LLukas22/scidocs huggingface dataset:
Opportunistic detection of atrial fibrillation in subjects aged 65 years or older in primare care: a randomised clinical trial of efficacy. DOFA-AP study protocol

BACKGROUND
Clinical Practice Guidelines recommend using peripheral blood pulse measuring as a screening test for Atrial Fibrillation. However, there is no adequate evidence supporting the efficacy of such procedure in primary care clinical practice. This paper describes a study protocol designed to verify whether early opportunistic screening for Atrial Fibrillation by measuring blood pulse is more effective than regular practice in subjects aged 65 years attending primary care centers.


METHODS/DESIGN
An cluster-randomized controlled trial conducted in Primary Care Centers of the Spanish National Health Service. A total of 269 physicians and nurses will be allocated to one of the two arms of the trial by stratified randomization with a 3:2 ratio (three practitioners will be assigned to the Control Group for every two practitioners assigned to the Experimental Group). As many as 12 870 patients aged 65 years or older and meeting eligibility criteria will be recruited (8 580 will be allocated to the Experimental Group and 4 290 to the Control Group). Randomization and allocation to trial groups will be carried out by a central computer system. The Experimental Group practitioners will conduct an opportunistic case finding for patients with Atrial Fibrillation, while the Control Group practitioners will follow the regular guidelines. The first step will be finding new Atrial Fibrillation cases. A descriptive inferential analysis will be performed (bivariate and multivariate by multilevel logistic regression analysis).


DISCUSSION
If our hypothesis is confirmed, we expect Primary Care professionals to take a more proactive approach and adopt a new protocol when a patient meeting the established screening criteria is identified. Finally, we expect this measure to be incorporated into Clinical Practice Guidelines.


TRIAL REGISTRATION
The study is registered as NCT01291953 (ClinicalTrials.gob).
The shock index predicts acute mortality outcomes in stroke.

BACKGROUND
Shock index (SI) (ratio between heart rate and systolic blood pressure) has been shown to be associated with poor mortality outcomes in trauma and pneumonia; however it has yet to be examined in stroke. We aimed to examine the relationship between SI and acute outcomes of inpatient, 3-day and 7-day mortality in stroke. Secondly, we aimed to compare SI and systolic blood pressure (SBP) alone in predicting above outcomes.


METHODS
Data from a multicentre prospective cohort study conducted between October 2009 and September 2012 in eight NHS trusts in East of England were analysed. The relationships between SI, SBP and study outcomes were assessed using multivariable logistic regression models using mid-quintile groups as the reference category. Receiver operating characteristic (ROC) curves assessed the discriminating ability between the SI and SBP models.


RESULTS
A total of 2121 stroke patients were included (47.4% men; mean age 77.10 (sd) 12.40) years. The lowest quintile of the SI, had an increased odds of 3-day and 7-day mortality, adjusted odds ratio (AOR) 2.45 (95% CI:1.16-5.17) and 1.88 (1.01-3.49), respectively. Patients with the highest quintile of SI also had increased odds of in-patient, 3-day and 7-day mortality, AORs 1.85 (1.17-2.92), 2.18 (1.03-4.63) and 2.45 (1.34-4.49), respectively. Similarly, SBP had a U-shape relationship with mortality. All measures had an ROC area under the curve >0.8 but there was no difference in the discriminating ability between SI and SBP.


CONCLUSIONS
SI at extremely high and low values appeared to predict stroke mortality and appears to be particularly useful in predicting very early (3-day) mortality.
Quantitative comparisons of the state-of-the-art data center architectures

