Miracle-dz/UniFAR-FTUs huggingface dataset:
The clinical and cost-effectiveness of implantable cardioverter defibrillators: a systematic review.

OBJECTIVES To consider the clinical effectiveness and cost-effectiveness of implantable cardioverter defibrillators (ICDs) for arrhythmias. DATA SOURCES Electronic databases. Manufacturer submissions. REVIEW METHODS A systematic review of the literature on clinical and cost-effectiveness was undertaken. The quality of selected randomised controlled trials (RCTs) was assessed using the Jadad criteria, and of selected systematic reviews using criteria developed by the NHS Centre for Reviews and Dissemination. Economic evaluations were quality assessed by their internal validity (i.e. the methods used) using a series of relevant questions, and external validity (i.e. generalisability of the economic study to the population of interest) by modified standard criteria. The clinical effectiveness and cost-effectiveness of ICDs for arrhythmias were synthesised through a narrative review with full tabulation of results of all included studies. RESULTS Eight RCTs, two systematic reviews and a meta-analysis met the inclusion criteria of the review. The RCTs were of variable quality, with most trials having a Jadad quality score of 1/5 or 2/5, owing to the nature of comparing a device with drug therapy and the impossibility of double-blinding. The outcome measure of interest was mortality, which was reported as all-cause mortality in most trials and sudden cardiac death in some trials. Eleven economic evaluations of ICDs for arrhythmias were identified. None were shown to have high internal and external validity. One unpublished study relevant to the UK was identified. The evidence suggests that ICDs reduce mortality in patients with previous ventricular arrest or symptomatic sustained ventricular arrhythmias, in patients who have not had a previous sudden cardiac episode or previous ventricular arrhythmia but have reduced left ventricular function due to coronary artery disease with asymptomatic non-sustained ventricular arrhythmia and sustained tachycardia that could be induced electrophysiologically, and in some patients with severe left ventricular dysfunction (ejection fraction 30%) after myocardial infarction. QoL data are inconsistent but suggest that there is impaired QoL in patients who received numerous shocks from implanted devices. Studies show that ICDs improve survival compared with drug treatment, but with considerably increased cost. Incremental cost per life-year gained ranges from 27,000 US dollars to 213,543 Can dollars and incremental cost per quality-adjusted life-year from 71,700 US dollars to 558,000 US dollars in the published literature. CONCLUSIONS The use of ICDs in the UK is increasing, but the technology is still under-utilised compared with other developed countries. Extending the current indications to patients with prior myocardial infarction and depressed heart function would impact on costs and service provision. Further research is needed on the risk stratification of patients in whom ICDs are most likely to be clinically and cost-effective. An evaluation of shock frequency on QoL is also required.
Saving Lives following the Expansion of Centralized Remote Telemetry Monitoring

Continuous monitoring of patients throughout the hospital is a desirable method to ensure the continuity of quality care. Hospitals looking to improve the manner in which they maintain such continuity without compromising efficiency must explore the benefits of implementing monitoring technology to its fullest potential. This case study chronicles the journey of a level-one trauma hospital during the expansion of remote wireless telemetry monitoring and the telemetry technician role. The lives saved as a result of this expansion were primarily attributable to the installation of remote wireless telemetry monitoring in the emergency department. The expansion of the telemetry technician role improved not only the quality of the monitoring signal and recognition, but also the ability to identify changes in trended data. The next step for improving care delivery includes the addition of a patient locator system within the facility, which will provide the most accurate information regarding patient location during transfer. Accurately identifying patient location in addition to alerting staff to changes in patient status will ensure that care providers respond promptly and that the highest quality of patient care is delivered while patients are away from the nursing unit.
Anthropometric Measurements and Their Value in Predicting Complications Following Reduction Mammaplasty and Abdominoplasty

