Miracle-dz/UniFAR-FTUs huggingface dataset:
How has hospital consolidation affected the price and quality of hospital care ?

1 6 POLICY IMPLICATIONS 2 3 4 5 THE SYNTHESIS PROJECT (Synthesis) is an initiative of the Robert Wood Johnson Foundation to produce relevant, concise, and thought-provoking briefs and reports on today's important health policy issues. By synthesizing what is known, while weighing the strength of fi ndings and exposing gaps in knowledge, Synthesis products give decision-makers reliable information and new insights to inform complex policy decisions. For more information about the Synthesis Project, visit the Synthesis Project's Web site at www.policysynthesis. org. For additional copies of Synthesis products, please go to the Project's Web site or send an e-mail request to pubsrequest@rwjf.org. Findings Over the 1990s the hospital industry underwent a wave of consolidation that transformed the inpatient hospital market place (Figure 1). By the mid-1990s, hospital merger and acquisition activity was nine times its level at the start of the decade. The wave of mergers dramatically increased market concentration for inpatient hospital services as measured by the Herfi ndahl Hirschman Index (HHI). 1 In 1990, the typical person living in a metropolitan statistical area (MSA) faced a concentrated hospital market with an HHI of 1,576. By 2003, however, the typical MSA resident faced a hospital market with an HHI of 2,323. This change is equivalent to a reduction from six to four competing local hospital systems. By 1990, almost 90 percent of people in populous MSAs sought care in highly concentrated markets. Figure 1 graphs the total number of horizontal mergers, acquisitions and system expansions (we refer to this collective consolidation activity as " M&A ") across populous metropolitan statistical areas (MSAs) from 1990 to 2003. Facing increasing growth rates in hospital spending, stakeholders and policy-makers have raised concerns that market concentration has increased the price of inpatient care. Several stakeholder groups, including the Blue Cross and Blue Shield Association and the American Hospital Association have published studies on this issue, with divergent results (4, 9–14). The Federal Trade Commission and Department of Justice have recently held extensive hearings on competition in health care markets and released a report on these issues (9). This synthesis summarizes the research on hospital consolidation to assess the likely effects of past and possible future hospital consolidation on health care prices, costs and quality. We critically examine the available research and reach conclusions based on our assessment of the literature, noting where evidence is inconclusive, lacking, or otherwise limited.
HIV-2 goes global: an unaddressed issue in Indian anti-retroviral programmes

Some people may be laughing when looking at you reading in your spare time. Some may be admired of you. And some may want be like you who have reading hobby. What about your own feel? Have you felt right? Reading is a need and a hobby at once. This condition is the on that will make you feel that you must read. If you know are looking for the book enPDFd hiv 2 goes global an unaddressed issue in indian anti retroviral programmes commentary report as the choice of reading, you can find here.
Multidirectional MTF measurement of digital image acquisition devices using a Siemens star

We propose a method for measuring the multidirectional modulation transfer function (MTF) of digital image acquisition devices using a Siemens star. There are two leading methods for measuring the MTF: the slanted-edge method and the modulated Siemens star method. The former measures the MTF in the horizontal or vertical spatial frequency based on the line spread function (LSF) derived from the edge profile of a slanted knife-edge image. The latter measures the multidirectional MTF using a pattern circumferentially modulated with continuous gray levels. Our method measures the multidirectional MTF using the multidirectional knife-edges of a Siemens star, which is a simple binary image consisting of radial spokes. The vertical edge of the Siemens star is slightly slanted so that the multidirectional edge profiles are obtained in super-resolution. A portion image consisting of the knife-edge is selected in each direction and rotated so that the knife-edge stands upright with a slight tilt. Along the edge slope detected by fitting a cumulative distribution function to the pixel levels, the pixels are projected onto the horizontal axis, forming the edge profile. The resulting multidirectional MTF computed from the edge profiles is in excellent agreement with that measured by the modulated Siemens star method.
Comparison of the carotenoid compositions and protection of in-season and anti-season tomato extracts against d-galactose-induced cognition deficits and oxidative damage in mice

Abstract The compositions and contents of carotenoids in in-season and anti-season tomatoes were compared by HPLC method. In-season and anti-season tomatoes differed not only in the contents of all-trans-lycopene and β-carotene but also in the contents of cis-isomers, implying environmental factors affected not only the accumulation of the all-trans-carotenoids but also their cis-isomers. Meanwhile, the protection of in-season and anti-season tomato extracts against d-galactose induced cognition deficits and oxidative damage in mice were studied. The water-soluble extracts of both season tomatoes showed little protecting effects on the impairment in mice induced by D-gal, while the fat-soluble extracts significantly attenuated d-gal-induced cognitive impairment, and prevented the oxidative damage in mice, but no remarkable difference was observed between the two season tomatoes at the same dose levels, indicating anti-season tomatoes showed similar in vivo protection against d-galactose induced cognition deficits and oxidative damage as that of in-season tomatoes.
Speech Synthesis on the World Wide Web : Evaluation of the Uppsala University Internet Portal

