LLukas22/scidocs huggingface dataset:
Cardiac arrest in the Emergency Department: a report from the National Registry of Cardiopulmonary Resuscitation.

BACKGROUND
Little is known about cardiac arrests (CA) in the Emergency Department (ED). The objective of this study was to determine the characteristics of ED CAs.


METHODS
60,852 adult, in-patient CA events in the National Registry of Cardiopulmonary Resuscitation were included. Multiple regression analysis compared ED CA with those occurring in the ICU, telemetry, or general floors. Subgroup analysis examined traumatic vs. non-traumatic ED CA and ED CA occurring after a successful pre-hospital resuscitation (recurrent) vs. primary ED event.


RESULTS
In multivariate analysis, ED location predicted improved survival to discharge (OR 0.74, 95%CI [0.67-0.82]). ED CAs had higher survival to discharge rates (ED 22.2, ICU 15.5, Tele 19.8, Floor 10.8, p<0.0001), better cerebral performance category scores (ED 1.59, ICU 1.73, Tele 1.96, Floor 1.69, p<0.0001), and shorter post-event length of stays (ED 8.6, ICU 17.5, Tele 16.5, Floor 14.2 days, p<0.0001) than other locations. Recurrent ED CAs were less likely to survive to discharge (10.1% vs. 24.6%, p<0.0001) than primary events. Trauma-related ED CAs had a lower survival to discharge rate (7.5% vs. 23.8%, p<0.0001), were less likely to be caused by an arrhythmia (23.6% vs. 32.5%, p<0.0008), and more likely to be preceded by hypotension or shock (41.6% vs. 29.0%, p<0.0001) than non-trauma ED events.


CONCLUSIONS
ED CAs have unique characteristics, and better survival and neurologic outcomes compared to other hospital locations. Primary ED CAs have a better chance of survival to discharge than recurrent events. Traumatic ED CAs have worse outcomes than non-traumatic CA.
Three 15-min Bouts of Moderate Postmeal Walking Significantly Improves 24-h Glycemic Control in Older People at Risk for Impaired Glucose Tolerance

OBJECTIVE
The purpose of this study was to compare the effectiveness of three 15-min bouts of postmeal walking with 45 min of sustained walking on 24-h glycemic control in older persons at risk for glucose intolerance.


RESEARCH DESIGN AND METHODS
Inactive older (≥60 years of age) participants (N=10) were recruited from the community and were nonsmoking, with a BMI<35 kg/m2 and a fasting blood glucose concentration between 105 and 125 mg dL(-1). Participants completed three randomly ordered exercise protocols spaced 4 weeks apart. Each protocol comprised a 48-h stay in a whole-room calorimeter, with the first day serving as the control day. On the second day, participants engaged in either 1) postmeal walking for 15 min or 45 min of sustained walking performed at 2) 10:30 a.m. or 3) 4:30 p.m. All walking was on a treadmill at an absolute intensity of 3 METs. Interstitial glucose concentrations were determined over 48 h with a continuous glucose monitor. Substrate utilization was measured continuously by respiratory exchange (VCO2/VO2).


RESULTS
Both sustained morning walking (127±23 vs. 118±14 mg dL(-1)) and postmeal walking (129±24 vs. 116±13 mg dL(-1)) significantly improved 24-h glycemic control relative to the control day (P<0.05). Moreover, postmeal walking was significantly (P<0.01) more effective than 45 min of sustained morning or afternoon walking in lowering 3-h postdinner glucose between the control and experimental day.


CONCLUSIONS
Short, intermittent bouts of postmeal walking appear to be an effective way to control postprandial hyperglycemia in older people.
Estimation of tail-related risk measures for heteroscedastic financial time series: an extreme value approach

We propose a method for estimating VaR and related risk measures describing the tail of the conditional distribution of a heteroscedastic nancial return series. Our approach combines pseudo-maximum-likelihood tting of GARCH models to estimate the current volatility and extreme value theory (EVT) for estimating the tail of the innovation distribution of the GARCH model. We use our method to estimate conditional quantiles (VaR) and conditional expected shortfalls (the expected size of a return exceeding VaR), this being an alternative measure of tail risk with better theoretical properties than the quantile. Using backtesting of historical daily return series we show that our procedure gives better one-day estimates than methods which ignore the heavy tails of the innovations or the stochastic nature of the volatility. With the help of our tted models we adopt a Monte Carlo approach to estimating the conditional quantiles of returns over multiple-day horizons and nd that this outperforms the simple square-root-of-time scaling method. J.E.L. Subject Classi cation: C.22, G.10, G.21
Lived-experience participation in nurse education: reducing stigma and enhancing popularity.

