Miracle-dz/UniFAR-FTUs huggingface dataset:
A Prospective Study on CT Scan Outcomes After Conservative Decompression Surgery for Lumbar Spinal Stenosis

This is a prospective study analyzing CT scan imaging outcomes after conservative decompression in patients with lumbar spinal stenosis. Forty patients (18 males and 22 females) initially underwent a laminarthrectomy surgical procedure to decompress the central canal as well as the neuroforamina and nerve root canals while respecting the integrity of the neural arches, facet joints, and most muscle attachments. Morphologic features of preoperative CT scan images were compared with postoperative CT scans of the operative levels, obtained for 36 patients (17 males and 19 females) after a minimum follow-up of 1 year (mean 1.7 years). Successful surgical outcome was defined as an improvement in at least three of the following four criteria: self-reported pain on a visual analog scale, self-reported functional status measured by LBOS, reduction of pain while walking, and reduction of leg pain. Fifty-five percent of patients met the successful surgical outcome criteria, including 14 subjects who met all four success criteria. Overall, there was a statistically significant increase in the interfacet bony canal diameter of the operated levels (3.9 mm, p < 001). However, patients categorized as successful surgical outcomes had a substantially, but not significantly, lower interfacet canal diameter increase postsurgically (mean 3.41 mm) in comparison with patients categorized as failures (mean postoperative increase 4.52 mm). Midsagittal canal diameters remained unchanged in the failure group but increased in the success group. The CT scan canal measures used in this study cannot be advocated for evaluation of outcome in conservative lumbar spinal canal decompression.
Charging station selection and charging price decision for PEV: A two level game approach

In this paper, we consider the problem that a group of plug-in electric vehicles (PEVs) seek to maximize their payoff by selecting a proper charging station and the charging stations try to maximize their revenue by adjusting the electricity price according to the total demands they received. Since both the decisions of the charging stations and the PEVs should be made dynamically under competition environments, we propose a two-level game framework to model this issue. At the lower level, the PEVs need to adapt their strategies, i.e. the charging station selection, according to the service they can get from each charging station, and we formulate it as an evolutionary game and use replicator dynamics to model the charging station selection process. Also, we propose an algorithm to arrive at the evolutionary equilibrium. At the upper level, each charging station needs to set the electricity price appropriately to maximize its revenue according to the received total amount of electricity requirement from PEVs. We formulate a differential game to describe the competition among the charging stations and analyze the Nash equilibrium for both open-loop strategies and closed-loop strategies. Simulation results demonstrate that the proposed mechanism can gain a higher profit and faster convergence speed than static control.
Von der Gesundheitsökonomie zur Gesundheitswirtschaft

Zusammenfassung Die Gesundheitsökonomie hat sich als Studienfach und Forschungsgebiet über die vergangenen rund 40 Jahre entwickelt. In diesem Überblicksartikel arbeitet Klaus-Dirk Henke die Ursachen heraus, verdeutlicht Besonderheiten und zieht einen Vergleich zu anderen Studienfächern. Nach diesem fachspezifischen Abschnitt folgt ein Überblick zur qualitativen und quantitativen Erfassung der Gesundheitswirtschaft sowie zu ihrem wirtschaftlichen und gesellschaftlichen Nutzen als eigenständige Wachstumsbranche mit ihren Stärken und Schwächen. Zudem enthält der Beitrag einen Exkurs zur Über- und Fehlversorgung in deutschen Krankenhäusern. Dieser Zusammenhang von Ökonomie und Medizin steht thematisch zwischen der Gesundheitsökonomie als Studienfach auf der einen Seite und der Gesundheitswirtschaft als Wirtschafts- und Industriezweig auf der anderen.
Distributional Effects of Tobacco Taxation: A Comparative Analysis

Tobacco taxes have positive impacts on health outcomes. However, policy makers often hesitate to use them because of the perception that poorer households are affected disproportionally more than richer households. This study compares the simulated distributional effects of tobacco tax increases in eight low- and middle-income countries. It applies a standardized extended cost-benefit analysis methodology and relies on comparable data sources across countries. The net effect of raising taxes on cigarettes encompasses the direct negative price shock to household budgets and the long-term benefits of improved health outcomes. The distributional incidence is assessed by estimating decile-specific behavioral responses and relative income gains. The comparative results do not support the claim that tobacco taxes are necessarily regressive. Although welfare losses from the first-order price shock disproportionally affect the poor, these negative shocks are attenuated by greater price-responsiveness among lower-income groups and further offset by higher long-term relative gains through reduced medical expenditures and additional years of productive life as taxes dissuade smoking. In several countries, increasing the price of cigarettes is pro-poor and welfare improving for a large share of the population. Along with raising taxes, policy should aim at encouraging responsiveness to price changes and target tobacco-related medical expenses that disproportionally burden the poor.
Contribution of health behaviours and clinical factors to socioeconomic differences in frailty among older adults

