LLukas22/scidocs huggingface dataset:
Association between comorbidities and absence of chest pain in acute coronary syndrome with in-hospital outcome.

BACKGROUND
To evaluate the impact of comorbidities on the management and outcomes of acute coronary syndrome (ACS) patients without chest pain/discomfort (i.e. ACS without typical presentation).


METHODS
Of the 11,458 ACS patients, enrolled by the International Survey of Acute Coronary Syndrome in Transitional Countries (ISACS-TC; ClinicalTrials.gov: NCT01218776), 8.7% did not have typical presentation at the initial evaluation, and 40.2% had comorbidities. The odds of atypical presentation increased proportionally with the number of comorbidities (odds ratio [OR]: 1, no-comorbid; OR: 1.64, 1 comorbidity; OR: 2.52, 2 comorbidities; OR: 4.57, ≥3 comorbidities).


RESULTS
Stratifying the study population by the presence/absence of comorbidities and typical presentation, we found a decreasing trend for use of medications and percutaneous intervention (OR: 1, typical presentation and no-comorbidities; OR: 0.70, typical presentation and comorbidities; OR: 0.23, atypical presentation and no-comorbidities; OR: 0.18, atypical presentation and comorbidities). On the opposite, compared with patients with typical presentation and no-comorbidities (OR: 1, referent), there was an increasing trend (p<0.001) in the risk of death (OR: 2.00, OR: 2.52 and OR: 4.83) in the above subgroups. However, after adjusting for comorbidities, medications and invasive procedures, atypical presentation was not a predictor of in-hospital death. Independent predictors of poor outcome were history of stroke (OR: 2.04), chronic kidney disease (OR: 1.57), diabetes mellitus (OR: 1.49) and underuse of invasive procedures.


CONCLUSIONS
In the ISACS-TC, atypical ACS presentation was often associated with comorbidities. Atypical presentation and comorbidities influenced underuse of in-hospital treatments. The latter and comorbidities are related with poor in-hospital outcome, but not atypical presentation, per se.
A consultation training program for physicians for communication about complementary medicine with breast cancer patients: a prospective, multi-center, cluster-randomized, mixed-method pilot study

The aim was to develop and evaluate a training program for physicians for communicating with breast cancer patients about complementary medicine (CM). In a cluster-randomized pilot trial eight breast cancer centers (two physicians per center) were randomized to either a complementary communication training program (9 h e-learning + 20 h on-site skills training) or to a control group without training. Each physician was asked to consult ten patients for whom he or she is not the physician in charge. We used mixed methods: Quantitative outcomes included physicians’ assessments (empathy, complexity of consultation, knowledge transfer) and patients’ assessments (satisfaction, empathy, knowledge transfer). For qualitative analyses, 15 (eight in the training and seven in the control group) videotaped consultations were analyzed based on grounded theory, and separate focus groups with the physicians of both groups were conducted. A total of 137 patients were included. Although cluster-randomized, physicians in the two groups differed. Those in the training group were younger (33.4 ± 8.9 vs. 40.0 ± 8.5 years) and had less work experience (5.4 ± 8.9 vs. 11.1 ± 7.4 years). Patient satisfaction with the CM consultation was relatively high on a scale from 0 to 24 and was comparable in the two groups (training group: 19.4 ± 4.6; control group 20.5 ± 4.1). The qualitative findings showed that physicians structured majority of consultations as taught during the training. Comparing only the younger and less CM experienced physicians, those trained in CM communication felt more confident discussing CM-related topics than those without training. A CM communication-training program might be especially beneficial for physicians with less consulting experience when communicating about CM-related issues. A larger trial using more suitable quantitative outcomes needs to confirm this. ClinicalTrials.gov: NCT02223091 , date of registration: 7 February 2014.
A New Collaborative Filtering Recommendation Approach Based on Naive Bayesian Method

