LLukas22/scidocs huggingface dataset:
Increase in end-systolic volume after exercise independently predicts mortality in patients with coronary heart disease: data from the Heart and Soul Study.

AIMS
The predictive value of changes in global left ventricular (LV) size after exercise has not been studied. Left ventricular end-systolic volume (ESV) is a relatively load-independent echocardiographic marker of contractility that is easily measured. We investigated the role of the change in ESV at rest and after peak exercise on mortality among patients with stable coronary heart disease (CHD).


METHODS AND RESULTS
We performed exercise treadmill testing with stress echocardiography in 934 ambulatory subjects with CHD. End-systolic volume was measured immediately before and after exercise using 2D echocardiography. We defined ESV reversal as an increase in ESV after exercise, and we examined the association of ESV reversal with all-cause mortality during a median follow-up of 3.92 years. Of the 934 participants, 199 (21%) had ESV reversal. At the end of follow-up, mortality was higher among participants with ESV reversal than those without (26 vs. 11%; P < 0.001). After adjustment for clinical covariates, ESV reversal remained predictive of all-cause mortality (HR 2.0; 95% CI 1.4-2.9; P = 0.001). The association of ESV reversal with mortality also persisted after adjustment for exercise-induced wall-motion abnormalities (HR 1.7; 95% CI 1.1-2.3, P = 0.006). To determine if the effect of ESV reversal was independent from other echocardiographic measurements, we created a separate model adjusting for resting LV ejection fraction, ESV, end-diastolic volume, and LV mass. End-systolic volume reversal was the only significant predictor of mortality in this model (HR 2.1, 95% CI 1.4-3.0, P < 0.001).


CONCLUSION
End-systolic volume reversal is a novel parameter that independently predicts mortality in patients with CHD undergoing exercise treadmill echocardiography, even after adjustment for a wide range of clinical, echocardiographic, and treadmill exercise variables. Because measurement of ESV is simple, reproducible, and requires no additional imaging views, identification of ESV reversal during exercise echocardiography can provide useful complementary information for risk stratification.
The impact of dermatology consultation on diagnostic accuracy and antibiotic use among patients with suspected cellulitis seen at outpatient internal medicine offices: a randomized clinical trial.

IMPORTANCE
Cellulitis is a common and costly problem, often diagnosed in the outpatient setting. Many cutaneous conditions may clinically mimic cellulitis, but little research has been done to assess the magnitude of the problem.


OBJECTIVE
To determine if obtaining dermatology consultations in the outpatient primary care setting could assist in the diagnosis of pseudocellulitic conditions and reduce the rate of unnecessary antibiotic use.


DESIGN, SETTING, AND PARTICIPANTS
Nonblinded randomized clinical trial of competent adults who were diagnosed as having cellulitis by their primary care physicians (PCPs), conducted at outpatient internal medical primary care offices affiliated with a large academic medical center.


INTERVENTIONS
Outpatient dermatology consultation.


MAIN OUTCOMES AND MEASURES
Primary outcomes were final diagnosis, antibiotic use, and need for hospitalization.


RESULTS
A total of 29 patients (12 male and 17 female) were enrolled for participation in this trial. Nine patients were randomized to continue with PCP management (control group), and 20 patients were randomized to receive a dermatology consultation (treatment group). Of the 20 patients in the dermatology consultation group, 2 (10%) were diagnosed as having cellulitis. In the control group, all 9 patients were diagnosed as having cellulitis by PCPs, but dermatologist evaluation determined that 6 (67%) of these patients had a psuedocellulitis rather than true infection. All 9 patients (100%) in the control group were treated for cellulitis with antibiotics vs 2 patients (10%) in the treatment group (P < .001). One patient in the control group was hospitalized. All patients in the treatment group reported improvement of their cutaneous condition at the 1-week follow-up examination.


CONCLUSIONS AND RELEVANCE
Dermatology consultation in the primary care setting improves the diagnostic accuracy of suspected cellulitis and decreases unnecessary antibiotic use in patients with pseudocellulitic conditions. Obtaining an outpatient dermatology consultation may be a cost-effective strategy that improves quality of care.


