LLukas22/scidocs huggingface dataset:
Large-joint damage in patients with early rheumatoid arthritis and its association with treatment strategy and damage of the small joints.

OBJECTIVE
To determine the prevalence of large-joint damage and the association with small-joint damage in patients with RA after 8 years of low DAS (≤2.4)-targeted treatment with different treatment strategies.


METHODS
Radiological data of 290 patients participating in the BeSt study, a randomized trial comparing initial monotherapy and initial combination therapy strategies, were used. Radiographs of large joints were scored using the Larsen score and of the small joints using the Sharp-van der Heijde score. With multivariate logistic regression analysis, an association between total damage of the small joints and of the large joints was investigated.


RESULTS
After 8 years of treatment, damage was observed in 12% of shoulders, 10% of elbows, 26% of wrists, 13% of hips, 18% of knees and 7% of the ankles. Damage in one or more large joints was found in 64% of patients, with a median score of 1. No difference was found between initial monotherapy or combination therapy strategies. There was a significant association between damage progression in small joints and damage to one or more large joints (OR 1.02; 95% CI 1.00-1.04).


CONCLUSION
After 8 years of DAS-targeted treatment in early RA patients, large-joint damage was found in 64% of patients and was associated with small-joint damage. Continued DAS-targeted treatment is probably more important in damage suppression than initial treatment strategy. Patients with more damage to hands and feet also have more damage to the large joints.
Lymphocyte subsets in healthy Malawians: Implications for immunologic assessment of HIV infection in Africa

BACKGROUND
CD4(+)T lymphocyte measurements are the most important indicator of mortality in HIV-infected individuals in resource-limited settings. There is currently a lack of comprehensive immunophenotyping data from African populations to guide the immunologic assessment of HIV infection.


OBJECTIVE
To quantify variation in absolute and relative lymphocyte subsets with age in healthy Malawians.


METHODS
Lymphocyte subsets in peripheral blood of 539 healthy HIV-uninfected Malawians stratified by age were enumerated by flow cytometry.


RESULTS
B and T-lymphocyte and T-lymphocyte subset absolute concentrations peaked in early childhood then decreased to adult levels, whereas lymphocyte subset proportions demonstrated much less variation with age. Adult lymphocyte subsets were similar to those in developed countries. In contrast, high B-lymphocyte and CD8(+)T-lymphocyte levels among children under 2 years, relative to those in developed countries, resulted in low CD4(+)T-lymphocyte percentages that varied little between 0 and 5 years (35% to 39%). The CD4(+)T-lymphocyte percentages in 35% of healthy children under 1 year and 18% of children age 1 to 3 years were below the World Health Organization threshold defining immunodeficiency in HIV-infected children in resource-limited settings. Thirteen percent of healthy children under 18 months old had a CD4:CD8T-lymphocyte ratio <1.0, which is commonly associated with HIV infection. All immunologic parameters except absolute natural killer lymphocyte concentration varied significantly with age, and percentage and overall absolute CD4(+)T-lymphocyte counts were higher in females than males.


CONCLUSION
Although lymphocyte subsets in Malawian adults are similar to those from developed countries, CD4(+)T-lymphocyte percentages in young children are comparatively low. These findings need to be considered when assessing the severity of HIV-related immunodeficiency in African children under 3 years.
Chip-Tool Interface Temperature Prediction Model for Turning Process

In this research work the tool-chip interface temperature is measured experimentally during turning of EN-31 steel alloy with tungsten carbide inserts using a tool-work thermocouple technique. First and secondorder mathematical models are developed in terms of machining parameters by using the response surface methodology on the basis of the experimental results. The results are analyzed statistically and graphically. The metal cutting parameters considered are cutting speed, feed rate, depth of cut and tool nose radius. It can be seen from the first order model that the cutting speed, feed rate and depth of cut are the most significantly influencing parameters for the chip-tool interface temperature followed by tool nose radius. Another quadratic model shows the variation of chip-tool interface with major interaction effect between cutting speed and depth of cut (V*D) and second order (quadratic) effect of cutting speed (V) appears to be highly significant. The results show that increase in cutting speed, feed rate and depth of cut increases the cutting temperature while increasing nose radius reduces the cutting temperature. The suggested models of chip-tool interface temperature adequately map within the range of the cutting conditions considered.
Occupational therapy using a sensory integrative approach: a case study of effectiveness.

