LLukas22/scidocs huggingface dataset:
Enhancing the Prediction of 30-Day Readmission After Percutaneous Coronary Intervention Using Data Extracted by Querying of the Electronic Health Record.

BACKGROUND
Early readmission after percutaneous coronary intervention is an important quality metric, but prediction models from registry data have only moderate discrimination. We aimed to improve ability to predict 30-day readmission after percutaneous coronary intervention from a previously validated registry-based model.


METHODS AND RESULTS
We matched readmitted to non-readmitted patients in a 1:2 ratio by risk of readmission, and extracted unstructured and unconventional structured data from the electronic medical record, including need for medical interpretation, albumin level, medical nonadherence, previous number of emergency department visits, atrial fibrillation/flutter, syncope/presyncope, end-stage liver disease, malignancy, and anxiety. We assessed differences in rates of these conditions between cases/controls, and estimated their independent association with 30-day readmission using logistic regression conditional on matched groups. Among 9288 percutaneous coronary interventions, we matched 888 readmitted with 1776 non-readmitted patients. In univariate analysis, cases and controls were significantly different with respect to interpreter (7.9% for cases and 5.3% for controls; P=0.009), emergency department visits (1.12 for cases and 0.77 for controls; P<0.001), homelessness (3.2% for cases and 1.6% for controls; P=0.007), anticoagulation (33.9% for cases and 22.1% for controls; P<0.001), atrial fibrillation/flutter (32.7% for cases and 28.9% for controls; P=0.045), presyncope/syncope (27.8% for cases and 21.3% for controls; P<0.001), and anxiety (69.4% for cases and 62.4% for controls; P<0.001). Anticoagulation, emergency department visits, and anxiety were independently associated with readmission.


CONCLUSIONS
Patient characteristics derived from review of the electronic health record can be used to refine risk prediction for hospital readmission after percutaneous coronary intervention.
Perceptions of the environment for eating and exercise in a rural community.

OBJECTIVE
To understand how members of a rural community perceive the effect of the built, natural, and social environments on their food choice and physical activity behaviors.


METHODS
A constructivist community environmental assessment was conducted including 17 individual qualitative interviews, 2 focus groups, and photo elicitation (n = 27) in a rural northeastern community where over 60% of the adult population is overweight or obese.


RESULTS
Participants described social, natural, and physical environmental factors that influenced their food choice and physical activity behaviors. Overweight and obesity were variably presented as an individual and/or a collective problem. Participants described conflicting goals for food choice and physical activity in the community, and an interrelationship between the social and physical environments.


CONCLUSIONS AND IMPLICATIONS
A community environmental assessment provides a view of the physical and social environments from the perspective of community residents that can serve as a foundation for locally tailored, community-based approaches to obesity prevention.
Efficient Focused Web Crawling Approach for Search Engine

Abstract— a focused crawler traverses the web, selecting out relevant pages to a predefined topic and neglecting those out of concern. Collecting domain specific documents using focused crawlers has been considered one of most important strategies to find relevant information. While surfing the internet, it is difficult to deal with irrelevant pages and to predict which links lead to quality pages. However most focused crawler use local search algorithm to traverse the web space, but they could easily trapped within limited a sub graph of the web that surrounds the starting URLs also there is problem related to relevant pages that are miss when no links from the starting URLs. There is some relevant pages are miss. To address this problem we design a focused crawler where calculating the frequency of the topic keyword also calculate the synonyms and sub synonyms of the keyword. The weight table is constructed according to the user query. To check the similarity of web pages with respect to topic keywords and priority of extracted link is calculated.
Withholding or withdrawing therapy in intensive care units: an analysis of collaboration among healthcare professionals