Mental health nursing consistently emerges as less popular than other specialties, and both service users and mental health practitioners are affected by negative attitudes. Education is fundamental to attracting students to the field of mental health nursing. The aim of this study was to determine the impact of undergraduate mental health curricula on student attitudes to people with mental illness, and career interest in mental health nursing. A traditional mental health course was compared to a course delivered by a person with lived experience of mental illness (and mental health service use) for its impact on student attitudes and career intentions in mental health nursing (cohort 1: n = 70, cohort 2: n = 131, respectively). In both cohorts, attitudes were measured via self-report, before and after the course, and changes were investigated through within-subjects t-tests. The lived experience-led course demonstrated statistically-significant positive changes in intentions to pursue mental health nursing and a decrease in negative stereotypes, which were not observed in the traditional course. The valuable contribution of mental health nursing emerged in the traditional, but not lived-experience-led, programmes. These findings support the value of an academic with lived experience of mental health challenges in promoting attraction to mental health nursing as a career option.
Patient characteristics, practice activities, and one-month outcomes for chronic, recurrent low-back pain treated by chiropractors and family medicine physicians: a practice-based feasibility study.

BACKGROUND
Chronic low-back pain is a significant public health problem for which few therapies are supported by predictable outcomes. In this report, practice activities and 1-month outcomes data are presented for 93 chiropractic patients and 45 medical patients with chronic, recurrent low-back pain.


DESIGN
A prospective, observational, community-based feasibility study involving chiropractors and family medicine physicians.


SETTING
Forty private chiropractic clinics, the outpatient clinic of the Department of Family Medicine at Oregon Health Sciences University, and 5 other Portland area family medicine clinics.


OUTCOMES MEASURES
The main outcome measures were pain severity, functional disability, sensory and affective pain quality at 1 month, and patient satisfaction assessed at 7 to 10 days and at 1 month.


RESULTS
Although differences were noted in age, sex, education, and employment, the patients were closely matched at baseline with respect to frequency, severity, and type of low-back pain and the psychosocial dimensions of general health. The treatment of choice for chiropractors was spinal manipulation and physical therapy modalities; for medical physicians antiinflammatory agents were most frequently used. Chiropractic patients averaged 4 visits, and medical patients averaged 1 visit. On average, chiropractic patients showed improvement across all outcomes: 31% change in pain severity, 29% in functional disability, 36% in sensory pain quality, and 57% in affective pain quality. Medical patients showed minimal improvement in pain severity (6%) and functional disability (1%) and showed deterioration in the sensory (29%) and affective (26%) dimensions of pain quality. Satisfaction scores were higher for chiropractic patients. Outcomes for medical patients were heavily dependent on psychosocial status at baseline.


CONCLUSION
Patients with chronic low-back pain treated by chiropractors show greater improvement and satisfaction at 1 month than patients treated by family physicians. Nonclinical factors may play an important role in patient progress. Findings from the Health Resources and Services Administration-funded project will include a report on the influence of practice activities, including more frequent visits by chiropractic patients, on the clinical course of low-back pain and patient outcomes. (J Manipulative Physiol Ther 2000;23:239-45).
EURObservational Research Programme: the Heart Failure Pilot Survey (ESC-HF Pilot).

AIMS
The primary objective of the new ESC-HF Pilot Survey was to describe the clinical epidemiology of outpatients and inpatients with heart failure (HF) and the diagnostic/therapeutic processes applied across 12 participating European countries. This pilot study was specifically aimed at validating the structure, performance, and quality of the data set, for continuing the survey into a permanent registry.


