LLukas22/scidocs huggingface dataset:
Treatment of diabetic nephropathy with Tripterygium wilfordii Hook F extract: a prospective, randomized, controlled clinical trial

Diabetic nephropathy (DN) is the most common cause of end-stage renal failure. Although angiotensin II receptor blockers (ARBs) can be used to attenuate proteinuria in DN patients, their efficacy remains limited. This clinical trial aimed to evaluate the efficacy of Tripterygium wilfordii Hook F (TwHF) extract in the treatment of type 2 diabetes mellitus (DM)-induced nephropathy. A total of 65 DN patients with proteinuria levels ≥ 2.5 g/24 h and serum creatinine levels < 3 mg/dl were enrolled in this six-month, prospective, randomized, controlled study. The patients were randomized into treatment groups that received either 120 mg of TwHF extract per day for three months, followed by 60 mg per day for three more months, or 160 mg of valsartan daily for six months. The urinary protein and estimated glomerular filtration (eGFR) level were measured at one, three, and six months after the commencement of treatment. The primary measure of treatment efficacy was a reduction in the 24-h urine protein level between baseline and the end of the study, and the secondary measure of treatment efficacy was a reduction in the eGFR value. At the end of the treatment period, the mean urine protein level in the TwHF group was dramatically decreased (4.99 ± 2.25 g/24 h vs 2.99 ± 1.81 g/24 h, p < 0.01), with decreases at one, three, and six months of 32.9%, 38.8%, and 34.3%, respectively. In contrast, the proteinuria in the valsartan group was not significantly attenuated, and the decreases in urine protein levels at treatment months one, three, and six were 1.05%, 10.1%, and -11.7%, respectively. The mean decrease in eGFR in the valsartan group was greater than that in the TwHF group (26.4% vs. 13.7%, respectively; p =0.067). TwHF extract can reduce the urine protein level of DN patients and represents a novel, potentially effective, and safe drug for the treatment of DN patients with proteinuria. ClinicalTrials.gov: NCT00518362
National Institutes of Health Stroke Scale score is poorly predictive of proximal occlusion in acute cerebral ischemia.

BACKGROUND AND PURPOSE
Multimodal imaging is gaining an important role in acute stroke. The benefit of obtaining additional clinically relevant information must be weighed against the detriment of increased cost, delaying time to treatment, and adverse events such as contrast-induced nephropathy. Use of National Institutes of Health Stroke Scale (NIHSS) score to predict a proximal arterial occlusion (PO) is suggested by several case series as a viable method of selecting cases appropriate for multimodal imaging.


METHODS
Six hundred ninety-nine patients enrolled in a prospective cohort study involving CT angiographic imaging in acute stroke were dichotomized according to the presence of a PO, including a subgroup of 177 subjects with middle cerebral artery M1 occlusion.


RESULTS
The median NIHSS score of patients found to have a PO was higher than the overall median (9 versus 5, P<0.0001). The median NIHSS score of patients with middle cerebral artery M1 occlusion was 14. NIHSS score > or =10 had 81% positive predictive value for PO but only 48% sensitivity with the majority of subjects with PO presenting with lower NIHSS scores. All patients with NIHSS score > or =2 would need to undergo angiographic imaging to detect 90% of PO.


CONCLUSIONS
High NIHSS score correlates with the presence of a proximal arterial occlusion in patients presenting with acute cerebral ischemia. No NIHSS score threshold can be applied to select a subgroup of patients for angiographic imaging without failing to capture the majority of cases with clinically important occlusive lesions. The finding of minimal clinical deficits should not deter urgent angiographic imaging in otherwise appropriate patients suspected of acute stroke.
The evaluation of a fall management program in a nursing home population.

PURPOSE OF THE STUDY
This study evaluates a nursing home Fall Management program to see if residents' mobility increased and injurious falls decreased.


DESIGN AND METHODS
Administrative health care use and fall occurrence report data were analyzed from 2 rural health regions in Manitoba, Canada, from June 1, 2003 to March 31, 2008. A quasiexperimental, pre-post, comparison group design was used to compare rates of three outcomes, falls, injurious falls, and falls resulting in hospitalization, by RHA (program vs nonprogram nursing homes) and period (preprogram vs postprogram). Data collectors entered occurrence report information into spreadsheets. This was supplemented with administrative health care use data.


