LLukas22/scidocs huggingface dataset:
Sentinel node biopsy for high-risk nonmelanoma cutaneous malignancy.

OBJECTIVE
To evaluate the feasibility of sentinel node staging for detection of occult regional lymph node metastasis in high-risk cutaneous nonmelanoma malignancies.


DESIGN
Consecutive clinical case series.


SETTING
Referral university medical center.


PATIENTS
A consecutive sample of patients with a variety of high-risk nonmelanoma cutaneous malignancies without evidence of regional lymph node metastases.


INTERVENTION
Sentinel node biopsies were performed using preoperative lymphoscintigraphy, blue dye, and intraoperative radiolocalization.


MAIN OUTCOME MEASURE
Sensitivity, determined by comparing the results of biopsy specimen evaluation with those of completion lymphadenectomy and/or clinical follow-up.


RESULTS
Twenty-four patients underwent sentinel node biopsy for the staging of 29 nodal basins identified by lymphoscintigraphy. Primary diagnoses were squamous cell carcinoma (n = 17), Merkel cell carcinoma (n = 5), and adenocarcinoma (n = 2). Seven patients (29%) had a tumor-positive sentinel node. Sentinel node biopsy followed by complete lymphadenectomy was performed in 12 patients and sentinel node biopsy alone in 12 patients. Tumor-positive lymph nodes were noted in 8 patients, 7 of whom also had positive sentinel nodes. There was 1 false-positive result (1/8 [12%]), in a patient with recurrent squamous cell carcinoma of the scalp. At a median follow-up of 10 months, no recurrences in a sentinel node-negative basin have been noted. Compared with all information, the sensitivity of sentinel node staging was 88% and the negative predictive value was 0.94.


CONCLUSIONS
Sentinel node biopsy is a minimally invasive staging procedure useful in identifying occult regional lymph node disease in selected patients with nonmelanoma cutaneous malignancies. Further studies to verify these findings and develop formal guidelines are indicated.
Robuste asymptotische Störkompensation mittels beobachterbasierter Störgrößenaufschaltungen

Zusammenfassung: In diesem Beitrag wird ein neues Verfahren zum Entwurf von Störgrößenaufschaltungen mit Störbeobachtern für Strecken mit unbekanntem Störeingriffsort vorgestellt. Die resultierenden Regler sichern die Robustheit der asymptotischen Störkompensation, womit auch bei Auftreten von nicht destabilisierender Modellunsicherheit die stationär vollständige Ausregelung von Störungen gewährleistet ist. Der neue Reglerentwurf ist dual zur Anwendung des internen Modellprinzips mittels des Ansatzes von Davison. Im Gegensatz zu letzterem ermöglicht die neue Entwurfsmethodik jedoch eine sehr einfache und vollständige Vermeidung von Regler-Windup durchEinspeisungdes begrenzten Stellsignals in den Störbeobachter. Ein einfaches Beispiel verdeutlicht die Vorteile des neuen Entwurfsverfahrens.
Waste collection vehicle routing problem with time windows

In this paper, we address a real life waste collection vehicle routing problem with time windows (VRPTW) with consideration of multiple disposal trips and drivers’ lunch breaks. Solomon’s well-known insertion algorithm is extended for the problem. While minimizing the number of vehicles and total traveling time is the major objective of vehicle routing problems in the literature, here we also consider the route compactness and workload balancing of a solution since they are very important aspects in practical applications. In order to improve the route compactness and workload balancing, a capacitated clustering-based waste collection VRPTW algorithm is developed. The proposed algorithms have been successfully implemented and deployed for the real life waste collection problems at Waste Management, Inc. A set of waste collection VRPTW benchmark problems is also presented in this paper. Waste collection problems are frequently considered as arc routing problems without time windows. However, that point of view can be applied only to residential waste collection problems. In the waste collection industry, there are three major areas: commercial waste collection, residential waste collection and roll-on-roll-off. In this paper, we mainly focus on the commercial waste collection problem. The problem can be characterized as a variant of VRPTW since commercial waste collection stops may have time windows. The major variation from a standard VRPTW is due to disposal operations and driver’s lunch break. When a vehicle is full, it needs to go to one of the disposal facilities (landfill or transfer station). Each vehicle can, and typically does, make multiple disposal trips per day. The purpose of this paper is to introduce the waste collection VRPTW, benchmark problem sets, and a solution approach for the problem. The proposed algorithms have been successfully implemented and deployed for the real life waste collection problems of Waste Management, the leading provider of comprehensive waste management services in North America with nearly 26,000 collection and transfer vehicles. 2005 Elsevier Ltd. All rights reserved.
A case-control study on the effect of hormone replacement therapy on ischaemic heart disease.