Recommendation is a popular and hot problem in e-commerce. Recommendation systems are realized in many ways such as content-based recommendation, collaborative filtering recommendation, and hybrid approach recommendation. In this article, a new collaborative filtering recommendation algorithm based on naive Bayesian method is proposed. Unlike original naive Bayesian method, the new algorithm can be applied to instances where conditional independence assumption is not obeyed strictly. According to our experiment, the new recommendation algorithm has a better performance than many existing algorithms including the popular k-NN algorithm used by Amazon.com especially at long length recommendation.
Effect of Acarbose on Glycemic Variability in Patients with Poorly Controlled Type 2 Diabetes Mellitus Receiving Stable Background Therapy: A Placebo-Controlled Trial.

STUDY OBJECTIVE
To evaluate the effect of acarbose on glycemic control and glycemic variability, using a continuous glucose-monitoring system, in patients with type 2 diabetes mellitus who were not well controlled on metformin and vildagliptin therapy.


DESIGN
Multicenter, randomized, double-blind, placebo-controlled study.


SETTING
Clinical research units at three hospitals in Italy.


PATIENTS
Fifty-three patients with type 2 diabetes who were taking stable dosages of metformin 850 mg 3 times/day and vildagliptin 50 mg twice/day for at least 3 months and who were not adequately controlled with these therapies.


INTERVENTION
Patients were randomized to either placebo or acarbose 100 mg 3 times/day to be added to their metformin-vildagliptin regimen.


MEASUREMENTS AND MAIN RESULTS
Glycemic excursions were assessed by using a continuous glucose-monitoring system for 1 week. Glycemic control was estimated as the mean blood glucose (MBG) level, the area under the glucose concentration-time curve for a glucose level above 70 mg/dl (AUC above 70) or 180 mg/dl (AUC above 180), and the percentage of time that the glucose level was above 70 mg/dl (T above 70) or 180 mg/dl (T above 180). Intraday glycemic variability was assessed by the standard deviation of the blood glucose level, the mean amplitude of glycemic excursions (MAGE), the M value, and continuous overlapping net glycemic action. Day-to-day glycemic variability was assessed as the mean of daily difference (MODD). The MBG level was ~20 mg/dl lower in the acarbose group than in the placebo group (p<0.05), particularly during the postprandial period. The AUC above 70 did not significantly differ between the two groups, whereas the AUC above 180 was ~40% lower in the acarbose group than in the placebo group during the daytime (p<0.01). The T above 180 was significantly higher in the placebo group than in the acarbose group (31% vs 8%, p<0.01. Moreover, the standard deviation and MAGE values were significantly lower in the acarbose group. The MODD value was not significantly changed in either group, and no significant differences were recorded between groups. All adverse events were mild in both groups, with only a significantly greater frequency of flatulence noted in the acarbose group (5% with acarbose vs 0.5% with placebo, p<0.05).


CONCLUSION
The addition of acarbose to metformin and vildagliptin background therapy in patients with inadequately controlled type 2 diabetes decreased intraday glycemic variability, especially postprandial variability, but it was not associated with a significant change in interday glycemic variability.
Low-temperature two-phase micro-channel cooling for high-heat-flux thermal management of defense electronics