TRIAL REGISTRATION
clinicaltrials.gov Identifier:NCT01795092.
Discontinuation of anticytomegalovirus therapy in patients with HIV infection and cytomegalovirus retinitis.

CONTEXT
Persons with cytomegalovirus (CMV) retinitis and acquired immunodeficiency syndrome (AIDS) have required lifelong anti-CMV therapy to prevent the progression of retinal disease and subsequent loss of vision.


OBJECTIVE
To determine whether patients who were taking highly active antiretroviral therapy (HAART) and who had stable CMV retinitis could safely discontinue anti-CMV therapy without reactivation of their retinitis or increase in human immunodeficiency virus (HIV) viral load.


DESIGN
Prospective nonrandomized interventional trial performed from July 1997 to August 1999.


SETTING
Clinical Center of the National Institutes of Health, Bethesda, Md.


PATIENTS
Fourteen patients with stable CMV retinitis and HIV infection and CD4+ cell counts higher than 0.1 5 x 10(9)/L and being treated with systemic anti-CMV medications and HAART.


INTERVENTIONS
Discontinuation of specific anti-CMV therapy.


MAIN OUTCOME MEASURES
Reactivation of CMV retinitis, development of extraocular CMV infection, detection of CMV in blood and urine, HIV burden, immunologic function, quality of life, morbidity, and mortality.


RESULTS
Twelve (89.7%) of 14 patients had evidence of immune recovery uveitis before anti-CMV drugs were discontinued. No patient had reactivation of CMV retinitis or development of extraocular CMV disease during mean follow-up of 16.4 months (range, 8.3-22.0 months) without anti-CMV therapy. Human immunodeficiency viral load remained stable following cessation of anti-CMV medications. Blood and urine assays for CMV were briefly positive in 9 patients but did not predict reactivation of CMV disease. Worsening immune recovery uveitis was associated with a substantial (>3 lines) vision loss in 3 patients.


CONCLUSIONS
Maintenance anti-CMV medications were safely stopped in those patients who had stable CMV retinitis and elevated CD4+ cell counts and who were taking HAART. The study demonstrates that immune recovery following potent antiretroviral therapy is effective in controlling a major opportunistic infection, even in patients with a history of severe immunosuppression.
A randomized double-blind crossover trial of triventricular versus biventricular pacing in heart failure.

AIMS
A significant proportion of patients implanted with biventricular (BiV) devices fail to respond. Clinical response may be improved by additional ventricular stimulation sites. This single-centre, double-blinded randomized crossover trial aimed to determine whether long-term multisite ventricular pacing is superior to conventional BiV pacing in heart failure patients.


METHODS AND RESULTS
A total of 43 patients referred for cardiac resynchronization therapy (CRT) underwent transvenous implantation of a triventricular (TriV) device. Pacing leads were positioned in the right ventricular (RV) apex and a lateral coronary sinus (CS) branch, with a third ventricular lead implanted in a further lateral CS branch in 23 patients (group A) and on the high RV septum in 20 patients (group B). Devices were programmed in a randomized order to four pre-determined pacing configurations: conventional BiV, TriV, and dual-site and single-site left bentricular (LV) or RV pacing for 3-month periods with clinical and echo assessment at the end of each period. The primary endpoint was the comparison of 6 min walk distance (6MW) after 3 months of BiV vs. TriV pacing; secondary endpoints were Minnesota Living With Heart Failure (MLWHF) scores, and LV dimensions and function. The 12-month follow-up period was completed by 37 patients. Compared with BiV pacing, TriV pacing resulted in significant improvements in 6MW (451 ± 112 m vs. 425 ± 119 m, P = 0.008), MLWHF (32 ± 19 vs. 38 ± 24, P = 0.036), LV end-systolic volume (158 ± 79mL vs. 168 ± 76 mL, P < 0.05), and ejection fraction (30 ± 8% vs. 27 ± 8%, P < 0.05).


