LLukas22/scidocs huggingface dataset:
Tattoos and body piercings as indicators of adolescent risk-taking behaviors.

PURPOSE
This study assessed tattoos and body piercings as markers of risk-taking behaviors in adolescents.


METHODS
A 58-question survey, based on the 1997 Centers for Disease Control and Prevention Youth Risk Behavior Survey, was offered to all adolescent beneficiaries that came to the Adolescent Clinic. The survey contained standard Youth Risk Behavior Survey questions that inquire about eating behavior, violence, drug abuse, sexual behavior, and suicide. Questions about tattoos and body piercings were added for the purposes of this study.


RESULTS
Participants with tattoos and/or body piercings were more likely to have engaged in risk-taking behaviors and at greater degrees of involvement than those without either. These included disordered eating behavior, gateway drug use, hard drug use, sexual activity, and suicide. Violence was associated with males having tattoos and with females having body piercings. Gateway drug use was associated with younger age of both tattooing and body piercing. Hard drug use was associated with number of body piercings. Suicide was associated with females having tattoos and younger age of both tattooing and body piercing. Tattoos and body piercings were found to be more common in females than males.


CONCLUSIONS
Tattoos and/or body piercings can alert practitioners to the possibility of other risk-taking behaviors in adolescents, leading to preventive measures, including counseling. Tattoo and body piercing discovery should be an important part of a health maintenance visit to best direct adolescent medical care.
Total Factor Productivity and Sources of Long-term Growth in Indian Agriculture

This paper assesses total factor productivity (TFP) growth in India, examines the sources of productivity growth, including public and private investment, and estimates the rates of return to public investments in agriculture. The results show that significant TFP growth in the Indian crops sector was produced by investments -primarily in research -but also in extension, markets, and irrigation. The high rates of return, particularly to public agricultural research and extension, indicate that the Government of India is not over investing in agricultural research and investment, but rather that current levels of public investment could be profitably expanded.
Quantification of Adequate Bowel Preparation for Screening or Surveillance Colonoscopy in Men.

BACKGROUND & AIMS
Bowel preparation is defined as adequate if it is sufficient for identification of polyps greater than 5 mm. However, adequate preparation has not been quantified. We performed a prospective observational study to provide an objective definition of adequate preparation, based on the Boston Bowel Prep Scale (BBPS, which consists of 0-3 points for each of 3 colon segments).


METHODS
We collected data from 438 men who underwent screening or surveillance colonoscopies and then repeat colonoscopy examinations within 60 days by a different blinded endoscopist (1161 colon segments total) at the West Haven Veterans Affairs Medical Center from January 2014 to February 2015. Missed polyps were defined as those detected on the second examination of patients with the best possible bowel preparation (colon segment BBPS score of 3) on the second examination. The primary outcome was the proportion of colon segments with adenomas larger than 5 mm that were missed in the first examination. We postulated that the miss rate was noninferior for segments with BBPS scores of 2 vs those with BBPS scores of 3 (noninferiority margin, <5%). Our secondary hypotheses were that miss rates were higher in segments with BBPS scores of 1 vs those with scores of 3 or of 2.


RESULTS
The adjusted proportion with missed adenomas greater than 5 mm was noninferior for segments with BBPS scores of 2 (5.2%) vs those with BBPS scores of 3 (5.6%) (a difference of -0.4%; 95% confidence interval [CI], -2.9% to 2.2%). Of study subjects, 347 (79.2%) had BBPS scores of 2 or greater in all segments on the initial examination. A higher proportion of segments with BBPS scores of 1 had missed adenomas larger than 5 mm (15.9%) than segments with BBPS scores of 3 (5.6%) (a difference of 10.3%; 95% CI, 2.7%-17.9%) or 2 (5.2%) (a difference of 10.7%; 95% CI, 3.2%-18.1%). Screening and surveillance intervals based solely on the findings at the first examination would have been incorrect for 16.3% of patients with BBPS scores of 3 in all segments, for 15.3% with BBPS scores of 2 or 3 in all segments, and for 43.5% of patients with a BBPS score of 1 in 1 or more segments.