Background To examine the association between socioeconomic status (SES) and risk of frailty, and to assess whether behavioural and clinical factors (BCF) mediate this association. Methods Cohort of 1857 non-institutionalised individuals aged ≥60 years recruited in 2008–2010 and followed through 2012. Education, occupation, and BCF were ascertained at baseline, and incident frailty was assessed at follow-up with the Fried frailty criteria. Results Men showed no differences in frailty risk by education or occupation. Compared with women with university education, the adjusted OR (aOR) adjusted for age and the number of frailty criteria at baseline for incident frailty in women with primary or lower education was 3.02 (95% CI 1.25 to 7.30); once fully adjusted for BCF, the OR was 2.00 (95% CI 0.76 to 5.23). No alcohol intake (vs light–moderate), longer time spent watching TV, less time spent reading, and a higher frequency of obesity, depression and musculoskeletal disease in those with primary or lower education accounted for most of the decline in OR. BCF explained 50.5% of the excess frailty risk associated with lower education. The aOR of frailty incidence for manual versus non-manual occupation was 2.24 (95% CI 1.41 to 3.56) versus a fully aOR of 2.05 (95% CI 1.24 to 3.37). BCF explained 15.3% of the association, with individual mediators being similar to those for education-related differences. Conclusions A lower education or a manual occupation was associated with higher frailty risk in older women. These associations were partly explained by lower alcohol consumption, higher sedentariness, and higher obesity and chronic disease rates in women with lower SES.
Integrase-LexA Fusion Proteins Incorporated into Human Immunodeficiency Virus Type 1 That Contains a Catalytically Inactive Integrase Gene Are Functional To Mediate Integration

ABSTRACT Purified fusion proteins made up of a retroviral integrase and a sequence-specific DNA-binding protein have been tested in in vitro assays for their ability to direct integration into specific target sites. To determine whether these fusion proteins can be incorporated into human immunodeficiency virus type 1 (HIV-1) and are functional to mediate integration, we used an in trans approach to deliver various integrase-LexA proteins to an integrase-defective virus containing an integrase mutation at aspartate residue 64. Integrase-LexA, integrase-LexA DNA-binding domain, or N- or C-terminally truncated integrase-LexA proteins were fused to the HIV-1 accessory protein, Vpr. Coexpression of the Vpr fusion proteins and an integrase-defective HIV-1 molecular clone by a producer cell line resulted in efficient incorporation of the fusion protein into the integrase-mutated virus. In addition, each of these viruses was infectious and capable of performing integration, as determined by two independent cellular assays that measure reporter gene expression. With the exception of the N-terminally truncated integrase fused to LexA, which was at about 1%, all of the fusion proteins restored integration to a similar level, at 17 to 24% of that of the wild-type virus. The low level observed with the N-terminally truncated integrase fused to LexA is consistent with previous results implying that the N terminus of integrase is involved in multiple steps of the retroviral life cycle. These data indicate that the integrase-fusion proteins retain catalytic function in the integrase-mutated viruses and demonstrate the feasibility of incorporating integrase fusion proteins into HIV-1 for the development of site-directed retroviral vectors.
Postoperative infusion of a low dose of dexmedetomidine reduces intravenous consumption of sufentanil in patient-controlled analgesia

