LLukas22/scidocs huggingface dataset:
Absent mandibular gap in the retronasal triangle view: a clue to the diagnosis of micrognathia in the first trimester.

OBJECTIVE
To describe a new ultrasound technique that may be useful for the diagnosis of micrognathia in the first trimester of pregnancy.


METHODS
The retronasal triangle (RNT) view is a technique that captures the coronal plane of the face in which the primary palate and the frontal processes of the maxilla are visualized simultaneously. Normal first-trimester fetuses display a characteristic gap between the right and left body of the mandible in this view (the 'mandibular gap'). The presence or absence of this gap was evaluated and measured prospectively during real-time scanning (n = 154) and retrospectively by analyzing three-dimensional (3D) datasets (n = 50) in normal first-trimester fetuses undergoing screening for aneuploidy at 11-13 weeks' gestation. 3D datasets from 12 fetuses with suspected micrognathia were also collected and examined retrospectively for the same features.


RESULTS
The mandibular gap was identified in all 204 normal fetuses and increased linearly with increasing crown-rump length (y = 0.033x + 0.435; R(2) = 0.316), with no statistically significant differences between measurements obtained by two-dimensional ultrasound and 3D offline analysis. Among fetuses with suspected micrognathia, three 3D datasets were excluded from analysis because of poor image quality in one and the diagnosis of a normal chin in two. In the remaining nine fetuses, the mandibular gap was absent and was replaced by a bony structure representing the receding chin in seven (77.8%) cases and was not visualized due to severe retrognathia in the remaining two (22.2%) cases. All fetuses with micrognathia had associated anomalies, including seven with aneuploidy and two with skeletal dysplasia.


CONCLUSIONS
The RNT view may be a helpful technique for detecting micrognathia in the first trimester. The absence of the mandibular gap or failure to identify the mandible in this view is highly suggestive of micrognathia and should prompt a targeted ultrasound scan to assess for other anomalies. Further research is needed to determine the false-positive and false-negative rates of this technique.
Activity Theory: Basic Concepts and Applications

This tutorial introduces participants to Activity Theory, a conceptual approach that provides a broad framework for describing the structure, development, and context of computer-supported activities. The tutorial will consist of lectures, discussion and small group exercises. A Web community will be established so attendees will be able to continue to learn about and use activity theory.
Peer mentoring for type 2 diabetes prevention in first nations children.

OBJECTIVE
The goal of this study was to assess the efficacy of an after-school, peer-led, healthy living program on adiposity, self-efficacy, and knowledge of healthy living behaviors in children living in a remote isolated First Nation.


METHODS
A quasi-experimental trial with a parallel nonequivalent control arm was performed with 151 children in Garden Hill First Nation during the 2010-2011 and 2011-2012 school years. Fourth grade students were offered a 5-month, peer-led intervention facilitated by high school mentors between January and May of each school year; students in the control arm received standard curriculum. The main outcome measures were waist circumference (WC) and BMI z score. Secondary outcome measures included healthy living knowledge and self-efficacy.


RESULTS
Fifty-one children (mean ± SD age: 9.7 ± 0.4 years; BMI z score: 1.46 ± 0.84) received the intervention, and 100 children were in the control arm. At baseline, WC (79.8 vs 83.9 cm), BMI z score (1.46 vs 1.48), and rates of overweight/obesity (75% vs 72%) did not differ between arms. After the intervention, the change in WC (adjusted treatment effect: -2.5 cm [95% confidence interval (CI): -4.1 to -0.90]; P = .002) and BMI z score (adjusted treatment effect: -0.09 [95% CI: -0.16 to -0.03]; P = .007) were significantly lower in the intervention arm compared to the control arm. The intervention arm also experienced improvements in knowledge of healthy dietary choices (2.25% [95% CI: -0.01 to 6.25]; P = .02). Self-efficacy was associated with the change in WC after the intervention (β = -7.9, P = .03).