CONCLUSIONS
Patients with BBPS scores of 2 or 3 for all colon segments have adequate bowel preparation for the detection of adenomas larger than 5 mm and should return for screening or surveillance colonoscopy at standard guideline-recommended intervals. Colon segments with a BBPS score of 1 have a significantly higher rate of missed adenomas larger than 5 mm than segments with scores of 2 or 3. This finding supports a recommendation for early repeat colonoscopic evaluation in patients with a BBPS score of 0 or 1 in any colon segment.
Nano-TiO2/PEEK bioactive composite as a bone substitute material: in vitro and in vivo studies

BACKGROUND
Compared with titanium (Ti) and other metal implant materials, poly(ether-ether ketone) (PEEK) shows outstanding biomechanical properties. A number of studies have also reported attractive bioactivity for nano-TiO(2) (n-TiO(2)).


METHODS
In this study, n-TiO(2)/PEEK nanocomposites were prepared, taking advantage of the unique properties of both PEEK polymer and n-TiO(2). The in vitro and in vivo bioactivity of these nanocomposites was assessed against a PEEK polymer control. The effect of surface morphology or roughness on the bioactivity of the n-TiO(2)/PEEK nanocomposites was also studied. n-TiO(2)/PEEK was successfully fabricated and cut into disks for physical and chemical characterization and in vitro studies, and prepared as cylindrical implants for in vivo studies. Their presence on the surface and dispersion in the composites was observed and analyzed by scanning and transmission electron microscopy and X-ray photoelectron spectroscopy.


RESULTS
Bioactivity evaluation of the nanocomposites revealed that pseudopods of osteoblasts preferred to anchor at areas where n-TiO(2) was present on the surface. In a cell attachment test, smooth PEEK showed the lowest optical density value (0.56 ± 0.07) while rough n-TiO(2)/PEEK exhibited the highest optical density value (1.21 ± 0.34, P < 0.05). In in vivo studies, the percent bone volume value of n-TiO(2)/PEEK was approximately twice as large as that of PEEK (P < 0.05). Vivid three-dimensional and histologic images of the newly generated bone on the implants further supported our test results.


CONCLUSION
Our study demonstrates that n-TiO(2) significantly improves the bioactivity of PEEK, especially if it has a rough composite surface. A n-TiO(2)/PEEK composite with a rough surface could be a novel alternative implant material for orthopedic and dental applications.
On-line trust: concepts, evolving themes, a model

Trust is emerging as a key element of success in the on-line environment. Although considerable research on trust in the offline world has been performed, to date empirical study of on-line trust has been limited. This paper examines on-line trust, specifically trust between people and informational or transactional websites. It begins by analysing the definitions of trust in previous offline and on-line research. The relevant dimensions of trust for an on-line context are identified, and a definition of trust between people and informational or transactional websites is presented. We then turn to an examination of the causes of on-line trust. Relevant findings in the human–computer interaction literature are identified. A model of on-line trust between users and websites is presented. The model identifies three perceptual factors that impact on-line trust: perception of credibility, ease of use and risk. The model is discussed in detail and suggestions for future applications of the model are presented. r 2003 Elsevier Science Ltd. All rights reserved.
Written action plan in pediatric emergency room improves asthma prescribing, adherence, and control.

RATIONALE
An acute-care visit for asthma often signals a management failure. Although a written action plan is effective when combined with self-management education and regular medical review, its independent value remains controversial.


OBJECTIVES
We examined the efficacy of providing a written action plan coupled with a prescription (WAP-P) to improve adherence to medications and other recommendations in a busy emergency department.


METHODS
We randomized 219 children aged 1-17 years to receive WAP-P (n = 109) or unformatted prescription (UP) (n = 110). All received fluticasone and albuterol inhalers, fitted with dose counters, to use at the discretion of the emergency physician. The main outcome was adherence to fluticasone (use/prescribed × 100%) over 28 days. Secondary outcomes included pharmacy dispensation of oral corticosteroids, β(2)-agonist use, medical follow-up, asthma education, acute-care visits, and control.