Body mass index (BMI) is the traditional way of assessing patients for body contouring surgery and has been shown to have a predictive value for surgical complications. In recent years, there have been discussions about accuracy of BMI as an indicator of obesity, and other obesity indices have been developed. This study aimed to measure and compare different anthropometric variables and examine their association with surgical morbidity. Prospective measurements of height, weight, waist, and percentage body fat were obtained preoperatively in 60 patients undergoing body contouring surgery. Demographics, patient characteristics, operative details, and postoperative complications were recorded. Statistical analysis was performed using &khgr;2, ANOVA, or Spearman rank correlations as appropriate. We found that BMI, percentage of body fat, weight, height-to-weight ratio, and waist circumference all correlate well as indicators of obesity and showed similar trends in their association with surgical complications.
Trends in Regionalization of Hospital Care for Common Pediatric Conditions

In this study of >252 million hospital encounters between 2006 and 2013, we document the increasing regionalization of pediatric care. OBJECTIVES: We have previously observed that hospital care for children is concentrating significantly in Massachusetts. We now extend those observations to include 4 US states and give closer attention to the management patterns of specific clinical conditions. METHODS: We used inpatient and emergency department administrative data sets from California, Florida, Massachusetts, and New York to measure transfer frequency and identify the site of care completion for >252 million hospital encounters from 2006 through 2013. We compared the concentration of pediatric care to adult care by using the Hospital Capability Index for all acute-care hospitals and quantified the regionalization of clinical conditions by using the Regionalization Index. RESULTS: The availability of hospital care was significantly more limited for children than adults in all 4 states (median Hospital Capability Index: 0.19 vs 0.74 in CA, 0.08 vs 0.79 in FL, 0.18 vs 0.69 in MA, and 0.16 vs 0.75 in NY). Between 2006 and 2011, care was concentrated for both adults and children but much more so for children. Although pediatric admissions decreased by 9.3% (from 545 330 to 494 645), interhospital transfers increased by 24.6% (from 64 285 to 80 101). The largest change in transfer rate was among children with common conditions, such as abdominal pain and asthma. CONCLUSIONS: Definitive pediatric hospital care is less available than adult care and is increasingly dependent on referral centers. This should be accounted for in public health plans, disaster preparedness, and determinations of network adequacy.
HIV‐Positive‐to‐HIV‐Positive Liver Transplantation

Most countries exclude human immunodeficiency virus (HIV)‐positive patients from organ donation because of concerns regarding donor‐derived HIV transmission. The Swiss Federal Act on Transplantation has allowed organ transplantation between HIV‐positive donors and recipients since 2007. We report the successful liver transplantation from an HIV‐positive donor to an HIV‐positive recipient. Both donor and recipient had been treated for many years with antiretroviral therapy and harbored multidrug‐resistant viruses. Five months after transplantation, HIV viremia remains undetectable. This observation supports the inclusion of appropriate HIV‐positive donors for transplants specifically allocated to HIV‐positive recipients.
Bax and Bak Promote Apoptosis by Modulating Endoplasmic Reticular and Mitochondrial Ca2+ Stores*

Alterations in intracellular Ca2+ homeostasis and cytochrome c release from mitochondria have been implicated in the regulation of apoptosis, but the relationship between these events remains unclear. Here we report that enforced expression of either Bax or Bak via adenoviral gene delivery results in the accumulation of the proteins in the endoplasmic reticulum (ER) and mitochondria, resulting in early caspase-independent BCL-2-sensitive release of the ER Ca2+pool and subsequent Ca2+ accumulation in mitochondria. The inhibition of ER-to-mitochondrial Ca2+ transport with a specific inhibitor of mitochondrial Ca2+ uptake attenuates cytochrome c release and downstream biochemical events associated with apoptosis. Bax and Bak also directly sensitize mitochondria to cytochrome c release induced by immediate emptying of ER Ca2+ pool. Our results demonstrate that the effects of the “multidomain” proapoptotic BCL-2 family members Bak and Bax involve direct effects on the endoplasmic reticular Ca2+ pool with subsequent sensitization of mitochondria to calcium-mediated fluxes and cytochrome c release. These effects modulate the kinetics of cytochrome c release and apoptosis.
Efficacy of several vaccination programmes in commercial layer and broiler breeder hens against experimental challenge with Salmonella enterica serovar Enteritidis

