LLukas22/scidocs huggingface dataset:
Who has life-sustaining therapy withdrawn after injury?

BACKGROUND
Trauma scoring systems have been developed to help surgeons predict who will die after injury. However, some patients may not actually die of their injuries but may undergo withdrawal of life-sustaining therapy (WLST). The goal of this study was to determine which factors were associated with WLST among older patients who died. We hypothesized that patients with comorbid illnesses, higher injury severity scores (ISS), complications, and existing advanced directives (AD) would be more likely to have WLST and that patients having WLST would receive more medication for symptom relief in the 24 hours before death.


METHODS
Data were collected via a retrospective chart review of patients age 55 years and older admitted to the intensive care unit after injury who subsequently died. In addition to demographic and injury information, documentation of family discussions regarding care wishes and formal ADs were evaluated. Patients dying despite curative attempts were compared with those who died after WLST by Student's t test and chi test where appropriate.


RESULTS
In a 3-year period, of 330 patients age 55 and older admitted to the intensive care unit, 66 (20%) died. Complete records were available for 64 patients. More than half of those who died (n = 35, 54.7%) had WLST. ADs were available for 15 patients (23.4%), and 11 (17.2%) patients had expressed to their families desires to not undergo aggressive curative care. Family discussions were documented for 50 (78%) cases. Comorbid illnesses were present in 46 (71.9%) patients and 35 (54.7%) developed at least one complication. Among people with ADs, 73% had WLST versus 49% of people without ADs (p = 0.09). WLST was independent of comorbid illnesses (p = 0.3), complications (p = 0.8), age (p = 0.5), and ISS (p = 0.2). Patients for whom there was documentation of a family discussion were more likely to have WLST than those without (91.4% versus 62.1%, p = 0.005). Morphine and benzodiazepine dosing in the 24 hours preceding death were greater in the WLST group than the curative therapy group (p = 0.02 and p = 0.05, respectively).


CONCLUSIONS
Expected associations with WLST such as age, ISS, comorbidities, and complications were not present in this population. Although trends may exist regarding patient wishes and ADs, larger studies are needed to corroborate these findings. Given the percentage of patients having supportive care withdrawn, trauma registries and scoring systems should include WLST.
Implementing Modified Command Filtering to Eliminate Multiple Modes of Vibration

The requirements for large robots in waste management and space applications necessitate active vibration control algorithms. The use of long, flexible links provides the needed range of motion but their inherent flexibility can generate undesirable vibrations making both control and endpoint positioning difficult. This paper presents two shaping algorithms, the impulse shaping method and the modified command filtering technique, to eliminate the first two modes of vibration in a flexible manipulator. The vibration suppression capabilities are demonstrated using a large elliptic trajectory that produces a significant change in the system properties of the two-link robot. The acceleration response of the tip of the manipulator provides a means of comparison for the different shaping algorithms.
Guidelines for Internet of Things Deployment Approaches - The Thing Commandments

The Internet of Things (IoT) describes the interconnection of objects (or Things) for various purposes including identification, communication, sensing, and data collection. “Things” in this context range from traditional computing devices like Personal Computers (PC) to general household objects embedded with capabilities for sensing and/or communication through the use of technologies such as Radio Frequency Identification (RFID). This conceptual paper, from a philosophical viewpoint, introduces an initial set of guiding principles also referred to in the paper as commandments that can be applied by all the stakeholders involved in the IoT during its introduction, deployment and thereafter. © 2011 Published by Elsevier Ltd. Selection and/or peer-review under responsibility of [name organizer]
Hilbert-Transform-Based Transient/Intermittent Earth Fault Detection in Noneffectively Grounded Distribution Systems