BACKGROUND
Many clinicians believe that hormone replacement therapy (HRT) protects against coronary heart disease (CHD) in women. However, recent reports have cast some doubt on this because of lack of dose-response or duration-response effects. Since CHD is common in women--about half of all postmenopausal women will get it and about a third of these will die from it--the effect of HRT on CHD is of great public health importance.


AIM
To determine the degree of cardioprotection conferred by HRT, including the effect of duration, time since last issue, the addition of progestogens, route of administration, and dose.


DESIGN
Population-based case-control study.


SETTING
Nine general practices recruited from the Trent Focus Collaborative Research Network.


METHOD
A total of 417 female cases with CHD matched by age and practice to 2435 controls with a case-control ratio of 1:5.8 were studied. The main outcome measure was the odds ratio for CHD calculated by conditional logistic regression adjusted for diabetes, hypertension, body mass index, and smoking.


RESULTS
No evidence was found, either from univariate analysis or multivariate analysis, that use of HRT was associated with reduced risk of CHD (odds ratio = 1.32; 95% confidence interval = 0.93 to 1.87). Indeed, the trend was in the opposite direction. There was no association for different types of HRT (opposed or unopposed) or routes of administration. Similarly, there was no association for current or past use and no effect for dose or duration.


CONCLUSION
This study adds to growing evidence that HRT does not confer cardioprotection. Until there is robust evidence to the contrary, general physicians need to assess risks and benefits of HRT independently of any possible reduction in risk of CHD.
Longitudinal Relationship between Physical Fitness , Walking-related Physical Activity and Fatigue in Children with Cerebral Palsy

Objective: A vicious cycle of decreased physical fitness, early fatigue and low physical activity levels (PAL) is thought to affect children with cerebral palsy (CP). However, the relationship of changes in physical fitness to changes in PAL and fatigue is unclear. The objective of this study was to investigate the relation between changes in physical fitness, walking-related PAL and fatigue in children with CP. Design: A secondary analysis of a randomized controlled trial with measurements at base-line, 6 months (after the intervention period) and 12 months. Participants: 24 children with bilateral and 22 with unilateral spastic CP, aged 7-13, all walking , participated in this study. Main Outcome Measures: Physical fitness was measured by aerobic capacity (VO 2 peak), anaerobic threshold, anaerobic capacity and, isometric and functional muscle strength. Walking-related PAL was measured using an ankle-worn StepWatch TM activity monitor for 1 week. Fatigue was determined with the PedsQL multidimensional fatigue scale. Longitudinal relationships were analyzed by random coefficient analysis (p < 0.05). Results: In children with bilateral CP, all fitness parameters showed a positive, significant relationship to walking-related PAL, whereas no relationship between physical fitness and walking-related PAL was seen in children with unilateral CP. No clinically relevant relationship between physical fitness and fatigue was found. Conclusions: Children with bilateral spastic CP might benefit from an improved physical fitness to increase their PAL or vice versa, while this is not the case in children with unilateral CP. There seems no relationship between physical fitness and self-reported fatigue in all children with CP. Interventions aimed at improving PAL may be differently targeted in children with either bilateral or unilateral CP. 7 Chapter Relations with fitness 119 INTRODUCTION It has been suggested that children with a physical disability may be trapped in a vicious circle of low physical fitness, early fatigue in daily activities and inactivity, resulting in decon-ditioning and a further decrease in physical activity.
Comparative effectiveness and safety of rituximab versus subsequent anti–tumor necrosis factor therapy in patients with rheumatoid arthritis with prior exposure to anti–tumor necrosis factor therapies in the United States Corrona registry

