LLukas22/scidocs huggingface dataset:
Reducing severe hypoglycaemia in hospitalised patients with diabetes: Early outcomes of standardised reporting and management

Background
Severe hypoglycaemic events (HGEs) in hospitalised patients are associated with poor outcomes and prolonged hospitalization. Systematic, coordinated care is required for acute management and prevention of HGEs; however, studies evaluating quality control efforts are scarce.


Objective
To investigate the effectiveness of system-based interventions to improve management response to HGEs.


Methods
System-based interventions were designed and implemented following a root cause analysis of HGE in adult patients with diabetes from two general medical wards with the highest incidence of HGE. Interventions included electronic medical record programming for a standardised order set for basal-bolus insulin regimen and hypoglycemia protocol, automated dextrose order, automated MD notification, and recommendation for endocrine consultation after two critical HGEs. The Pyxis MedStation was programmed to alert nurses to recheck blood glucose 15 min after the treatment. A card with the HGE management protocol was attached to each provider's ID badge and educational seminars were given to all providers.


Main outcomes and measures
Primary outcomes were to evaluate median time from HGE (glucose <50 mg/dL) to euglycemia (>100 mg/dL), and time from HGE to follow-up finger-stick (FS) testing preintervention and postintervention. Secondary outcomes were cumulative incidence of HGEs, recurrent hypoglycemia, rate of physician notification and use of standardised treatments among adults with diabetes on the two general medical wards.


Results
Among hospitalised adults with diabetes and HGE, median time from HGE to euglycemia declined from 225±46 min preintervention to 87±26 min postintervention (p=0.03). Median time from HGE to next FS testing also declined (76±14 min to 28±10 min, p<0.001). Standardised treatment administration for HGE improved significantly from 34% (12/35) to 97% (36/37); physician notification rate improved significantly from 51% (18/35) to 78% (29/37).Among hospitalised adults with diabetes, incidence of HGE decreased from 12% (35/295) over 3 months (preintervention period) to 6% (37/610) over 6 months (postintervention period) (p<0.001), while recurrent HGE did not show significant differences (37% (13/35) to 24% (9/37), p=0.09).


Conclusions
System-based interventions had a clinically important impact on decreasing time from HGE to euglycemia and to next FS testing. This hypoglycemia bundle of care may be applied and tested in other community hospitals to improve patient safety.
Management of the critically ill patient with severe acute pancreatitis.

OBJECTIVE
Acute pancreatitis represents a spectrum of disease ranging from a mild, self-limited course requiring only brief hospitalization to a rapidly progressive, fulminant illness resulting in the multiple organ dysfunction syndrome (MODS), with or without accompanying sepsis. The goal of this consensus statement is to provide recommendations regarding the management of the critically ill patient with severe acute pancreatitis (SAP).


DATA SOURCES AND METHODS
An international consensus conference was held in April 2004 to develop recommendations for the management of the critically ill patient with SAP. Evidence-based recommendations were developed by a jury of ten persons representing surgery, internal medicine, and critical care after conferring with experts and reviewing the pertinent literature to address specific questions concerning the management of patients with severe acute pancreatitis.


DATA SYNTHESIS
There were a total of 23 recommendations developed to provide guidance to critical care clinicians caring for the patient with SAP. Topics addressed were as follows. 1) When should the patient admitted with acute pancreatitis be monitored in an ICU or stepdown unit? 2) Should patients with severe acute pancreatitis receive prophylactic antibiotics? 3) What is the optimal mode and timing of nutritional support for the patient with SAP? 4) What are the indications for surgery in acute pancreatitis, what is the optimal timing for intervention, and what are the roles for less invasive approaches including percutaneous drainage and laparoscopy? 5) Under what circumstances should patients with gallstone pancreatitis undergo interventions for clearance of the bile duct? 6) Is there a role for therapy targeting the inflammatory response in the patient with SAP? Some of the recommendations included a recommendation against the routine use of prophylactic systemic antibacterial or antifungal agents in patients with necrotizing pancreatitis. The jury also recommended against pancreatic debridement or drainage for sterile necrosis, limiting debridement or drainage to those with infected pancreatic necrosis and/or abscess confirmed by radiologic evidence of gas or results or fine needle aspirate. Furthermore, the jury recommended that whenever possible, operative necrosectomy and/or drainage be delayed at least 2-3 wk to allow for demarcation of the necrotic pancreas.