Conventional relaying algorithms are mostly based on phasor computation. Since it is difficult to obtain accurate phasor results in fast transient situations, most of the feeder relays fail to correctly respond to transient/intermittent earth faults, which are, however, frequent fault cases in distribution systems. This paper presents a novel approach for fault detection and direction determination for these transient/intermittent faults. The basic idea is to extract the fault direction using the instantaneous power's direction. The instantaneous power is obtained by using Hilbert transform. The proposed direction element inherently utilizes the high-frequency components of the transient fault signals at a conventional sampling rate. Together with an intermittence detection algorithm, a scheme for transient/intermittent earth fault detection has been proposed. It has been implemented as a prototype relay. Electromagnetic Transients Program tests as well as physical model tests have proved the effectiveness of the proposed scheme.
School and home connections and children's kindergarten achievement gains: The mediating role of family involvement

Children’s home and school are the most influential contexts in which learning and development occur, especially during early childhood. This paper builds on Bronfenbrenner’s ecological theory and Epstein’s theory of overlapping spheres of influence to examine school and family connections and their relationships to family involvement and students’ achievement gains. We used a nationally representative
The rat estrous cycle revisited: a quantitative and qualitative analysis

The rat has been elected as the main animal model in several studies involving reproduction. However, there are scarce and conflicting data related to its estrous cycle. It comprises phases characterized by different cell types in vaginal smears (proestrus, estrus, metestrus and diestrus). Nevertheless, this classification and the time span of each phase are controversial and may induce misleading interpretations. In addition, there are no reports regarding the quantification of all cell types in each phase, including pre-acidophilic cells and leukocytes. The goal of this study was to revisit the literature about the rat estrous cycle and to perform a detailed quantitative and qualitative description of its phases and the transitional periods among them. Vaginal smears were obtained twice daily for 20 days from Wistar rats and stained using the Shorr method. Cells were classified as small (SBC) or large (LBC) basophilic cells, nucleated (NAC) or enucleated (EAC) acidophilic cells, pre-acidophilic cells (PAC) or leukocytes. Ten fields per smear were analyzed and cellular frequencies were determined to distinguish the phases. Enucleated acidophilic cells were observed in all phases. The number of PAC was high during proestrus, but none were found during estrus. Frequency of NAC was higher during the transitional period between metestrus II and diestrus than during other phases. Leukocytes were first observed during metestrus and showed very high frequency during diestrus. This study demonstrated that the quantitative analysis of cell populations in vaginal smears improves the identification of the estrous cycle phases and may contribute to a more precise detection of cyclical alterations.
Cayuga : A High-Performance Event Processing Engine ∗ [ Demonstration Paper ]

We propose a demonstration of Cayuga, a complex event monitoring system for high speed data streams. Our demonstration will show Cayuga applied to monitoring Web feeds; the demo will illustrate the expressiveness of the Cayuga query language, the scalability of its query processing engine to high stream rates, and a visualization of the internals of the query processing engine.
Students' perceptions of prosthodontics in a PBL hybrid curriculum.

PURPOSE
A survey was distributed to the Harvard School of Dental Medicine (HSDM) predoctoral student classes of 2005 and 2006 to assess their perceptions regarding preclinical prosthodontics laboratory exercises. Prosthodontics curriculum clock hours, prosthodontics teaching participation, and plans for specialization were also analyzed. We hypothesized that reduced hours and perceived stress in the prosthodontics curriculum might impact students' choice of specialty at HSDM.


MATERIALS AND METHODS
HSDM preclinical prosthodontics clock hours were compared with national means from published data. A survey was distributed to the HSDM classes of 2005 and 2006 (n = 70) at the end of their preclinical prosthodontics laboratory exercises, prior to students seeing their first patient in the clinics.


RESULTS
A 100% response rate was achieved. Results from this study show that HSDM preclinical prosthodontics clock hours are on average shorter than other schools. The majority of the students felt stressed during the laboratory exercises, and they felt they did not gain adequate knowledge from the lectures, resulting in low self-esteem (confidence) in treating patients in the clinic. Despite this perception, HSDM students do just as well, if not better, than other students, as judged by external and internal outcome measures. Graduate prosthodontics specialization is still a specialty of choice among the graduates when compared to national data.