Accessibility on the World Wide Web is a process of designing web sites, so that the entire community of users may gain access to the information and communication provided by each site, regardless of the user’s personal needs or possible disabilities. This process is regulated by official standards and guidelines, foremost the World Wide Web Consortium (W3C); the process is carried out by the web administrators, and in the end affects how the visitors experience the site. In the past five years, there has been an increase in accessibility awareness. Direct steps have been taken to open the web to the general public, by introducing software and alternative sources of information. Following these actions are evaluations, which assess various aspects of the web site: the user’s experience during their visit, as well as the administrator’s work process. This thesis evaluates the accessibility and communication of the Uppsala University web portal (http://www.uu.se/), which is equipped with an automated web reading service, Readspeaker. Readspeaker is provided by Phoneticom (http://www.phoneticom.com/) and based on BrightSpeech, a text-to-speech system developed by InfoVox, which synthesizes a textual input into a sound file. The qualitative black-box evaluation includes a questionnaire and follow-up interview questions, posed to a group of six users, who frequently visit the university web portal. An additional assessment was done with web masters at Uppsala University, who shared their opinion of the Readspeaker service from an administrative point of view. The thesis discusses terms, which are crucial to the assessment of the online text-to-speech service. The terms refer to the discipline of computational linguistics, from which the thesis subject originates, as well as to the accessibility standards Uppsala University’s web policy comply with. The evaluation shows that by providing their visitors with Readspeaker, Uppsala University attempts to adapt the web portal to the recommendations of accessibility, which concern information as well as Design For All. The various categories of assessment show that the users felt a general appreciation for the service, navigation and linguistic abilities. However, the overall request from the user group as well as from the web masters was improved interaction.
Improved stability of a class of switched neutral systems via Lyapunov–Krasovskii functionals and an average dwell-time scheme

This article is concerned with the stability analysis for a class of switched neutral systems with mixed time-varying delays. The upper bound of derivative of the discrete time-varying delay is not restricted to one. A delay-dependent criterion of exponential stability under switching signals with an average dwell time is developed by employing free weighting matrices. The criterion is given in the form of linear matrix inequality. A state decay estimation for the switched system is explicitly given by considering the individual rate of decay of state for each subsystem. Two simulation examples are given to illustrate the effectiveness of the proposed method.
ATP-sulfurylase, sulfur-compounds, and plant stress tolerance

Sulfur (S) stands fourth in the list of major plant nutrients after N, P, and K. Sulfate (SO42-), a form of soil-S taken up by plant roots is metabolically inert. As the first committed step of S-assimilation, ATP-sulfurylase (ATP-S) catalyzes SO42--activation and yields activated high-energy compound adenosine-5′-phosphosulfate that is reduced to sulfide (S2-) and incorporated into cysteine (Cys). In turn, Cys acts as a precursor or donor of reduced S for a range of S-compounds such as methionine (Met), glutathione (GSH), homo-GSH (h-GSH), and phytochelatins (PCs). Among S-compounds, GSH, h-GSH, and PCs are known for their involvement in plant tolerance to varied abiotic stresses, Cys is a major component of GSH, h-GSH, and PCs; whereas, several key stress-metabolites such as ethylene, are controlled by Met through its first metabolite S-adenosylmethionine. With the major aim of briefly highlighting S-compound-mediated role of ATP-S in plant stress tolerance, this paper: (a) overviews ATP-S structure/chemistry and occurrence, (b) appraises recent literature available on ATP-S roles and regulations, and underlying mechanisms in plant abiotic and biotic stress tolerance, (c) summarizes ATP-S-intrinsic regulation by major S-compounds, and (d) highlights major open-questions in the present context. Future research in the current direction can be devised based on the discussion outcomes.
Lycopene Enhances Antioxidant Enzyme Activities and Immunity Function in N-Methyl-N′-nitro-N-nitrosoguanidine–Induced Gastric Cancer Rats