Data centers are experiencing a remarkable growth in the number of interconnected servers. Being one of the foremost data center design concerns, network infrastructure plays a pivotal role in the initial capital investment and ascertaining the performance parameters for the data center. Legacy data center network (DCN) infrastructure lacks the inherent capability to meet the data centers growth trend and aggregate bandwidth demands. Deployment of even the highest-end enterprise network equipment only delivers around 50% of the aggregate bandwidth at the edge of network. The vital challenges faced by the legacy DCN architecture trigger the need for new DCN architectures, to accommodate the growing demands of the ‘cloud computing’ paradigm. We have implemented and simulated the state of the art DCN models in this paper, namely: (a) legacy DCN architecture, (b) switch-based, and (c) hybrid models, and compared their effectiveness by monitoring the network: (a) throughput and (b) average packet delay. The presented analysis may be perceived as a background benchmarking study for the further research on the simulation and implementation of the DCN-customized topologies and customized addressing protocols in the large-scale data centers. We have performed extensive simulations under various network traffic patterns to ascertain the strengths and inadequacies of the different DCN architectures. Moreover, we provide a firm foundation for further research and enhancement in DCN architectures. Copyright © 2012 John Wiley & Sons, Ltd.
Early tumor shrinkage in patients with metastatic colorectal cancer receiving first-line treatment with cetuximab combined with either CAPIRI or CAPOX: an analysis of the German AIO KRK 0104 trial.

PURPOSE
This study investigated the impact of early tumor shrinkage (ETS) on progression-free- (PFS) and overall survival (OS) in patients with metastatic colorectal cancer (mCRC) treated within the AIO KRK 0104 trial as first-line therapy. Moreover, correlations of ETS with clinical characteristics and prognostic markers were evaluated.


PATIENTS AND METHODS
In total, 121 patients were included into this analysis. Patients were treated with cetuximab combined with either CAPIRI or CAPOX. ETS at six weeks was defined as a relative change of ≥ 20% in the sum of the longest diameters of target lesions compared to baseline. Survival times were compared between patients with ETS ≥ 20% versus no-ETS.


RESULTS
ETS ≥ 20% was observed in 59% of all patients with KRAS wild-type tumors. In these patients ETS ≥ 20% was associated with higher overall response rate (82% vs. 19%, p < 0.001). Also, PFS (8.9 vs. 4.7 months, p < 0.001) and OS (31.6 vs. 15.8 months, p = 0.005) were significantly superior in ETS ≥ 20% of patients compared to no-ETS. In patients with KRAS mutant mCRC ETS ≥ 20% neither had an effect on PFS nor OS. Cetuximab-induced skin toxicity correlated with the occurrence of ETS ≥ 20% (p = 0.002).


CONCLUSION
In patients with KRAS wild-type tumors treated with cetuximab plus capecitabine-based chemotherapy ETS ≥ 20% is an important predictor of favorable outcome.
Goal-setting for behavior change in primary care: an exploration and status report.

OBJECTIVE
This paper explores the behavior change method of goal-setting and reviews the literature on goal-setting in primary care for patients with chronic conditions.


METHODS
A literature search was conducted resulting in eight articles meeting the criteria of goal-setting interventions in primary care for adults or adolescents with chronic conditions.


RESULTS
Hypotheses are advanced that goal-setting is generally conducted by collaboratively working with patients to set short-term and specific goals, with follow-up to provide feedback to patients. The articles reviewed generally confirmed these hypotheses. This review did not focus on clinical outcomes, but on the processes of engaging patients in goal-setting discussions.


CONCLUSION
Evidence that goal-setting is superior to other behavior change methods has not been shown. Since goal-setting is being utilized as a behavior change technique in many primary care sites, primary care practices can benefit from information on how best to implement this innovation.


PRACTICE IMPLICATIONS
Generally, clinicians are minimally involved in goal-setting discussions with their patients. Engaging patients in goal-setting can be done with interactive computer programs and non-clinical members of the primary care team.
Cardiac sympathetic reserve and response to cardiac resynchronization therapy.

BACKGROUND
The objective of the present study was to investigate the effect of cardiac resynchronization therapy (CRT) on cardiac autonomic function.