RESULTS
The program appears to have benefitted residents-falls trended upward, injurious falls remained stable, and hospitalized falls decreased significantly (0.036-0.021 per person-year [ppy]; p = .043). Compared with nonprogram residents in the postperiod, both groups had the same fall rate, but program residents had significantly fewer injurious falls (0.596-0.746 ppy; p = .02) and hospitalized falls (0.02-0.041 ppy; p = .023).


IMPLICATIONS
These results are among a small body of literature showing that Fall Management was associated with improved outcomes in program nursing homes from pre- to postperiod and compared with nonprogram nursing homes. This research provides some support for the benefits of being proactive and implementing injury prevention strategies universally and pre-emptively before a resident falls, helping to minimize injuries while keeping residents mobile and active. Larger scale research is needed to identify the true effectiveness of the Fall Management program and generalizability of results.
Fast and robust wavelet-based dynamic range compression with local contrast enhancement

In this paper, a new wavelet-based dynamic range compression algorithm is proposed to improve the visual quality of digital images captured in the high dynamic range scenes with non-uniform lighting conditions. Wavelet transform is used especially for dimension reduction such that a dynamic range compression with local contrast enhancement algorithm is applied only to the approximation coefficients which are obtained by low-pass filtering and down-sampling the original intensity image. The normalized approximation coefficients are transformed using a hyperbolic sine curve and the contrast enhancement is realized by tuning the magnitude of the each coefficient with respect to surrounding coefficients. The transformed coefficients are then de-normalized to their original range. The detail coefficients are also modified to prevent the edge deformation. The inverse wavelet transform is carried out resulting in a low dynamic range and contrast enhanced intensity image. A color restoration process based on relationship between spectral bands and the luminance of the original image is applied to convert the enhanced intensity image back to a color image.
A Deeper Look at FFT and Winograd Convolutions

Since convolutional layers are computationally expensive and dominate the total execution time of modern deep ConvNets [13, 16, 18, 19], many efforts have been made to improve the performance of the convolutional primitives for CPUs [1, 7, 20, 25, 27], GPUs [4, 8, 15, 21] or both [26]. Initially, several approaches using FFT–based convolutions were proposed [15, 21, 25, 26]. Recent work by Lavin et al. on Winograd–based convolutions [14] demonstrated a great speedup, which shifted the focus from FFT–based to Winograd–based implementations, as it became widely accepted that the Winograd–based approach provides greater reduction in the number of operations required by the algorithm, especially for small kernels (e.g. 3 × 3). A well optimized manycore CPU implementation [3, 12] of the Winograd approach can improve the performances by more than 3X. The main reduction in operations in the Winograd method, compared to FFT, comes from the fact that it works with real numbers. However, due to its numerical instability, the Winograd method can only use small tile (transform) sizes [7, 14, 22], which result in a larger amount of required data movement to and from memory. In contrast, the FFT–based method does not suffer from such instability, thus larger tile sizes can be used, which can partially reduce the number of required operations and greatly reduce the amount of data movements; these savings can, in certain cases, offset the increase in the number of operations due to complex arithmetic. These observations raise the question, under what conditions the Winograd-based approach performs better than the FFT– based approach and vice versa, and how to compare the two approaches.
The effect of childbirth on hiatal dimensions.

OBJECTIVE
To estimate changes in levator hiatal dimensions after childbirth in women with and without ultrasonographically visible morphological abnormalities of the levator ani and to correlate those changes with delivery mode.


METHODS
A total of 296 nulliparous women were recruited. They were examined with four-dimensional translabial ultrasonography at 36-38 weeks of gestation and at 3-4 months postpartum. Peripartal changes in levator hiatal dimensions were correlated with delivery data.