OBJECTIVE
This article presents a case report of a child with poor sensory processing and describes the disorders impact on the child's occupational behavior and the changes in occupational performance during 10 months of occupational therapy using a sensory integrative approach (OT-SI).


METHOD
Retrospective chart review of assessment data and analysis of parent interview data are reviewed. Progress toward goals and objectives is measured using goal attainment scaling. Themes from parent interview regarding past and present occupational challenges are presented.


RESULTS
Notable improvements in occupational performance are noted on goal attainment scales, and these are consistent with improvements in behavior. Parent interview data indicate noteworthy progress in the child's ability to participate in home, school, and family activities.


CONCLUSION
This case report demonstrates a model for OT-SI. The findings support the theoretical underpinnings of sensory integration theory: that improvement in the ability to process and integrate sensory input will influence adaptive behavior and occupational performance. Although these findings cannot be generalized, they provide preliminary evidence supporting the theory and the effectiveness of this approach.
Some equivalent conditions on convergence in uncertain measure

In the uncertainty space, some equivalent conditions on convergence in uncertain measure for the uncertain variable sequences are established, the results are the generalizations of the corresponding ones of the existing literatures.
Adsorptive granulocyte/monocyte apheresis for the treatment of refractory rheumatoid arthritis: an open pilot multicentre trial.

OBJECTIVE
To assess the efficacy and safety of adsorptive granulocyte and monocyte apheresis (GCAP) in patients with refractory rheumatoid arthritis (RA).


METHODS
Patients with active and refractory RA were treated with weekly GCAP sessions using a column filled with acetate beads (Adacolumn) over five consecutive weeks. Clinical assessments and response to therapy were analysed at weeks 5, 7, 12 and 20 in an open multicentre trial. The primary outcome measure of clinical response was 20% improvement in the American College of Rheumatology criteria (ACR20) at week 20. EULAR (European League Against Rheumatism) response criteria, based on the disease activity score for 28 joints (DAS28) and disability using the Health Assessment Questionnaire (HAQ), were also assessed.


RESULTS
Of 27 patients, 81.5% were women with mean disease duration of 14.4 yr. The mean number of previous disease-modifying antirheumatic drugs (DMARDs) was 3.7, and 48.1% of patients had previously failed on biologicals. On an intention-to-treat basis, 40.7% of patients achieved an ACR20 and 44.4% a therapeutic EULAR response at week 20. These percentages were 50 and 54.5% in 22 patients who completed the trial. In the 10 completers who had previously failed on biologicals, an ACR response was achieved in four patients (ACR20, two; ACR50, one; ACR70, one). A significant decrease was recorded in different ACR response components, including the tender joint and swollen joint counts, pain score and patient and physician global disease assessments, as well as the DAS28 index; most of them improved after week 5. ESR and CRP, but not the HAQ score, had decreased significantly at week 20. The treatment was well tolerated and only one serious adverse event related to the study procedure was documented (sepsis due to a catheter infection).


CONCLUSIONS
GCAP treatment led to significant clinical improvement in a subset of patients with RA who had failed to respond to DMARDs or biologicals. Further large, placebo-controlled studies are warranted to fully assess the therapeutic value of GCAP for refractory RA.
Decomposition of polarimetric synthetic aperture radar backscatter from upland and flooded forests