To investigate anticancer effect of lycopene, we examined the effects of lycopene on the oxidative injury and immunity activities of N-methyl-N′-nitro-N-nitrosoguanidine (MNNG)-induced gastric cancer rats. The animals were divided into five groups. Group I served as the normal control and was given corn oil orally for 20 weeks. Group II were induced with MNNG 200 mg/kg body weight by oral gavage at days 0 and 14, and saturated NaCl (1 mL per rats) was given once every three days for four weeks until the end of the experimental period. Group III, IV and V were posttreated with lycopene (50, 100 and 150 mg/kg body weight, dissolved in corn oil) from the sixth week of MNNG (as in group II) induction up to the end of the experimental period. In the presence of MNNG, MDA and immunity levels were significantly increased, whereas enzymatic (SOD, CAT, and GPx) antioxidant activities were decreased in the treated rats compared with normal control rats. Administration of lycopene to gastric carcinoma-induced rats largely up-regulated the redox status and immunity activities to decrease the risk of cancer compared to group II. We conclude that up-regulation of antioxidants and immunity by lycopene treatment might be responsible for the anticancer effect in gastric carcinoma.
Compilation into actors

The Act compiler optimizes the transformation of the Scripter programming language into actors. This transformation consists of changing the synchronous function calls written in Scripter into asynchronous message sends acceptable to actors. This is accomplished by compiling the Scripter function call into a leading actor script which sends a message to the target function, and a customer script which receives the reply message. In optimizing the translation, the compiler conserves time by minimizing the number of message sends, and conserves space by minimizing the number of customer and customer scripts generated. The number of message sends is reduced by the use of customer lifting and tail recursion. The number of customers generated is reduced by customer sharing. The number of customer scripts generated is reduced by message sharing, parallel unrecursing, and tail recursion.
Interactive fault localization leveraging simple user feedback

Many fault localization methods have been proposed in the literature. These methods take in a set of program execution profiles and output a list of suspicious program elements. The list of program elements ranked by their suspiciousness is then presented to developers for manual inspection. Currently, the suspicious elements are ranked in a batch process where developers' inspection efforts are rarely utilized for ranking. The inaccuracy and static nature of existing fault localization methods prompt us to incorporate user feedback to improve the accuracy of the existing methods. In this paper, we propose an interactive fault localization framework that leverages simple user feedback. Our framework only needs users to label the statements examined as faulty or clean, which does not require additional effort than conventional non-interactive methods. After users label suspicious program elements as faulty or clean, our framework incorporates such information and re-orders the rest of the suspicious program elements, aiming to expose truly faulty elements earlier. We have integrated our solution with three well-known fault localization methods: Ochiai, Tarantula, and Jaccard. The evaluation on five Unix programs and the Siemens test suite shows that our solution achieves significant improvements on fault localization accuracy.
Incorporating background knowledge and structured explananda in abductive reasoning: a framework

Abductive reasoning plays a dominant role in a wide variety of cognitive tasks, including diagnosis, language understanding, and learning. The author's work is aimed at developing a computational model of abductive reasoning keeping in view some of the important aspects that cut across specific instances of abductive reasoning. A significant portion of the paper is devoted to the discussion of two of those aspects, namely, those of background knowledge and structured explananda. The former aspect concerns the effect the agent's memory of specific facts has on abductive reasoning. The latter aspect corresponds to dealing with explananda having conceptual structure and contrasts with the approach of taking explananda to be atomic. The paper discusses various issues related to these two aspects and develops an algorithm for abductive reasoning incorporating those aspects. >
Modeling Fatty Acid Transfer from Artery to Cardiomyocyte

Despite the importance of oxidation of blood-borne long-chain fatty acids (Fa) in the cardiomyocytes for contractile energy of the heart, the mechanisms underlying the transfer of Fa from the coronary plasma to the cardiomyocyte is still incompletely understood. To obtain detailed insight into this transfer process, we designed a novel model of Fa transfer dynamics from coronary plasma through the endothelial cells and interstitium to the cardiomyocyte, applying standard physicochemical principles on diffusion and on the chemical equilibrium of Fa binding to carrier proteins Cp, like albumin in plasma and interstitium and Fatty Acid-Binding Proteins within endothelium and cardiomyocytes. Applying these principles, the present model strongly suggests that in the heart, binding and release of Fa to and from Cp in the aqueous border zones on both sides of the cell membranes form the major hindrance to Fa transfer. Although often considered, the membrane itself appears not to be a significant hindrance to diffusion of Fa. Proteins, residing in the cellular membrane, may facilitate transfer of Fa between Cp and membrane. The model is suited to simulate multiple tracer dilution experiments performed on isolated rabbit hearts administrating albumin and Fa as tracer substances into the coronary arterial perfusion line. Using parameter values on myocardial ultrastructure and physicochemical properties of Fa and Cp as reported in literature, simulated washout curves appear to be similar to the experimentally determined ones. We conclude therefore that the model is realistic and, hence, can be considered as a useful tool to better understand Fa transfer by evaluation of experimentally determined tracer washout curves.
Rosiglitazone Decreases C-Reactive Protein to a Greater Extent Relative to Glyburide and Metformin Over 4 Years Despite Greater Weight Gain