MEASUREMENTS AND MAIN RESULTS
Although both groups showed a similar drop in adherence in the initial 14 days, adherence to fluticasone was significantly higher over Days 15-28 in children receiving WAP-P (mean group difference, 16.13% [2.09, 29.91]). More WAP-P than UP patients filled their oral corticosteroid prescription (relative risk, 1.31 [1.07, 1.60]) and were well-controlled at 28 days (1.39 [1.04, 1.86]). Compared with UP, use of WAP-P increased physicians' prescription of maintenance fluticasone (2.47 [1.53, 3.99]) and recommendation for medical follow-up (1.87 [1.48, 2.35]), without group differences in other outcomes.


CONCLUSIONS
Provision of a written action plan significantly increased patient adherence to inhaled and oral corticosteroids and asthma control and physicians' recommendation for maintenance fluticasone and medical follow-up, supporting its independent value in the acute-care setting. Clinical trial registered with www.clinicaltrials.gov (NCT 00381355).
Primary care endorsement letter and a patient leaflet to improve participation in colorectal cancer screening: results of a factorial randomised trial

Background:The trial aimed to investigate whether a general practitioner's (GP) letter encouraging participation and a more explicit leaflet explaining how to complete faecal occult blood test (FOBT) included with the England Bowel Cancer Screening Programme invitation materials would improve uptake.Methods:A randomised controlled 2 × 2 factorial trial was conducted in the south of England. Overall, 1288 patients registered with 20 GPs invited for screening in October 2009 participated in the trial. Participants were randomised to either a GP's endorsement letter and/or an enhanced information leaflet with their FOBT kit. The primary outcome was verified with return of the test kit within 20 weeks.Results:Both the GP's endorsement letter and the enhanced procedural leaflet, each increased participation by ∼6% – the GP's letter by 5.8% (95% CI: 4.1–7.8%) and the leaflet by 6.0% (95% CI: 4.3–8.1%). On the basis of the intention-to-treat analysis, the random effects logistic regression model confirmed that there was no important interaction between the two interventions, and estimated an adjusted rate ratio of 1.11 (P=0.038) for the GP's letter and 1.12 (P=0.029) for the leaflet. In the absence of an interaction, an additive effect for receiving both the GP's letter and leaflet (11.8%, 95% CI: 8.5–16%) was confirmed. The per-protocol analysis indicated that the insertion of an electronic GP's signature on the endorsement letter was associated with increased participation (P=0.039).Conclusion:Including both an endorsement letter from each patient's GP and a more explicit procedural leaflet could increase participation in the English Bowel Cancer Screening Programme by ∼10%, a relative improvement of 20% on current performance.
Influence of football match time-motion parameters on recovery time course of muscle damage and jump ability.

We analysed the time course of recovery of creatine kinase (CK) and countermovement jump (CMJ) parameters after a football match, and correlations between changes in these variables and match time-motion parameters (GPS-accelerometry) in 15 U-19 elite male players. Plasma CK and CMJ height (CMJH), average concentric force (CMJCON) and average eccentric force (CMJECC) were assessed 2 h before and 30 min, 24 h and 48 h post-match. There were substantially higher CK levels 30 min, 24 h and 48 h (ES: 0.43, 0.62, 0.40, respectively), post-match. CMJECC (ES: -0.38), CMJH (ES: -0.35) decreased 30 min post, CMJCON (ES: -0.35), CMJECC (ES: -0.35) and CMJH (ES: -1.35) decreased 24 h post, and CMJCON (ES: -0.41) and CMJH (ES: -0.53) decreased 48 h post. We found correlations between distance covered at velocities ≤21 km · h(-1) and changes in CK at 24 h (r = 0.56) and at 48 h (r = 0.54) and correlations between CK and distance covered >14 km · h(-1) (r = 0.50), accelerations (r = 0.48), and decelerations (r = 0.58) at 48 h. Changes in CMJCON 30 min and 24 h post (both r = -0.68) correlated with impacts >7.1·G. Decelerations >2 m · s(-)(2) correlated with changes CMJCON (r = -0.49) at 48 h and CMJECC (r = -0.47) at 30 min. Our results suggest that match GPS-accelerometry parameters may predict muscle damage and changes in components of neuromuscular performance immediately and 24-48 h post-match.
Update and new approaches in the treatment of Castleman disease