CONCLUSIONS
TriV pacing was associated with significant improvements in clinical and echocardiographic parameters compared with BiV pacing.
Microstructure evolution in γ-irradiated carbon fibers revealed by a hierarchical model and Raman spectra from fiber section

Abstract The surface activity and mechanical properties of carbon fibers (CFs) were improved simultaneously by magical γ-irradiation. However, microstructure evolution rules of γ-irradiated CFs were still ambiguous. As a representative, T1000 CFs were irradiated by γ-rays and then observed by X-ray diffraction, X-ray photoelectron spectroscopy and Raman spectroscopy from fiber surface, deducing the paradoxical results in terms of fiber structural transformation due to the different penetration depth of above measurements. Therefore, a hierarchical model composed of outer-surface, sub-surface and core parts had been proposed, which allowed us to understand the microstructure evolution of irradiated CFs profoundly. Subsequently, Raman spectra from fiber cross-section were performed to further confirm the accuracy of new model. The results demonstrated that oxygen-containing functional groups were significantly introduced into the outer-surface by the combined effect of γ-rays and reactive media, which increased the surface activity and disordered the structure of outer-surface part. Meanwhile, γ-irradiation improved the graphitic order and atomic rearrangement of sub-surface and core parts regardless of medium effect. Furthermore, the graphitization of sub-surface part showed more notable increase than that of core part under γ-irradiation. This paper would offer the key to reveal the relationship among microstructure, surface activities and mechanical properties of γ-irradiated CFs.
Percutaneous ablative treatment of metastatic bone tumours: visual analogue scale scores in a short-term series.

INTRODUCTION
The aim of this study was to examine the role of palliative percutaneous secondary lesions bone treatment by comparing the visual analogue scale (VAS) scores of cryoablation plus vertebroplasty versus radiofrequency (RF) plus vertebroplasty so as to determine their feasibility, reliability and efficacy in a short-term series.


METHODS
Combined RF thermal ablation plus osteoplasty or cryoablation plus osteoplasty was performed in osteolytic secondary bone localisations in 30 consecutive patients who were suffering from pain refractory to conservative therapies. We evaluated pain with the VAS during the preoperative period and at four hours, 24 hours, one week, one month, three months and six months post procedure.


RESULTS
There were no statistically significant differences in the VAS score between patients treated with cryoablation plus osteoplasty and those treated with RF ablation plus osteoplasty at one week (p-value is 0.34), one month (p-value is 1), three months (p-value is 0.68) and six months (p-value is 0.65) post procedure. Patients treated with cryoablation plus vertebroplasty have less pain at four hours (p-value less than 0.001) and 24 hours (p-value less than 0.001) than patients treated with RF ablation plus vertebroplasty.


CONCLUSION
Both RF ablation and cryoablation are optimal techniques in the treatment of painful bone metastatic cancer. Cryoablation achieves less treatment-related pain during the early period of follow-up and better volume control by real-time depiction of ablation margins.
A comprehensive overview of cyber-physical systems: from perspective of feedback system

Cyber-physical systems (CPS) are characterized by integrating cybernetic and physical processes. The theories and applications of CPS face the enormous challenges. The aim of this paper is to provide a latest understanding of this emerging multi-disciplinary methodology. First, the features of CPS are described, and the research progresses are summarized from different components in CPS, such as system modeling, information acquisition, communication, control and security. Each part is also followed by the future directions. Then some typical applications are given to show the prospects of CPS.
Data-Intensive Scalable Computing for Scientific Applications

Increasingly, scientific computing applications must accumulate and manage massive datasets, as well as perform sophisticated computations over these data. Such applications call for data-intensive scalable computer (DISC) systems, which differ in fundamental ways from existing high-performance computing systems.
Raising healthy software systems

We elaborate on the analogy between humans and bespoke software systems and we use this analogy to inform an alternative perspective on the development and management of such systems.
Diagnosis of incomplete Kawasaki disease