METHODS AND RESULTS
This prospective study included 45 consecutive patients with heart failure who received CRT devices with defibrillator and 20 age-matched, healthy control subjects. At baseline and 3 months and 6 months after CRT, we assessed New York Heart Association (NYHA) class, 6-minute walk distance, plasma sympathetic biomarker nerve growth factor, echocardiography, heart rate variability and cardiac presynaptic sympathetic function determined by iodine 123 metaiodobenzylguanidine scintigraphy. After CRT, NYHA class improved by 1 class (P<0.001), and left ventricular ejection fraction increased by 8% (P<0.001). Along with improvement in the standard deviation of all normal-to-normal R-R intervals (85.63±31.66 ms versus 114.79±38.99 ms; P=0.004) and the standard deviation of the averaged normal-to-normal R-R intervals (82.62±23.03 ms versus 100.50±34.87 ms; P=0.004), the delayed heart/mediastinum (H/M) ratio increased (1.82 [0.58] versus 1.97 [0.59]; P=0.03), whereas the mean (SD) H/M washout rate was reduced (48% [19%] versus 37% [22%]; P=0.01). Twenty-two of 45 study patients responded to CRT, with a reduction of left ventricular end-systolic volume index >15%. Compared with nonresponders, responders had a higher delayed H/M ratio (2.11 versus 1.48; P=0.003) and lower H/M washout rate (37% versus 62%; P=0.003) at baseline.


CONCLUSIONS
CRT improved sympathetic function. Cardiac sympathetic reserve may be a marker for the reversibility of failing myocardial function.
Pooled analysis of two randomized trials comparing titanium-nitride-oxide-coated stent versus drug-eluting stent in STEMI.

INTRODUCTION AND OBJECTIVES
We performed a pooled analysis based on patient-level data from the TITAX-AMI and BASE-ACS trials to evaluate the outcome of titanium-nitride-oxide-coated bioactive stents vs drug-eluting stents in patients with ST-segment elevation myocardial infarction at 2-year follow-up.


METHODS
The TITAX-AMI trial compared bioactive stents with paclitaxel-eluting stents in 425 patients with acute myocardial infarction. The BASE-ACS trial compared bioactive stents with everolimus-eluting stents in 827 patients with acute coronary syndrome. The primary endpoint for the pooled analysis was major adverse cardiac events: a composite of cardiac death, recurrent myocardial infarction, or ischemia-driven target lesion revascularization at 2-year follow-up.


RESULTS
The pooled analysis included 501 patients; 245 received bioactive stents, and 256 received drug-eluting stents. The pooled bioactive stent group was associated with a risk ratio of 0.85 for major adverse cardiac events (95% confidence interval, 0.53-1.35; P=.49) compared to the pooled drug-eluting stent group. Similarly, the pooled bioactive stent group was associated with a risk ratio of 0.71 for cardiac death (95% confidence interval, 0.26-1.95; P=.51), 0.44 for recurrent myocardial infarction (95% confidence interval, 0.20-0.97; P=.04), and 1.39 for ischemia-driven target lesion revascularization (95% confidence interval, 0.74-2.59; P=.30), compared to the pooled drug-eluting stent group. These results were confirmed by propensity-score adjusted analysis of the combined datasets.


CONCLUSIONS
In patients with ST-segment elevation myocardial infarction, bioactive stents were associated with lower rates of recurrent myocardial infarction compared to drug-eluting stents at 2-year follow-up; yet, the rates of cardiac death and ischemia-driven target lesion revascularization were similar.
Smart Textiles and Wearable Technology – A