CONCLUSIONS
An after-school, peer-led, healthy living program attenuated weight gain and improved healthy living knowledge in children living in a remote isolated First Nation.
MULTINATIONALS AND US PRODUCTIVITY LEADERSHIP: EVIDENCE FROM GREAT

We study the productivity of US and other foreign owned plants in the UK. Using a new dataset that can identify for the flrst time domestic UK MNEs in such a study, we flnd that UK MNEs are less productive than US a‐liates, but as productive as non US foreign a‐liates. Exploiting dynamic variation in our data, we flnd evidence suggesting that this additional US advantage is due to the takeover of already highly productive UK plants rather than the sharing of superior flrm speciflc assets. The study also features a novel approach to TFP calculation. JEL Classiflcation: F230, L600 Keywords: Multinational Firms, Productivity, Foreign Ownership, US leadership ⁄ This work contains statistical data from the O‐ce of National Statistics (ONS) which is Crown copyright and reproduced with the permission of the controller of HMSO and Queen’s Printer for Scotland. The use of the ONS statistical data in this work does not imply endorsement of the ONS in relation to the interpretation or analysis of the statistical data. y We thank two anonymous referees for extremely helpful comments, plus Lee Branstetter, Tony
Ad-Hoc Routing Protocol Avoiding Route Breaks Based on AODV

Many routing protocols in mobile ad-hoc networks have been developed by many researchers. One of ad-hoc routing protocol types is the on-demand routing that establishes a route to a destination node only when required. But it is necessary to re-establish a new route when its route breaks down. However, most of on-demand routing protocols re-establish a new route after a route break. In this paper, we propose a new route maintenance algorithm to avoid route breaks because each intermediate node on an active route detects a danger of a link break to an upstream node and re-establishes a new route before a route break. We propose this algorithm based on AODV (Ad-hoc On-demand Distance Vector routing protocol) that is one of the routing protocols under study by the IETF MANET Working Group. Then, we evaluate the performance of our proposal by computer simulations.
Gap Trap : A Pothole Detection and Reporting System Utilizing Mobile Devices

In this paper we present a new method and implementation for detecting and reporting roadway potholes. Potholes are a major problem that cost cities and motorists around the world billions of dollars per year. Gap Trap addresses the issue by automatically discovering and reporting potholes so that motorists may avoid them, and cities may quickly repair them. This paper compares Gap Trap with similarly designed systems, and goes on to discuss the implemented prototype system that demonstrates the usefulness of this idea.
Minimally invasive pancreatic surgery – a review

During the past 20 years the application of a minimally invasive approach to pancreatic surgery has progressively increased. Distal pancreatectomy is the most frequently performed procedure, because of the absence of a reconstructive phase. However, middle pancreatectomy and pancreatoduodenectomy have been demonstrated to be safe and feasible as well. Laparoscopic distal pancreatectomy is recognized as the gold standard treatment for small tumors of the pancreatic body-tail, with several advantages over the traditional open approach in terms of patient recovery. The surgical treatment of lesions of the pancreatic head via a minimally invasive approach is still limited to a few highly experienced surgeons, due to the very challenging resection and complex anastomoses. Middle pancreatectomy and enucleation are indicated for small and benign tumors and offer the maximum preservation of the parenchyma. The introduction of a robotic platform more than ten years ago increased the interest of many surgeons in minimally invasive treatment of pancreatic diseases. This new technology overcomes all the limitations of laparoscopic surgery, but actual benefits for the patients are still under investigation. The increased costs associated with robotic surgery are under debate too. This article presents the state of the art of minimally invasive pancreatic surgery.
Anterior cervical dynamic ABC plating with single level corpectomy and fusion in forty-two patients