Several authors suggested that the clinical characteristics of incomplete presentation of Kawasaki disease are similar to those of complete presentation and that the 2 forms of presentation are not separate entities. Based on this suggestion, a diagnosis of incomplete Kawasaki disease in analogy to the findings of complete presentation is reasonable. Currently, the diagnosis of incomplete Kawasaki disease might be made in cases with fewer classical diagnostic criteria and with several compatible clinical, laboratory or echocardiographic findings on the exclusion of other febrile illness. Definition of incomplete presentation in which coronary artery abnormalities are included as a necessary condition, is restrictive and specific. The validity of the diagnostic criteria of incomplete presentation by the American Heart Association should be thoroughly tested in the immediate future.
Elevated oxidative stress among coronary artery disease patients on statin therapy: A cross sectional study.

BACKGROUND
Statins are a major group of drugs that reduces LDL-C levels, which are proven to have other beneficial effects such as preventing coronary events. The objective of this study was to evaluate oxidative stress and select novel coronary artery disease risk factors among coronary artery disease patients on statins.


METHODS
In this observational, cross-sectional study, we compared total cholesterol, triglycerides, HDL-cholesterol, LDL-cholesterol, apolipoprotein B, lipoprotein (a), homocysteine, reduced glutathione, glutathione peroxidase, superoxide dismutase, ascorbic acid, malondialdehyde and oxidized LDL among male coronary artery disease patients on statin therapy (group 2, n = 151) with sex-matched, diabetic patients (group 3, n = 80) as well as healthy controls (group 1, n = 84).


RESULTS
Total cholesterol, triglycerides, HDL-cholesterol and LDL-cholesterol were significantly lower among subjects of group 2 compared to other two groups. The novel risk factors studied did not differ significantly between groups, except for a higher homocysteine level among group 2 subjects compared to the other two groups. Elevated oxidative stress, indicated by lower reduced glutathione, glutathione peroxidase, and ascorbic acid as well as higher malondialdehyde and oxidized LDL was observed among group 2 subjects. Triglycerides, HDL-cholesterol, ascorbic acid and malondialdehyde were found to be independent predictors for coronary artery disease among this study population.


CONCLUSIONS
Though coronary artery disease subjects had healthy lipid profile, oxidative stress, a recognized risk factor for coronary events, was still elevated among this patient group. Novel risk factors were not found to be major predictors for coronary artery disease among the study subjects.
Molecular mechanisms of curcumin action: gene expression.

Curcumin derived from the tropical plant Curcuma longa has a long history of use as a dietary agent, food preservative, and in traditional Asian medicine. It has been used for centuries to treat biliary disorders, anorexia, cough, diabetic wounds, hepatic disorders, rheumatism, and sinusitis. The preventive and therapeutic properties of curcumin are associated with its antioxidant, anti-inflammatory, and anticancer properties. Extensive research over several decades has attempted to identify the molecular mechanisms of curcumin action. Curcumin modulates numerous molecular targets by altering their gene expression, signaling pathways, or through direct interaction. Curcumin regulates the expression of inflammatory cytokines (e.g., TNF, IL-1), growth factors (e.g., VEGF, EGF, FGF), growth factor receptors (e.g., EGFR, HER-2, AR), enzymes (e.g., COX-2, LOX, MMP9, MAPK, mTOR, Akt), adhesion molecules (e.g., ELAM-1, ICAM-1, VCAM-1), apoptosis related proteins (e.g., Bcl-2, caspases, DR, Fas), and cell cycle proteins (e.g., cyclin D1). Curcumin modulates the activity of several transcription factors (e.g., NF-κB, AP-1, STAT) and their signaling pathways. Based on its ability to affect multiple targets, curcumin has the potential for the prevention and treatment of various diseases including cancers, arthritis, allergies, atherosclerosis, aging, neurodegenerative disease, hepatic disorders, obesity, diabetes, psoriasis, and autoimmune diseases. This review summarizes the molecular mechanisms of modulation of gene expression by curcumin.
Comparison of patient outcomes in Magnet® and non-Magnet hospitals.