Background Combining adjunctive medications with patient-controlled analgesia (PCA) has been used to minimize opioid related side-effects. The aim of this study was to evaluate whether postoperative infusion of a sub-sedative dose of dexmedetomidine can reduce opioid consumption and opioid related side-effects. Methods We selected 60 patients from 18 to 60 years old with an American Society of Anesthesiologists physical status of 1–2 who were scheduled for elective surgery. The types of surgery were limited to thoracoscopic wedge resection of the lung and pulmonary wedge resection under a mini-thoracotomy. Patients received PCA with sufentanil upon arrival in the recovery room, along with a separate continuous infusion of dexmedetomidine that was not mixed in the PCA but started at the same time. Patients were randomly allocated to two groups: dexmedetomidine 0.15 μg/kg/h was administered to patients in group D and normal saline was administered to patients in group C. The visual analogue scale (VAS) pain score, blood pressure, pulse rate, and respiratory rate were measured at each assessment. PCA related side-effects were evaluated. Results The VAS pain score was significantly lower in the dexmedetomidine group. Patients in the dexmedetomidine group required significantly less PCA at postoperative 1–4, 4–8, and 8–24 h time intervals. The incidence of nausea was significantly less in the dexmedetomidine group, and levels of sedation and hemodynamic variables except for blood pressure at postoperative 8 h were similar between the groups. Conclusions In conclusion, a postoperatively administered sub-sedative dose of dexmedetomidine reduces PCA sufentanil consumption and decreases nausea.
Biologically inspired synthesis of bone-like composite: self-assembled collagen fibers/hydroxyapatite nanocrystals.

Replacement of bone tissue by graft materials and products of tissue engineering having composition, structure, and biological features that mimic natural tissue is a goal to be pursued. A biomimetic synthesis was performed to prepare new bone-like composites constituted of hydroxyapatite nanocrystals and self-assembled type I collagen fibers. We used a biological inspired approach that proved that the biological systems stored and processed information at the molecular level. Two different methodologies were used: dispersion of synthetic hydroxyapatite in telopeptides free collagen molecules solution and direct nucleation of hydroxyapatite into reconstituted collagen fibers during their assembling. The different preparation techniques were experimented then the composites thoroughly characterized and compared. Composite obtained by direct nucleation showed an intimated interaction of the inorganic and proteic components, which modified the apatitic phase and made its composition, morphology and structure similar to the mineral component of natural bone.
Lipoprotein apheresis reduces circulating galectin‐3 in humans

Plasma galectin‐3 (Gal‐3) is elevated in, and drives, diverse systemic inflammatory disorders, including cancer, cardiovascular diseases, and diabetes. Circulating Gal‐3 promotes tumorigenesis and metastasis, as well as fibrotic remodeling, and is a promising therapeutic target. Apheresis has proven utility in reducing circulating disease‐promoting substances, exemplified by the success of lipoprotein apheresis (LA) in abrogating cardiovascular disease progression in drug‐refractory hypercholesterolemia patients. We compared the clinical utility of two FDA‐approved LA systems in reducing plasma Gal‐3 in humans.
Large-scale characterization of comprehensive online video service in mobile network

Video service in mobile network generates massive Internet traffic and consumes a large share of bandwidth. Nowadays, more and more video portals have upgraded their service to a comprehensive one-stop solution, providing UGC, VoD and Live streaming at the same time. Understanding the characteristics of such service is crucial for the network traffic engineering and the sustainable development of service. In this paper we present the first characterization work in mobile network on a leading comprehensive online video service in China, Youku. Our study is based on large-scale datasets containing 16 billion network traffic traces and long-term crawling data (over 1 month). We examine the user activity in both temporal and spacial dimensions and reveal the relatively fixed service usage. We demonstrate the strong correlations between users, which is reflected by the small-world phenomenon. We also investigate the static properties of Youku mobile videos and observe noticeably differences from other UGC videos. Eventually, we study the distribution of view count and find out four growth patterns for the new published videos. Our analysis result provides a insight into how Youku is utilized by mobile users and demonstrates promising practical applications for both network operators and service providers.
Role of transcriptional and posttranscriptional regulation of methionine adenosyltransferases in liver cancer progression