CONCLUSIONS
The shortened preclinical didactic and laboratory exercises in prosthodontics at HSDM affect student anxiety, but not their didactic and clinical performances or their decisions in choosing their graduate program. Problem-based learning (PBL) tutorials help the students to integrate preclinical and clinical knowledge and skills in prosthodontics.
Concomitant loss of dynorphin, NARP, and orexin in narcolepsy.

BACKGROUND
Narcolepsy with cataplexy is associated with a loss of orexin/hypocretin. It is speculated that an autoimmune process kills the orexin-producing neurons, but these cells may survive yet fail to produce orexin.


OBJECTIVE
To examine whether other markers of the orexin neurons are lost in narcolepsy with cataplexy.


METHODS
We used immunohistochemistry and in situ hybridization to examine the expression of orexin, neuronal activity-regulated pentraxin (NARP), and prodynorphin in hypothalami from five control and two narcoleptic individuals.


RESULTS
In the control hypothalami, at least 80% of the orexin-producing neurons also contained prodynorphin mRNA and NARP. In the patients with narcolepsy, the number of cells producing these markers was reduced to about 5 to 10% of normal.


CONCLUSIONS
Narcolepsy with cataplexy is likely caused by a loss of the orexin-producing neurons. In addition, loss of dynorphin and neuronal activity-regulated pentraxin may contribute to the symptoms of narcolepsy.
Planning Approximations to the Average Length of Vehicle Routing Problems with Time Window Constraints

This paper studies approximations to the average length of Vehicle Routing Problems (VRP) with time window, route duration, and capacity constraints. The approximations are valuable for the strategic and planning analysis of transportation and logistics problems. Using asymptotic properties of vehicle routing problems and the average probability of successfully sequencing a customer with time windows a new expression to estimate VRP distances is developed. The increase in the number of routes when time constraints are added is modeled probabilistically. This paper introduces the concept of the average probability of successfully sequencing a customer with time windows. It is proven that this average probability is a unique characteristic of a vehicle routing problem. The approximation proposed is tested in instances with different customer spatial distributions, depot locations and number of customers. Regression results indicate that the proposed approximation is not only intuitive but also predicts the average length of VRP problems with a high level of accuracy.
A randomized, controlled trial of oral and intramuscular dexamethasone in the prevention of neonatal respiratory distress syndrome.

OBJECTIVE
The study's objective was to compare the efficacies of oral and intramuscular antenatal administration of dexamethasone in reducing neonatal respiratory distress syndrome.


STUDY DESIGN
Subjects at high risk for preterm delivery between 24 and 33 weeks' gestation were prospectively randomly assigned to receive either 6 mg intramuscular dexamethasone or 8 mg oral dexamethasone every 12 hours for 4 doses. The regimen was repeated weekly until 34 weeks' gestation if delivery had not yet occurred. A blinded data review was performed. The primary outcome of the trial was respiratory distress syndrome. Data were analyzed in an intent to treat fashion. Comparisons were made with an unpaired t test, chi2 or Fisher exact test, and survival analysis. P <.05 was considered significant.


RESULTS
The study was discontinued at 39% enrollment after a blinded review of available outcomes. A total of 170 women with 188 fetuses were randomly assigned. The oral and intramuscular groups had similar mean gestational ages at enrollment (29.9 weeks vs 29.2 weeks) and similar median latencies (9.5 vs 10 days). No difference in the frequency of respiratory distress syndrome was found between the oral and intramuscular groups, (34.3% vs 29.8%). Neonatal sepsis (10.1% vs 1.2%, P =.01) and intraventricular hemorrhage (10.1% vs 2. 4%, P =.04) were significantly higher in the oral group. There were no statistical differences in the frequencies of necrotizing enterocolitis or neonatal death. A subgroup analysis of 112 patients who were delivered at <34 weeks' gestation revealed no statistical difference in respiratory distress syndrome between the groups; however, oral dexamethasone was associated with a significant increase in sepsis (15.9% vs 1.6%, P =.009) and intraventricular hemorrhage (15.9% vs 3.3%, P =.03).


CONCLUSION
Oral administration increases neonatal morbidity without demonstrable benefit and should not at this time be used clinically for induction of fetal pulmonary maturation.
Panobinostat as part of induction and maintenance for elderly patients with newly diagnosed acute myeloid leukemia: phase Ib/II panobidara study.