For a given heat sink thermal resistance and ambient temperature, the temperature of an electronic device rises fairly linearly with increasing device heat flux. This relationship is especially problematic for defense electronics, where heat dissipation is projected to exceed 1000 W/cm2 in the near future. Direct and indirect low temperature refrigeration cooling facilitate appreciable reduction in the temperature of both coolant and device. This study explores the benefits of cooling the device using direct and indirect refrigeration cooling systems. In the direct cooling system, a micro-channel heat sink serves as an evaporator in a conventional vapor compression cycle using R134a as working fluid. In the indirect cooling system, HFE 7100 is used to cool the heat sink in a primary pumped liquid loop that rejects heat to a secondary refrigeration loop. Two drastically different flow behaviors are observed in these systems. Because of compressor performance constraints, mostly high void fraction two-phase patterns are encountered in the R134a system, dominated by saturated boiling. On the other hand, the indirect refrigeration cooling system facilitates highly subcooled boiling inside the heat sink. Both systems are shown to provide important cooling benefits, but the indirect cooling system is far more effective at dissipating high heat fluxes. Tests with this system yielded cooling heat fluxes as high as 840 W/cm2 without incurring critical heat flux (CHF). Results from both systems are combined to construct an overall map of performance trends relative to mass velocity, subcooling, pressure, and surface tension. Extreme conditions of near-saturated flow, low mass velocity, and low pressure produce 'micro' behavior, where macro-channel flow pattern maps simply fail to apply, instabilities are prominent, and CHF is quite low. One the other hand, systems with high mass velocity, high subcooling, and high pressure are far more stable and yield very high CHF values; two-phase flow in these systems follows the fluid flow and heat transfer behavior as well as the flow pattern maps of macro-channels.
Using 3D virtual environments to facilitate students in constructivist learning

a r t i c l e i n f o Advances in network infrastructure and computing technology have made 3D virtual environment increasingly popular and less costly. Many education institutions have shown interests in its application in teaching and learning activities. In this project, we evaluated how the 3D virtual environment can facilitate students in achieving learning outcomes. To provide students with learning experience in 3D virtual environments, we designed a task which requested students to identify some information security issues in a virtual office setup in Second Life, the most widely adopted 3D virtual environment. In this paper, we report our experience in having students finish the task within the virtual environment in an introductory management information system course. Evaluation on the students' learning experience showed that 3D virtual environments could indeed facilitate students in achieving learning outcomes through constructivist learning. We suggest some recommendations in using 3D virtual environments as an educational platform. Three-dimensional virtual worlds on the Internet have emerged as a popular trend in digital world in the recent decade due to advancement in computing technology and network infrastructure. Virtual worlds such as Second Life, World of Warcraft, Sony Playstation Home and Xbox Live have gained vast popularity and worldwide success. Taking Second Life as an example, according to the statistic provided by Linden Lab — the creator of Second Life, the number of unique users in the Second Life exceeds 750,000 in 2010, and they spent more than 105 million hours in the virtual online world (Linden Lab, 2010). A virtual world is a computer-generated, boundaryless, immersive " game-like " environment often equipped with three-dimensional graphics that resembles the real world [21]. Users can create in-world characters, known as avatars, to represent themselves in the virtual world and participate in different kinds of activities. User can communicate and interact with other users using body language, voice and text messages. The use of multi-channel expressive communications in the virtual world allows users to communicate and convey their emotions through the Internet in a more real-world-like setting [7]. In light of various special and unique features provided by virtual worlds, there is an opportunity of using virtual worlds for educational purpose. Despite the fact that virtual worlds are mainly for entertainment purpose, it has been suggested that they have great potential to become innovative education platform in the future, providing students with real-world-like experiential learning. Universities …
Quantifying and optimizing visualization: An evolutionary computing-based approach

Advances in computing technology and computer graphics engulfed with huge collections of data have introduced new visualization techniques. This gives users many choices of visualization techniques to gain an insight about the dataset at hand. However, selecting the most suitable visualization for a given dataset and the task to be performed on the data is subjective. The work presented here introduces a set of visualization metrics to quantify visualization techniques. Based on a comprehensive literature survey, we propose effectiveness, expressiveness, readability, and interactivity as the visualization metrics. Using these metrics, a framework for optimizing the layout of a visualization technique is also presented. The framework is based on an evolutionary algorithm (EA) which uses treemaps as a case study. The EA starts with a randomly initialized population, where each chromosome of the population represents one complete treemap. Using the genetic operators and the proposed visualization metrics as an objective function, the EA finds the optimum visualization layout. The visualizations that evolved are compared with the state-of-the-art treemap visualization tool through a user study. The user study utilizes benchmark tasks for the evaluation. A comparison is also performed using direct assessment, where internal and external visualization metrics are used. Results are further verified using analysis of variance (ANOVA) test. The results suggest better performance of the proposed metrics and the EA-based framework for optimizing visualization layout. The proposed methodology can also be extended to other visualization techniques. © 2017 Elsevier Inc. All rights reserved.
Comparisons of a Computer-Based Propagation Prediction Tool with Experimental Data Collected in Urban Microcelluar Environments

