LLukas22/scidocs huggingface dataset:
Intraoperative measurement of rectourethral fistula: prevention of incomplete excision in male patients with high-/intermediate-type imperforate anus.

INTRODUCTION
We report a novel technique to measure the length of the rectourethral fistula (RUF) in male patients with high-/intermediate-type imperforate anus during laparoscopically assisted anorectal pull-through (LAARP) to prevent incomplete excision.


METHOD
During LAARP for RUF in 5 male patients (mean age, 4.6 months; prostatic in 3, bulbar in 2), the RUF was dissected carefully close to the urethra and opened; and a fine catheter with 10-mm calibrations was inserted by the laparoscopic surgeon until it was seen to emerge at or near the verumontanum by another surgeon performing cystoscopy. The laparoscopic surgeon then measured the distance from the point where dissection was ceased at the rectal end to the urethral orifice. The RUF was dissected free from the prostate for exactly this length, tied, and excised; and colon pull-through was performed to finish LAARP.


RESULT
Rectourethral fistulae ranged from 5 to 15 mm and were much longer than expected. All dissections were uncomplicated without any injury to the urethra, and postoperative courses were unremarkable. At mean follow-up of 11 months, urination is normal in all without evidence of residual fistula.


CONCLUSION
Knowing the exact length of the RUF facilitates safe and complete excision in an otherwise blind situation.
A fractional-order hyperchaotic system and its synchronization

In this paper a novel fractional-order hyperchaotic system is proposed. The chaotic properties of the system in phase portraits are analyzed by using linear transfer function approximation of the fractional-order integrator block. Furthermore, synchronization between two fractional-order systems is achieved by utilizing a single-variable feedback method. Simulation results show that our scheme can not only make the two systems synchronized, but also let them remain in chaotic states. 2008 Elsevier Ltd. All rights reserved.
The impact of an empowering Internet-based Breast Cancer Patient Pathway programme on breast cancer patients' knowledge: a randomised control trial.

OBJECTIVE
The aim of this study was to analyse the effect of Breast Cancer Patient Pathway program.


METHODS
In one Finnish university hospital during 2008-10 newly diagnosed breast cancer patients were randomised to the intervention (n = 50) and the control groups (n = 48). The breast cancer patient's knowledge expectations and perception of received knowledge, knowledge, the source of information and satisfaction in received patient education were measured. Baseline and one year follow up data collection was conducted.


RESULTS
No differences were found in knowledge expectations between the groups at baseline. Patients in the control group evaluated their perception of received knowledge to be higher and they were more satisfied with the patient education they received from the hospital staff. However, the Intervention group's knowledge level was higher. The most important source of information was the healthcare professionals in both groups.


CONCLUSION
The results of study indicate that when patient education increases, patients' knowledge expectations increase as well, while their perceptions of received knowledge decrease. Future research is needed to examine the relationship between patients' knowledge expectations and perception of received knowledge as patients' knowledge level increases.


PRACTICE IMPLICATIONS
Patient education has to be individually adjusted, taking patients' expectations into account.
Impact of age, weight and concomitant treatment on lamotrigine pharmacokinetics.

WHAT IS KNOWN AND OBJECTIVE
Lamotrigine metabolism may be substantially altered with concomitant administration of valproic acid and/or carbamazepine. Such alterations may require the adjustment of lamotrigine dose to ensure optimal treatment efficacy and safety.


METHODS
The extent of lamotrigine interactions was investigated dependent on age, gender, weight and dose of concomitant carbamazepine and/or valproic acid in 65 patients with epilepsy. Lamotrigine plasma steady-state oral clearance (CLss/F) and area under the curve (AUCss) were calculated from the dose of drug, average steady-state concentration (Css) and interval of administration. Multiple regression analysis was used for the identification and quantification of factors that influenced lamotrigine pharmacokinetics.