Two experiments were performed to evaluate the protective effect of various vaccination combinations given at 5 and 9 weeks of age against experimental challenge with Salmonella enterica serovar Enteritidis (SE) phage type 4 at 12 weeks of age. In Experiment 1, groups of commercial layers were vaccinated by one of the following programmes: Group 1, two doses of a SE bacterin (Layermune SE); Group 2, one dose of a live Salmonella enterica serovar Gallinarum vaccine (Cevac SG9R) followed by one dose of the SE bacterin; Group 3, one dose of each of two different multivalent inactivated vaccines containing SE cells (Corymune 4K and Corymune 7K; and Group 4, unvaccinated, challenged controls. In Experiment 2, groups of broiler breeders were vaccinated by the same programmes as Groups 1 and 2 above while Group 3 was an unvaccinated, challenged control group. All vaccination programmes and the challenge induced significant (P < 0.05) seroconversion as measured by enzyme-linked immunosorbent assay. Overall, in both experiments, all vaccination schemes were significantly effective in reducing organ (spleen, liver and caeca) colonization by the challenge strain as well as reducing faecal excretion for at least 3 weeks. Vaccinated layers in Groups 1 and 2 and broiler breeders in Group 2 showed the greatest reduction in organ colonization and the least faecal excretion. In Experiment 1, layers vaccinated with multivalent inactivated vaccines containing a SE component (Group 3) were only moderately protected, indicating that such a vaccination programme may be useful in farms with good husbandry and housing conditions and low environmental infectious pressure by Salmonella.
Solar Radiation Utilization by Tropical Forage Grasses: Light Interception and Use Efficiency

Neotropical grasslands or savannas cover almost half the surface of Africa and large areas of Australia, South America, India and Southeast Asia (FAO, 2010). In South America vegetation like savanna covers over 2.1 million km2 mainly in central Brazil (also called Cerrado), Colombia and Venezuela. Tropical savannas are currently undergoing rapid and radical transformation due to human interventions on land-use patterns (Lehmann et al., 2009). In the last 30 years about 54 million hectares of native Cerrado vegetation have been replaced by cultivated pasture, mainly African grasses of the genus Brachiaria spp. (Boddey et al., 2004, Meirelles et al., 2011). At the same time, the majority of deforested land in the Amazon Basin has become cattle pasture, making forest-to-pasture conversion an important contributor to the carbon and climate dynamics of the region (Asner et al., 2004). The terminology here follows the International Forage and Grazing Terminology Committee (Allen et al., 2011):“the term grassland bridges pastureland and rangeland and may be either a natural or an imposed ecosystem. Grassland has evolved to imply broad interpretation for lands committed to a forage use”.
A comparison of computational strategies for multi-label prediction of protein subcellular localizations

The subcellular localization of a protein is closely correlated with its functions. Although many machine learning algorithms have been developed and applied to predict protein compartments using different data sources, such as protein amino acid sequence and motif information, automatic prediction of subcellular localization remains a challenging problem. In this study, we compared three support vector machines (SVM)-based computational strategies for interpreting differential detection of proteins in isolated organellar compartments by high-throughput mass spectrometry. The main focus is on how to deal with multi-compartmental ambiguity in predicting protein subcellular localizations. When applied them to a global-scale proteomic study, their Area Under the Receiver Operating Characteristics Curves (ROC) for four major organellar compartments (cytosol, microsomes, mitochondria, and nucleus) are more than 0.75.
Ultrasonic Attenuation Measurements for Estimating Milk Coagulation Time

An ultrasonic system has been developed to employ a pulse-transmission method of measurement during coagulation of rennetted milk. The ultrasonic waves were transmitted through the milk and the coagulation process was followed after adding the enzyme. The observed changes in ultrasonic attenuation during coagulation were used to predict the coagulation time indicating the onset of coagulation. Coagulation times were also determined by measuring the apparent viscosity of the coagulum as suggested in the literature. Statistical analysis indicated that there was no significant difference (at 95% level) between the coagulation times determined by both methods. Thus, the ultrasonic method has potential for nondestructively estimating the coagulation time of rennetted milk. Determination of coagulation time is useful in evaluating the effectiveness of different enzymes under varying conditions.
Detecting the Learner's Motivational States in An Interactive Learning Environment