Engineers designing and installing outdoor and indoor wireless communications systems need effective and practical tools to help them determine base station antenna locations for adequate signal coverage. Computer-based radio propagation prediction tools are now often used in designing these systems. In this paper, we assess the performance of such a propagation tool based on ray-tracing and advanced computational methods. We have compared its predictions with outdoor experimental data collected in Manhattan and Boston (at 900 MHz and 2 GHz). The comparisons show that the computer-based propagation tool can predict signal strengths in these environments with very good accuracy. The prediction errors are within 6 dB in both mean and standard deviation. This shows that simulations, rather than costly field measurements, can lead to accurate determination of the coverage area for a given system design.
Country-wide rapid epidemiological mapping of onchocerciasis (REMO) in Cameroon.

The prevalence of infection in local communities has been used as the basis for the country-wide repartition of onchocerciasis in Cameroon, following the principles for rapid epidemiological mapping of onchocerciasis (REMO) developed by the World Health Organization. The levels of endemicity were evaluated in 349 villages by rapid epidemiological assessment (REA), a method based on the examination of nodules in males aged > or = 20 years. An onchocerciasis map was then drawn from the epidemiological data which had been collected previously, from clinico-parasitological surveys based on the examination of skin snips, and the results of the REA surveys. The REMO surveys allowed the main onchocerciasis foci in Cameroon to be accurately delineated, and several small endemic areas which had never been reported before to be identified. The total 'at risk' population (i.e. those for which ivermectin treatment should be considered as urgent or highly desirable) was estimated by combining the epidemiological results and the demographical data available from an administrative census. Those at risk were estimated to number 3.5 million, representing about 50% of the total rural population in Cameroon.
What do people do with porn ? qualitative research into the consumption , use and experience of pornography and other sexually explicit media

Published version ATTWOOD, F. (2005). What do people do with porn? qualitative research into the consumption, use and experience of pornography and other sexually explicit media. Sexuality and culture, 9 (2), 65-86. one copy of any article(s) in SHURA to facilitate their private study or for non-commercial research. You may not engage in further distribution of the material or use it for any profit-making activities or any commercial gain.
Pilonidal sinus disease. The conservative approach.

OBJECTIVE
To examine the role of conservative, nonexcisional methods in the treatment of pilonidal sinus disease.


DESIGN
Pilot nonrandomized cohort study and follow-up retrospective study.


SETTING AND PATIENTS
In the pilot study, all patients treated for pilonidal sinus disease consecutively over 3 years at an Army community hospital, and in the follow-up study within a closed federal population, all patients admitted with a diagnosis of pilonidal sinus disease over 17 years to an Army medical center.


INTERVENTIONS
Conservative, nonexcisional therapy (meticulous hair control by natal cleft shaving, improved perineal hygiene, and limited lateral incision and drainage for abscess) with initial comparison to excisional procedures.


MAIN OUTCOME MEASURES
Occupied-bed days for conservative vs excisional therapy during a 3-year pilot study and the number of admissions and procedures performed for pilonidal sinus disease at an institution dedicated to conservative treatment alone.


RESULTS
Complete healing over 83 occupied-bed days was demonstrated in 101 consecutive cases managed during 1 year with the conservative method, whereas slower healing over 4760 occupied-bed days was observed in 229 patients undergoing 240 operative procedures during the preceding 2 years. With application of conservative treatment over 17 years, only 23 excisional operations were performed.


