaminated with Escherichiacoli. Number and ratio of contaminations was greater in samples from areas ofpoor sanitation than those of better sanitation as expected. Whereas C.F. Ucounts of Dahi (yogurt) for both areas were amazingly higher counted up to212.16±17.54×103 and 189.35±3.42×103 for the poor and better sanitation areas,respectively. Visualization of the milk products in terms of their cultivableE. coli contents declare fecal contamination and a possible route fortravelling of enteric pathogens.
Obstinate Choledocholithiasis

Obstinate choledocholithiasis occurs when an obstructing common duct stone is large in size and does not easily respond to simple endoscopic or laparoscopic removal techniques. Such stones increase the risk of complications from causing biliary obstruction and from requiring more invasive methods of extraction. Sonography combined with computed tomography can confirm the presence, size, and position of common duct stones under ideal conditions before deciding if and how to treat choledocholithiasis. The sonographer must often battle bowel gas and difficult body habitus to image common duct stones, but it is crucial to document them when possible for proper diagnosis and management.
Do Clinical Pathways Really Improve Clinical Performance in Mental Health Settings?

Objective: Royal Brisbane and Women's Hospital (RBWH) Mental Health developed and trialled two clinical pathways on psychosis and depression between 2001 and 2003 with the aim of improving a range of clinical and financial parameters. There was a strong commitment from senior management, appropriate resources were allocated and there was adequate staff support. Following a 6-month trial, the pathways were reworked extensively and combined into an acute inpatient pathway. From October 2003 to 2004, we trialled the acute inpatient clinical pathway, and monitored clinical and financial parameters. Conclusion: Over this 12-month period, the acute inpatient clinical pathway failed to demonstrate improvement on a range of clinical and financial parameters and its use was ceased. This trial lends support to the view that the complexity, individuality and variability of mental disorders means that clinical pathways are not beneficial in mental health settings.
Clinicopathological study of 50 cases of leprosy in Northern Pakistan

Objective To document different clinical and pathological pa tterns of leprosy in Northern Pakistan. Patients and methods Fifty clinically and histologically confirmed case s of leprosy were enrolled for this study. Results Forty patients were male and ten female. Seven pati ents had tuberculoid leprosy, 25 borderline tuberculoid, 3 borderline lepromatous, 1 3 lepromatous leprosy and 2 were indeterminate type. Highest number of patients belonged to Khyber pakhtunkhwa and Punjab provinces. Conclusion Leprosy is still prevalent in Pakistan. Doctors an d other health personnel should be trained to make them aware of the different present ations of this disabling disease.
Reducing Social Isolation in People with Mental Illness: The role of the Psychiatrist

Results: Loneliness and social exclusion are major issues for Australians with mental illness who are in contact with SANE Australia. Almost three out of four respondents said that they, or the person they care for, experienced loneliness often, if not all the time. Consumers who attended psychosocial rehabilitation services regularly were more content with their close relationships than those who did not. Psychiatrists were identified as one of the preferred points of referral for psychosocial rehabilitation services.
EFFECT OF ETHANOLIC EXTRACT OF ALSTONIA BOONEI LEAVES ON SERUM ELECTROLYTE LEVELS IN WISTAR ALBINO RATS.

This study evaluates the effect of methanol extract of Alstonia boonei leaves on levels of serum Mg2+, Ca2+, K+, Na+, HCO3-, urea and creatinine in wistar albino rats as a way of assessing the effect of the extract on kidney function. Twenty rats weighing 180-240 g were assigned to four groups (A, B, C and D) with five animals in each group. Group A served as the control while groups B, C and D served as the test groups and received 100 mg/kg, 200 mg/kg and 400 mg/kg of the extract respectively. All the animals were sacrificed after fourteen days of extract administration. Blood was collected by cardiac puncture for biochemical analysis of serum electrolytes. Serum chemistry showed that there was no significant difference (P<0.05) in the serum levels of bicarbonate, calcium, potassium and urea at all doses tested. Significantly raised sodium and decreased magnessium levels was observed in animals treated with 100mg/kgbw (P<0.05) however, the values were brought close to those of control at doses of 200 mg/kgbw and 400 mg/kgbw. The serum creatinine level was however significantly (P<0.05) higher than control at 400 mg/kgbw. From the result of this experiment, it is concluded that the administration of ethanolic extract of Alstonia boonei leaves does not alter the levels of serum electrolyte. However, care must be taken when exploring the medicinal value of the leaf because of the observed increased creatinine levels observed in the study.
Fiscal policy coordination in currency unions

According to the pre-crises consensus there are separate domains for monetary and fiscal stabilization in a currency union. While the common monetary policy takes care of unionwide fluctuations, fiscal policies should be tailored to meet country-specific conditions. This separation is no longer optimal, however, if monetary policy is constrained by an effective lower bound on interest rates. Specifically, we show that in this case there are benefits from coordinating fiscal policies across countries. By coordinating on a common fiscal stance, policy makers are able to stabilize union-wide activity and inflation while avoiding detrimental movements of a country’s terms of trade.
‘Like Minds, Like Mine’: A New Zealand Project to Counter the Stigma and Discrimination Associated with Mental Illness

