LLukas22/scidocs huggingface dataset:
Evaluation of Salud Para Su Corazón (Health for Your Heart) — National Council of La Raza Promotora Outreach Program

INTRODUCTION
In 2001, the National Heart, Lung, and Blood Institute partnered with the National Council of La Raza to conduct a pilot test of its community-based outreach program Salud Para Su Corazón (Health for Your Heart), which aims to reduce the burden of morbidity and mortality associated with cardiovascular disease among Latinos.


METHODS
The effectiveness of promotores de salud (community health workers) in improving heart-healthy behaviors among Latino families participating in the pilot program at seven sites was evaluated. Data on the characteristics of the promotores in the Salud Para Su Corazón program were compiled. Promotores collected data on family risk factors, health habits, referrals and screenings, information sharing, and program satisfaction from 223 participating Latino families (320 individual family members) through questionnaires. Paired t tests and chi-square tests were used to measure pretest-posttest differences among program participants.


RESULTS
Results demonstrated the effectiveness of the promotora model in improving heart-healthy behaviors, promoting community referrals and screenings, enhancing information sharing beyond families, and satisfying participants' expectations of the program. The main outcome of interest was the change in heart-healthy behaviors among families.


CONCLUSION
The community outreach model worked well in the seven pilot programs because of the successes of the promotores and the support of the community-based organizations. Successes stemmed in part from the train-the-trainer approach. Promotoria, as implemented in this program, has the potential to be integrated with a medical model of patient care for primary, secondary, and tertiary prevention.
Immediate and late benefits of treating very elderly people with hypertension: results from active treatment extension to Hypertension in the Very Elderly randomised controlled trial.

OBJECTIVE
To assess if very elderly people with hypertension obtain early benefit from antihypertensive treatment.


DESIGN
One year open label active treatment extension of randomised controlled trial (Hypertension in the Very Elderly Trial (HYVET)).


SETTING
Hospital and general practice based centres mainly in eastern and western Europe, China, and Tunisia.


PARTICIPANTS
People on double blind treatment at the end of HYVET were eligible to enter the extension.


INTERVENTIONS
Participants on active blood pressure lowering treatment continued taking active drug; those on placebo were given active blood pressure lowering treatment. The treatment regimen was as used in the main trial-indapamide SR 1.5 mg (plus perindopril 2-4 mg if required)-with the same target blood pressure of less than 150/80 mm Hg.


MAIN OUTCOME MEASURES
The primary outcome was all stroke; other outcomes included total mortality, cardiovascular mortality, and cardiovascular events.


RESULTS
Of 1882 people eligible for entry to the extension, 1712 (91%) agreed to participate. During the extension period, 1682 patient years were accrued. By six months, the difference in blood pressure between the two groups was 1.2/0.7 mm Hg. Comparing people previously treated with active drug and those previously on placebo, no significant differences were seen for stroke (n = 13; hazard ratio 1.92, 95% confidence interval 0.59 to 6.22) or cardiovascular events (n = 25; 0.78, 0.36 to 1.72). Differences were seen for total mortality (47 deaths; hazard ratio 0.48, 0.26 to 0.87; P = 0.02) and cardiovascular mortality (11 deaths; 0.19, 0.04 to 0.87; P = 0.03).


CONCLUSION
Very elderly patients with hypertension may gain immediate benefit from treatment. Sustained differences in reductions of total mortality and cardiovascular mortality reinforce the benefits and support the need for early and long term treatment. Trial registration Clinical trials NCT00122811.
Outcomes after thyroidectomy and parathyroidectomy.

BACKGROUND
Previous reports on postoperative outcomes following thyroid and parathyroid surgery are limited by relatively small sample size. We report 30-day outcomes following thyroid and parathyroid surgery and analyze factors affecting length of stay (LOS) and postoperative adverse events (AEs).


METHODS
The multicenter, prospective, National Surgical Quality Improvement Program (NSQIP) datasets (2007/2008) were used. Multivariable logistic regression and analysis of covariance (ANCOVA) were performed.