INTRODUCTION
Patients with active rheumatoid arthritis (RA) despite anti-tumor necrosis factor(anti-TNF)agent treatment can switch to either a subsequent anti-TNF agent or a biologic with an alternative mechanism of action, such as rituximab; however, there are limited data available to help physicians decide between these 2 strategies. The objective of this analysis was to examine the effectiveness and safety of rituximab versus a subsequent anti-TNF agent in anti-TNF-experienced patients with RA using clinical practice data from the Corrona registry.


METHODS
Rituximab-naive patients from the Corrona registry with prior exposure to ≥1 anti-TNF agent who initiated rituximab or anti-TNF agents (2/28/2006-10/31/2012) were included. Two cohorts were analyzed: the trimmed population (excluding patients who fell outside the propensity score distribution overlap) and the stratified-matched population (stratified by 1 vs.  ≥2 anti-TNF agents, then matched based on propensity score). The primary effectiveness outcome was achievement of low disease activity (LDA)/remission (Clinical Disease Activity Index ≤10) at 1 year. Secondary outcomes included achievement of modified American College of Rheumatology (mACR) 20/50/70 responses and meaningful improvement (≥0.25) in modified Health Assessment Questionnaire (mHAQ) score at 1 year. New cardiovascular, infectious and cancer events were reported.


RESULTS
Estimates for LDA/remission, mACR response and mHAQ improvement were consistently better for rituximab than for anti-TNF agent users in adjusted analyses. The odds ratio for likelihood of LDA/remission in rituximab versus anti-TNF patients was 1.35 (95% CI, 0.95-1.91) in the trimmed population and 1.54 (95% CI, 1.01-2.35) in the stratified-matched population. Rituximab patients were significantly more likely than anti-TNF patients to achieve mACR20/50 and mHAQ improvement in the trimmed population and mACR20 and mHAQ in the stratified-matched population. The rate of new adverse events per 100 patient-years was similar between groups.


CONCLUSIONS
In anti-TNF-experienced patients with RA, rituximab was associated with an increased likelihood of achieving LDA/remission, mACR response and physical function improvement, with a comparable safety profile, versus subsequent anti-TNF agent users.


TRIAL REGISTRATION
ClinicalTrials.gov NCT01402661 . Registered 25 July 2011.
The influence of age on stroke outcome. The Copenhagen Stroke Study.

BACKGROUND AND PURPOSE
This study was undertaken to elucidate whether and how age influences stroke outcome.


METHODS
This prospective and community-based study comprised 515 consecutive acute stroke patients. Computed tomographic scan was performed in 79% of patients. Activities of daily living (ADL) and neurological status were assessed weekly during hospital stay using the Barthel Index (BI) and the Scandinavian Stroke Scale (SSS), respectively. Information regarding social condition and comorbidity before stroke was also registered. A multiple regression model was used to analyze the independent influence of age on stroke outcome.


RESULTS
Age was not related to the type of stroke lesion or infarct size. However, age independently influenced initial BI (-4 points per 10 years, P < .01), initial SSS (-2 points per 10 years, P = .01), and discharge BI (-3 points per 10 years, P < .01). No independent influence of age was found regarding mortality within 3 months, discharge SSS, length of hospital stay, and discharge placement. ADL improvement was influenced independently by age (-3 points per 10 years, P < .01), whereas age had no influence on neurological improvement or on speed of recovery.


CONCLUSIONS
Age independently influences stroke outcome selectively in ADL-related aspects (BI) but not in neurological aspects (SSS), suggesting a poorer compensatory ability in elderly stroke patients. Therefore, rehabilitation of elderly stroke patients should be focused more on ADL and compensation rather than on the recovery of neurological status, and age itself should not be a selection criterion for rehabilitation.
EASL-EORTC clinical practice guidelines: management of hepatocellular carcinoma.