RESULTS
Mean postpartum follow-up was 5.3 months (median 4.1, interquartile range 3.7 to 5.1). Of 212 women who returned for follow-up, 101 had had normal vaginal deliveries (48%), 31 vacuum/forceps (15%), and 80 cesarean deliveries (38%). After cesarean delivery, there was a decrease in the mean hiatal area on Valsalva maneuver of 8.5% (P=.005). Vaginal delivery without avulsion was associated with an increase of 6% (P=.035). In women with avulsion injury, hiatal area increased by 28% (P=.002). Mean postpartum hiatal area on Valsalva was 25.46 cm after vaginal delivery with avulsion, 22.61 cm without avulsion, and 19.13 cm in the cesarean delivery group. After avulsion, hiatal area on contraction also increased significantly (P<.001).


CONCLUSION
Vaginal childbirth results in enlargement of the levator hiatus, especially after an avulsion. However, even without macroscopic levator trauma, there may be increased distensibility of the hiatus, which may be another mechanism leading to enlargement of the hiatus and pelvic organ prolapse.


LEVEL OF EVIDENCE
II.
Comparison of quantitative and semiquantitative dynamic contrast-enhanced MRI with respect to their correlation to delayed gadolinium-enhanced MRI of the cartilage in patients with early rheumatoid arthritis.

OBJECTIVE
The objective of this study was to investigate the correlation between semiquantitative and quantitative dynamic contrast-enhanced (DCE) parameters with delayed gadolinium-enhanced magnetic resonance imaging (MRI) of the cartilage (dGEMRIC).


METHODS
Fifteen patients with early rheumatoid arthritis (RA) from the ArthroMark cohort were investigated at a 3-T MRI scanner. The metacarpophalangeal (MCP) joint of the index finger was examined with DCE-MRI and dGEMRIC. Semiquantitative and quantitative DCE perfusion parameters were calculated. The RA MRI score of the second MCP joint and the joint space width were measured.


RESULTS
Significant correlations were noted between both semiquantitative and quantitative DCE parameters and the RA MRI score of the second MCP joint. There was a significant negative correlation between DCE parameters and dGEMRIC. No association between joint space width and DCE parameters was observed.


CONCLUSIONS
Semiquantitative and quantitative analyses of perfusion are applicable to show that cartilage damage correlates with the inflammation activity despite the absence of joint space narrowing.
Twenty years experiences of interprofessional education in Linkoping--ground-breaking and sustainable.

A pioneering and ground-breaking effort to organize interprofessional education (IPE) was initiated in 1986 at the Faculty of Health Sciences at Linkoping University in Sweden. The so-called "Linkoping IPE model" has now yielded practical experience and development of curricula for over 20 years. The basic idea of this model is that it is favorable for the development of students' own professional identity to meet other health and social professions already into their undergraduate studies. Interprofessional learning is a process over time that requires several integrated stages to gain interprofessional competence, i.e., the skills required to work together interprofessionally in practice. We believe that defined IPE modules early in the curriculum combined with student-training ward placement as the final module is an encouraging example of how to implement undergraduate IPE among health science students. It is strengthened by problem based learning (PBL) in small groups and student-centered learning. Based on these experiences, this paper aims to contribute to the discussion on how to implement and achieve the aims of IPE and to keep it sustainable. It is not a description of "how to do it" but rather a summarizing of our experiences for successful performance of IPE. The article presents how the Linkoping model was developed, the outcomes, experiences and some outlines for future challenges.
Kangaroo mother care--an alternative to conventional care.

The term kangaroo mother care (KMC) is derived from practical similarities to marsupial care-giving, i.e., the premature infant is kept warm in the maternal pouch and close to the breasts for unlimited feeding. It is a gentle and effective method that avoids agitation routinely experienced in a busy ward with preterm infants. An important main stay of kangaroo mother care is breastfeeding encouragement. Observational studies have shown reduction in mortality after institution of KMC. Preterm babies exposed to skin to skin contact showed a better mental development and better results in motor tests. It also improves thermal care. All stable LBW babies are candidate for KMC. Often this is desirable, until the baby's gestation reaches term or the weight is around 2500 g. The mother and family members are encouraged to take care of the baby in KMC and should be counseled to come for follow-up visits regularly.
Change in heart rate variability in relation to a significant ST-event associates with newborn metabolic acidosis.

OBJECTIVE
To find whether low-to-high frequency (LF/HF) ratio of fetal heart rate (FHR) variability changes in relation to a significant ST-event during delivery, and if the change is predictive of metabolic acidosis of the newborn.