Down‐regulation of the liver‐specific MAT1A gene, encoding S‐adenosylmethionine (SAM) synthesizing isozymes MATI/III, and up‐regulation of widely expressed MAT2A, encoding MATII isozyme, known as MAT1A:MAT2A switch, occurs in hepatocellular carcinoma (HCC). Here we found Mat1A:Mat2A switch and low SAM levels, associated with CpG hypermethylation and histone H4 deacetylation of Mat1A promoter, and prevalent CpG hypomethylation and histone H4 acetylation in Mat2A promoter of fast‐growing HCC of F344 rats, genetically susceptible to hepatocarcinogenesis. In HCC of genetically resistant BN rats, very low changes in the Mat1A:Mat2A ratio, CpG methylation, and histone H4 acetylation occurred. The highest MAT1A promoter hypermethylation and MAT2A promoter hypomethylation occurred in human HCC with poorer prognosis. Furthermore, levels of AUF1 protein, which destabilizes MAT1A messenger RNA (mRNA), Mat1A‐AUF1 ribonucleoprotein, HuR protein, which stabilizes MAT2A mRNA, and Mat2A‐HuR ribonucleoprotein sharply increased in F344 and human HCC, and underwent low/no increase in BN HCC. In human HCC, Mat1A:MAT2A expression and MATI/III:MATII activity ratios correlated negatively with cell proliferation and genomic instability, and positively with apoptosis and DNA methylation. Noticeably, the MATI/III:MATII ratio strongly predicted patient survival length. Forced MAT1A overexpression in HepG2 and HuH7 cells led to a rise in the SAM level, decreased cell proliferation, increased apoptosis, down‐regulation of Cyclin D1, E2F1, IKK, NF‐κB, and antiapoptotic BCL2 and XIAP genes, and up‐regulation of BAX and BAK proapoptotic genes. In conclusion, we found for the first time a post‐transcriptional regulation of MAT1A and MAT2A by AUF1 and HuR in HCC. Low MATI/III:MATII ratio is a prognostic marker that contributes to determine a phenotype susceptible to HCC and patients' survival. Conclusion: Interference with cell cycle progression and I‐kappa B kinase (IKK)/nuclear factor kappa B (NF‐κB) signaling contributes to the antiproliferative and proapoptotic effect of high SAM levels in HCC. (HEPATOLOGY 2012;56:165–175)
CD14-dependent Endotoxin Internalization via a Macropinocytic Pathway*

Gram-negative bacterial endotoxin (a lipopolysaccharide (LPS)) specifically binds to CD14, a glycosylphosphatidyl inositol (GPI)-anchored surface myeloid glycoprotein. This interaction leads to cell activation, but it also promotes LPS internalization and detoxification. In this work, we investigated the route of LPS and CD14 internalization and the relevance of CD14 GPI anchor in the endocytic pathway. In promonocytic THP-1 cells transfected with a GPI or a chimeric integral form of CD14, we showed by differential buoyancy in sucrose density gradients that these two forms of CD14 were sorted to different plasma membrane subdomains. However, both forms of CD14 associated preferentially with the same surface microfilament-enriched microvilli or ruffles. Electron microscopic studies indicated that CD14 internalized via macropinocytosis, a process resembling that of phagocytosis, different from “classical” receptor-mediated endocytic pathways, such as clathrin-coated pits or caveolae. With cell warming, the CD14-enriched ruffles fused and formed large vesicles. Later, these vacuoles made stacks and condensed into phago-lysosomes. CD14 was specifically associated with all of these structures. Radiolabeled LPS internalization paralleled CD14 internalization. Confocal microscopic studies confirmed the co-localization of LPS and CD14 both at the cell surface and in endosomal compartments. The microfilament-disrupting, macropinocytosis blocking agent cytochalasin D inhibited LPS and CD14 internalization but did not prevent LPS-dependent activation, indicating that these two processes are dissociated.
Tetrahydrobiopterin and GTP cyclohydrolase I in a rat model of endotoxic shock: relation to nitric oxide synthesis

Induction of the inducible isoform of nitric oxide synthase (iNOS) in various types of cells is implicated as the cause of septic shock. We evaluated the concentration of tetrahydrobiopterin (BH4), a cofactor of NOS, in plasma and various other tissues of rats treated with lipopolysaccharide (LPS; 10 mg/kg I.V.). The activity of GTP cyclohydrolase I (GTPCH), the first and rate‐limiting enzyme in the de novo synthesis of BH4, in rat tissues was also determined. Three hours after administration of LPS, rats showed plasma levels of BH4 and NOx (NO3‐ and NO2‐) that were elevated by 137 and 206%, respectively. GTPCH was expressed in liver and, to a lesser extent, in the lung, heart and kidney of control rats. In control rats, although a high concentration of BH4 was detected in the liver, its level was lower in lung, heart, kidney and aorta. Three hours after LPS administration, a significant increase in BH4 concentration and/or GTPCH activity was observed in all tissues examined except the liver. Our results demonstrate that the de novo synthesis of BH4 is upregulated by LPS in the rat in vivo, which may, at least in part, account for the increases in plasma level and tissue concentration of BH4 after the administration of LPS.
Ultrastructure and chemical composition of the sheath of Leptothrix discophora SP-6