2 Foreword This report is the result of a study of the research field smart textiles, which has been carried out within the EU financed Baltic Fashion Project. The report gives an overview of projects combining smart textiles and clothing as a basis of discussions of how smart textile innovation could be introduced in fashion. The overview covers different projects, research as well as commercial projects, within smart textiles and clothing, with a certain focus on European activities. All information is based on literature studies, inquires from the Baltic Fashion partners and search for projects in different databases. The Swedish School of Textiles is the Swedish national contact for the Baltic Fashion project, which aims to promote fashion. Between 2011-2013, activities and research are carried out within various subjects, e.g. mapping production, innovation, smart textiles and wearable technology. Abstract This report covers different projects, research as well as commercial projects, within smart textiles and clothing, with a certain focus on European activities. Each projects is categorized as either EU-project, University project not funded by EU and commercial projects. All information is based on literature studies, inquires from the Baltic Fashion Partners and search for projects in project databases. The collected materials shows that there are research initiative on both European and national levels. In these projects there has been a focus on medical applications and applications concentrated on enabling technologies. Despite an extensive research effort in several projects for over 10 years there are only few smart textile products on the market. In earlier investigations technical and production aspects are explained as barriers for the commercialisation of smart textiles. Fashion is rarely mentioned as a potential area for smart textiles. However, in this report it is most of the companies that are found are deals with fashion. The companies are certainly small and several authors dismiss the potential in their applications as more or less uninteresting. Despite these opinions the report shows that fashion players take private economical risks by producing and selling smart textile fashion products. The new companies also shows ability to take lead in using new developed technologies in their applications in order to avoid the technical barriers. The argument that the new companies are too small to consider also shows expectancy that smart textiles concern mass consumption and mass production, which is not necessarily the case. Several of the companies have focused on tailor-made solutions for …
Fog Computing Distributing Data and Intelligence for Resiliency and Scale Necessary for IoT: The Internet of Things (Ubiquity symposium)

The Internet of Everything (IoE) is more than a $19 trillion opportunity over 10 years. Fifty billions of devices will be connected to various networks in 2020. This is bringing new technical challenges in all domains and specifically in the data processing. Distributed intelligence is one of the key technological answers. We call it "fog computing." Fog can provide intelligent connection of people, processes, data, and things in hierarchical Internet of Things networks. By supplementing the cloud and providing intermediate layers of computation, networking, and storage, fog nodes can optimize IoE deployments---greatly enhancing latency, bandwidth, reliability, security, and overall IoE network performance. The article will analyze the architecture and main design choices of this technology.
Construction of a DNA Vaccine Encoding Mtb32C and HBHA Genes of Mycobacterium tuberculosis

BACKGROUND
Tuberculosis (TB) is a contagious disease caused by Mycobacterium tuberculosis. Development of a new vaccine for tuberculosis requires immunogenic antigens capable of inducing suitable and long-lasting T cell immunity. The emergence of multidrugs and extensively drug-resistant strains of M. tuberculosis has made it a global public health concern.


OBJECTIVES
DNA vaccine is a straightforward method to introduce antigens to the host. In the present study, two immunodominant mycobacterial antigens (Mtb32C and HBHA) were isolated and cloned into pcDNA3.1 (+) to design and construct a new DNA vaccine. This vector is capable of producing new potent chimeric protein.


MATERIALS AND METHODS
Mtb32C (Rv0125) and heparin-binding haemagglutinin adhesion (HBHA) genes were amplified using polymerase chain reaction (PCR) of M. tuberculosis H37Rv genome and ligated into pcDNA3.1 (+). Colony-PCR and restriction enzyme analysis were used to confirm the accuracy of the cloning procedure.


RESULTS
In the current study, recombinant pcDNA3.1 (+) vector containing Mtb32C and HBHA genes was successfully constructed. The desired size of DNA fragment was observed using single and double digestion methods.


CONCLUSIONS
Mtb32C and HBHA genes were successfully isolated from H37Rv genome and cloned into an eukaryotic expression vector. This vector can be considered as a vaccine to evaluate immune responses in animal models.
Sensitivity and specificity of different methods for cystic fibrosis-related diabetes screening: is the oral glucose tolerance test still the standard?

BACKGROUND
Cystic fibrosis-related diabetes (CFRD) is a late cystic fibrosis (CF)-associated comorbidity whose prevalence is increasing sharply lifelong. Guidelines for glucose metabolism (GM) monitoring rely on the oral glucose tolerance test (OGTT). However, this test is neither sensitive nor specific. The aim of this study was to compare sensitivity and specificity of different methods for GM monitoring in children and adolescents with CF.


METHODS
Continuous glucose monitoring system (CGMS), used as the reference method, was compared with the OGTT, intravenous glucose tolerance test (IGTT), homeostasis model assessment index of insulin resistance (HOMA-IR), homeostasis model assessment index of β-cell function (HOMA-%B) and glycated haemoglobin A1C. Patients were classified into three groups according to CGMS: normal glucose tolerance (NGT), impaired glucose tolerance (IGT) and diabetes mellitus (DM).