The goal of this research was to decompose polarimetric Synthetic Aperture Radar (SAR) imagery of upland and  ̄ ooded forests into three backscatter types: single re ̄ ection, double re ̄ ection, and cross-polarized backscatter. We used a decomposition method that exploits the covariance matrix of backscatter terms. First we applied this method to SAR imagery of dihedral and trihedral corner re ̄ ectors positioned on a smooth, dry lake bed, and veri® ed that it accurately isolated the di erent backscatter types. We then applied the method to decompose multi-frequency Jet Propulsion Laboratory (JPL) airborne SAR (AIRSAR) backscatter from upland and  ̄ ooded forests to explain scattering components in SAR imagery from forested surfaces. For upland ponderosa pine forest in California, as SAR wavelength increased from C-band to P-band, scattering with an odd number of re ̄ ections decreased and scattering with an even number of re ̄ ections increased. There was no obvious trend with wavelength for cross-polarized scattering. For a bald cypress-tupelo  ̄ oodplain forest in Georgia, scattering with an odd number of re ̄ ections dominated at C-band. Scattering power with an even number of re ̄ ections from the  ̄ ooded forest was strong at L -band and strongest at P-band. Cross-polarized scattering may not be a major component of total backscatter at all three wavelengths. Various forest structural classes and land cover types were readily distinguishable in the imagery derived by the decomposition method. More importantly, the decomposition method provided a means of unraveling complex interactions between radar signals and vegetated surfaces in terms of scattering mechanisms from targets. The decomposed scattering components were additions to the traditional HH and V V backscatter. One cautionary note: the method was not well suited to targets with low backscatter and a low signal-to-noise ratio.
Dietary antioxidant intake and its association with cognitive function in an ethnically diverse sample of US adults.

BACKGROUND
Dietary antioxidants can inhibit reactions accompanying neurodegeneration and thus prevent cognitive impairment. We describe associations of dietary antioxidants with cognitive function in a large biracial population, while testing moderation by sex, race, and age and mediation by depressive symptoms.


METHODS
This was a cross-sectional analysis of 1274 adults (541 men and 733 women) aged 30 to 64 years at baseline (mean [standard deviation] = 47.5 [9.3]) in the Healthy Aging in Neighborhoods of Diversity Across the Lifespan Study, Baltimore city, MD. Cognitive performance in the domains of memory, language/verbal, attention, spatial, psychomotor speed, executive function, and global mental status were assessed. The 20-item Center for Epidemiologic Studies Depression Scale was used to measure depressive symptoms. Dietary intake was assessed with two 24-hour recalls, estimating daily consumption of total carotenoids and vitamins A, C, and E per 1000 kcal.


RESULTS
Among key findings, 1 standard deviation (∼ 2.02 mg/1000 kcal) higher vitamin E was associated with a higher score on verbal memory, immediate recall (β = +0.64 [0.19], p = .001), and better language/verbal fluency performance (β = +0.53 [0.16], p = .001), particularly among the younger age group. Women with higher vitamin E intake (β = +0.68 [0.21], p = .001) had better performance on a psychomotor speed test. The vitamin E-verbal memory association was partially mediated by depressive symptoms (proportion mediated = 13%-16%).


CONCLUSIONS
In sum, future cohort studies and dietary interventions should focus on associations of dietary vitamin E with cognitive decline, specifically for domains of verbal memory, verbal fluency, and psychomotor speed.
Factors predicting organizational commitment among Nurses in state Hospitals, Malaysia = ปัจจัยทำนายความยึดมั่นผูกพันต่อองค์กรของพยาบาลในโรงพยาบาลประจำรัฐประเทศมาเลเซีย / Lee Siew Pien

Introduction: With an increase in national nursing shortage, organizational commitment is extremely important for retention of nurses. This predictive study determines the level of organizational commitment and the predictive ability of perceived organizational support, components of job satisfaction, including pay, task requirement, organizational policies, autonomy, interaction and professional status as well as years of experience on organizational commitment. Method: Data were collected from 416 nurses in four state hospitals in Malaysia, using self-administered questionnaires. The hospitals were selected from each region in Peninsular Malaysia and samples were selected by a random sampling method. Questionnaires, including demographic data, Organizational Commitment Questionnaires, Survey of Perceived Organizational Support, and Index Work Satisfaction were distributed by researcher and research assistants. Stepwise multiple regression technique was used to analyze the data. Results: The results discovered that (1) nearly half of the subjects (48.07%) reported high level of organizational commitment. (2) Professional status, autonomy, interaction, task requirement and years of experience could predict the organizational commitment (ß = 0.52, 0.17, p < 0.01); ß= 0.13, 0.11, 0.09, p < 0.05 respectively). Overall, all predictors explained 33% of variability in the organizational commitment among nurses in state hospitals. Conclusions: This study found that nurses in state hospitals were highly committed to their organizations. Results of this study provide information for nurse administrators to consider and maintain these factors in nursing practice to foster a high level of organizational commitment among Malaysian nurses.
Intravenous Immune Globulin for the Prevention of Infections in Children with Symptomatic Human Immunodeficiency Virus Infection