OBJECTIVE C-reactive protein (CRP) is closely associated with obesity and cardiovascular disease in both diabetic and nondiabetic populations. In the short term, commonly prescribed antidiabetic agents have different effects on CRP; however, the long-term effects of those agents are unknown. RESEARCH DESIGN AND METHODS In A Diabetes Outcome Progression Trial (ADOPT), we examined the long-term effects of rosiglitazone, glyburide, and metformin on CRP and the relationship among CRP, weight, and glycemic variables in 904 subjects over 4 years. RESULTS Baseline CRP was significantly correlated with homeostasis model assessment of insulin resistance (HOMA-IR), A1C, BMI, waist circumference, and waist-to-hip ratio. CRP reduction was greater in the rosiglitazone group by −47.6% relative to glyburide and by −30.5% relative to metformin at 48 months. Mean weight gain from baseline (at 48 months) was 5.6 kg with rosiglitazone, 1.8 kg with glyburide, and −2.8 kg with metformin. The change in CRP from baseline to 12 months was correlated positively with change in BMI in glyburide (r = 0.18) and metformin (r = 0.20) groups but not in the rosiglitazone (r = −0.05, NS) group. However, there was no longer a significant correlation between change in CRP and change in HOMA-IR, A1C, or waist-to-hip ratio in any of the three treatment groups. CONCLUSIONS Rosiglitazone treatment was associated with durable reductions in CRP independent of changes in insulin sensitivity, A1C, and weight gain. CRP in the glyburide and metformin groups was positively associated with changes in weight, but this was not the case with rosiglitazone.
Epidemiology of BK Virus in Renal Allograft Recipients: Independent Risk Factors for BK Virus Replication

Background. Identification of risk factors for BK virus (BKV) replication may improve transplant outcome. We investigated the impact of immunosuppressive drugs on the prevalence of BKV replication in recipients of human renal allografts. Methods. One hundred twenty renal allograft recipients were studied prospectively at 1, 3, and 6 months posttransplantation to identify risk factors for BKV replication. BKV replication was quantified by measurement of urinary cell BKV VP1 mRNA levels using BKV specific primers and TaqMan probe in a real-time quantitative polymerase chain reaction assay. Levels of urinary cell mRNA for granzyme B, CD103, and transforming growth factor-β1 were measured to ascertain whether BKV replication is associated with an inflammatory signature. Results. The prevalence of BKV replication increased over time and was highest at 6 months compared with 1 or 3 months posttransplantation (P<0.001). A logistic regression model analysis demonstrated that steroid maintenance therapy (odds ratio: 8.3, P=0.003) and induction with rabbit anti-human thymocyte globulin (odds ratio: 5.8, P=0.008) were independent risk factors for BKV replication. Neither mycophenolate mofetil dose nor tacrolimus dose or trough levels were different between those with or without BKV replication. The development of acute rejection or antirejection treatment with methylprednisolone did not increase the risk of BKV replication. BKV replication was associated with heightened levels of urinary cell mRNA for granzyme B (P<0.002), CD103 (P<0.005) but not for transforming growth factor-β1 (P>0.05). Conclusions. Steroid maintenance therapy and induction with antithymocyte globulin are independent risk factors for BKV replication in renal allograft recipients treated with tacrolimus and mycophenolate mofetil.
Computer Display of Curved Surfaces

Abstract : The report describes a method for producing shaded pictures of curved surfaces. It uses a small polygon approximation of the surface to solve efficiently the hidden parts detection, and then computes the shading on each polygon in such a way that visual discontinuities between adjacent polygons disappear, thus restoring the apparent smoothness of the surface and increasing greatly the realism of the pictures produced. The smooth shading technique described here has been used to produce a large variety of pictures of which several airplanes, a car, a human face and some mathematical surfaces are included to illustrate the effect of the method. (Author)
miR‐130A as a diagnostic marker to differentiate malignant mesothelioma from lung adenocarcinoma in pleural effusion cytology

Malignant pleural mesothelioma is a rare tumor with a dismal prognosis, usually presenting with recurrent effusions. However, the majority of malignant pleural effusions are due to lung adenocarcinoma (AdC). The distinction between these tumors has considerable therapeutic and medicolegal implications and can be very challenging both histologically and cytologically. Appropriate immunohistochemistry (IHC) is required to support the diagnosis. MicroRNA (miRNA) expression analysis could be a viable diagnostic tool for distinguishing between these tumors. The purpose of the current study was to assess the reliability of miRNAs as diagnostic markers to differentiate epithelioid malignant mesothelioma (MM) from lung AdC.