RESULTS
Patients undergoing thyroidectomy, parathyroidectomy, or both were identified (n = 13,380, 6154, 1535, respectively). Thirty-day mortality was 0.08%, 0.16%, and 0.2%, respectively; 30-day morbidity was 3.50%, 3.02%, and 4.04%, respectively. Mean LOS values were 1.1 ± 1.4, 1.1 ± 2.1, and 1.4 ± 3.1 days, respectively. Congestive heart failure, dependent functional status, dialysis dependence, and chronic corticosteroid use were significantly associated with increased LOS and postoperative AE.


CONCLUSIONS
Morbidity and mortality rates following thyroid and parathyroid surgery are low. These data could be used by third-party interests, and surgeons should be aware of them to ensure their outcomes are in the national norm.
Alpha Shapes Applied to Molecular Shape Characterization Exhibit Novel Properties Compared to Established Shape Descriptors

Despite considerable efforts, description of molecular shape is still largely an unresolved problem. Given the importance of molecular shape in the description of spatial interactions in crystals or ligand-target complexes, this is not a satisfying state. In the current work, we propose a novel application of alpha shapes to the description of the shapes of small molecules. Alpha shapes are parametrized generalizations of the convex hull. For a specific value of alpha, the alpha shape is the geometric dual of the space-filling model of a molecule, with the parameter alpha allowing description of shape in varying degrees of detail. To date, alpha shapes have been used to find macromolecular cavities and to estimate molecular surface areas and volumes. We developed a novel methodology for computing molecular shape characteristics from the alpha shape. In this work, we show that alpha-shape descriptors reveal aspects of molecular shape that are complementary to other shape descriptors and that accord well with chemists' intuition about shape. While our implementation of alpha-shape descriptors is not computationally trivial, we suggest that the additional shape characteristics they provide can be used to improve and complement shape-analysis methods in domains such as crystallography and ligand-target interactions. In this communication, we present a unique methodology for computing molecular shape characteristics from the alpha shape. We first describe details of the alpha-shape calculation, an outline of validation experiments performed, and a discussion of the advantages and challenges we found while implementing this approach. The results show that, relative to known shape calculations, this method provides a high degree of shape resolution with even small changes in atomic coordinates.
Towards a didactical theory for mathematical modelling

Mathematics education research has been somewhat short of its own paradigmatic theories (see ZDM, 2005, issue 6 and ZDM 2006, issue 1 for an ongoing discussion). Theories are often borrowed from the background sciences and applied to the field of mathematics education e.g. general learning theories from pedagogy, sociology, psychology etc. This has led to our field being a subject to a host of criticisms (e,g., Lerman, 2006; Lester, 2005; Sriraman & English, 2005, 2006; Steen, 1999). Therefore it is relevant to look for areas in mathematics education where theories may emerge from studying the processes of teaching and learning mathematics. In this issue of ZDM we present and discuss what we consider to be an example of a developing theory within the field of mathematics education research, namely a theory for the teaching and learning of mathematical modelling. During the last decades a coherent theoretical understanding of mathematical modelling processes and connected teaching and learning processes has been emerging. This has happened through a close interplay between the development of curricula, teaching practices, experimental teaching, theoretical reflections and research. Together with the use of information technology, the introduction of mathematical modelling and applications is a prominent general feature of the recent developments in the practice of mathematics teaching, especially with regard to secondary level teaching. In this development, didactical research has already played an important role and we find it of general interest for mathematics education research to examine the development of a theory for mathematical modelling as a paradigmatic case for developing theory in close interplay with teaching practice.
Time to treatment in rheumatoid arthritis: factors associated with time to treatment initiation and urgent triage assessment of general practitioner referrals.

BACKGROUND
The importance of early diagnosis and treatment of rheumatoid arthritis (RA) is increasingly being recognized. This requires accurate triaging of suspected RA referrals from primary care and expedient assessment of these patients in secondary care.


OBJECTIVES
To assess the factors associated with urgent triage for first specialist appointment and early disease modifying agents in rheumatic disease treatment.


