Miracle-dz/UniFAR-FTUs huggingface dataset:
Refining DRGs: The Example of Children's Diagnosis-Related Groups

Congress exempted certain types of specialty hospitals from the Medicare Prospective Payment System because it was recognized that Diagnosis-Related Groups (DRGs) may not properly define the case mixes in such institutions. This study is part of a larger investigation into case mix and payment in children's hospitals, one category of exempted institutions. A national sample of approximately 500,000 cases was developed with intentional oversampling of children's and university hospitals to allow detection of specialized types of cases. Five case-mix classification schemes—DRGs, Disease Staging, Patient Management Categories, Severity of Illness Score, and Pediatric Diagnosis System groups—were applied to the data set, and data items not included in the Uniform Hospital Discharge Data Set were collected. A set of Children's Diagnosis- Related Groups (CDRGs), based on modification of the current DRG system, resulted from the study. When CDRGs were applied to an independent sample of children's hospital data, length of stay variance was reduced by 47.6% compared with 32.3% for DRGs (length of stay outliers removed). These results suggest that incremental approaches to DRG refinement in other clinical areas where current definitions are inadequate may be better than rejecting the large amounts of statistical and clinical analyses existing in the DRG system. Similar methods can be used to correct problems brought on by changes in medical practice.
Estradiol suppresses rapid eye movement sleep and activation of sleep‐active neurons in the ventrolateral preoptic area

Studies from multiple species, including humans, suggest that gonadal hormones, and ovarian hormones in particular, influence the physiology of sleep, but the mechanisms by which these hormones influence sleep behaviors are unknown. Previously, we demonstrated a 50% reduction in lipocalin‐prostaglandin D synthase (L‐PGDS) transcript levels, following estradiol treatment, at the level of the ventrolateral preoptic area (VLPO), a putative sleep‐active nucleus. Catalytic activity of L‐PGDS produces prostaglandin D2 (PGD2), an endogenous somnogen. Based on our previous studies, we hypothesized that estradiol is acting via PGD2 to suppress neuronal activity in the VLPO of females. To begin to test whether this is true, we quantified the number of Fos‐immunopositive cells in hormonally manipulated male and female rats. We found that in females during the light phase, estradiol suppressed Fos expression in VLPO neurons. Interestingly, protein expression of L‐PGDS followed the same pattern. Surprisingly, changes in the hormonal milieu of males had no effect. Using telemetry to record electroencephalograms from gonadally intact females, we found, in the light phase of proestrus when estradiol levels are high, a marked reduction in rapid eye movement (REM) sleep compared with the other days of the estrous cycle. However, during the dark phase of proestrus when estrogen and progesterone levels are elevated, significantly less time was spent in both non‐REM and REM sleep. Thus, it seems that hormones in females play a major role in the regulation of sleep and arousal via activation of neurons in key sleep and arousal centers.
ERP evidence of MI activation without motor response execution

There has been controversy concerning the activity of the primary motor cortex (MI) during the mental rehearsal of movement (motor imagination). In this study we found that the lateralized readiness potential (LRP), an event-related potential probably generated in MI, appeared with similar latencies during both trials requiring execution of hand movements and trials requiring only their mental rehearsal, regardless of whether misleading pre-cues that increased latency were employed. However, LRPs obtained during imagination trials had smaller amplitudes. We conclude that MI is involved in motor imagination as well as in preparing overt movement, and that in overt movement the LRP sums neural activity common to these two situations and neural activity exclusive to overt movement.
The Effect of 50 Hz External Electrical Interference on Implanted Cardiac Pacemakers

The effects of injected 50 Hz alternating current on the function of cardiac pacemakers has been observed in 18 patients with implanted unipolar VVI units. Current, in the range 0–600 μA was applied via electrodes attached to the patients' upper body and feet and fed from a specially designed current injection unit at the bedside. Most implanted pacemakers reverted to interference mode in the current range 29–250 μA. At current levels just below the reversion current all units developed irregular and inappropriate pacing. This current level was pacemaker dependent and varied in the range 27–246 μA. The total reversion current depended on the location of the injecting electrodes and on the patients' posture. The sensitivity of the units to injected interference was increased by deep inspiration. Temporary pacing catheters fitted to an additional ten patients were used to monitor the interference voltage which would be sensed by an implanted unit. This voltage was similarly dependent on patient posture and on deep respiration. Current injection has proved to be a safe, controllable and reproducible method of testing the sensitivity of implanted pacemakers to 50 Hz external interference.
A Novel Method to Read Remotely Resonant Passive Sensors in Biotelemetric Systems