It is important for pedagogical agents to have the ability to detect the learner's motivational states. With this ability, agents will be more sensitive to the cognitive and emotional states of the learner and be able to promote the learner's motivation through interaction with the learner. In this paper we present a method for agents to assess learner's motivational states in an interactive learning environment. It takes into account the learner's attention, current task and expected time to perform the task. An experiment was conducted to collect data for evaluating the performance of the method, and the results showed that there is more than 75% to detect the learner's motivational states where intervention is warranted.
Concurrent Hex-Band GaN Power Amplifier for Wireless Communication Systems

In this letter, we propose a novel multi-section transmission line matching technique applied to the design of a concurrent hex-band HEMT GaN power amplifier (PA). The PA has been designed for a concurrent operation at 0.9, 1.8, 2.5, 3.5, 5.2, and 5.8 GHz. Experimental results have shown minimum and maximum saturated output power levels of 33 dBm and 36.7 dBm respectively over the different frequency bands, with the power added efficiency (PAE) ranging from a minimum of 20% to a maximum of 49%. A detailed comparison between simulation and experimental results data has also been reported.
Classifications of the Host Galaxies of Supernovae

Classifications on the DDO system are given for the host galaxies of 177 supernovae (SNe) that have been discovered since 1997 during the course of the Lick Observatory Supernova Search with the Katzman Automatic Imaging Telescope. Whereas SNe Ia occur in all galaxy types, it is found, at a high level of statistical confidence, that SNe Ib, Ic, and II are strongly concentrated in late‐type galaxies. However, attention is drawn to a possible exception provided by SN 2001I. This SN IIn occurred in the E2 galaxy UGC 2836, which was not expected to harbor a massive young supernova progenitor.
Physical and Functional Interactions of Neuronal Growth Suppressor Necdin with p53*

Necdin is expressed in virtually all postmitotic neurons, and ectopic expression of this protein suppresses cell proliferation. Necdin, like the retinoblastoma protein, interacts with cell cycle promoting proteins such as simian virus 40 large T antigen, adenovirus E1A, and the transcription factor E2F1. Here we demonstrate that necdin interacts with the tumor suppressor protein p53 as well. The yeast two-hybrid and in vitro binding analyses revealed that necdin bound to a narrow region (amino acids 35–62) located between the MDM2-binding site and the proline-rich region in the amino-terminal domain of p53. The electrophoretic mobility shift assay showed that necdin supershifted a complex between p53 and its binding DNA, implying that the p53-necdin complex is competent for DNA binding. In p53-deficient osteosarcoma SAOS-2 cells, necdin markedly suppressed p53-dependent activation of the p21/WAF promoter. Necdin and p53 inhibited cell growth in an additive manner as assessed by the colony formation of SAOS-2 cells, suggesting that necdin does not affect p53-mediated growth suppression. On the other hand, necdin inhibited p53-induced apoptosis of osteosarcoma U2OS cells. Thus, necdin can be a growth suppressor that targets p53 and modulates its biological functions in postmitotic neurons.
Mycobacterial ("Buruli") ulcer in a Peace Corps worker.

MYCOBACTERIAL ("Buruli") ulcer is one of the diseases endemic in other parts of the world but virtually unknown in this country. It is not unexpected that diseases may be transmitted to and from other countries by Peace Corps personnel; and therefore may present here where previously unencountered. This report describes a patient with a mycobacterial ulcer similar to those which have been referred to as Buruli ulcers.1The disorder was acquired in Nigeria and treated in this country. The difficulty in establishing the clinical diagnosis in this case points up to the necessity of being aware of the specific entity. Report of a Case A 20-year-old white man was admitted to the University Hospital in June, 1966, for treatment of lymphedema and a nonhealing ulcer of the left foot. The patient had spent 20 months in Aro Chuku, Nigeria, on a Peace Corps assignment. In March 1966, he first
Prevalence of Fragilysin Gene in Bacteroides fragilis Isolates from Blood and Other Extraintestinal Samples