The purpose of the study was to determine the views of intensive care nurses, intensivists, and primary physicians regarding collaboration and other aspects of withholding and withdrawing therapy in the intensive care unit (ICU). A questionnaire survey was conducted in seven hospitals in the Region of Southern Denmark, including six regional and four university ICUs. Four hundred ninety-five nurses, 135 intensivists, and 146 primary physicians participated in the study. The primary physicians came from two regional hospitals. The unified response rate was 84%. “Futile therapy” and “Patient’s wish” were for all participants the main reasons for considering withholding or withdrawing therapy. Of primary physicians 63% found their general experience of collaboration very or extremely satisfactory compared to 36% of intensivists and 27% of nurses. Forty-three percent of nurses, 29% of intensivists, and 2% of primary physicians found that decisions regarding withdrawal of therapy were often, very often, or always unnecessarily postponed. Intensivists with ICU as their main workplace were more satisfied with the collaboration and more rarely found that end-of-life decisions were changed or postponed compared to intensivists who did not have ICU as their main workplace. Nurses, intensivists and primary physicians differ in their perception of collaboration and other aspects of withholding and withdrawing therapy practises at the ICU. Multi-disciplinary patient conferences, nurse involvement in the decision-making process, and guidelines for withholding and withdrawing therapy are recommended.
The Electromagnetic Fields of an Accelerating Charge: Applications in Lightning Return-Stroke Models

In the literature, three procedures have been used to calculate the electromagnetic fields from return strokes. In the first technique, the source is described only in terms of current density and the fields are expressed entirely in terms of the return-stroke current. In the second technique, the source is expressed in terms of the current and the charge densities and the fields are given in terms of both the current and the charge density. In the third technique, the fields are expressed in terms of the apparent charge density. The fields are connected to the source terms through the vector and scalar potentials. In this paper, the standard equations for the electromagnetic fields generated by an accelerating charge are utilized to evaluate the electromagnetic fields from lightning return strokes. It is shown that the total fields evaluated at any distance using these expressions are identical to those obtained using other techniques. However, the composition of the terms that vary as 1/R, 1/R2, and 1/R3 of the total electric field is different from those of other formulations. In the case of the transmission-line model, where the return stroke is described as a current pulse propagating with uniform velocity, radiation emanates only from the bottom of the channel where current is generated. When the speed of propagation is equal to the speed of light, the total field throughout the entire space becomes radiation. The procedure is also applied here to obtain the electric fields of the traveling-current-source model. The electric fields obtained for this case, too, agree with the previous study. It is also shown how the equations can be applied rather conveniently to evaluate: 1) the electromagnetic fields generated by current pulses propagating along overhead power lines; and 2) the electromagnetic fields generated by vertical conductors and towers during lightning strikes.
Gender Dysphoria and Co-Occurring Autism Spectrum Disorders: Review, Case Examples, and Treatment Considerations.

PURPOSE
Transgender and gender nonconforming people who fulfill diagnostic criteria for autism spectrum disorders (ASDs) often present to mental health providers with concerns that are distinct from those without ASDs. Gender Dysphoria (GD) and ASDs have been proposed to share etiologic mechanisms and there is evidence that ASDs may be more common in transgender and gender nonconforming people. We explore the impact of ASD characteristics on individual gender identity, expression, and the process of psychotherapy.


METHOD
The authors present two case studies of high-functioning individuals with ASD and GD diagnoses.


RESULTS
The limited ability to articulate an inner experience, deficits in Theory of Mind (ToM), along with the intolerance of ambiguity as a manifestation of the cognitive rigidity characteristic of ASDs, may present special difficulties to gender identity formation and consolidation and create challenges in psychotherapy.


CONCLUSIONS
The authors suggest that ASDs do not preclude gender transition and that individuals with high-functioning ASDs are capable of making informed decisions regarding their medical care and life choices. The authors also consider possible challenges and suggest techniques for assisting such clients in exploring their gender identities.
Mortality risk in patients with dementia treated with antipsychotics versus other psychiatric medications.

OBJECTIVE
Mortality rates in the year following new antipsychotic medication starts for neuropsychiatric symptoms of dementia were compared with rates after starts of other psychiatric medications.