METHODS
The general practitioner (GP) referrals to a single rheumatology service from 128 new RA patients were assessed for their information content and triage allocation by the Rheumatologists. Information on symptoms, signs, and investigation results were collected. Factors associated with urgent triage allocation, time to treatment, and a GP requesting urgency were assessed.


RESULTS
Median time from symptom onset to treatment was 6.1 months. Triage allocation to urgent was associated with earlier treatment (difference of 97 days, P = 0.003). GP perception of urgency (odds ratio = 13.34, 95% confidence interval: 2.20-81.02) was independently associated with an urgent triage allocation by the triaging rheumatologist. Swollen joints and a raised C-reactive protein predicted GP request for urgency.


CONCLUSION
Triage is important to facilitate early treatment; however, rheumatologists in this service are not currently triaging suspected RA referrals with reference to known poor prognostic indicators. Several interventions could improve both informative referrals and triaging of referrals to decrease time to diagnosis and treatment. These interventions could include public education, GP education sessions with associated distribution of referral guidelines, and reminding triaging rheumatology clinicians about the available prognostic factors often present in GP referrals that assist with correct triage.
Testosterone undecanoate improves lipid profile in patients with type 1 diabetes and hypogonadotrophic hypogonadism.

Testosterone deficiency (Td) has been associated with the metabolic syndrome. Few studies have evaluated this condition in type 1 diabetes (T1D). The primary aim of this study was to evaluate the effectiveness of testosterone undecanoate (TU) on insulin sensitivity, glycemic control, anthropometric parameters, blood pressure and lipid profile in patients with Td and T1D. We performed a randomized placebo-controlled multicenter study.


INCLUSION CRITERIA
a) age ≥ 18 years; b) autoimmune diabetes; c) Td (total testosterone <10 nmol/L or calculated free testosterone <225 pmol/L and low/normal LH; d) ability to sign informed consent; e) comply with the study protocol.


EXCLUSION CRITERIA
a) pituitary tumor, empty sella, hyperprolactinemia, panhypopituitarism or secondary hypogonadism; b) contraindications for treatment with testosterone undecanoate (TU); c) patients who did not agree to sign their informed consent. Six patients were randomly assigned to testosterone undecanoate (TU) treatment and 7 to placebo with the following dosing schedule: baseline, 6 weeks and 16 weeks. Blood test, anthropometric parameters, blood pressure and insulin sensitivity were determined at baseline, 6, 16 and 22 weeks. No differences were observed regarding insulin sensitivity, HbA1c or basal glucose, anthropometric parameters or blood pressure. At 22 weeks, the decrease in total cholesterol was 37.4 ± 27.5 mg/dL in the TU group compared with an increase of 13.2 ± 17.8 mg/dL in the placebo group (P<0.005), and LDL cholesterol concentration decreased 30.2 ± 22.1 mg/dL, compared with an increase of 10.5 ± 13.4 mg/dL in the placebo group (P=0.004). We conclude that treatment with TU in patients with T1D and Td improves lipid profile, with no effects on metabolic control or anthropometric parameters.
Robust watermarking based on DWT and nonnegative matrix factorization

Article history: Received 16 September 2007 Received in revised form 1 July 2008 Accepted 16 September 2008 Available online 5 November 2008
Translocation and insecticidal activity of Bacillus thuringiensis living inside of plants

The major biological pesticide for the control of insect infestations of crops, Bacillus thuringiensis was found to be present naturally within cotton plants from fields that had never been treated with commercial formulations of this bacterium. The ability of B. thuringiensis to colonize plants as an endophyte was further established by the introduction of a strain marked by production of green fluorescent protein (GFP). After inoculation of this preparation close to the roots of cotton and cabbage seedlings, GFP-marked bacteria could be re-isolated from all parts of the plant, having entered the roots and migrated through the xylem. Leaves taken from the treated plants were able to cause toxicity when fed to the Lepidoptera Spodoptera frugiperda (cotton) and Plutella xylostella (cabbage). These results open up new horizons for understanding the natural ecology and evolution of B. thuringiensis and use of B. thuringiensis in insect control.
Risk of diabetes mellitus associated with atypical antipsychotic use among Medicaid patients with bipolar disorder: a nested case-control study.