RESULTS AND DISCUSSION
Age and dose of carbamazepine and valproic acid had significant influence on lamotrigine CLss/F and AUCss. Carbamazepine was associated with a dose-dependent increase and valproic acid with a dose-dependent decrease of lamotrigine metabolism rate. The effect of carbamazepine was more pronounced. Younger patients were expected to metabolize lamotrigine more rapidly whereas overweight patients may be less susceptible to interactions. Gender had no influence on lamotrigine pharmacokinetics.


WHAT IS NEW AND CONCLUSION
The efficacy and safety of lamotrigine may be altered by concomitant administration of carbamazepine and valproic acid. The models developed may be useful for estimating doses of lamotrigine for individual patients to minimize clinically significant interactions. Therapeutic monitoring is advisable when those drugs are used concomitantly.
Ultrasound-guided obturator nerve block: a sonoanatomic study of a new methodologic approach.

BACKGROUND
Obturator nerve block is one of the most technically challenging regional anesthesia techniques. Recently, the characteristics of the nerve have been described using ultrasound. However, clinical application of proximal ultrasound-guided obturator nerve block on patients has not been reported. In this study, we used ultrasound to describe the anatomical localization of the obturator nerve and its two branches in cadavers, volunteers, and also patients.


METHODS
A hyperechoic triangular shape formed by the superior pubic ramus, posterior margin of the pectineus muscle and anterior aspect of the external obturator muscle containing the obturator vessels and nerve was defined by ultrasound imaging in cadavers. In eight volunteers, bilateral obturator nerve images were obtained and the distances to specific landmarks (femoral artery, femoral vein, and pubic tubercle) were recorded. Ultrasound-guided obturator nerve block was further performed in 15 patients by using the previously defined approach. The final distance of the needle tip to the femoral artery, distances between the needle insertion point to the pubic tubercle and the depth of needle insertion were recorded.


RESULTS
The rates of common obturator nerve, anterior and branching obturator nerve pattern visibility with ultrasound were determined in 12/16, 13/16, and 7/16 sites in volunteers, respectively. Mean (SD) values of critical landmarks obtained from volunteers were obturator nerve-femoral vein 12.9 +/- 2.9 mm and obturator nerve-pubic tubercle 19.9 +/- 2.6 mm. Mean measurements obtained from patients were: femoral artery- needle tip 18.5 +/- 2.4 mm, needle depth 48.3 +/- 10.4 mm, pubic tubercle- needle insertion point (horizontal) 18.8 +/- 2.0 mm, and pubic tubercle- needle insertion point (vertical) 21.1 +/- 2.9 mm. Visual analog scale scores obtained from patients at 1 and 24 h were lower compared to baseline values (P < 0.001). Ninety-three percent (14 of 15) of the patients reported satisfaction from the block.


CONCLUSIONS
Landmarks defined in this clinical trial can be used in patients for obturator nerve block with ultrasound guidance.
Forging a New Hegemony? The Role of Transnational Policy Groups in the Network and Discourses of Global Corporate Governance

In recent decades the development of a transnational phase of capitalism, said to include the global integration of national economies, the mobility of capital and global reach of accumulation circuits, and the growing role of organizations like the World Economic Forum (WEF) and the World Trade Organization (WTO), has claimed the attention of legions of social scientists. With this interest has come a concern to theorize the segment of the world bourgeoisie purported to represent transnational capital and the ideology, neoliberalism, which seems to underwrite its expansion. Th ese issues have gained additional salience as scholars such as Robinson and Harris (2000) and Sklair (2001) have discerned the formation of a fully transnational capitalist class (TCC). A range of theoretical perspectives on transnational capitalist class formation now exists. In the early 1970s, dramatic increases in direct foreign investment through multinational corporations led Hymer (1979) to observe that “an international capitalist class is emerging whose interests lie in the world economy as a whole system of international private property which allows free movement of capital between countries” (262). In the 1980s, the Gramscian turn in IPE, advocating a “historically grounded conception of the dialectic totality of structure and agency” in processes of class formation and world order (Overbeek
A Stereo Image Processing System for Visually Impaired