First described 60 years ago, Castleman disease comprises a rare and heterogeneous cluster of disorders, characterized by lymphadenopathy with unique histological features and associated with cytokine-driven constitutional symptoms and biochemical disturbances. Although unicentric Castleman disease is curable with complete surgical excision, its multicentric counterpart is a considerable therapeutic challenge. The recent development of biological agents, particularly monoclonal antibodies to interleukin-6 and its receptor, allow for more targeted disease-specific intervention that promises improved response rates and more durable disease control; however, further work is required to fill knowledge gaps in terms of underlying pathophysiology and to facilitate alternative treatment options for refractory cases.
An Origami Reconfigurable Axial-Mode Bifilar Helical Antenna

This communication presents a new reconfigurable origami bifilar helical antenna. This antenna can change its operating frequencies by changing its height. Also, analytical equations for the design of such antennas are derived based on an equivalent model of a standard helical antenna. An origami bifilar helical antenna is designed and its performance is verified using simulations and measurements.
Incremental Deployment of SDN in Hybrid Enterprise and ISP Networks

Introducing SDN into an existing network causes both deployment and operational issues. A systematic incremental deployment methodology as well as a hybrid operation model is needed. We present such a system for incremental deployment of hybrid SDN networks consisting of both legacy forwarding devices (i.e., traditional IP routers) and programmable SDN switches. We design the system on a production SDN controller to answer the following questions: which legacy devices to upgrade to SDN, and how legacy and SDN devices can interoperate in a hybrid environment to satisfy a variety of traffic engineering (TE) goals such as load balancing and fast failure recovery. Evaluation on real ISP and enterprise topologies shows that with only 20% devices upgraded to SDN, our system reduces the maximum link usage by an average of 32% compared with pure-legacy networks (shortest path routing), while only requiring an average of 41% of flow table capacity compared with pure-SDN networks.
Health Monitoring of Civil Infrastructures Using Wireless Sensor Networks

A Wireless Sensor Network (WSN) for Structural Health Monitoring (SHM) is designed, implemented, deployed and tested on the 4200ft long main span and the south tower of the Golden Gate Bridge (GGB). Ambient structural vibrations are reliably measured at a low cost and without interfering with the operation of the bridge. Requirements that SHM imposes on WSN are identified and new solutions to meet these requirements are proposed and implemented. In the GGB deployment, 64 nodes are distributed over the main span and the tower, collecting ambient vibrations synchronously at 1kHz rate, with less than 10μs jitter, and with an accuracy of 30μG. The sampled data is collected reliably over a 46-hop network, with a bandwidth of 441B/s at the 46th hop. The collected data agrees with theoretical models and previous studies of the bridge. The deployment is the largest WSN for SHM.
The palatal island flap for reconstruction of palatal and retromolar trigone defects revisited.

BACKGROUND
Although a host of local soft tissue flaps have been described for the reconstruction of postoperative palatal defects, tissue-borne palatal obturators remain the most common form of rehabilitation of these defects. The palatal island flap, first applied to the reconstruction of the retromolar trigone and palatal defects, was first described by Gullane and Arena in 1977. This single-staged mucoperiosteal flap offers a reliable source of regional vascularized soft tissue that obviates the need for prosthetic palatal rehabilitation.


OBJECTIVE
To describe a series of 5 cases in which the palatal island flap was used as a primary palatal or retromolar reconstruction.


METHODS
We have retrospectively reviewed 5 consecutive cases between March 1998 and August 1999 wherein palatal island flaps were used for the primary reconstruction of postablative palatal defects. Each case was reviewed for primary pathologic findings, postoperative wound complications, postoperative speech and swallowing, and donor site morbidity. Selection of this reconstructive technique was based on the size and location of the defect and the assessment by the surgeon that the arc of rotation and amount of residual palatal mucosa were appropriate.