ABSTRACT Of 166 Bacteroides fragilis isolates, 26.2% of 103 isolates from blood and 20.6% of 63 extraintestinal isolates harbored the fragilysin gene (difference not statistically significant). Clinical characteristics and evolution were comparable in patients with B. fragilis bacteremia with or without this enterotoxin. Fragilysin seems not to be an important virulence factor in B. fragilis disease.
Cdc42 and RhoA are differentially regulated during arachidonate‐mediated HeLa cell adhesion

Cell adhesion to extracellular matrix requires stimulation of an eicosanoid signaling pathway through the metabolism of arachidonate by 5‐lipoxygenase to leukotrienes and cyclooxygenase‐1/2 to prostaglandins, as well as activation of the small GTPase signaling pathway involving Cdc42 and Rho. These signaling pathways direct remodeling of the actin cytoskeleton during the adhesion process, specifically the polymerization of actin during cell spreading and the bundling of actin filaments when cells migrate. However, few studies linking these signaling pathways have been described in the literature. We have previously shown that HeLa cell adhesion to collagen requires oxidation of arachidonic acid (AA) by lipoxygenase for actin polymerization and cell spreading, and cyclooxygenase for bundling actin filaments during cell migration. We demonstrate that small GTPase activity is required for HeLa cell spreading upon gelatin, and that Cdc42 is activated while Rho is downregulated during the spreading process. Using constitutively active and dominant negative expression studies, we show that Cdc42 is required for HeLa cell spreading and migration, while activated RhoA is antagonistic towards spreading. Constitutively active RhoA promotes cell migration and increases the degree of actin bundling in HeLa cells. Further, we demonstrate that activation of either the AA oxidation pathway or the small GTPase pathway cannot rescue inhibition of spreading when the alternate pathway is blocked. Our results suggest (1) both the eicosanoid signaling pathway and small GTPase activation are required during HeLa cell adhesion, and (2) these signaling pathways converge to properly direct remodeling of the actin cytoskeleton during HeLa cell spreading and migration upon collagen. © 2003 Wiley‐Liss, Inc.
Isolated SEPIC converter fed trinary hybrid cascaded H-bridge multilevel inverter for solar PV system

Solar electrical energy generation and its conversion techniques gain more attention because Photo Voltaic (PV) power generation system is more attractive due to its advantages among all the RESs (Renewable Energy Sources). In this paper, Isolated SEPIC(Single-Ended Primary-Inductance Converter)converter fed grid connected Multilevel Inverter is proposed. SEPIC converter is a buck-boost derived topology gives regulated output voltage with varying solar energy by using single switch. The output of the SEPIC is regulated at a trinary ratio and the cascaded H-bridge multilevel inverter is used here for maximum levels in the output voltage with minimum number of power electronic switches. A low THD output voltage is created and fed to the grid. Proposed system is validated with MATLAB/Simulink model and the results are compared with the existing models.
Placebo-controlled trial of fluoxetine as an adjunct to relapse prevention in alcoholics.

OBJECTIVE The authors tested the hypothesis that fluoxetine, when used in combination with relapse prevention psychotherapy, directly reduces relapse frequency and severity for alcoholics. METHOD The authors conducted a randomized, placebo-controlled trial of fluoxetine (up to a maximum of 60 mg/day) for 12 weeks in combination with weekly psychotherapy for 101 alcohol-dependent subjects who were not selected on the basis of comorbid major depression. Outcomes were measured at the end of treatment and 6 months after treatment. RESULTS Placebo-treated subjects were more complaint with the medication regimen and remained in the study longer than fluoxetine-treated subjects. There was significantly less alcohol consumption in both groups during treatment than before treatment. These effects persisted during the posttreatment period. Although fluoxetine treatment had no significant effects on alcohol consumption, it reduced Hamilton Depression Rating Scale scores more than placebo treatment among subjects with current major depression. CONCLUSIONS Fluoxetine at a dose of 60 mg/day is probably not of use for relapse prevention in alcoholics with mild to moderate alcohol dependence and no comorbid depression. In alcoholics with major depression, the drug may reduce depressive symptoms. Subsequent studies with fluoxetine should probably focus on more severely alcohol-dependent subjects or those with comorbid depression.