Study Design: Forty-two consecutive patients undergoing dynamic ABC plated one-level ACF utilizing iliac crest autograft (38 patients) and fibula allografts (four patients) were evaluated. The unique ABC slotted plate design allows for up to 10 mm of cephalad and 10 mm of caudad plate migration.Objectives: To evaluate the incidence and etiology of complications in forty-two patients undergoing anterior cervical dynamic ABC plating (Aesculap, Tuttlingen, Germany), during one level anterior corpectomy with fusion (ACF).Setting: New York, USA.Methods: Serial dynamic X-ray and 2 Dimensional CAT Scan (2D-CT) studies, obtained 3, 6, and up to 12 months postoperatively, in 42 patients documented the presence of fusion or complications including plate or graft extrusion or pseudarthrosis.Results: Four (9.5%) of 42 patients developed postoperative plate or graft-related complications during the average follow up interval of 34 months. One patient, with a plate/graft extrusion, required a second two level ACF with posterior wiring and fusion (PWF). Two patients with pseudarthroses and one patient with a delayed iliac crest strut fracture required secondary PWF.Conclusions: Effective arthrodesis and a low incidence of complications following one level ACF performed utilizing dynamic ABC plates were attributed to reduced stress shielding and greater graft compression afforded by the unique plate design. Applying dynamic ABC plates for one level ACF was biomechanically advantageous with low morbidity.
Do low-dose corticosteroids improve mortality or shock reversal in patients with septic shock? A systematic review and position statement prepared for the American Academy of Emergency Medicine.

BACKGROUND
The management of septic shock has undergone a significant evolution in the past decade. A number of trials have been published to evaluate the efficacy of low-dose corticosteroid administration in patients with septic shock.


METHODS
The Sepsis Sub-committee of the American Academy of Emergency Medicine Clinical Practice Committee performed an extensive search of the contemporary literature and identified seven relevant trials.


RESULTS
Six of the seven trials reported a mortality outcome of patients in septic shock. Analysis of the data revealed that the relative risk (RR) of 28-day all-cause mortality in septic shock patients who received low-dose corticosteroids was 0.92 (95% confidence interval [CI] 0.79-1.07). All seven trials reported data concerning shock reversal or the withdrawal of vasopressors. Pooled results revealed that the RR of shock reversal is 1.17 (95% CI 1.07-1.28), which suggests that there may be significant improvement in shock reversal after corticosteroid administration. It is important to understand that two of the seven studies reviewed were disproportionately represented and accounted for 799 of 1005 patients (80%) considered for this recommendation.


CONCLUSIONS
The evidence suggests that low-dose corticosteroids may reverse shock faster; however, mortality is not improved for the overall population.
Morphological predictors of restenosis after coronary stenting in humans.

BACKGROUND
Experimental studies suggest that arterial injury and inflammation lead to increased neointimal growth after stenting. Despite the increased use of coronary stents in humans, there are only limited pathological data on the morphological features of in-stent restenosis.


METHODS AND RESULTS
Detailed histology was performed on 116 stents, implanted > or =90 days in 87 coronary arteries, from 56 patients (mean age, 59+/-13 years). The mean duration of stent implant was 10 months. In-stent restenosis was defined as a stent area stenosis of >75%. Lumen area increased as stent area increased (r2=0.27, P=0.0001), but there was a much stronger correlation between stent area and neointimal area (r2=0.70, P<0.0001). Arterial medial fracture was associated with a 29% increase (P<0.01) in neointimal thickness compared with arteries with an intact media. Neointimal thickness (P=0.0001), inflammatory cell density (P<0.0001), and neointimal vascular channel density (P<0.0001) were greater when struts were in contact with a ruptured arterial media compared with fibrous plaque or an intact fibrous cap. Stent strut penetration into a lipid core was associated with increased neointimal thickness (P=0.04) and inflammatory cell density (P=0.03). Neointimal inflammatory cell content was 2.4-fold greater in stents with restenosis versus no restenosis, and inflammation was associated with increased neoangiogenesis.


CONCLUSIONS
Coronary stenting that is accompanied by medial damage or penetration of the stent into a lipid core induces increased arterial inflammation, which is associated with increased neointimal growth. These data suggest the use of stenting strategies that reduce inflammation and neoangiogenesis to reduce the incidence of restenosis.
The safety of antiepileptic drug withdrawal in patients with non-epileptic seizures.

BACKGROUND
To determine whether withdrawal of anticonvulsant drugs (AED) can be carried out safely in patients with non-epileptic seizures (NES).


METHODS
Prospective evaluation of safety and outcome in 78 patients with NES who satisfied a standardised set of criteria for excluding the diagnosis of coexisting or underlying epilepsy.