EASL–EORTC Clinical Practice Guidelines (CPG) on the management of hepatocellular carcinoma (HCC) define the use of surveillance, diagnosis, and therapeutic strategies recommended for patients with this type of cancer. This is the first European joint effort by the European Association for the Study of the Liver (EASL) and the European Organization for Research and Treatment of Cancer (EORTC) to provide common guidelines for the management of hepatocellular carcinoma. These guidelines update the recommendations reported by the EASL panel of experts in HCC published in 2001 [1]. Several clinical and scientific advances have occurred during the past decade and, thus, a modern version of the document is urgently needed. The purpose of this document is to assist physicians, patients, health-care providers, and health-policy makers from Europe and worldwide in the decision-making process according to evidencebased data. Users of these guidelines should be aware that the recommendations are intended to guide clinical practice in circumstances where all possible resources and therapies are available. Thus, they should adapt the recommendations to their local regulations and/or team capacities, infrastructure, and cost– benefit strategies. Finally, this document sets out some recommendations that should be instrumental in advancing the research and knowledge of this disease and ultimately contribute to improve patient care. The EASL–EORTC CPG on the management of hepatocellular carcinoma provide recommendations based on the level of evi-
Web data mining trends and techniques

Web Services and Web-based applications are growing at an exponential rate. This is generating a huge amount of Web data having its own peculiar characteristics. This in turn makes research in the area of Web Data Mining more challenging. Web Data Mining is an application of Data Mining which deals with extraction of interesting or hidden knowledge from the World Wide Web. Web Data Mining can be categorized into: Web Content Mining, Web Structure Mining, and Web Usage Mining. In this paper, we survey the state-of-the-art in each of these three types of Web Data Mining thereby describing a variety of specific trends and techniques. We also discuss different challenges and issues pertaining to Web Data Mining research.
Safety and Tolerability of the Treatment of Youth-Onset Type 2 Diabetes

OBJECTIVE
Data related to the safety and tolerability of treatments for pediatric type 2 diabetes are limited. The TODAY clinical trial assessed severe adverse events (SAEs) and targeted nonsevere adverse events (AEs) before and after treatment failure, which was the primary outcome (PO).


RESEARCH DESIGN AND METHODS
Obese 10- to 17-year-olds (N = 699) with type 2 diabetes for <2 years and hemoglobin A1c (A1C) ≤ 8% on metformin monotherapy were randomized to one of three treatments: metformin, metformin plus rosiglitazone (M + R), or metformin plus lifestyle program (M + L). Participants were followed for 2-6.5 years.


RESULTS
Gastrointestinal (GI) disturbance was the most common AE (41%) and was lower in the M + R group (P = 0.018). Other common AEs included anemia (20% before PO, 14% after PO), abnormal liver transaminases (16, 15%), excessive weight gain (7, 9%), and psychological events (10, 18%); the AEs were similar across treatments. Permanent medication reductions/discontinuations occurred most often because of abnormal liver transaminases and were lowest in the M + R group (P = 0.005). Treatment-emergent SAEs were uncommon and similar across treatments. Most (98%) were unrelated or unlikely related to the study intervention. There were no deaths and only 18 targeted SAEs (diabetic ketoacidosis, n = 12; severe hypoglycemia, n = 5; lactic acidosis, n = 1). There were 62 pregnancies occurring in 45 participants, and 6 infants had congenital anomalies.


CONCLUSIONS
The TODAY study represents extensive experience managing type 2 diabetes in youth and found that the three treatment approaches were generally safe and well tolerated. Adding rosiglitazone to metformin may reduce GI side effects and hepatotoxicity.
Cryptographic Currencies Crash Course (C4): Tutorial