CONCLUSIONS
Conservative therapy effectively controls pilonidal sinus disease in the nonoperative outpatient setting while promoting near-normal work status and is preferred over excisional operations.
Interface transparency and the psychosemantics of most

This paper proposes an Interface Transparency Thesis concerning how linguistic meanings are related to the cognitive systems that are used to evaluate sentences for truth/falsity: a declarative sentence S is semantically associated with a canonical procedure for determining whether S is true; while this procedure need not be used as a verification strategy, competent speakers are biased towards strategies that directly reflect canonical specifications of truth conditions. Evidence in favor of this hypothesis comes from a psycholinguistic experiment examining adult judgments concerning ‘Most of the dots are blue’. This sentence is true if and only if the number of blue dots exceeds the number of nonblue dots. But this leaves unsettled, e.g., how the second cardinality is specified for purposes of understanding and/or verification: via the nonblue things, given a restriction to the dots, as in ‘|{x: Dot(x) & ~Blue(x)}|’; via the blue things, given the same restriction, and subtraction from the number of dots, as in ‘|{x: Dot(x)}| ) |{x: Dot(x) & Blue(x)}|’; or in some other way. Psycholinguistic evidence and psychophysical modeling support the second hypothesis.
Community-wide cardiovascular disease prevention programs and health outcomes in a rural county, 1970-2010.

IMPORTANCE
Few comprehensive cardiovascular risk reduction programs, particularly those in rural, low-income communities, have sustained community-wide interventions for more than 10 years and demonstrated the effect of risk factor improvements on reductions in morbidity and mortality.


OBJECTIVE
To document health outcomes associated with an integrated, comprehensive cardiovascular risk reduction program in Franklin County, Maine, a low-income rural community.


DESIGN, SETTING, AND PARTICIPANTS
Forty-year observational study involving residents of Franklin County, Maine, a rural, low-income population of 22,444 in 1970, that used the preceding decade as a baseline and compared Franklin County with other Maine counties and state averages.


INTERVENTIONS
Community-wide programs targeting hypertension, cholesterol, and smoking, as well as diet and physical activity, sponsored by multiple community organizations, including the local hospital and clinicians.


MAIN OUTCOMES AND MEASURES
Resident participation; hypertension and hyperlipidemia detection, treatment, and control; smoking quit rates; hospitalization rates from 1994 through 2006, adjusted for median household income; and mortality rates from 1970 through 2010, adjusted for household income and age.


RESULTS
More than 150,000 individual county resident contacts occurred over 40 years. Over time, as cardiovascular risk factor programs were added, relevant health indicators improved. Hypertension control had an absolute increase of 24.7% (95% CI, 21.6%-27.7%) from 18.3% to 43.0%, from 1975 to 1978; later, elevated cholesterol control had an absolute increase of 28.5% (95% CI, 25.3%-31.6%) from 0.4% to 28.9%, from 1986 to 2010. Smoking quit rates improved from 48.5% to 69.5%, better than state averages (observed - expected [O - E], 11.3%; 95% CI, 5.5%-17.7%; P < .001), 1996-2000; these differences later disappeared when Maine's overall quit rate increased. Franklin County hospitalizations per capita were less than expected for the measured period, 1994-2006 (O - E, -17 discharges/1000 residents; 95% CI -20.1 to -13.9; P < .001). Franklin was the only Maine county with consistently lower adjusted mortality than predicted over the time periods 1970-1989 and 1990-2010 (O - E, -60.4 deaths/100,000; 95% CI, -97.9 to -22.8; P < .001, and -41.6/100,000; 95% CI, -77.3 to -5.8; P = .005, respectively).


CONCLUSIONS AND RELEVANCE
Sustained, community-wide programs targeting cardiovascular risk factors and behavior changes to improve a Maine county's population health were associated with reductions in hospitalization and mortality rates over 40 years, compared with the rest of the state. Further studies are needed to assess the generalizability of such programs to other US county populations, especially rural ones, and to other parts of the world.