This phase Ib/II trial combined the pan-deacetylase inhibitor panobinostat with chemotherapy followed by panobinostat maintenance in elderly patients with newly diagnosed acute myeloid leukemia. Patients with prior history of myelodysplastic syndrome were excluded and 38 evaluable patients were included in the study (median age: 71 years; range: 65-83). Study patients received an induction with idarubicin (8 mg/m(2) iv days 1-3) plus cytarabine (100 mg/m(2) iv days 1-7) plus panobinostat po at escalating doses (days 8, 10, 12, 15, 17 and 19) that could be repeated in non-responding patients. Patients achieving complete remission received a consolidation cycle with the same schema, followed by panobinostat maintenance (40 mg po 3 days/week) every other week until progression. Thirty-one patients were treated at the maximum tolerated dose of panobinostat in the combination (10 mg) with good tolerability. Complete remission rate was 64% with a time to relapse of 17.0 months (12.8-21.1). Median overall survival for the whole series was 17 months (5.5-28.4). Moreover, in 4 of 5 patients with persistent minimal residual disease before maintenance, panobinostat monotherapy reduced its levels, with complete negativization in two of them. Maintenance phase was well tolerated. The most frequent adverse events were thrombocytopenia (25% grades 3/4), and gastrointestinal toxicity, asthenia and anorexia (mainly grades 1/2). Five patients required dose reduction during this phase, but only one discontinued therapy due to toxicity. These results suggest that panobinostat is one of the first novel agents with activity in elderly acute myeloid leukemia patients, and suggest further investigation is warranted, particularly in the context of maintenance therapy. This trial is registered at clinicaltrials.gov identifier: 00840346.
An Enhanced QoS Prediction Approach for Service Selection

In this paper, we propose an enhanced QoS prediction approach to predict the missing QoS values for QoS-based selection. Compared with existing QoS prediction methods, our proposed A Smooth approach has two differences: 1) using A-cosine equation for similarity calculation to remove the impact of different QoS scale, 2) adding a data Smoothing process to improve the prediction accuracy. An extensive performance study based on a real public dataset is reported to verify the prediction accuracy of our proposed approach.
Massive Open Online Courses

The Georgia Institute of Technology (Georgia Tech) is one of the world’s leading universities in computer science education. Starting from 2014’s winter term, Georgia Tech is providing a Master’s program in Computer Science. Individual courses are offered exclusively as “massive open online courses” (MOOCs).1 The tuition fees will cover only a fraction of the traditional Master’s program in order to enhance accessibility. To realize this project, Georgia Tech is cooperating with AT&T and the private educational organization Udacity.2 AT&T supports the program with 2 million USD. The telecommunication company uses the program for educating its own members of staff as well as for recruiting highly skilled graduates. With MOOCs for up to 300,000 participants, Udacity has gained global media attraction. Top German universities, e.g., Freiburg, Munich, and Berlin, have already started to accept some Udacity-MOOCs in their regular curricula.3 As a consequence, MOOCs are increasingly challenging traditional teaching methods and institutions (Vardi 2012). What are MOOCs? MOOCs are webbased online courses for an unlimited number of participants held by professors or other experts. The following constitutive characteristics can be identified (Clow 2013; McAuley et al. 2010; Vardi 2012): • Large number of participants (“massive”): In contrast to traditional distance learning courses, MOOCs address an unlimited number of participants. • Open accessibility (“open”): There are no, or very few, formal conditions for participation. The courses address a global target group. Specific previous knowledge is only required if the course is embedded in a degree program. Moreover, MOOCs are often free of charge or impose only low participation fees. • Digitization (“online”): Courses are exclusively conducted via the Internet and thus are not location-dependent. Digitization comprises the learning material, the teaching process, social interaction of participants as well as their examination. • Didactical concept (“course”): The learning content is structured according to a didactical concept. The teaching process and the development of knowledge follows pre-defined learning objectives. Elements of design may include course scheduling, a prestructuring of the learning content, the control of social learning interaction, as well as the execution of reviews of educational objectives and tests. From an information systems research perspective, MOOCs represent an innovative, web-based business model for financing, designing, and provisioning educational services. Due to the increasing digitization and respective structuring of these services, the laws of the Internet economy (cf. Shapiro and Varian 1999; marginal costs of additional participants tend towards zero, occurrence of network and long-tail effects) open up higher education and vocational training to the masses. Thus, MOOCs offer great potential (e.g., increased effectiveness and efficiency in education; Leimeister 2012, pp. 46–102) and challenges (e.g., new competitors) for academic institutions and other providers of educational services.
Fulminant demyelinating encephalomyelitis: Insights from antibody studies and neuropathology.