METHOD
The retrospective, cohort study used national data from the Department of Veterans Affairs (fiscal years 2001-2005) on patients older than 65 years who began outpatient treatment with psychiatric medication following a dementia diagnosis (N=10,615). Twelve-month mortality rates were compared in patients taking antipsychotics and those taking other psychiatric medications. The authors controlled for confounding by using multivariate models and propensity-scoring methods. Secondary analyses included a no-medication group and examination of mortality causes.


RESULTS
All groups taking antipsychotics had significantly higher mortality rates (22.6%-29.1%) than patients taking nonantipsychotic medications (14.6%). Adjusted mortality risks for atypicals and for combined atypical and conventional antipsychotics were similar to those for conventional antipsychotics. The mortality risk was significantly lower for nonantipsychotic medications than conventional antipsychotics. Except for anticonvulsants, the adjusted risks for all individual classes of nonantipsychotics were significantly lower than the risk for antipsychotics. Mortality risks did not change over 12 months. The proportions of patients taking antipsychotics who died from cerebrovascular, cardiovascular, or infectious causes were not higher than rates for those taking nonantipsychotic psychiatric medications.


CONCLUSIONS
Antipsychotic medications taken by patients with dementia were associated with higher mortality rates than were most other medications used for neuropsychiatric symptoms. The association between mortality and antipsychotics is not well understood and may be due to a direct medication effect or the pathophysiology underlying neuropsychiatric symptoms that prompt antipsychotic use.
Structure evolution and ablation behavior of ZrC coating on C/C composites under single and cyclic oxyacetylene torch environment

Abstract ZrC ablation resistance coating was prepared on carbon/carbon composites by low pressure chemical vapor deposition using the ZrCl 4 –C 3 H 6 –H 2 –Ar system. The structure evolution and ablation behavior of the coating under single and cyclic ablation were investigated in an oxyacetylene torch environment. Single ablation results show that the ablated coating consists of three layers (outer ZrO 2 layer, transitional ZrC x O y layer and residual ZrC layer). An oxidation progress is inferred that ZrC is oxidized into ZrC x O y firstly and then into ZrO 2 in the case of the continuous diffusion of oxygen. Cyclic ablation results show that the effect of crack growth inhibition and the oxygen diffusion limitation of ZrO 2 and ZrC x O y layers dominate the ablation of the coating and result in two different ablation behaviors. Based on the role of the ZrO 2 and ZrC x O y layers in the single and cyclic ablation, two different ablation modes of the coating are proposed.
Milk with Honey Heals after Tonsillectomy ; Bleeding , Pain and Wound Healing are in a Better Condition : An Experimental Study with Control Group

Objectives: To assess the effect of milk with honey in childre n undergoing tonsillectomy on bleeding, pain and wound healing. Methods: The experimental study wit contol group was conduct ed out ear, nose and throat clinic and outpatient clinic in a public hospital. In the study, it were studied with children undergoing tonsillectomy who are 6-17 years of age (N=68). The standardized natural flowe r honey was applied to children in the experimental group after tonsillectomy, every day, in addition to the standard diet in clinical routine. The children wer e assigned randomly the experimental and control groups accord ing to the operation sequence. In collecting the da ta, questionnaire, pain, wound healing and visual analo g scales was used. The data were analyzed by percen tage distributions, means, chi-square test, variance ana lysis, and correlation analysis. It was depended on ethical principles. Results: In the study, it was determined that not bleeding, is significant less pain and the level of wound he aling of children in group milk with honey than children i milk group (p<.001). It has been found that a st rong negative correlation between the level of pain and wound healing of children in milk with honey and mi lk groups (p<.001). Conclusions: It has been determined that milk with honey was ef fective in prevent bleeding, reducing pain, and accelerate wound healing. Honey, which is a natural nutrient is a safe care tool that can be applied i n children undergoing tonsillectomy without diabetes and aller gic to honey and oral feeding in addition to routin e clinical the diet.
Depression treatment preferences after acute traumatic spinal cord injury.

OBJECTIVE
To examine preferences for depression treatment modalities and settings and predictors of treatment preference in persons with spinal cord injury (SCI).


DESIGN
Cross-sectional surveys.