CONCLUSIONS
This consensus statement provides 23 different recommendations concerning the management of patients with SAP. These recommendations differ in several ways from previous recommendations because of the release of recent data concerning the management of these patients and also because of the focus on the critically ill patient. There are a number of important questions that could not be answered using an evidence-based approach, and areas in need of further research were identified.
Uses, traditional management, perception of variation and preferences in ackee (Blighia sapida K.D. Koenig) fruit traits in Benin: implications for domestication and conservation

BACKGROUND
Blighia sapida is a woody perennial multipurpose fruit tree species native to the Guinean forests of West Africa. The fleshy arils of the ripened fruits are edible. Seeds and capsules of the fruits are used for soap-making and all parts of the tree have medicinal properties. Although so far overlooked by researchers in the region, the tree is highly valued by farmers and is an important component of traditional agroforestry systems in Benin. Fresh arils, dried arils and soap are traded in local and regional markets in Benin providing substantial revenues for farmers, especially women. Recently, ackee has emerged as high-priority species for domestication in Benin but information necessary to elaborate a clear domestication strategy is still very sketchy. This study addresses farmers' indigenous knowledge on uses, management and perception of variation of the species among different ethnic groups taking into account also gender differences.


METHODS
240 randomly selected persons (50% women) belonging to five different ethnic groups, 5 women active in the processing of ackee fruits and 6 traditional healers were surveyed with semi-structured interviews. Information collected refer mainly to the motivation of the respondents to conserve ackee trees in their land, the local uses, the perception of variation, the preference in fruits traits, the management practices to improve the production and regenerate ackee.


RESULTS
People have different interests on using ackee, variable knowledge on uses and management practices, and have reported nine differentiation criteria mainly related to the fruits. Ackee phenotypes with preferred fruit traits are perceived by local people to be more abundant in managed in-situ and cultivated stands than in unmanaged wild stands, suggesting that traditional management has initiated a domestication process. As many as 22 diseases have been reported to be healed with ackee. In general, indigenous knowledge about ackee varies among ethnic and gender groups.


CONCLUSIONS
With the variation observed among ethnic groups and gender groups for indigenous knowledge and preference in fruits traits, a multiple breeding sampling strategy is recommended during germplasm collection and multiplication. This approach will promote sustainable use and conservation of ackee genetic resources.
Prospective validation of the pediatric appendicitis score.

OBJECTIVE
To prospectively validate the Pediatric Appendicitis Score (PAS), developed on a cohort of children with abdominal pain suggestive of appendicitis, in unselected children with abdominal pain who present to the emergency department.


STUDY DESIGN
Over a 19-month period, we prospectively recruited children 1 to 17 years old who came to our tertiary pediatric emergency department, with a chief complaint of abdominal pain of duration less than 7 days. PAS components included fever >38 degrees C, anorexia, nausea/vomiting, cough/percussion/hopping tenderness (2 points), right-lower-quadrant tenderness (2 points), migration of pain, leukocytosis >10 000 cells/mm(3), and polymorphonuclear neutrophilia > 7500 cells/mm(3). A follow-up call was made to verify final outcome. Sensitivity, specificity, and the receiver operating characteristic curve of the PAS with respect to diagnosis of appendicitis were calculated.


RESULTS
We collected data on 849 children. 123 (14.5%) had pathologic study-proven appendicitis. Mean (median, range) score for children with appendicitis and without appendicitis was 7.0 (7, 2-10) and 1.9 (1, 0-9), respectively. If a cutoff PAS of <or=2 was used to discharge patients without further investigation, only 3 (2.4%) with appendicitis would be sent home. If a PAS of >or=7 was used to take children to the operating room without further investigation, only 29 (4%) would not have appendicitis. For the PAS the area under the receiver operator curve was 0.95.