Objective: To demonstrate how mass media advertising and community education has been successfully used in New Zealand as part of a comprehensive public health project to reduce stigma and discrimination associated with mental illness. Conclusions: The involvement of people with experience of mental illness in the campaign has been critical to its success. Advertising involving the stories of well-known and famous people who have experienced mental illness has created significant interest, awareness and improved attitudes among the general public. Local community education and other follow-up activities have also contributed to this success.
3D ultrasound in pregnancy : discourses, women's experiences and psychological understanding

This study explores discourses around private three- and four-dimensional (3/4D) ultrasound scans in pregnancy, the experiences of women who have 3/4D scans and what impact these scans may have on pregnant women. A critical discourse analysis of scanning company websites was undertaken to explore the discourses, identities and genres set up on the websites. Longitudinal interviews exploring women’s experiences of 3/4D scans were analysed using interpretative phenomenological analysis. Case studies, using longitudinal questionnaire and interview data, were used to investigate the psychological impact of 3/4D scans on pregnant women. The critical discourse analysis revealed mixed discourses, identities and genres. While 3/4D scans are not overtly medical, they nevertheless contain medical aspects. They are promoted as enhancing bonding and reassurance. In the interview analysis, two superordinate themes emerged: ‘Getting to know the baby’ and ‘Experiences of pregnancy’. While the women’s physical and emotional experiences of pregnancy varied considerably, there were more convergences in the desire to ‘get to know’ the fetus and how women approached this. While routine and 3/4D scans played an important role, fetal movement also emerged as a significant factor. The case studies showed that the psychological impact was not consistent. Scans had no effect on fetal health locus of control, may have reduced anxiety about specific issues for some women and may have had a positive impact on some components of bonding for some women. It is not possible to state categorically that they reduce anxiety or increase bonding. The psychological impact of 3/4D scans appears to be individually mediated and depends on pregnancy experience and individual psychological differences, highlighting the significance of individual factors in both research and practice. Two opposing discourses portray 3/4D scans as either beneficial, by enhancing reassurance and bonding, or problematic, by undermining women’s embodied knowledge and experience and being potentially risky. This study suggests that neither of these two conflicting discourses are reflected in women’s experiences. The women in this study were not motivated primarily by bonding or reassurance when choosing 3/4D scans, but considered them a nice experience; on the other hand, the scans do not seem to have had a detrimental impact either. The interview analysis suggests that women acquire knowledge about the fetus through scans and fetal movement and combine these to make sense of the fetus. This study also provides evidence that the concept and measurement of bonding during pregnancy is problematic and that professional and academic perspectives are not necessarily reflected in women’s experiences.
Prevalence of Non-alcoholic Fatty Liver Disease in the Russian Federation: the Open, Multicenter, Prospective Study, DIREG 1

Background: Non-alcoholic fatty liver disease (NAFLD) is a very serious medical and social problem that can lead to the progression of liver cirrhosis and eventually hepatic failure. There is a paucity of data regarding the prevalence and risk factors for NAFLD in the Russian Federation. Methods: The open multicenter prospective screening study, DIREG 1, involved patients aged 18–80 years who were admitted to various polyclinics for ambulatory therapeutic care (with or without apparent signs of hepatic diseases) at 208 centers in the Russian Federation from March 25th to November 26th, 2007. NAFLD was diagnosed by ultrasonography; a range of clinical and laboratory findings were also recorded for each participant. Results: A total of 30,754 outpatients were included in the screening study analysis. The prevalence of NAFLD was 27.0% (8,315/30,754), of which 80.3% had steatosis, 16.8% had steatohepatitis and 2.9% had disease at the cirrhotic stage. Most cases of NAFLD were observed in those aged 50-59 years (31.1%), 40-49 years (23.6%), and 60-69 years (18.1%). The most common risk factors associated with the NAFLD cohort vs the general screening population were dyslipidemia (75.9% vs 37.6%), arterial hypertension (69.9% vs 41.8%), and hypercholesterolemia (68.8% vs 33.5%) (all P<0.001). Conclusion: There is an urgent need to address the high prevalence of NAFLD in the Russian Federation (27%) and the large proportion of individuals with associated risk factors.
Mobile Phones, E E G And Mental Activity

Background: The published results about possible mental effects of mobile phone (MP) exposure are still inconsistent and inconclusive. Methods: The sigmoid arousal-frequency correlation combined with the brain rate concept is used to characterize the effects of mobile phones on mental states. Results: MP exposure leads to pronounced asymmetries and individualities in brain rate values, characterizing EEG spectral shifts towards overarousal or underarousal. Conclusion: The mental consequences of mobile phone use could be, in principle, detrimental or beneficial, depending on the individual initial EEG spectra and the different exposure frequencies from mobile phone technologies. Thereby, brain rate can serve as a useful preliminary indicator.
Analysis of spectrum of ovarian tumours: a study of 55 cases