RESULTS
Six local palatal island flaps were performed on 5 patients who had not undergone irradiation (1 patient underwent bilateral flaps). The primary pathologic findings included T1 N0 squamous cell carcinoma, T4 N0 squamous cell carcinoma, T2 N0 low-grade mucoepidermoid carcinoma, pigmented neurofibroma, and T2 N0 low-grade clear cell carcinoma. All of the lesions were located on the hard or soft palate or the retromolar trigone, and the average defect size was 7.2 cm(2). All 5 patients began an oral diet between postoperative days 1 and 5 (mean, 2 days), and all patients were discharged home without postoperative donor site or recipient site complications between days 1 and 6 (mean, 3 days). Donor site reepithelialization was complete by 4 weeks in all 5 patients.


CONCLUSIONS
The palatal island flap offers a reliable method of primary reconstruction for limited lesions of the retromolar trigone and hard and soft palate. The mucoperiosteal tissue associated with this flap is ideal for partitioning the oral and nasal cavities and obviates the need for prosthetic palatal obturation.
User charges in health care: Evidence of effect on service utilization & equity from north India

BACKGROUND & OBJECTIVES
User charges have been advocated on efficiency grounds despite the widespread criticism about their adverse effect on equity. We assessed the effect of user charges on inpatient hospitalizations rate and equity in Haryana State.


METHODS
The inpatient department (IPD) statistics of the public sector facilities in Yamuna Nagar district where user charges had been introduced were analysed and compared with Rohtak district which did not have user charge between 2000 and 2006. National Sample Survey data of Haryana for the 2004-2005 period were analyzed to compare utilization of public sector facilities for hospitalization, cost of hospitalization, and prevalence of catastrophic out-of-pocket (OOP) expenditure by income quintiles in three districts which had user charges and 17 districts of Haryana which did not levy user charges.


RESULTS
During 2000 and 2006, hospital admissions declined by 23.8 per cent in Yamuna Nagar district where user charges had been introduced compared to an almost static hospitalization rate in Rohtak district which did not have user charges (P<0.01). Public sector hospital utilization for inpatient services had a pro-rich (concentration index 0.144) distribution in the three districts with user charges and pro-poor (concentration index -0.047) in the 17 districts without user charges. Significantly higher prevalence of catastrophic health expenditure was observed in public sector institutions with user charges (48%) compared to those without user charges (35.4%) (P<0.001).


INTERPRETATION & CONCLUSIONS
The findings of our study showed that user charges had a negative influence on hospitalizations in Haryana especially among the poor. Public policies for revenue generation should avoid user charges.
Improvements in patient-reported outcomes associated with an intervention to enhance quality of care for rural patients with type 2 diabetes: results of a controlled trial.

OBJECTIVE
The aim of this study was to examine patient-reported outcomes in a controlled trial of a multifaceted provider-level intervention to improve quality of care for rural patients with type 2 diabetes.


RESEARCH DESIGN AND METHODS
We conducted a before/after intervention study with concurrent controls in two rural regions in Alberta, Canada. The intervention consisted of six monthly visits by a multidisciplinary health care team and was primarily directed at primary care providers. Clinical and patient-reported outcomes were assessed after 6 months. Patient-reported outcomes included changes in health-related quality of life (Health Utilities Index Mark 3 [HUI3]), satisfaction with care, lifestyle (Diabetes Lifestyle Form), and adherence to self-care activities. Analysis of covariance was used to assess differences over time between the control and intervention regions.


RESULTS
A total of 200 intervention and 172 control subjects were included in this analysis. After adjusting for important clinical and demographic differences, a statistically significant and clinically important improvement in the overall HUI3 score was seen at the 6-month follow-up in the intervention region (0.06 [95% CI 0.02-0.10]) compared with the control region (0.01 [-0.04 to 0.04]) (P = 0.03 for the difference between groups). Satisfaction with general medical care (P < 0.001 between groups) and diabetes care (P < 0.001 between groups) increased among patients in the intervention region compared with the control region. Self-efficacy, attitudes, and beliefs about diabetes control all increased in the intervention region when compared with the control region, but adherence to self-care activities did not.


CONCLUSIONS
A provider-level intervention directed at improving quality of clinical care for patients with type 2 diabetes also had a favorable impact on overall health-related quality of life, satisfaction with care, and other humanistic outcomes.