Resonant passive sensors composed by resistive, inductive, and capacitive (RLC) simple sensors are widely used in biotelemetric systems. In this paper, a novel method to read remotely these RLC sensors is presented. The developed method is based on the simultaneous application of three excitation signals of same amplitudes, set at different frequencies, to determine remotely the RLC sensor resonance frequency and quality factor . Theoretical analysis and experimental results are also presented.
Biliverdin, a natural product of heme catabolism, induces tolerance to cardiac allografts

Biliverdin, a product of heme oxygenase‐1 (HO‐1) enzymatic action, is converted into bilirubin, which has been considered a waste product in the past. We now show that administration of biliverdin has a salutary effect in organ transplantation. A brief course of treatment with biliverdin leads to long‐term survival of H‐2 incompatible heart allografts. Furthermore, those recipients harboring long‐surviving (>100 days) allografts were tolerant to donor antigens indicated by the acceptance of second donor strain hearts but not third‐party grafts. Treatment with biliverdin decreased intragraft leukocyte infiltration and inhibited T cell proliferation. Likely related to tolerance induction, biliverdin interferes with T cell signaling by inhibiting activation of nuclear factor of activated T cells (NFAT) and nuclear factor κB (NF‐κB), two transcription factors involved in interleukin‐2 (IL‐2) transcription and T cell proliferation, as well as suppressing Th1 interferon‐γ (IFN‐γ) production in vitro. These findings support the potential use of biliverdin, a natural product, in transplantation and other T cell mediated immune disorders.
Proinflammatory Cytokines Enhance Estrogen-dependent Expression of the Multidrug Transporter Gene ABCG2 through Estrogen Receptor and NFκB Cooperativity at Adjacent Response Elements*♦

Constitutive activation of NFκB in estrogen receptor (ER)-positive breast cancer is associated with tumor recurrence and development of anti-estrogen resistance. Furthermore, a gene expression signature containing common targets for ER and NFκB has been identified and found to be associated with the more aggressive luminal B intrinsic subtype of ER-positive breast tumors. Here, we describe a novel mechanism by which ER and NFκB cooperate to up-regulate expression of one important gene from this signature, ABCG2, which encodes a transporter protein associated with the development of drug-resistant breast cancer. We and others have confirmed that this gene is regulated primarily by estrogen in an ER- and estrogen response element (ERE)-dependent manner. We found that whereas proinflammatory cytokines have little effect on this gene in the absence of 17β-estradiol, they can potentiate ER activity in an NFκB-dependent manner. ER allows the NFκB family member p65 to access a latent NFκB response element located near the ERE in the gene promoter. NFκB recruitment to the gene is, in turn, required to stabilize ER occupancy at the functional ERE. The result of this cooperative binding of ER and p65 at adjacent response elements leads to a major increase in both ABCG2 mRNA and protein expression. These findings indicate that estrogen and inflammatory factors can modify each other's activity through modulation of transcription factor accessibility and/or occupancy at adjacent response elements. This novel transcriptional mechanism could have important implications in breast cancer, where both inflammation and estrogen can promote cancer progression.
Strengthening surf descriptor with discriminant image filter learning: application to face recognition

Face recognition in extreme situations is still challenging to researchers. While several algorithms have shown great recognition results in ideal conditions, accuracy decreases when recognition tasks present a high illumination variation. In this paper, we propose to add two components to the recognition system to make the surf descriptor efficient in such extreme situations. First, we learn a discriminant image filter that maximizes the discrimination of surf. Second, the obtained discriminant SURF(d-surf) is further strengthened by using multispectral images instead of broad band images. DSURF and multispectral d-surf (MD-SURF) were evaluated against two face databases: the feret database, which served as a benchmark, and the iris-m3 multispectral face database, which presented sun lighted faces. Our algorithms have been evaluated against three state-of-the-art algorithms that are MBLBP, HGPP and LGBPHS. The results validated the superiority of D-SURF over the traditional surf descriptor, while MD-SURF performed best out of all studied algorithms.
Thermal analysis of high power LED array system