CONCLUSIONS
The PAS is useful, because a value <or=2 (found in 73% of children without appendicitis) has high validity for ruling out appendicitis, and a score >or=7 (found in 61% of children with appendicitis) has a high validity for predicting the presence of appendicitis. Children with PAS of 3 to 6 (37% with appendicitis and 23% without appendicitis in this study) should undergo further investigation such as observation, ultrasonography, or computed tomography.
Separation of Reflection Components by Sparse Non-negative Matrix Factorization

This paper presents a novel method for separating reflection components in a single image based on the dichromatic reflection model. Our method is based on a modified version of sparse non-negative matrix factorization (NMF). It simultaneously performs the estimation of body colors and the separation of reflection components through optimization. Our method does not use a spatial prior such as smoothness of colors on the object surface, which is in contrast with recent methods attempting to use such priors to improve separation accuracy. Experimental results show that as compared with these recent methods that use priors, our method is more accurate and robust. For example, it can better deal with difficult cases such as the case where a body color is close to the illumination color.
Short and long term effects of a lifestyle intervention for construction workers at risk for cardiovascular disease: a randomized controlled trial

BACKGROUND
The prevalence of overweight and elevated cardiovascular disease (CVD) risk among workers in the construction industry is relatively high. Improving lifestyle lowers CVD risk and may have work-related benefits. The purpose of the study was to evaluate the effects on physical activity (PA), diet, and smoking of a lifestyle intervention consisting of individual counseling among male workers in the construction industry with an elevated risk of cardiovascular disease (CVD).


METHODS
In a randomized controlled trial including 816 male blue- and white-collar workers in the construction industry with an elevated risk of CVD, usual care was compared to a 6-month lifestyle intervention. The intervention consisted of individual counseling using motivational interviewing techniques, and was delivered by an occupational physician or occupational nurse. In three face to face and four telephone contacts, the participant's risk profile, personal determinants, and barriers for behavior change were discussed, and personal goals were set. Participants chose to aim at either diet and PA, or smoking. Data were collected at baseline and after six and 12 months, by means of a questionnaire. To analyse the data, linear and logistic regression analyses were performed.


RESULTS
The intervention had a statistically significant beneficial effect on snack intake (β-1.9, 95%CI -3.7; -0.02) and fruit intake (β 1.7, 95%CI 0.6; 2.9) at 6 months. The effect on snack intake was sustained until 12 months; 6 months after the intervention had ended (β -1.9, 95%CI -3.6; -0.2). The intervention effects on leisure time PA and metabolic equivalent-minutes were not statistically significant. The beneficial effect on smoking was statistically significant at 6 (OR smoking 0.3, 95%CI 0.1;0.7), but not at 12 months (OR 0.8, 95%CI 0.4; 1.6).


CONCLUSIONS
Beneficial effects on smoking, fruit, and snack intake can be achieved by an individual-based lifestyle intervention among male construction workers with an elevated risk of CVD. Future research should be done on strategies to improve leisure time PA and on determinants of maintenance of changed behavior. Considering the rising prevalence of unhealthy lifestyle and CVD, especially in the aging population, implementation of this intervention in the occupational health care setting is recommended.


TRIAL REGISTRATION
Current Controlled Trials ISRCTN60545588
Flywheel energy and power storage systems