SETTING
Rehabilitation inpatient services.


PARTICIPANTS
Persons with traumatic SCI (N=183) undergoing inpatient rehabilitation.


INTERVENTIONS
Not applicable.


MAIN OUTCOME MEASURES
Patient Health Questionnaire-9 depression scale, history of psychiatric diagnoses and treatments, and a depression treatment preference survey.


RESULTS
Among inpatients with SCI (28% had Patient Health Questionnaire-9 score ≥10 indicating probable major depression), a physical exercise program was the most preferred treatment option (78% somewhat or very likely to try) followed by antidepressants prescribed by a primary care provider (63%) and individual counseling in a medical or rehabilitation clinic (62%). All modalities were preferred over group counseling. Although not statistically significant, more depressed individuals stated a willingness to try antidepressants and counseling than nondepressed individuals. Subjects preferred treatment in a medical/rehabilitation setting over a mental health setting. Those with a prior diagnosis of depression and a history of antidepressant use were significantly more willing to take an antidepressant. Age ≥40 years was a significant predictor of willingness to receive individual counseling.


CONCLUSIONS
Treatment preferences and patient education are important factors when choosing a depression treatment modality for patients with SCI. The results suggest that antidepressants, counseling, and exercise may be promising components of depression treatment in this population, particularly if they are integrated into medical or rehabilitation care.
The metabolic drug-drug interaction profile of Dabrafenib: in vitro investigations and quantitative extrapolation of the P450-mediated DDI risk.

Dabrafenib is a potent ATP-competitive inhibitor for the V600 mutant b-rapidly accelerated fibrosarcoma (b-raf) kinase currently approved in the United States for the treatment of metastatic melanoma. Studies were conducted in human liver microsomes, recombinant human cytochrome P450 (P450) enzymes, and human hepatocytes to investigate the potential of dabrafenib and its major circulating metabolites to perpetrate pharmacokinetic drug-drug interactions (DDIs) as well as have their own pharmacokinetics affected (victim) by coadministered drugs. Dabrafenib metabolism was mediated by CYP2C8 (56% to 67%) and CYP3A4 (24%); in addition, it has demonstrated inhibition of CYP2C8, 2C9, 2C19, 3A4 (atorvastatin), and (nifedipine), with calculated IC50 values of 8.2, 7.2, 22.4, 16, and 32 μM. It also demonstrated metabolism-dependent inhibition of CYP3A4 with a maximal inactivation rate constant of 0.040 minute(-1) and a concentration required to achieve half-maximal inactivation for CYP3A4 of 38 μM. Hydroxy-dabrafenib inhibited CYP1A2, 2C9, and 3A4 (midazolam) with calculated IC50 values of 83, 29, and 44 μM, and carboxy-dabrafenib did not inhibit any of the P450 enzymes tested. Desmethyl-dabrafenib inhibited CYP2B6, 2C8, 2C9, 2C19, and 3A4 (midazolam, atorvastatin, and nifedipine) with calculated IC50 values of 78, 47, 6.3, 36, 17, 20, and 28 μM, respectively. At 30 μM dabrafenib showed increases in CYP2B6 and CYP3A4 mRNA expression indicative of induction. The potential clinical relevance of these findings was explored by using mechanistic static mathematical models to estimate the magnitude of change (area under the curve change) as a result of P450-mediated DDI interactions. This risk-assessment approach indicated that dabrafenib is unlikely to perpetrate any in vivo DDIs by inhibition mechanisms, but is a likely inducer of CYP3A4 and a victim of CYP3A4 and CYP2C8 inhibitors. Furthermore, inclusion of the in vitro drug interaction data for dabrafenib metabolites did not impact the overall clinical risk assessment.
Female Genital Cosmetic and Plastic Surgery :