It's proved that the physical meaning of the electrical average temperature rise of series LED array system tested by electrical temperature sensitive parameter (TSP) method is the arithmetic mean of the temperature rises of all sub-LEDs in the system. Based on this relationship, a novel method to evaluate the temperature distribution of series LED systems by scan measurement and recursive calculation is proposed in this paper. Transient heating response measurements of GaN based high power LED arrays are presented to provide experimental verification for this method. The results show that this method is real-time valid and package form independent. The error between the results of individual measurement and this proposed method is less than ±2°C.
Towards Provably-Secure Timed E-Commerce: The Trusted Delivery Layer

Certified exchange of messages is an essential mechanism for e-commerce; the timing aspects (timeouts and timestamps) are very important for practical applications. However existing formal methods for security analysis assume simplified completely synchronous or completely asynchronous models, and cannot deal with the timing aspects of these (and other e-commerce) protocols. We present model for realistic, �-synchronized adversarial settings. We then present a simple, efficient and provably-secure protocol for certified, time-stamped message delivery, providing precise guarantees of delay and timestamps. Our model and analysis use concrete (rather than asymptotic) notions of security.
The Influence of Calcium Channel Antagonists on Isolated Human Distal Radial Arteries

A comparison was made between the efficacies and potencies of calcium channel antagonists on contractions induced by 5-hydroxytryptamine, norepinephrine, or high-potassium buffer in isolated human distal radial arteries. Also, the impact of removal of extracellular calcium ions on contractions induced by 5-hydroxytryptamine or norepinephrine was assessed. Isometric contractions were induced by agonists, and relaxant responses to calcium channel antagonists, nifedipine, diltiazem, verapamil, or mibefradil were examined. 5-hydroxytryptamine-induced contractions when compared with norepinephrine or high-potassium induced contractions were significantly more sensitive to inhibition by nifedipine (pIC50 = 7.53 ± 0.15; 6.78 ± 0.12; 6.6 ± 0.22, respectively, mean ± SEM). Diltiazem was more effective in producing relaxations when contractions were elicited with 5-hydroxytryptamine (pIC50 = 6.48 ± 0.84) or norepinephrine (pIC50 = 6.20 ± 0.21) than with high potassium (pIC50 = 5.43 ± 0.10). Verapamil was more effective at relaxing arteries contracted with 5-hydroxytryptamine (pIC50 = 6.09 ± 0.19) or norepinephrine (pIC50 = 6.00 ± 0.17) than with high potassium (pIC50 = 5.60 ± 0.16). Mibefradil was not very effective in producing relaxations. The studies revealed that removal of extracellular calcium significantly attenuated contractions produced by 5-hydroxytryptamine (−67.7 ± 6.3%) and norepinephrine (−89 ± 1.5%). In conclusion, our data indicates that nifedipine was the most effective drug in producing relaxations; also, contractions produced by 5-hydroxytryptamine and norepinephrine were found to be critically dependent on the presence of extracellular calcium.
Body distribution and endocrine toxicity of hexachlorobenzene (HCB) in the female rat

Hexachlorobenzene (HCB) residue levels in dosed rats (50.0 mg kg−1 body wt. day−1, n = 9) were significantly (P<0.05) greater in the periovarian fat compared to the thyroid gland. Hexachlorobenzene residue levels were significantly (P<0.05) greater in the thyroid versus the adrenal and ovary. Ovarian HCB residue levels were greater than those found in the thymus, liver and lung. Serum thyroxin (T4) and the free T4 index (FTI) were significantly (P<0.05) suppressed in HCB‐treated rats compared to the control group (n = 8). In contrast, no significant differences in serum concentrations of oestradiol (E2), progesterone (P4) or percentage triiodothyronine uptake (%T3) were observed, thus suggesting an HCB‐induced hypothyroid‐like state. In a second experiment, adult female Sprague Dawley rats (n = 16) were dosed as above and superovulated with pregnant mare serum gonadotrophin (PMSG, 10 IU s.c.) and human chorionic gonadotrophin (hCG, 20 IU s.c.). Circulating levels of P4 were significantly (P<0.05) elevated compared to the control group (n = 8). The %T3 uptake and serum T4 levels were significantly (P = 0.05) suppressed compared to controls. Hexachlorobenzene treatment had no effect on circulating levels of E2 or on the FTI. These results suggest that HCB‐induced changes found in the spontaneously cycling rat are augmented by ovulation induction strategies. We also conclude that HCB concentrates in the endocrine tissues in addition to the fat.
Recommended Neuroanatomical Sampling Practices for Comprehensive Brain Evaluation in Nonclinical Safety Studies