OBJECTIVE
: This study compared patient outcomes and staffing in Magnet® and non-Magnet hospitals.


BACKGROUND
: The pursuit of Magnet designation is a highly regarded program for improving staff and patient outcomes. Research has confirmed that Magnet hospitals provide positive work environments for nurses. Research related to patient outcomes in Magnet hospitals is scarce, and results vary.


METHODS
: The University Health Systems Consortium provided the clinical and operational databases for the study. Using bivariate and multivariate analyses, a comparison of patient outcomes and nurse staffing in general units and ICUs of Magnet and non-Magnet hospitals was studied.


OUTCOMES
: Non-Magnet hospitals had better patient outcomes than Magnet hospitals. Magnet hospitals had slightly better outcomes for pressure ulcers, but infections, postoperative sepsis, and postoperative metabolic derangement outcomes were worse in Magnet hospitals. Magnet hospitals also had lower staffing numbers.


CONCLUSIONS
: Magnet hospitals in this study had less total staff and a lower RN skill mix compared with non-Magnet hospitals, which contributed to the outcomes.
Spacetime Holism and the Passage of Time

The most fascinating of the riddles of time is the so-called passage of time which, however, is not accounted for by natural science. In this contribution, we suggest an approach to the phenomena of time which aims at explaining why time passes for us.1
Deriving the DEA frontier for two-stage processes

Data envelopment analysis (DEA) is a method for measuring the efficiency of peer decision making units (DMUs). Recently DEA has been extended to examine the efficiency of two-stage processes, where all the outputs from the first stage are intermediate measures that make up the inputs to the second stage. The resulting two-stage DEA model provides not only an overall efficiency score for the entire process, but as well yields an efficiency score for each of the individual stages. Due to the existence of intermediate measures, the usual procedure of adjusting the inputs or outputs by the efficiency scores, as in the standard DEA approach, does not necessarily yield a frontier projection. The current paper develops an approach for determining the frontier points for inefficient DMUs within the framework of two-stage DEA. 2009 Elsevier B.V. All rights reserved.
Critical Evaluation of Alumino-silicate Systems : Thermodynamic Modeling of Alumina-containing Liquid and Solid Solutions

Alumino-silicate systems are of great interest for materials scientists and geochemists. Thermodynamic knowledge of these systems is useful in steel and ceramic industries, and for understanding ge ...
Analysis of Cesarean Section Rate - According to Robson's 10-group Classification.

High cesarean birth rates are an issue of international public health concern.1 Worries over such increases have led the World Health Organization to advise that Cesarean Section (CS) rates should not be more than 15%,2 with some evidence that CS rates above 15% are not associated with additional reduction in maternal and neonatal mortality and morbidity.3 Analyzing CS rates in different countries, including primary vs. repeat CS and potential reasons of these, provide important insights into the solution for reducing the overall CS rate. Robson,4 proposed a new classification system, the Robson Ten-Group Classification System to allow critical analysis according to characteristics of pregnancy (Table 1). The characteristics used are: (i) single or multiple pregnancy (ii) nulliparous, multiparous, or multiparous with a previous CS (iii) cephalic, breech presentation or other malpresentation (iv) spontaneous or induced labor (v) term or preterm births.
Wideband Slot Antenna for WLAN Access Points

This letter presents a new printed slot antenna with cavity back for wireless local area network (WLAN) access points (base stations) providing wideband operation bandwidth at least from 2.5 to 4.8 GHz. The design is based upon an ultrawideband (UWB) antenna configuration modified with the inclusion of a cavity back in order to produce stable unidirectional radiation pattern. The new configuration also ensures a stable linear polarization with cross-polarization level below -20 dB. Results are confirmed with measurements. Not disregarding other applications, the new design is especially adequate for multiple-input-multiple-output (MIMO) space and polarization diversity arrangements, presenting low cross polarization and very low coupling to adjacent elements.