DESIGN
A case-control study.


SETTING
Data from a multicentre project.


SUBJECTS
Acidotic and control fetuses with abnormal cardiotocography together with a ST-event in fetal electrocardiogram (ECG).


METHODS
We studied intrapartum FHR variability with spectral analysis from 34 fetuses with a significant ST-event in the fetal ECG. LF/HF ratio of FHR variability was measured within a period of 1 hour before and 1 hour after a significant ST-event. Sensitivity and specificity of the change in LF/HF ratio of FHR variability in prediction of metabolic acidosis (pH < or = 7.05 and base deficit value > 12.0 mmol/l) of the newborn were described by means of the receiver operating characteristic curve.


MAIN OUTCOME MEASURES
Change in LF/HF ratio of FHR in relation to a significant ST-event.


RESULTS
We found that a relative change in LF/HF ratio greater than 30% in relation to a significant ST-event predicted cord arterial metabolic acidosis with a sensitivity of 89% (95% CI 68-100%) and specificity of 80% (95% CI 64-96%).


CONCLUSIONS
Relative changes in LF/HF ratio of FHR variability in relation to a significant ST-event are more pronounced in fetuses born with metabolic acidosis.
Priming Immunization with DNA Augments Immunogenicity of Recombinant Adenoviral Vectors for Both HIV-1 Specific Antibody and T-Cell Responses

BACKGROUND
Induction of HIV-1-specific T-cell responses relevant to diverse subtypes is a major goal of HIV vaccine development. Prime-boost regimens using heterologous gene-based vaccine vectors have induced potent, polyfunctional T cell responses in preclinical studies.


METHODS
The first opportunity to evaluate the immunogenicity of DNA priming followed by recombinant adenovirus serotype 5 (rAd5) boosting was as open-label rollover trials in subjects who had been enrolled in prior studies of HIV-1 specific DNA vaccines. All subjects underwent apheresis before and after rAd5 boosting to characterize in depth the T cell and antibody response induced by the heterologous DNA/rAd5 prime-boost combination.


RESULTS
rAd5 boosting was well-tolerated with no serious adverse events. Compared to DNA or rAd5 vaccine alone, sequential DNA/rAd5 administration induced 7-fold higher magnitude Env-biased HIV-1-specific CD8(+) T-cell responses and 100-fold greater antibody titers measured by ELISA. There was no significant neutralizing antibody activity against primary isolates. Vaccine-elicited CD4(+) and CD8(+) T-cells expressed multiple functions and were predominantly long-term (CD127(+)) central or effector memory T cells and that persisted in blood for >6 months. Epitopes mapped in Gag and Env demonstrated partial cross-clade recognition.


CONCLUSION
Heterologous prime-boost using vector-based gene delivery of vaccine antigens is a potent immunization strategy for inducing both antibody and T-cell responses.


TRIAL REGISTRATION
ClinicalTrials.gov NCT00102089, NCT00108654.
Summary for leadership and management in software architecture (lMSA 2008)

Software architecture, in education and practice, is primarily concerned with technical issues associated with the quality of software architecture and design. However, as project size increases, leadership, management skills, and the organizational context of the architect become more important, to the point where the non-technical duties of the project architect can "make or break" a project. This workshop is focused on understanding these non-technical duties.
A Beam Scanning Leaky-Wave Slot Antenna With Enhanced Scanning Angle Range and Flat Gain Characteristic Using Composite Phase-Shifting Transmission Line

In this communication, a planar beam scanning substrate integrated waveguide (SIW) slot leaky-wave antenna (LWA) is proposed for enhancing scanning range and gain flatness using a modified composite right/left-handed transmission line (CRLH TL) structure. The curved phase-shifting characteristics of the modified CRLH TLs positioned between the radiation slots are adopted to increase the scanning range of the proposed antenna. Compared with conventional SIW CRLH LWAs, this antenna offers less gain variation due to its better balance between left-handed and right-handed bands and less sensitivity to its geometrical dimensions. The proposed antenna operating at the center frequency of 25.45 GHz is designed and experimentally verified for an automotive collision avoidance radar. The results show that the antenna achieves a twofold improvement in beam scanning ability with identical overall size.
Knowledge-based platform for eGovernment agents: A Web-based solution using semantic technologies