”Bitcoin is a rare case where practice seems to be ahead of theory.” Joseph Bonneau et al. [15] This tutorial aims to further close the gap between IT security research and the area of cryptographic currencies and block chains. We will describe and refer to Bitcoin as an example throughout the tutorial, as it is the most prominent representative of a such a system. It also is a good reference to discuss the underlying block chain mechanics which are the foundation of various altcoins (e.g. Namecoin) and other derived systems. In this tutorial, the topic of cryptographic currencies is solely addressed from a technical IT security point-of-view. Therefore we do not cover any legal, sociological, financial and economical aspects. The tutorial is designed for participants with a solid IT security background but will not assume any prior knowledge on cryptographic currencies. Thus, we will quickly advance our discussion into core aspects of this field.
Maintaining hepatocyte differentiation in vitro through co-culture with hepatic stellate cells

Primary hepatocytes lose their differentiated functions rapidly when in culture. Our aim was to maintain the differentiated status of hepatocytes in vitro by means of vital hepatic stellate cells (HSCs), their soluble and particulate factors and lipid extracts. Hepatocytes were placed into collagen-coated culture dishes in the presence of HSCs at different ages of pre-culture, with or without direct cell to cell contacts, at different cell ratios and in monoculture with cellular HSC components in place of vital cells. Changes in morphology and enhancement of phosphoenolpyruvate carboxykinase (PCK) activity by glucagon were used to determine the differentiated status of hepatocytes in 2d-short-term culture. HSCs proved able to maintain the differentiated function of hepatocytes in co-culture either by direct cell contacts or via factors derived from HSC-conditioned medium. In comparison, however, without cellular contact to hepatocytes five to ten times as many HSCs were necessary to increase the PCK activity to the same degree as in the presence of intercellular contacts. Whereas stimulation in the presence of HSC/hepatocyte contacts was independent of HSC culture age only quiescent, resting HSCs (precultured for 1–2 d) were able to stimulate hepatocytes significantly via soluble factors. Culturing of hepatocytes with a lipid extract or a particulate fraction from HSCs clearly displayed a very strong beneficial effect on enzyme activity and morphology. HSCs maintain hepatocyte function and structure through preferentially cell-bound signalling and transfer of lipids.
The role of abdominal radiography in the evaluation of the nontrauma emergency patient.

PURPOSE
To characterize the utility of abdominal radiography for nontrauma emergency patients in a single-institution setting.


MATERIALS AND METHODS
Following approval from the Director of Professional Services, a retrospective review of radiography and of patient records was conducted for patients who presented to a nontrauma emergency department over a period of 6 months and who were imaged by using abdominal radiography. Only the first radiograph per patient was used for analysis. The interpretations were sorted as normal, nonspecific, or abnormal. The patients' medical records were reviewed to determine whether further imaging was performed (computed tomography, ultrasonography, or upper gastrointestinal imaging) and results were compared with abdominal radiography. Chart reviews were conducted to identify patients in whom abdominal radiography alone influenced treatment.


RESULTS
In 874 patients, interpretation of abdominal radiography was normal in 34% (n = 300), nonspecific in 46% (n = 406), and abnormal in 19% (n = 168). Further imaging was performed for 50% (436) of all patients. Of 300 patients whose abdominal radiography results were normal, 42% (n = 125) had follow-up imaging; 72% (n = 90) of these showed abnormal, 78% (165 of 212) showed nonspecific, and 87% (86 of 99) showed abnormal findings. Of 438 patients who did not undergo follow-up imaging, 75% (n = 327) were discharged. For all indications other than catheter placement, abdominal radiography helped confirm the suspected diagnosis in 2%-8% of cases. In 37 (4%) of 874 patients, abdominal radiography was possibly helpful in changing patient treatment without a follow-up study.


CONCLUSION
Abdominal radiography is often requested; however, its results contribute to patient treatment in a small percentage of cases. With the exception of catheter placement, if a patient requires investigation beyond clinical history, physical examination, and lab results, the emergency physician should be encouraged to request more definitive imaging.
Precision medicine--personalized, problematic, and promising.

The growing recognition of precision medicine by clinicians, health systems, and the pharmaceutical industry, as well as by patients and policymakers,1 reflects the emergence of a field that is accelerating rapidly and will leave a major imprint on the practice of medicine. In this article, we summarize the forces accelerating precision medicine, the challenges to its implementation, and the implications for clinical practice.