Adequate tissue sampling is known to reduce the likelihood that the toxicity of novel biomolecules, chemicals, and drugs might go undetected. Each organ, and often specific structurally and functionally distinct regions within it, must be assessed to detect potential site-specific toxicity. Adequate sampling of the brain requires particular consideration because of the many major substructures and more than 600 subpopulations of generally irreplaceable cells with unique functions and vulnerabilities. All known neurotoxicants affect specific subpopulations (usually neurons) rather than damaging a certain percentage of cells throughout the brain; thus, all populations should be independently assessed for lesions. Historically, the affected neural cell subpopulation has not been predictable, but it is now clear that sampling selected populations (e.g., cerebral cortex, hippocampus, cerebellar folia) cannot forecast the health of other populations. This article reviews the neuroanatomical domains affected by several model neurotoxicants to illustrate the need for more comprehensive neurohistological evaluation during nonclinical development of novel compounds. The article also describes an easily executed, cost-effective method that uses a set number of evenly spaced coronal (cross) sections to accomplish this comprehensive brain assessment during nonclinical safety studies performed in rodents, dogs, and nonhuman primates.
Classification and selection methodology for multi-element resonant converters

A systematic method is proposed to select desired multi-elements resonant topologies, like three-element, four-element or more elements resonant topologies. The intrinsic characteristics of multi-element resonant converters are utilized for this classification and selection method. Three-element resonant tanks are grouped. One group is chosen for illustration. The characteristics of topologies in this group are compared. This method is also used for four-element resonant converters to improve three-element resonant converters. A test board is built to verify proposed method.
Broad-spectrum Antibiotic Plus Metronidazole May Not Prevent the Deterioration of Necrotizing Enterocolitis From Stage II to III in Full-term and Near-term Infants: A Propensity Score-matched Cohort Study: Erratum

: Necrotizing enterocolitis (NEC) is the most common and frequently dangerous neonatal gastrointestinal disease. Studies have shown broad-spectrum antibiotics plus anaerobic antimicrobial therapy did not prevent the deterioration of NEC among very low birth preterm infants. However, few studies about this therapy which focused on full-term and near-term infant with NEC has been reported. The aim of this study was to evaluate the effect of broad-spectrum antibiotic plus metronidazole in preventing the deterioration of NEC from stage II to III in full-term and near-term infants. A retrospective cohort study based on the propensity score (PS) 1:1 matchingwasperformedamongthefull-termand near-terminfants with NEC (Bell stage (cid:2) II). All infants who received broad-spectrum anti- biotics were divided into 2 groups: group with metronidazole treatment (metronidazole was used (cid:2) 4 days continuously, 15mg/kg/day) and group without metronidazole treatment. The depraved rates of stage II NEC between the 2 groups were compared. Meanwhile, the risk factors associated with the deterioration of stage II NEC were analyzedby case-control study in the PS-matched cases. A total of 229 infants met the inclusion criteria. Before PS-match-ing, we found the deterioration of NEC rate in the group with metro- nidazole treatment was higher than that in the group without metronidazole treatment (18.1% [28/155] vs 8.1% [6/74]; P ¼ 0.048). After PS-matching, 73 pairs were matched, and the depraved rate of NEC in the group with metronidazole treatment was not lower than that in the group without metronidazole treatment (15.1% vs 8.2%; P ¼ 0.2). Binary logistic regression analysis showed that sepsis after NEC (odds ratio [OR] 3.748, 95% conﬁdence interval [CI] 1.171–11.998, P ¼ 0.03), the need to use transfusion of blood products after diagnosis of NEC (OR 8.003, 95% CI 2.365–27.087, P ¼ 0.00), and the need of longer time for nasogastric suction were risk factors for stage II NEC progressing to stage III (OR 1.102, 95% CI 1.004–1.21, P ¼ 0.04). Broad-spectrum antibiotic plus metronidazole may not prevent the deterioration of NEC in full-term and near-term infants. Those infants who had sepsis required transfusion of blood products, and needed longer time for nasogastric suction after stage II NEC was more likely to progress to stage III. Medicine 94(42):e1862)
Improvement of 800-m running performance with prior high-intensity exercise.