OBJECTIVES
Antibodies to myelin oligodendrocyte glycoprotein (MOG) are detectable in inflammatory demyelinating CNS diseases, and MOG antibody-associated diseases seem to have a better prognosis despite occasionally severe presentations.


METHODS
We report the case of a 71-year-old patient with acute visual and gait disturbance that dramatically worsened to bilateral amaurosis, tetraplegia, and respiratory insufficiency within a few days.


RESULTS
MRI showed multiple progressive cerebral and spinal lesions with diffusion restriction (including both optic nerves) and marginal contrast enhancement. Routine blood and CSF measures including oligoclonal bands were normal. At disease onset, MOG immunoglobulin G was detected (serum titer 1:1,280, corresponding CSF titer was 1:20) and remained positive in patient serum. Aquaporin-4 antibodies were absent at disease onset but seroconverted to positive at week 9. In addition, CSF glial fibrillary acid protein and myelin basic protein levels were very high at onset but decreased during disease course. After 4 months, the patient died despite immunomodulatory treatment. Postmortem neuropathologic examination revealed an acute multiple sclerosis (MS) defined by multiple demyelinating lesions with a pronounced destructive component and loss of astrocytes. Lesion pattern of optic chiasm met MS pattern II characterized by antibody and complement-mediated demyelination.


CONCLUSION
The case with the clinical presentation of an acute demyelinating encephalomyelitis with predominant optic and spinal involvement, absent oligoclonal bands, a histopathology of acute MS pattern II and development of aquaporin-4 antibodies extends the spectrum of MOG antibody-associated encephalomyelitis. Although, MOG antibodies are suspected to indicate a favorable prognosis, fulminant disease courses are possible and warrant an aggressive immunotherapy.
Effects of repetitive transcranial magnetic stimulation of the unaffected hemisphere leg motor area in patients with subacute stroke and substantial leg impairment: A pilot study.

OBJECTIVE
To evaluate the effects of repetitive transcranial magnetic stimulation (rTMS) on mobility among patients with substantial leg impairment after subacute stroke.


DESIGN
Double-blinded, stratified, randomized trial involving a sham control group.


PARTICIPANTS
Patients who developed unilateral hemiplegia after first-ever subacute stroke and underwent inpatient stroke rehabilitation.


METHODS
The 15-day intervention programme used in the present study included the application of rTMS (1 Hz, 15 min) over the leg motor area of the unaffected hemisphere, followed by 45 min physical therapy. Overall, 32 participants were randomly assigned to receive either real rTMS or sham stimulation. Clinical assessments, including the Postural Assessment Scale for Stroke Patients (PASS), balance subscale of the Performance Oriented Mobility Assessment (POMA-b), Fugl-Meyer Assessment, Barthel Index (BI), and Timed Up and Go test, were performed immediately before and after the intervention.


RESULTS
Both groups demonstrated significant improvements in all the test results over time. At the post-test assessment, the patients in the real rTMS group demonstrated greater improvements in the PASS, POMA, and BI scores than did the patients in the sham rTMS group. In addition, a significantly higher number of patients in the real rTMS group regained mobility at the post-test assessment compared with the corresponding number of patients in the sham rTMS group.


CONCLUSION
Application of 1-Hz rTMS may improve mobility among patients with substantial leg impairment after subacute stroke.