This paper presents a review on vision aided systems and proposes an approach for visual rehabilitation using stereo vision technology. The proposed system utilizes stereo vision, image processing methodology and a sonification procedure to support blind navigation. The developed system includes a wearable computer, stereo cameras as vision sensor and stereo earphones, all moulded in a helmet. The image of the scene infront of visually handicapped is captured by the vision sensors. The captured images are processed to enhance the important features in the scene in front, for navigation assistance. The image processing is designed as model of human vision by identifying the obstacles and their depth information. The processed image is mapped on to musical stereo sound for the blind’s understanding of the scene infront. The developed method has been tested in the indoor and outdoor environments and the proposed image processing methodology is found to be effective for object identification. Keywords—Blind navigation, stereo vision, image processing, object preference, music tones.
Surface roughness of zirconia for full-contour crowns after clinically simulated grinding and polishing

The aim of this study was to evaluate the effect of controlled intraoral grinding and polishing on the roughness of full-contour zirconia compared to classical veneered zirconia. Thirty bar-shaped zirconia specimens were fabricated and divided into two groups (n=15). Fifteen specimens (group 1) were glazed and 15 specimens (group 2) were veneered with feldspathic ceramic and then glazed. Prior to grinding, maximum roughness depth (Rmax) values were measured using a profilometer, 5 times per specimen. Simulated clinical grinding and polishing were performed on the specimens under water coolant for 15 s and 2 N pressure. For grinding, NTI diamonds burs with grain sizes of 20 µm, 10 µm, and 7.5 µm were used sequentially. The ground surfaces were polished using NTI kits with coarse, medium and fine polishers. After each step, Rmax values were determined. Differences between groups were examined using one-way analysis of variance (ANOVA). The roughness of group 1 was significantly lower than that of group 2. The roughness increased significantly after coarse grinding in both groups. The results after glazing were similar to those obtained after fine grinding for non-veneered zirconia. However, fine-ground veneered zirconia had significantly higher roughness than venerred, glazed zirconia. No significant difference was found between fine-polished and glazed zirconia, but after the fine polishing of veneered zirconia, the roughness was significantly higher than after glazing. It can be concluded that for full-contour zirconia, fewer defects and lower roughness values resulted after grinding and polishing compared to veneered zirconia. After polishing zirconia, lower roughness values were achieved compared to glazing; more interesting was that the grinding of glazed zirconia using the NTI three-step system could deliver smooth surfaces comparable to untreated glazed zirconia surfaces.
A pentagonal surface patch for computer aided geometric design

A vector valued interpolation scheme for a pentagon is described which is compatible with surface patches which have a rectangular domain of definition. Such a scheme could be useful in computeraided geometric design problems, where a pentagonal patch occurs within a rectangular patch framework.
High Power Resonant Inverter with Simultaneous Dual-frequency Output

Induction surface hardening of parts with non-uniform cylindrical shape requires a multi-frequency process in order to obtain a uniform surface hardened depth. This paper presents an induction heating high power supply constituted of an only inverter circuit and a specially designed output resonant circuit. The whole circuit supplies both medium and high frequency power signals to the heating inductor simultaneously
Delirium, how does it end? Mortality as an outcome in older medical inpatients.

OBJECTIVES
Delirium is associated with poor outcomes. Previous research in delirium and mortality gave rather inconclusive results. This study aims to find out the rates of mortality at 1 year and the factors associated with it in a cohort of hospitalized older patients.


METHOD
Prospective, observational, longitudinal study. All acute medical admissions 70 years of age and above were approached within 72 h of admission. Exclusion criteria are as follows: severe aphasia; intubation; severe sensory problems; and non-English speakers. Patients eligible for inclusion were assessed four times, twice weekly during admission. Delirium was defined using the Confusion Assessment Method.


RESULTS
Two hundred patients were recruited. The mean age was 81.13 years (SD = 6.45; minimum 70 and maximum 100 years old), of which 100 (50%) participants were women. One hundred fifty-four (77%) patients never developed delirium during hospitalization. The overall rate of delirium was 23%. A total of 55 (27.5%) patients died during the 1-year follow-up. Although at 1-year follow-up, more people with delirium died (χ(2) = 9.873, df:1, p = 0.002), survival analysis after controlling for other variables showed that mortality was independent of delirium and that severity of illness, longer hospital stay and cognition were significant risk factors for mortality.