Background: Malignant epithelial tumours are the most common ovarian cancers and also the most lethal gynaecological malignancies. This study was undertaken to analyse histomorphological spectrum and clinicopathological correlation of ovarian tumours. Methods: This retrospective study was done for the period of one year at Department of Pathology, New Civil Hospital, Surat, which is a tertiary health care center. Here we studied 55 cases of ovarian mass received in formalin, which were subjected to histopathological examination and immunohistochemistry as and when required. Results: In total, 55 ovarian tumour specimens were examined. Out of which 28 cases (51%) were benign, 3 cases (5%) were borderline and 24 cases (44%) were malignant. Most common histological type was surface epithelial tumours (60%) followed by germ cell tumours (13%). The commonest benign tumour was mucinous cystadenoma and commonest malignant tumour was serous adenocarcinoma. Malignancy was quite common in ovarian masses in our institute. Conclusions: Ovarian tumours are quite common in our set up and epithelial tumours are the commonest variety of ovarian tumours. The histological type of ovarian tumour correlates with the prognosis of the tumour.
Computer-Aided Diagnosis of Liver Cirrhosis by Simultaneous Comparisons of the Ultrasound Images of Liver and Spleen

Ultrasound imaging is an important tool for early detection and regular check-ups of liver cirrhosis. The diagnosis can be performed by analysis of echo textures of the liver and of the accompanying spleen. The simultaneous comparison of liver and spleen images for the same person at the same system setup can be used to reduce subject, machine, and system variations. This study aims to investigate the computer-aided diagnosis of features derived from the ultrasound images of livers and the accompanying spleens. We will incorporate the techniques of an early vision model, di- mension reduction, fractal dimension, nonparametric discriminant rules by kernel density estimation and classification trees to improve the statistical analysis methods. These methods are tested by the clinical images collected at National Taiwan University Hospital with 64 normal livers and 30 cir- rhosis ones. The smallest overall bootstrap prediction error is found to be 5.29% by these new methods.
On the Design of Yaw Rate Control via Variable Front-to-Total Anti-Roll Moment Distribution

In vehicle dynamics, yaw rate control is used to improve the cornering response in steady-state and transient conditions. This can be achieved through an appropriate anti-roll moment distribution between the front and rear axles of a vehicle with controllable suspension actuators. Such control action alters the load transfer distribution, which in turn provokes a lateral tire force variation. With respect to the extensive set of papers from the literature discussing yaw rate tracking through active suspension control, this study presents: i) A detailed analysis of the effect of the load transfer on the lateral axle force and cornering stiffness; ii) A novel linearized single-track vehicle model formulation for control system design, based on the results in i); and iii) An optimization-based routine for the design of the non-linear feedforward contribution of the control action. The resulting feedforward-feedback controller is assessed through: a) Simulations with an experimentally validated model of a vehicle with active anti-roll bars (case study 1); and b) Experimental tests on a vehicle prototype with an active suspension system (case study 2).
A Diagnostic Challenge

Autoimmune hepatitis (AIH) is a chronic liver disease of unknown etiology. It is composed of immune-mediated liver injury and significant immunological aspects. Arthritis can be observed in patients with AIH before recognition of the disease, which can lead to a diagnostic challenge. Although there are few reported cases in literature, peripheral blood eosinophilia might also play a part in such diagnosis. We report an intriguing case of a 41-year-old man who presented to our service with arthritis and eosinophilia as initial manifestations and was eventually diagnosed with overlap syndrome: AIH and primary sclerosing cholangitis. The present report aims to include eosinophilia among the clinical features of AIH, highlighting the possibility of its detection before the onset of either articular or hepatic disturbances.
A comparison of intravaginal misoprostol with extraamniotic ethacridine lactate for second trimester MTP

RESULTS : The rate of successful abortions within 48 hours was 95% (57/60 women) in each group. Among those who had aborted within 48 hours, the mean interval from induction to abortion was shorter in misoprostol group (15.5 hours vs 31.3 hours, P<0.0001). The rate of complete abortion, defined as expulsion of both fetus and placenta without operative assistance, was 66.6% for misoprostol and 70% for ethacridine lactate (P=0.344). The average cost per treatment was Rs. 57.95 for misoprostol as compared to Rs.86. 10 for ethacridine lactate. Side effects were uncommon and did not differ between the two groups.
Three complementary approaches for the development of a flexible membrane tidal energy converter : analytical, experimental and numerical

The development and the comparison of three development tools: analytical, experimental and numerical are discussed. The analytical model provides the operating forces and predicts the general tends in order to evaluate the consistency of optimization choices. The experimental prototype shows the real behaviour and the test results give an important database to fit the models. The numerical model, validated with the experimental results, gives access to many more parameters and configurations but it needs much time to process. Energy conversion is discussed.