STUDY OBJECTIVE
To quantify the risk of diabetes mellitus associated with atypical antipsychotics compared with conventional antipsychotics in managed care Medicaid patients with bipolar disorder.


DESIGN
Retrospective nested case-control study.


DATA SOURCE
Integrated seven-state Medicaid managed care claims database from January 1, 1998-December 31, 2002.


PATIENTS
Two hundred eighty-three patients with diabetes (cases) and 1134 controls matched by age, sex, and the index date on which bipolar disorder was diagnosed.


MEASUREMENTS AND MAIN RESULTS
Cases were defined as those having an International Classification of Diseases, Ninth Revision diagnosis of diabetes or those receiving treatment with antidiabetic drugs. Both case and control patients had at least a 3-month exposure to either conventional or atypical antipsychotic agents or three filled prescriptions related to treatment for bipolar disorder. Of the 283 cases, 139 (49%) received atypical antipsychotics (olanzapine, risperidone, quetiapine, ziprasidone, and clozapine) and 133 (47%) were prescribed conventional antipsychotics. To compare the risk for new-onset diabetes associated with atypical versus conventional antipsychotics, we conducted a Cox proportional hazard regression, in which we controlled for age; sex; duration of bipolar disorder follow-up; use of lithium, anticonvulsants, antidepressants, and other drugs; and psychiatric and medical comorbidities. Compared with patients receiving conventional antipsychotics, the risk of diabetes was greatest among patients taking risperidone (hazard ratio [HR] 3.8, 95% confidence interval [CI] 2.7-5.3), olanzapine (3.7, 95% CI 2.5-5.3), and quetiapine (2.5, 95% CI 1.4-4.3). The risk for developing diabetes was also associated with weight gain (HR 2.5, 95% CI 1.9-3.4), hypertension (HR 1.6, 95% CI 1.2-2.2), and substance abuse (HR 1.5, 95% CI 1.0-2.2).


CONCLUSION
Olanzapine, risperidone, and quetiapine are all associated with development or exacerbation of diabetes mellitus in patients with bipolar disorder. When prescribing therapy for this patient population, metabolic complications such as diabetes, weight gain, and hypertension need to be considered.
Changing preventive practice: a controlled trial on the effects of outreach visits to organise prevention of cardiovascular disease.

OBJECTIVES
To assess the effects of outreach visits by trained nurse facilitators on the organisation of services used to prevent cardiovascular disease. To identify the characteristics of general practices that determined success.


DESIGN
A non-randomised controlled trial of two methods of implementing guidelines to organise prevention of cardiovascular disease: an innovative outreach visit method compared with a feedback method. The results in both groups were compared with data from a control group.


SETTING AND SUBJECTS
95 general practices in two regions in The Netherlands.


INTERVENTIONS
Trained nurse facilitators visited practices, focusing on solving problems in the organisation of prevention. They applied a four step model in each practice. The number of visits depended on the needs of the practice team. The feedback method consisted of the provision of a feedback report with advice specific to each practice and standardised instructions.


MAIN OUTCOME MEASURES
The proportion of practices adhering to 10 different guidelines. Guidelines were on the detection of patients at risk, their follow up, the registration of preventive activities, and teamwork within the practice.


RESULTS
Outreach visits were more effective than feedback in implementing guidelines to organise prevention. Within the group with outreach visits, the increase in the number of practices adhering to the guidelines was significant for six out of 10 guidelines. Within the feedback group, a comparison of data before and after intervention showed no significant differences. Partnerships and practices with a computer changed more.