For ages flywheels have been used to achieve smooth operation of machines. The early models where purely mechanical consisting of only a stone wheel attached to an axle. Nowadays flywheels are complex constructions where energy is stored mechanically and transferred to and from the flywheel by an integrated motor/generator. The stone wheel has been replaced by a steel or composite rotor and magnetic bearings have been introduced. Today flywheels are used as supplementary UPS storage at several industries world over. Future applications span a wide range including electric vehicles, intermediate storage for renewable energy generation and direct grid applications from power quality issues to offering an alternative to strengthening transmission. One of the key issues for viable flywheel construction is a high overall efficiency, hence a reduction of the total losses. By increasing the voltage, current losses are decreased and otherwise necessary transformer steps become redundant. So far flywheels over 10 kV have not been constructed, mainly due to isolation problems associated with high voltage, but also because of limitations in the power electronics. Recent progress in semi-conductor technology enables faster switching and lower costs. The predominant part of prior studies have been directed towards optimising mechanical issues whereas the electro technical part now seem to show great potential for improvement. An overview of flywheel technology and previous projects are presented and moreover a 200 kW flywheel using high voltage technology is simulated. r 2006 Elsevier Ltd. All rights reserved.
Comparing Cortical Plasticity Induced by Conventional and High-Definition 4 × 1 Ring tDCS: A Neurophysiological Study

BACKGROUND
Transcranial direct current stimulation (tDCS) induces long-lasting NMDA receptor-dependent cortical plasticity via persistent subthreshold polarization of neuronal membranes. Conventional bipolar tDCS is applied with two large (35 cm(2)) rectangular electrodes, resulting in directional modulation of neuronal excitability. Recently a newly designed 4 × 1 high-definition (HD) tDCS protocol was proposed for more focal stimulation according to the results of computational modeling. HD tDCS utilizes small disc electrodes deployed in 4 × 1 ring configuration whereby the physiological effects of the induced electric field are thought to be grossly constrained to the cortical area circumscribed by the ring.


OBJECTIVE
We aim to compare the physiological effects of both tDCS electrode arrangements on motor cortex excitability.


METHODS
tDCS was applied with 2 mA for 10 min. Fourteen healthy subjects participated, and motor cortex excitability was monitored by transcranial magnetic stimulation (TMS) before and after tDCS.


RESULTS
Excitability enhancement following anodal and a respective reduction after cathodal stimulation occurred in both, conventional and HD tDCS. However, the plastic changes showed a more delayed peak at 30 min and longer lasting after-effects for more than 2 h after HD tDCS for both polarities, as compared to conventional tDCS.


CONCLUSION
The results show that this new electrode arrangement is efficient for the induction of neuroplasticity in the primary motor cortex. The pattern of aftereffects might be compatible with the concept of GABA-mediated surround inhibition, which should be explored in future studies directly.
Cystoscopic diagnosis of bladder cancer by intravesical instillation of 5-aminolevulinic acid induced porphyrin fluorescence--the Singapore experience.

OBJECTIVES
1) To determine whether fluorescence cystoscopy after intravesical administration of 5-aminolevulinic acid (5-ALA) is more sensitive in detection of dysplasia and bladder cancer when compared with conventional cystoscopy. 2) To determine the safety of using 5-ALA.


MATERIALS AND METHODS
A 3% 5-ALA solution was instilled intravesically before cystoscopy in 41 patients. The 5-ALA-induced porphyrin fluorescence was excited by violet light from a xenon arc lamp (lambda 375-440 mm).


RESULTS
Among the 175 biopsies obtained, the sensitivity of the fluorescence cystoscopy was greater than that of conventional cystoscopy (89.1% versus 65.6%, P < 0.05). Specificity was at 64.8% and 83.8% respectively with P < 0.05. Duration of ALA instillation did not seem to affect the sensitivity and specificity of photodynamic diagnosis. The procedures were well tolerated by all patients with no additional complication.