ABSTRACT: Infection with human immunodeficiency virus (HIV) causes a progressive immunodeficiency, often manifested in adults by the development of infections with relatively rare, opportunistic organisms. However, in HIV-infected children, recurrent serious infections with common encapsulated bacteria, as well as recurrent minor bacterial and viral infections, may be early and frequent manifestations of HIV disease. The use of i.v. immune globulin (IVIG) has been shown to prevent infections in patients with primary immunodeficiency and in uncontrolled studies of HIV-infected children. This article reviews the problem of and immunologic predisposition for recurrent infections in pediatric HIV infection and reports on the use of IVIG for prophylaxis. Updated analysis from the National Institute of Child Health and Human Development IVIG Clinical Trial, a multicenter, double-blind, placebo-controlled trial of the safety and efficacy of IVIG for the prevention of infections in children with symptomatic HIV infection, is presented. Between March 1988 and January 1991, 376 children with clinical or immunologic evidence of HIV disease who were randomized to receive IVIG or albumin placebo were enrolled in this trial. In children with an entry CD4+ count of 200/mm3 or higher, IVIG significantly increased the time free from serious bacterial infections and significantly decreased the rates of minor bacterial infections and viral infections.
The Oxford Implementation Index: a new tool for incorporating implementation data into systematic reviews and meta-analyses.

OBJECTIVES
This article presents a new tool that helps systematic reviewers to extract and compare implementation data across primary trials. Currently, systematic review guidance does not provide guidelines for the identification and extraction of data related to the implementation of the underlying interventions.


STUDY DESIGN AND SETTING
A team of systematic reviewers used a multistaged consensus development approach to develop this tool. First, a systematic literature search on the implementation and synthesis of clinical trial evidence was performed. The team then met in a series of subcommittees to develop an initial draft index. Drafts were presented at several research conferences and circulated to methodological experts in various health-related disciplines for feedback. The team systematically recorded, discussed, and incorporated all feedback into further revisions. A penultimate draft was discussed at the 2010 Cochrane-Campbell Collaboration Colloquium to finalize its content.


RESULTS
The Oxford Implementation Index provides a checklist of implementation data to extract from primary trials. Checklist items are organized into four domains: intervention design, actual delivery by trial practitioners, uptake of the intervention by participants, and contextual factors. Systematic reviewers piloting the index at the Cochrane-Campbell Colloquium reported that the index was helpful for the identification of implementation data.


CONCLUSION
The Oxford Implementation Index provides a framework to help reviewers assess implementation data across trials. Reviewers can use this tool to identify implementation data, extract relevant information, and compare features of implementation across primary trials in a systematic review. The index is a work-in-progress, and future efforts will focus on refining the index, improving usability, and integrating the index with other guidance on systematic reviewing.
A statistical comparison of prognostic index systems for brain metastases after stereotactic radiosurgery or fractionated stereotactic radiation therapy.

AIMS
Prognostic indices are commonly used in the context of brain metastases radiotherapy to guide patient decision-making and clinical trial stratification. The purpose of this investigation was to compare nine published brain metastases prognostic indices using traditional and novel statistical comparison metrics.