CONCLUSION
Outreach visits by trained nurse facilitators proved to be effective in implementing guidelines within general practices, probably because their help was practical and designed for the individual practice, guided by the wishes and capabilities of the practice team.
Learning-centred leadership or pedagogical leadership? An alternative approach to leadership in education contexts

This paper critically reviews models of learning-centred leadership for selfdetermining educational organisations (i.e. those with a large degree of control over their own destiny and in vogue during the closing decades of the previous century) and argues for a more holistic approach to educational leadership based on pedagogical knowledge and understanding. In developing the case for pedagogical leadership in education we focus on key elements of education administration, such as the centrality of relationships, teaching and learning, and building communities of learning. On the basis of this discussion, it will be argued that, in education contexts, knowledge is the most important element. Knowledge is grounded in experience or in reason and as such Pedagogy is the key epistemological base addressing this (referred to in this article as the ‘episteme’). Thus, leaders in education contexts should be concerned with the development of their episteme – Pedagogy – and to be more concerned with pedagogical leadership in education than with models of learning-centred leadership promulgated through the current body of literature, as well as through the actions of central government agencies. It will therefore be proposed that, for effective leadership to be evident in education contexts, pedagogical leadership is a more accurate approach, given that it is concerned with the context, people, and development /construction of knowledge.
Advertising influences on young children's food choices and parental influence.

OBJECTIVE
To evaluate whether advertising for food influences choices made by children, the strength of these influences, and whether they might be easily undone by parental influences.


STUDY DESIGN
Children between 3 and 8 years of age (n=75) were randomized to watch a series of programs with embedded commercials. Some children watched a commercial for a relatively healthy food item, the other children watched a commercial for a less healthy item, both from the same fast-food company. Children were also randomized either to receive parental encouragement to choose the healthy item or to choose whichever item they preferred.


RESULTS
Results indicated that children were more likely to choose the advertised item, despite parental input. Parental input only slightly moderated this influence.


CONCLUSION
Although advertising impact on children's food choices is moderate in size, it appears resilient to parental efforts to intervene. Food advertisements directed at children may have a small but meaningful effect on their healthy food choices.
Saying Thank You to an Ambivalent Society

Sudanese refugees in Australia are thankful to the country for granting them a new life, and are finding ways to show their appreciation to the Australian society. They are unmindful of the mild opposition to their presence and racist stereotypes and are trying to rectify misleading notions about them.
Serum biomarkers of bone metabolism in castration-resistant prostate cancer patients with skeletal metastases: results from SWOG 0421.

BACKGROUND
Prior studies suggest that elevated markers of bone turnover are prognostic for poor survival in castration-resistant prostate cancer (CRPC). The predictive role of these markers relative to bone-targeted therapy is unknown. We prospectively evaluated the prognostic and predictive value of bone biomarkers in sera from CRPC patients treated on a placebo-controlled phase III trial of docetaxel with or without the bone targeted endothelin-A receptor antagonist atrasentan (SWOG S0421).


METHODS
Markers for bone resorption (N-telopeptide and pyridinoline) and formation (C-terminal collagen propeptide and bone alkaline phosphatase) were assayed in pretreatment and serial sera. Cox proportional hazards regression models were fit for overall survival. Models were fit with main effects for marker levels and with/without terms for marker-treatment interaction, adjusted for clinical variables, to assess the prognostic and predictive value of atrasentan. Analysis was adjusted for multiple comparisons. Two-sided P values were calculated using the Wald test.


RESULTS
Sera from 778 patients were analyzed. Elevated baseline levels of each of the markers were associated with worse survival (P < .001). Increasing marker levels by week nine of therapy were also associated with subsequent poor survival (P < .001). Patients with the highest marker levels (upper 25th percentile for all markers) not only had a poor prognosis (hazard ratio [HR] = 4.3; 95% confidence interval [CI] = 2.41 to 7.65; P < .001) but also had a survival benefit from atrasentan (HR = 0.33; 95% CI = 0.15 to 0.71; median survival = 13 [atrasentan] vs 5 months [placebo]; P interaction = .005).


CONCLUSIONS
Serum bone metabolism markers have statistically significant independent prognostic value in CRPC. Importantly, a small group of patients (6%) with highly elevated markers of bone turnover appear to preferentially benefit from atrasentan therapy.