CONCLUSIONS
Fluorescence-guided biopsies are more sensitive than random biopsies in detecting dysplasia or bladder cancer without additional risk or complication. The duration of ALA instillation did not seem to affect the accuracy of photodynamic diagnosis.
Applications of perceptual hash algorithm in agriculture images

According to the characteristics of agriculture image, new image recognition scheme and image authentication scheme were designed, which based on perceptual hash algorithm. Some tomato leaf diseases pictures were used to achieve image perceptual hash feature extraction. And the experimental results show that the same diseases images have closer perceptual hash characteristics.
Islam and Online Imagery on Malaysian Tourist Destination Websites

In December 1996, TIME magazine published an article titled ‘‘Finding God on the Web,’’ which projected how the Internet would shape information seeking on faith and religion. A decade later, the Web has become a popular tool for gathering religious information as well as information and imagery related to religious travel. Yet there is little research on religious destination imagery online. Imagery—positive or negative, pictographic or narrative—influences the selection of tourism destinations. This study explored online Muslim images in Malaysia via interviews and content analyses of pictures and text on tourism destination websites’ homepages. The results reveal minimal portrayal of Muslim images by Malaysian tourism destination organizations. This study adds to the small body of research, especially in Muslim countries, on online religious imagery and suggests avenues for tourism operators in Malaysia and elsewhere to improve their online image with both Muslim and non-Muslim travelers.
Nonlinear ferroelectric and dielectric properties of bi(Mg0.5Ti0.5)O3-PbTiO3 perovskite solid solutions

Polycrystalline samples of Bi(Mg0.5Ti0.5)O3-PbTiO3 (BMT-PT) solid solutions exhibit high ferroelectric Curie temperatures and are promising materials for high temperature piezoelectric devices. A morphotropic phase boundary (MPB) between ferroelectric rhombohedral and tetragonal phases occurs between BMT-PT ratio of 70-30 and 65-35 compositions. In the present investigation, ceramics having BMT-PT ratios in the range from 70-30 to 50-50 were prepared by a conventional solid state reaction method. The change of crystal structure as a function of composition and temperature has been studied using high temperature X-ray diffraction. Polarisation-Electric field hysteresis curves at different temperatures show antiferroelectric behaviour for x = 0.30, 0.35 and 0.40 compositions while 0.45 and 0.50 show a ferroelectric behavior. Copyright © 2012 VBRI Press.
The cooperative capital constraint revisited

Purpose - – There is little reason a priori to expect that a cooperative firm’s capital needs are different from a non-cooperative firm’s needs if the two firms are otherwise similar in function and size and operate within similar market economies. However, the notion that cooperatives face capital constraints that investor-owned firms (IOFs) do not is a persistent theme in the literature. The paper aims to discuss these issues. Design/methodology/approach - – The authors revisit this hypothesis with an empirical examination of capital constraints in a panel data set of US agricultural supply and grain cooperatives and IOFs. Findings - – The findings are mixed. While the authors find little to suggest that cooperatives face financial constraints on borrowing in the short run, relative to IOFs, the authors do find some evidence that for long-term investments, a capital constraint may exist. Originality/value - – These short and long run differences have implications for the survival and growth of agricultural cooperatives. While in the short run, access to debt financing allows these firms to operative profitably, ultimately long-term large investments in technology and fixed assets will be required to maintain competitiveness in this industry.
Twitter spammer detection using data stream clustering

The rapid growth of Twitter has triggered a dramatic increase in spam volume and sophistication. The abuse of certain Twitter components such as ‘‘hashtags’’, ‘‘mentions’’, and shortened URLs enables spammers to operate efficiently. These same features, however, may be a key factor in identifying new spam accounts as shown in previous studies. Our study provides three novel contributions. Firstly, previous studies have approached spam detection as a classification problem, whereas we view it as an anomaly detection problem. Secondly, 95 one-gram features from tweet text were introduced alongside the user information analyzed in previous studies. Finally, to effectively handle the streaming nature of tweets, two stream clustering algorithms, StreamKM++ and DenStream, were modified to facilitate spam identification. Both algorithms clustered normal Twitter users, treating outliers as spammers. Each of these algorithms performed well individually, with StreamKM++ achieving 99% recall and a 6.4% false positive rate; and DenStream producing 99% recall and a 2.8% false positive rate. When used in conjunction, these algorithms reached 100% recall and a 2.2% false positive rate, meaning that our system was able to identify 100% of the spammers in our test while incorrectly detecting only 2.2% of normal users as spammers. 2013 Published by Elsevier Inc.