MATERIALS AND METHODS
A retrospective review was carried out on two institutional databases of 501 patients diagnosed with brain metastatic disease, who received either stereotactic radiosurgery (n = 381) or fractionated stereotactic radiation therapy (n = 120) between 2002 and 2011. Descriptive statistics were generated for patient, tumour and treatment factors, as well as prognostic indices distribution. To identify predictors of overall survival, Kaplan-Meier estimates and multivariable Cox proportional hazard analyses were carried out. Prognostic indices were compared with each other using novel metrics, including: net reclassification improvement (NRI) index, integrated discrimination improvement (IDI) index and decision curve analysis (DCA).


RESULTS
Multivariable Cox modelling confirmed the importance of all individual prognostic indices component factors except for 'active primary cancer' tumour status. When traditional and novel comparative metrics were incorporated, the available published prognostic indices were found to have important general classification benefits as follows: Radiation Therapy Oncology Group recursive partitioning analysis (RTOG RPA; NRI and DCA), Rades et al. first index (RADES I; IDI and DCA), Golden grading system (GGS; IDI and DCA) and Rotterdam index (RDAM; major misclassification rate and NRI). The graded prognostic assessment system had the smallest misclassification rate (5%) in terms of high-risk (i.e. poor prognosis) classification.


CONCLUSIONS
Summarising the various comparative approaches used in this report, we found that the RTOG RPA, GGS, RADES I and RDAM systems were superior in more than one metric studied. Of these, only the RTOG RPA has been extensively validated using large datasets and clinically utilised both at the patient level and in clinical trials.
Understanding gastro-oesophageal reflux disease: a patient-cluster analysis

OBJECTIVE
To determine whether patients with gastro-oesophageal reflux disease (GERD) can be grouped according to the physical and psychological impact of their disease.


METHODS
In this multinational study, 7713 primary care physicians (PCPs) and gastrointestinal (GI) specialists took part in a structured online survey to determine how they perceive the clinical and psychological needs of their GERD patients, based on their three most recent consultations. Patients were grouped according to one of the five clusters that were subjectively developed based on preceding qualitative research.


RESULTS
Findings are reported for 1157 respondents (875 PCPs, 282 GI specialists), who reviewed 3471 patient records. Two of the five original clusters were collapsed because of overlapping characteristics, giving rise to three patient clusters. Patients with 'long-term, disrupting GERD' (39%) had symptoms considered to have not only high physical but also psychological impact. Patients with 'recurrent, distressing GERD' (14%) experienced both physical and psychological impact and were worried about the recurrent, restrictive nature of their disease or the possibility of having a more serious underlying condition. Patients with 'inconveniencing GERD' (48%) had less frequent symptoms with overall lower impact. Overall, there was a trend for GI specialists to more likely see patients at higher clinical need than PCPs.


CONCLUSIONS
Patients with GERD can generally be classified according to the physical and psychological impact of their disease. Recognition that such patients have different needs may facilitate improved management of GERD by allowing treatment to be tailored according to the patient's need.
Managing Infusion-Related Reactions for Patients With Chronic Lymphocytic Leukemia Receiving Obinutuzumab.

BACKGROUND
In patients with previously untreated chronic lymphocytic leukemia (CLL) and comorbidities, treatment with the glycoengineered, type II anti-CD20 monoclonal antibody obinutuzumab (Gazyva®) (GA101) plus chlorambucil (Leukeran®) was associated with superior outcomes to rituximab (Rituxan®) plus chlorambucil, with a similar safety profile. However, a higher occurrence of infusion-related reactions (IRRs) was reported with obinutuzumab. These reactions typically require additional management.


OBJECTIVES
The focus of this article is to provide oncology nurses and physicians with advice for obinutuzumab IRR management based on clinical trial data and nursing experience.


METHODS
The authors reviewed the published management strategies for IRRs with obinutuzumab that were identified during the phase III CLL11 trial and an expanded access phase IIb study (ML28979). Practical advice for obinutuzumab IRR management was developed based on available clinical trial information and nursing experience.


FINDINGS
IRRs with obinutuzumab are generally manageable. Most IRRs (all grades), and all grade 3-4 IRRs, occurred during the first infusion. Therefore, IRR management could be improved substantially with extra vigilance at this early stage.