Introduction. This review studies rationale and outcome of vulvovaginal aesthetic surgery. Aim. Discuss procedures designed to alter genital appearance and function; investigate sexual, philosophical, and ethical issues; examine outcomes. Methods. (i) Medline search of the existing literature utilizing terms labiaplasty, clitoral hood reduction, hymenoplasty (HP), vaginoplasty (VP), perineoplasty (PP), female genital surgery, sexual satisfaction/body image, and anterior/posterior colporrhaphy; (ii) references from bibliographies of papers found through the literature search and in the author’s reading of available literature. Main Outcome Measures. (i) Demographics and psychosexual dynamics of women requesting female genital plastic/cosmetic surgery; (ii) overall and sexual satisfaction of subjects undergoing these procedures. Results. The majority of studies regarding patient satisfaction and sexual function after vaginal aesthetic and functional plastic procedures report beneficial results, with overall patient satisfaction in the 90–95% range, sexual satisfaction over 80–85%. These data are supported by outcome data from nonelective vaginal support procedures. Complications appear minor and acceptable to patients. There are little data available regarding outcomes and satisfaction of HP, or function during the rigors of subsequent vaginal childbirth, although the literature contains no case reports of labiaplasty disruption during parturition. Conclusion. Women requesting labiaplasty and reduction of their clitoral hoods do so for both cosmetic and functional (chafing, interference with coitus, interference with athletic activities, etc.) reasons, while patients requesting VP and/or PP do so in order to increase friction and sexual satisfaction, occasionally for aesthetic reasons. Patients appear generally happy with outcomes. The majority of patients undergoing genital plastic surgery report overall satisfaction and subjective enhancement of sexual function and body image, but the literature is retrospective. Female genital plastic surgery procedures appear to fulfill the majority of patient’s desires for cosmetic and functional improvement, as well as enhancement of the sexual experience. Little information is available regarding HP outcomes. Goodman MP. Female genital cosmetic and plastic surgery: A review. J Sex Med **;**:**–**.
Awareness and Attitude towards Human Papillomavirus (HPV) Vaccine among Medical Students in a Premier Medical School in India

BACKGROUND
As preventing cancer with the help of a vaccine is a comparatively new concept, awareness and education about it will have important implication in the implementation of this strategy.


MATERIALS AND METHODS
Present explorative questionnaire based survey included 618 MBBS students for final analysis.


RESULTS
Majority of participants (89.6%) were well aware of the preventable nature of cervical cancer. Most of them (89.2%) knew that necessary factor responsible for cervical cancer is infection with high risk HPV. Awareness regarding the availability of vaccine against cervical cancer was 75.6%. Females had a better awareness regarding availability of vaccine, target population for vaccination and about the catch up program. Overall acceptance of HPV vaccine among the population studied was 67.8%. Medical teaching had a definitive impact on the understanding of this important public health issue. Females seemed to be more ready to accept the vaccine and recommend it to others. For our study population the most common source of information was medical school teaching. Majority of participants agreed that the most important obstacle in implementation of HPV vaccination program in our country is inadequate information and 86.2% wanted to be educated by experts in this regard.


CONCLUSION
HPV vaccine for primary prevention of cervical cancer is a relatively new concept. Health professional will be able to play a pivotal role in popularizing this strategy.
On the sensitivity and specificity of nonword repetition and sentence recall to language and memory impairments in children.

PURPOSE
The present study examined the utility of 2 measures proposed as markers of specific language impairment (SLI) in identifying specific impairments in language or working memory in school-age children.


METHOD
A group of 400 school-age children completed a 5-min screening consisting of nonword repetition and sentence recall. A subset of low (n = 52) and average (n = 38) scorers completed standardized tests of language, short-term and working memory, and nonverbal intelligence.


RESULTS
Approximately equal numbers of children were identified with specific impairments in either language or working memory. A group about twice as large had deficits in both language and working memory. Sensitivity of the screening measure for both SLI and specific working memory impairments was 84% or greater, although specificity was closer to 50%. Sentence recall performance below the 10th percentile was associated with sensitivity and specificity values above 80% for SLI.


CONCLUSIONS
Developmental deficits may be specific to language or working memory, or include impairments in both areas. Sentence recall is a useful clinical marker of SLI and combined language and working memory impairments.