UNLABELLED Prior high-intensity exercise increases the oxidative energy contribution to subsequent exercise and may enhance exercise tolerance. The potential impact of a high-intensity warm-up on competitive performance, however, has not been investigated. PURPOSE To test the hypothesis that a high-intensity warm-up would speed VO2 kinetics and enhance 800-m running performance in well-trained athletes. METHODS Eleven highly trained middle-distance runners completed two 800-m time trials on separate days on an indoor track, preceded by 2 different warm-up procedures. The 800-m time trials were preceded by a 10-min self-paced jog and standardized mobility drills, followed by either 6 × 50-m strides (control [CON]) or 2 × 50-m strides and a continuous high-intensity 200-m run (HWU) at race pace. Blood [La] was measured before the time trials, and VO2 was measured breath by breath throughout exercise. RESULTS 800-m time-trial performance was significantly faster after HWU (124.5 ± 8.3 vs CON, 125.7 ± 8.7 s, P < .05). Blood [La] was greater after HWU (3.6 ± 1.9 vs CON, 1.7 ± 0.8 mM; P < .01). The mean response time for VO2 was not different between conditions (HWU, 27 ± 6 vs CON, 28 ± 7 s), but total O2 consumed (HWU, 119 ± 18 vs CON, 109 ± 28 ml/kg, P = .05) and peak VO2 attained (HWU, 4.21 ± 0.85 vs CON, 3.91 ± 0.63 L/min; P = .08) tended to be greater after HWU. CONCLUSIONS These data indicate that a sustained high-intensity warm-up enhances 800-m time-trial performance in trained athletes.
Study of the impact of cranberry extract on the virulence factors and biofilm formation by Enterococcus faecalis strains isolated from urinary tract infections

Abstract Drinking of cranberry fruit juice and application of commercial preparations containing the cranberry extracts are recommended in the prevention and treatment of urinary tract infections (UTIs), especially in women with recurrent UTIs. Many studies focus on the activity of cranberries against uropathogenic Escherichia coli (E. coli) strains. However, the knowledge of the cranberry effect on Gram-positive Enterococcus faecalis (E. faecalis) is limited. Therefore, the aim of our study was to establish the activity of commercial concentrated cranberry extract on the growth, virulence factors and biofilm formation of E. faecalis strains isolated from urine. Minimal inhibitory concentrations (MICs) of cranberry extract were determined by the broth microdilution method. Disc diffusion method was used to determine antimicrobial susceptibility. The impact of cranberry extract on bacterial survival, hydrophobicity, synthesis of lipase, lecithinase, DNase, hemolysin, gelatinase and biofilm mass was determined. Results show that cranberry extract inhibits the growth, enzymatic activities of bacteria and limits biofilm formation. The antibacterial activities of the studied cranberry extract confirm that it could be successfully used in prevention of UTIs caused by E. faecalis.
A season-long investigation of competitive cognition in collegiate wrestlers.

Recently, Gould, Eklund, and Jackson (1992b) reported the results of an extensive investigation with 1988 U.S. Olympic wrestlers. Examination of retrospective data revealed clear differences in the organization and content of thought during all-time best and Olympic worst performances. However, Gould and associates (1992b) advised caution in the interpretation of their findings because of the investigation's episodic nature and stressed the need for further in-depth exploration. The present investigation addressed this need by collecting qualitative data from six NCAA Division I wrestlers via in-depth retrospective interviews regarding 38 season matches in addition to data regarding all-time best and worst performances. Examination of performance data revealed high, moderate, and low performance quality levels. Observable patterns in the organization and content of competitive thought were identified across these performance levels. These patterns are reminiscent of the findings of Gould et al. (1992b), the results of previous research comparing successful and unsuccessful athletes, and other research examining optimal performance states. As might be anticipated from research comparing elite and less elite athletes, the collegiate athletes differed from Olympians on several accounts.