FINDINGS
The patients were taking from one to three AED. Sixty four patients were withdrawn as outpatients, 14 as inpatients. Five patients stopped their drugs abruptly, and two had AED restarted and had to be withdrawn again. Otherwise all patients adhered to withdrawal schedules. A new type of attack in addition to NES was seen in three patients (complex partial seizures in all three cases). NES frequency declined in the group as a whole over the period of the study (follow up 6-12 months) in all individuals except for eight patients in whom there was a transient increase. Fourteen patients reported new physical symptoms after withdrawal; however, no serious adverse events were reported.


CONCLUSIONS
With appropriate diagnostic investigation and surveillance during follow up withdrawal of AED can be achieved safely in patients with NES.
Distal hyperintense vessels on FLAIR: an MRI marker for collateral circulation in acute stroke?

BACKGROUND
Hyperintense vessels (HV) on fluid-attenuated inversion recovery imaging are frequently observed in acute ischemic stroke patients. However, the exact mechanism and clinical implications of this sign have not yet been clearly defined. The features of HV and its relevance to other imaging factors are presented here.


METHODS
Prominence and location of HV were documented in 52 consecutive patients with middle cerebral artery (MCA) territory infarction, before treatment with IV recombinant tissue plasminogen activator. Pretreatment ischemic lesion volume, perfusion lesion volume, and vessel occlusion were determined in addition to recanalization status and ischemic lesion volume on follow-up imaging. NIH Stroke Scale (NIHSS) was used as a measure of clinical severity.


RESULTS
HV distal to arterial occlusion was observed in 73% of patients; more frequent in proximal than distal MCA occlusion patients. Among the 38 patients with proximal MCA occlusion, initial perfusion lesion volume was comparable among patients with different grade distal HV. However, patients with more prominent distal HV had smaller initial, 24-hour, and subacute ischemic lesion volumes and lower initial NIHSS scores.


CONCLUSIONS
The presence of distal hyperintense vessels before thrombolytic treatment is associated with large diffusion-perfusion mismatch and smaller subacute ischemic lesion volumes in patients with proximal middle cerebral artery occlusion. DWI = diffusion-weighted imaging; FLAIR = fluid-attenuated inversion recovery; GRE = gradient recalled echo; HV = hyperintense vessels; MCA = middle cerebral artery; MRA = magnetic resonance angiography; MTT = mean transit time; NIHSS = NIH Stroke Scale; PWI = perfusion-weighted imaging; rt-PA = recombinant tissue plasminogen activator; TE = echo time; TI = inversion time; TIMI = thrombolysis in myocardial infarction; TR = repetition time.
Mortality from diseases other than cancer following low doses of ionizing radiation: results from the 15-Country Study of nuclear industry workers.

BACKGROUND
Ionizing radiation at very high (radio-therapeutic) dose levels can cause diseases other than cancer, particularly heart diseases. There is increasing evidence that doses of the order of a few sievert (Sv) may also increase the risk of non-cancer diseases. It is not known, however, whether such effects also occur following the lower doses and dose rates of public health concern.


METHODS
We used data from an international (15-country) nuclear workers cohort study to evaluate whether mortality from diseases other than cancer is related to low doses of external ionizing radiation. Analyses included 275 312 workers with adequate information on socioeconomic status, over 4 million person-years of follow-up and an average cumulative radiation dose of 20.7 mSv; 11 255 workers had died of non-cancer diseases.


RESULTS
The excess relative risk (ERR) per Sv was 0.24 [95% CI (confidence intervals) -0.23, 0.78] for mortality from all non-cancer diseases and 0.09 (95% CI -0.43, 0.70) for circulatory diseases. Higher risk estimates were observed for mortality from respiratory and digestive diseases, but confidence intervals included zero. Increased risks were observed among the younger workers (attained age <50 years, identified post hoc) for all groupings of non-cancer causes of death, including external causes. It is unclear therefore whether these findings reflect real effects of radiation, random variation or residual confounding.