RESULTS
Twenty-nine patients (median age: 13.1 years) were recruited. According to CGMS, 11 had DM, 12 IGT and six NGT, whereas OGTT identified three patients with DM and five with IGT. While 13 of 27 had insulin deficiency according to IGTT, there was 19 of 28 according to HOMA-%B. According to HOMA-IR, 12 of 28 had insulin resistance. HOMA-%B was the most sensitive method for CFRD screening [sensitivity 91% (95% CI), specificity 47% (95% CI) and negative predictive value 89% (95% CI)].


CONCLUSIONS
OGTT showed the weak capacity to diagnose DM in CF and should no longer be considered as the reference method for CFRD screening in patients with CF. In our study, HOMA-%B showed promising metrics for CFRD screening. Finally, CGMS revealed that pathological glucose excursions were frequent even early in life.
Real-time collision avoidance in teleoperated whole-sensitive robot arm manipulators

In traditional teleoperation systems, the human operator is saddled with two distinct tasks: I) moving the robot arm to its desired position, and 2) avoiding obstacles that can obstruct the arm motion. The current robot teleopera tion research concentrates on providing the operator with as much input information about the task site as possible using, for example, stereo vision or contact force feedback. These methods presume that the operator is capable of planning motion for the entire body of the robot in a cluttered environment. Studies show, however, that the operators, first, cannot address both tasks in real time, and second, are not good at generating collision-free motion in a complex environment. Recent results in sensor-based motion planning suggest that the collision avoidance task can be handled automatically, thus freeing the operator for global control. To this end, it is also proposed to use whole-sensitive arm manipulators whose whole bodies are covered with a sensitive skin sensor to detect nearby objects. The data from the skin is processed by motion planning algorithms, to avoid collisions for the entire a rm body in an unknown or time-varying environment. The motion of the operator-controlled master arm is either repeated faithfully by the slave arm, or, to avoid collisions, is used as general guidance. In the latter case the slave arm attempts to be as close as possible to the positions commanded by the operator, without jeopardizing its safety. The result is an efficient, safe and robust hybrid system in which integration of control by the operator and the automatic system is done transparently and in real time.
Practical advice for planning and conducting focus groups.

Article: Focus groups, originally called focused interviews, have been used as a data collection method since World War II and are commonly used in social science research. Krueger (1994) describes a focus group as "a carefully planned discussion designed to obtain perceptions on a defined area of interest in a permissive, nonthreatening environment" (p. 6). Guided by a skilled interviewer, participants share their ideas and perceptions, influencing each other by responding to ideas and comments in the discussion. Nurse researchers have many of the necessary skills and topics of interest appropriate for focus groups, yet this methodology is often underutilized. Multiple resources are available that provide indepth information on conducting focus groups (Krueger, 1994; Morgan, 1993; Morgan & Krueger, 1997; Stewart & Shamdasani, 1990) and analyzing the resulting qualitative data (Krueger, 1997a; Miles & Huberman, 1994). The purpose of this article is to provide researchers with suggestions for adapting focus group guidelines to facilitate data collection and ensure optimal use of resources. Insights gained from focus groups conducted by the authors with women at risk for HIV and women with a history of pregnancy after perinatal loss will be presented as examples.
Self-compassion as a moderator of the relationship between academic burn-out and psychological health in Korean cyber university students

The moderating effect of self-compassion was examined in the relationship between academic burden and psychological health. The participants were students (N = 350) from a cyber university in Korea. At the beginning of the fall 2011 semester, the participants were surveyed using items from the academic burn-out, self-compassion, depression, and psychological well-being measures. Multiple regression analysis showed that self-compassion moderated the relationship between academic burn-out and psychological well-being. And self-compassion also moderated the relationship between academic burn-out and depression. This study presents an empirical framework for the research through investigating the relationship among academic burden, self-compassion, and psychological health for cyber university students. 2013 Elsevier Ltd. All rights reserved.