CONCLUSION
Although the sample size precludes drawing any definite conclusion, the findings of this study suggest that delirium is not an important risk factor for subsequent mortality. Perhaps delirium and cognitive impairment share common pathophysiological pathways that are related to mortality and in which the currently used methods cannot detect.
Frailty and 10-year mortality in community-living Mexican American older adults.

BACKGROUND
The older Hispanic population of the United States is growing rapidly. Hispanic older adults have relatively high-risk profiles for increased morbidity and disability, yet little is known about how the construct of frailty is related to health trajectories in this population.


OBJECTIVE
The purpose of this study was to examine the relationship between frailty and 10-year mortality in older community-dwelling Mexican Americans.


METHODS
Data were from the Hispanic Established Populations for Epidemiologic Studies of the Elderly and included 1,996 Mexican Americans, aged 65 and older, living in the southwestern US. Primary measures included mortality and a 5-item frailty index comprised of weight loss, exhaustion, walking speed, grip strength, and physical activity.


RESULTS
Mean baseline age was 74.5 years (SD 6.1) and 58.5% were women. Baseline frailty assessments yielded the following distribution: 44.9% non-frail, 47.3% pre-frail, and 7.8% frail. Overall, 892 (44.7%) participants died during the 10-year study period. Hazard ratios (HR), adjusted for sociodemographic, health, and medical factors, demonstrated increased odds for mortality in the pre-frail (HR = 1.25, 95% confidence interval, CI(95%), 1.07-1.46) and frail (HR = 1.81, CI(95%) 1.41-2.31) groups compared to the non-frail cohort.


CONCLUSION
The 5-item frailty index differentiated odds of 10-year mortality in older community-dwelling Mexican Americans. This clinical index has the potential to identify older minorities at risk for poor health outcomes and mortality.
A 3.4mW photovoltaic energy-harvesting charger with integrated maximum power point tracking and battery management

Energy harvesting is an attractive technique to take advantage of renewable energy and make systems, such as wireless sensor nodes, less dependent on external power sources. A photovoltaic (PV) energy-harvesting charger can convert energy from solar panels to charge batteries or super capacitors. To manage the variation in illumination, maximum power point tracking (MPPT) is essential to lock the output power of solar panels on the maximum power points [1, 2]. For any generic solar cell, its output current is determined by the output voltage in an exponential relation. Without knowing the characteristics of the solar cell in advance, it is necessary to monitor a feedback parameter to reach its maximum power point. Current measurement is needed at the output of the boost converter [1] or in the output path of the solar cell [2]. Motivated by the topology in [2], we propose a mixed-signal integration to avoid power hungry digital signal processing. In this paper, we report a charger with an integrated MPPT controller that can provide fast tracking for wide-range illumination levels while keeping high conversion efficiency. Also, a battery management unit is implemented and integrated on the same IC.
Assessing posterior shoulder contracture: the reliability and validity of measuring glenohumeral joint horizontal adduction.

CONTEXT
Increased contracture of the dominant posterior shoulder in throwing athletes has been associated with the development of altered shoulder rotational motion as well as several shoulder conditions. Clinicians must be able to accurately and reliably measure posterior shoulder contractures during the evaluation of such athletes in order to provide appropriate treatment.


OBJECTIVE
To evaluate the reliability and validity of assessing posterior shoulder contracture by measuring supine glenohumeral (GH) horizontal adduction.


DESIGN
Descriptive with repeated measures.


SETTING
The biomechanics laboratory at Illinois State University (Normal, IL) and the athletic training room in Surprise, AZ.


PATIENTS OR OTHER PARTICIPANTS
Twenty-four shoulders were tested in 12 subjects (age = 21.9 +/- 4.3 years, height = 175.0 +/- 10.0 cm, mass = 82.4 +/- 19.1 kg) for determination of reliability, and 46 shoulders were tested in 23 professional baseball pitchers (age = 21.25 +/- 1.66 years, height = 190.0 +/- 5.0 cm, mass = 88.45 +/- 6.99 kg) for determination of validity.