CONCLUSIONS
The most informative low-dose radiation study to date provides little evidence for a relationship between mortality from non-malignant diseases and radiation dose. However, we cannot rule out risks per unit dose of the same order of magnitude as found in studies at higher doses.
Presentation by tree transformation

Structured documents are represented as trees. The layout or presentation of a document is also often modeled as a computation over a tree. But these trees are not generally the same. For instance, L/sup A/T/sub E/X converts a structured document to the T/sub E/X formatting hierarchy of boxes and glue. In other words, presentation is a mapping between trees. Casting it as a formal tree transformation offers both expressive, compact style specifications and efficient implementation. In our structured document system Ensemble, we have implemented a general framework for presentation by tree transformation. It consists of a core transformation engine; several distinct output tree languages or 'media'; and style files in a common language. To demonstrate its flexibility, we have built media for formatting programs, for presenting numerical data as graphs, and for displaying the tree structure of any document. We have also defined four efficiency requirements for interactive presentation, and tuned the implementation to meet each one.
Effect of acute heat exposure on skin blood flow of the paralyzed thigh in persons with spinal cord injury

Objectives: To investigate whether increased body temperature during heat exposure promotes skin blood flow of the thigh (SBFT) in individuals with spinal cord injury at rest. Study design: A prospective study with high lesion and with low lesion. Setting: Hiroshima University, Higashi-Hiroshima, Japan. Methods: Seven male paraplegics (T5-L2) and seven able-bodied subjects volunteered to participate in the experiment. First the subject rested for 1 h at an ambient temperature (Ta) of 25°C and a relative humidity (Rh) of 50%. Thereafter, the subject moved to a climatic chamber heated to Ta of 33°C an Rh of 50–55% and was exposed to this environment for 1 h. SBFT, stroke volume, heart rate, the skin temperature of the medial thigh (Tthigh) and the tympanic membrane temperature (Tty) were assessed during the experiment. Results: The four subjects with high lesions between Th6 and Th10 (HL) showed no increase in SBFT, while the remaining three subjects with low lesion at Th11 or Th12 (LL) showed increased SBFT in the hot environment. Although Tty increased with exposure time in heat, correlation between Tty and SBFT was not significant in either paraplegic group. However, correlation between SBFT and Tthigh was highly significant in both groups. The increase in Tthigh in LL was due to increased skin blood flow in the thigh, while in HL it was considered attributable to heat transfer from the environment to the skin. Conclusion: These findings indicate that SBFT during heat exposure was largely dependent on the level of spinal cord injury. SBFT with low lesions increased during heat exposure when the sympathetic cutaneous vasomotor supply of the thigh was preserved. Spinal Cord (2000) 38, 224–228.
Everyday functioning of people with Parkinson's disease and impairments in executive function: a qualitative investigation.

PURPOSE
Executive function is the key area of cognitive impairment in Parkinson's disease. This study investigated how cognitive difficulties impact on everyday life of people with Parkinson's disease and their carers, and whether they explicitly mention executive-type difficulties.


METHODS
Semistructured interviews with 11 people with Parkinson's disease and six carers were analyzed thematically. People with Parkinson's disease performed within the normal range on cognitive screening tests, but all had abnormal scores on tests of executive function.


RESULTS
Despite relatively mild executive deficits and no global cognitive impairment, participants described executive-type difficulties as well as a range of problems in other cognitive domains, such as memory, processing speed and apathy. Cognitive difficulties had a far-reaching impact on everyday life and their significance depended on personal circumstances, such as the level of responsibilities of the person with Parkinson's disease and the extent of available support.


CONCLUSIONS
By presenting subjective accounts of living with Parkinson's disease and cognitive difficulties, this study improves our understanding of how the observed level of cognitive impairment translates into everyday functioning. The study results have implications for recognizing cognitive difficulties and for planning support for people with Parkinson's disease and their families, and can help identify ways of promoting effective self-management. Implications for rehabilitation Treatment of Parkinson's disease tends to focus on the movement disorder, meaning that cognitive difficulties and their impact can be overlooked. Participants in this study had only relatively mild executive deficits but described a range of cognitive problems, including executive-type difficulties. Cognitive difficulties have an emotional impact and can cause a range of challenges in everyday life, adding to the burden of physical symptoms of Parkinson's disease. Results of this study provide insights into how executive functions impairments translate into everyday difficulties in Parkinson's disease and have implications for planning support for people with Parkinson's disease and their families.