Light microscopy and transmission electron microscopy of thin sections and metal-shadowed specimens showed that the sheath of Leptothrix discophora SP-6 (ATCC 51168) is a tube-like extracellular polymeric structure consisting of a condensed fabric of 6.5-nm-diameter fibrils underlying a more diffuse outer capsular layer. In thin sections, outer membrane bridges seen to contact the inner sheath layer suggested that the sheath fabric was attached to the outer layer of the gram-negative cell wall. The capsular polymers showed an affinity for cationic colloidal iron and polycationic ferritin, indicating that they carry a negative charge. Cell-free sheaths were isolated by treatment with a mixture of lysozyme, EDTA, and N-lauroylsarcosine (Sarkosyl) or sodium dodecyl sulfate (SDS). Both Sarkosyl- and SDS-isolated sheaths were indistinguishable in microscopic appearance. However, the Mn-oxidizing activity of Sarkosyl-isolated sheaths was more stable than that of SDS-isolated sheaths. The Sarkosyl-isolated sheaths also contained more 2-keto-3-deoxyoctanoic acid and more outer membrane protein than SDS-isolated sheaths. The oven-dried mass of detergent-isolated sheaths represented approximately 9% of the total oven-dried biomass of SP-6 cultures; the oven-dried sheaths contained 38% C, 6.9% N, 6% H, and 2.1% S and approximately 34 to 35% carbohydrate (polysaccharide), 23 to 25% protein, 8% lipid, and 4% inorganic ash. Gas-liquid chromatography showed that the polysaccharide was an approximately 1:1 mixture of uronic acids (glucuronic, galacturonic, and mannuronic acids and at least one other unidentified uronic acid) and an amino sugar (galactosamine). Neutral sugars were not detected. Amino acid analysis showed that sheath proteins were enriched in cysteine (6 mol%). The cysteine residues in the sheath proteins probably provide sulfhydryls for disulfide bonds that play an important role in maintaining the structural integrity of the sheath (D. Emerson and W.C. Ghiorse, J. Bacteriol. 175:7819-7827, 1993).
Defibrillation Energy Requirements with Single Endocardial (Endotak™) Lead

The need for thoracotomy in usually high risk patients has limited the use of the implantable cardioverter defibrillator. Initial clinical results with endocardial and subcutanous patch electrodes (SQPs) are en couraging. Using a single endocardial lead in the absence of a SQP for chronic implantation of the cardioverter defibrillator, the goal of the study was to obtain defibrillation thresholds (DFTs) of 15 Joules (J) or less and to investigate changes in DFT over time. We tested 19 consecutive patients (15 men, 4 women] age 62 ± 8.5 years with malignant ventricular arrhythmias (14 VT/5 VF). The underlying heart disease was coronary artery disease in 15 pafients, dilative cardiomyopathy in two patients, and primary electricaJ disease in two patients. Four patients had undergone previous cardiac surgery. Left ventricular ejection fraction ranged between 14% and 66% (39%± 12.6%). Pacing thresholds (0.54 ± 0.17 Vat 0.5 msec), R wave amplitude for pacemaker sensing (14.2 ± 7.0 mV), slew rate (2.12 ± 1.4 V/sec), and resistance (500.3 ± 73.9 W) were sufficient in all patients. Eighteen patients met our endocardial impiant criteria with a DFT ≤ 15 J (10.05 ± 4.03 J) using monophasic (14 patients) or biphasic (four patients) pulse wave forms. In the one remaining patient, with a DFT of 20 J, we implanted a SQP but there was no reduction of the DFT. All patients tested showed successful defibrillation prior to discharge. During follow‐up of 88 patient‐months (1–9 months), 114 spontaneous VT/VF episodes occurred in five patients and were all successfully terminated. Eleven patients with a minimum follow‐up of 2 months were reassessed. In seven out of 11 patients, termination of VF was achieved with the same minimal energy requirements obtained intraoperatively. In three patients, DFT increased by 5 J (one patient) and 10 J (two patients). In a further patient, X ray revealed dislocation of the endocardial lead. Our data suggest that effective defibrillation is feasible with a single endocardial lead for implantation of cardioverter defibrillator. In addition, we strongly recommend repetitive x‐ray control to detect asymptomatic lead dislocation. Despite stable DFTs in most of our patients, an energy difference of ≤ 15 J between acute DFT and cardioverter defibrillator energy rating seems to be currently desirable to ensure successful postoperative defibrillation.