MAIN OUTCOME MEASURE(S)
We examined intratester and intertester reliability over 3 testing sessions by having 2 examiners measure GH horizontal adduction with the subject in a supine position with the scapula stabilized. To determine the validity and clinical usefulness of this measurement, we examined the relationship between GH horizontal adduction motion and internal shoulder rotational motion among a group of baseball pitchers.


RESULTS
Intraclass correlation coefficients were high for intratester (0.93, SEM = 1.64 degrees ) and intertester (0.91, SEM = 1.71 degrees ) measurements. This measurement was also shown to have a moderate to good relationship with lost internal shoulder rotational motion ( r = .72, P = .001) of the dominant arm among the baseball pitchers.


CONCLUSIONS
Based on the results of this study, we found that measuring GH horizontal adduction with the subject supine and the scapula stabilized is a reliable and valid technique for assessing posterior shoulder contracture.
A Multidisciplinary survey on controversies in the use of EUS-guided FNA: assessing perspectives of surgeons, oncologists and gastroenterologists

BACKGROUND
EUS-guided FNA can help diagnose and differentiate between various pancreatic and other lesions.The aim of this study was to compare approaches among involved/relevant physicians to the controversies surrounding the use of FNA in EUS.


METHODS
A five-case survey was developed, piloted, and validated. It was collected from a total of 101 physicians, who were all either gastroenterologists (GIs), surgeons or oncologists. The survey compared the management strategies chosen by members of these relevant disciplines regarding EUS-guided FNA.


RESULTS
For CT operable T2NOM0 pancreatic tumors the research demonstrated variance as to whether to undertake EUS-guided FNA, at p < 0.05. For inoperable pancreatic tumors 66.7% of oncologists, 62.2% of surgeons and 79.1% of GIs opted for FNA (p < 0.05). For cystic pancreatic lesions, oncologists were more likely to send patients to surgery without FNA. For stable simple pancreatic cysts (23 mm), most physicians (66.67%) did not recommend FNA. For a submucosal gastric 19 mm lesion, 63.2% of surgeons recommended FNA, vs. 90.0% of oncologists (p < 0.05).


CONCLUSIONS
Controversies as to ideal application of EUS-FNA persist. Optimal guidelines should reflect the needs and concerns of the multidisciplinary team who treat patients who need EUS-FNA. Multi-specialty meetings assembled to manage patients with these disorders may be enlightening and may help develop consensus.
Blockchain Without Waste : Proof-of-Stake ∗

Abstract A blockchain constitutes a distributed ledger that records transactions across a network of agents. Blockchain’s value proposition requires that agents eventually agree on the ledger’s contents since payments possess risk otherwise. Restricted blockchains ensure this consensus by appointing a central authority to dictate payment validity. Permissionless blockchains (e.g. Bitcoin, Ethereum), however, admit no central authority and therefore face a non-trivial issue of inducing consensus endogenously. Nakamoto (2008) provided a temporary solution to the problem by invoking an economic mechanism known as Proof-of-Work (PoW). PoW, however, lacks sustainability, so, in recent years, a variety of alternatives have been proposed. This paper studies the most famous such alternative, Proof-of-Stake (PoS). I provide the first formal economic model of PoS and demonstrate that PoS induces consensus in equilibrium. My result arises because I endogenize blockchain coin prices. Propagating disagreement introduces the prospect of default and thereby reduces blockchain coin value which implies that stake-holders face an implicit cost from delaying consensus. PoS randomly selects a stake-holder to update the blockchain and provides her an explicit monetary incentive, a “block reward,” for her service. In the event of disagreement, block rewards constitute a perverse incentive, but I demonstrate that restricting updating ability to large stake-holders induces an equilibrium in which consensus obtains as soon as possible. I also demonstrate that consensus obtains eventually almost surely in any equilibrium so long as the blockchain employs a modest block reward schedule. My work reveals the economic viability of permissionless blockchains.