Currently eGovernment is clearly gaining momentum in our society. Many solutions and projects are being developed and, among the large amount of used tools, semantics is called to play a paramount role. In order to overcome issues related to cooperation, interoperability and accessibility of services in the domain, semantics can be used to improve in-use solutions and to develop new mechanisms able to support the development of expert and intelligent systems in eGovernment. This paper addresses a semantic based philosophy to tackle a holistic platform for the domain taking into account the knowledge of the administrations. By means of intelligent documents and Life Events, as they are presented in the paper, it is possible to build up a intelligent platform to host eGovernment services, as proved by the successful study case Tecut portal. 2009 Elsevier Ltd. All rights reserved.
Analysis of operative versus nonoperative treatment of displaced scapular fractures.

BACKGROUND
Operative indications for displaced scapular fractures have been controversial and inconsistent. Surgeons have been dissuaded to operate on these uncommon fractures because of the complex anatomy, approaches, and fracture patterns. It is unclear whether return to work, pain, or complications differ in patients with scapular fractures treated nonoperatively or operatively.


QUESTIONS/PURPOSES
We therefore assessed differences in rates of union, range of motion, ability to return to work, pain, and complications between operatively and nonoperatively treated scapular body and neck fractures. PATIENTS AND METHODS: We retrospectively reviewed 182 patients with 182 scapular fractures treated between 2002 and 2005. Of the 182 fractures, 31 were treated with open reduction internal fixation and matched by age, occupation, and gender to 31 patients treated nonoperatively. The proportions of AO/OTA fracture types were similar in the two groups. The mean displacement, shortening, and angulation were greater in the operative group as compared with the nonoperative group. All patients were followed until healing or discharge from care (average, 1.5 years; range, 14-32 months). We assessed complications, return to work, and radiographic healing.


RESULTS
All fractures healed. We found no differences in return to work, pain, or complications.


CONCLUSIONS
Our observations suggest operative treatment of displaced scapula fractures results in similar healing, return to work, pain, and complications as nonoperative treatment. We do not recommend operating on any scapular neck or body fractures displaced less than 20 mm.


LEVEL OF EVIDENCE
Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
‘HeART of Stroke (HoS)’, a community-based Arts for Health group intervention to support self-confidence and psychological well-being following a stroke: protocol for a randomised controlled feasibility study

INTRODUCTION
Over 152,000 people in the UK have strokes annually and a third experience residual disability. Low mood also affects a third of stroke survivors; yet psychological support is poor. While Arts for Health interventions have been shown to improve well-being in people with mild-to-moderate depression post-stroke, their role in helping people regain sense of self, well-being and confidence has yet to be evaluated. The main aim of this study is to explore the feasibility of conducting a pragmatic multicentre randomised controlled trial to assess the effectiveness and cost-effectiveness of an Arts for Health group intervention ('HeART of Stroke' (HoS)) for stroke survivors. HoS is a 10-session artist-facilitated group intervention held in the community over 14 weeks. It offers a non-judgemental, supportive environment for people to explore sense of self, potentially enhancing well-being and confidence.


METHODS AND ANALYSIS
Sixty-four people, up to 2 years post-stroke, recruited via secondary care research staff or community stroke/rehabilitation teams in two UK centres will be randomised to either HoS plus usual care or usual care only. Self-reported outcomes, measured at baseline and approximately 5 months postrandomisation, will include stroke-related, well-being, mood, self-esteem, quality of life and process measures. Analyses will focus on estimating key feasibility parameters (eg, rates of recruitment, retention, intervention attendance). We will develop outcome and resource use data collection methods to inform an effectiveness and cost-effectiveness analysis in the future trial. Interviews, with a sample of participants, will explore the acceptability of the intervention and study processes, as well as experiences of the HoS group.


ETHICS AND DISSEMINATION
National Health Service (NHS), Research and Development and University ethical approvals have been obtained. Two peer-reviewed journal publications are planned plus one service user led publication. Findings will be disseminated at key national conferences, local stakeholder events and via institutional websites.


TRIAL REGISTRATION NUMBER
ISRCTN99728983.