METHODS AND RESULTS
The ESC-HF Pilot study is a prospective, multicentre, observational survey conducted in 136 cardiology centres from 12 European countries selected to represent the different health systems and care attitudes across Europe. All outpatients with HF and patients admitted for acute HF were included during the enrolment period (1 day per week for 8 consecutive months). From October 2009 to May 2010, 5118 patients were included in this pilot survey, of which 1892 (37%) were admitted for acute HF and 3226 (63%) for chronic HF. Ischaemic aetiology was reported in about half of the patients. In patients admitted for acute HF, the most frequent clinical profile was decompensated HF (75% of cases), whereas pulmonary oedema and cardiogenic shock were reported, respectively, in 13.3 and 2.3% of the cases. The total in-hospital mortality rate was 3.8% and was cardiovascular in 90.1% of the cases. Lowest and highest mortality rates were observed in hypertensive HF and in cardiogenic shock, respectively. More than 80% of patients with chronic HF were treated with renin-angiotensin-aldosterone system blockers and β-adrenergic blockers. However, target doses of such drugs were reached in one-third to one-fourth of the patients only.


CONCLUSION
The ESC-HF Pilot Survey is an example of the possibility of utilizing an observational methodology to get insights into the current clinical practice in Europe, whose picture will be completed by the 1-year follow-up. Moreover, this study offered the opportunity to refine the organizational structure of a long-term, extended European network.
Prevalence and clinical correlates of pruritus in patients with systemic sclerosis: an updated analysis of 959 patients.

OBJECTIVES
One previous study has estimated the prevalence of pruritus in SSc, but that study had important limitations due to a relatively small sample size. The present study updates the analyses of the previous study using a substantially larger patient sample. The objectives were to (i) document the proportion of patients who experience pruritus on most days overall and by disease duration and (ii) identify clinical correlates of pruritus.


METHODS
Patients from the Canadian Scleroderma Research Group Registry ≥1 year after registry enrolment were asked on two consecutive annual visits whether they had experienced pruritus in the past month on most days and underwent clinical history and medical examination. Multiple logistic regression was used to assess the association between sociodemographic and clinical variables and pruritus.


RESULTS
Among 959 patients, 42.6% reported pruritus. Of 693 patients with data for both visits, 333 (48%) did not report pruritus at either visit, 209 (30%) reported pruritus at both visits and 151 (22%) reported pruritus at one, but not the other, visit. The presence of pruritus was independently associated with greater skin involvement [odds ratio (OR) = 1.02, 95% CI 1.00, 1.04, P = 0.017] and greater gastrointestinal involvement (OR = 1.24, 95% CI 1.04, 1.48, P = 0.018).


CONCLUSION
Pruritus is common in SSc across the course of the disease and has small but statistically significant associations with the degree of skin involvement and gastrointestinal system involvement.
Near Point of Convergence after Concussion in Children.

PURPOSE
To determine the incidence of abnormal near point of convergence (NPC) after acute concussion in pediatric patients and to describe the clinical course of such patients.


METHODS
A retrospective cohort study of 275 pediatric patients 5 to 18 years of age presenting to a tertiary care children's hospital subspecialty concussion program with a new concussion between July 1, 2014 and June 30, 2015 was conducted.


RESULTS
Sixty-seven out of 275 pediatric patients presenting to a subspecialty concussion referral program were found to have abnormal NPC on physical examination as measured by an accommodative rule. Twenty-six (46%) patients recovered with standard clinical care over a median time frame of 4.5 weeks (range 1-18), including a brief period of cognitive and physical rest followed by gradual return to school and physical activities without any formal interventions. An additional 23 (41%) patients recovered a median of 11 weeks post-injury after referral for formal vestibular therapy, including interventions for abnormal convergence, such as Brock string and pencil pushups. Seven (13%) patients with persistent abnormal NPC and concomitant symptoms that necessitated referral for formal office-based vision therapy with developmental optometry recovered a median of 23 weeks post-injury and a median of 16 weeks after referral to vision therapy.


CONCLUSIONS
Assessment for NPC is a diagnostic entity that warrants consideration in children with concussion. Concussion questionnaires may not be sensitive to detect vision symptoms in children, making an accurate assessment for convergence important in the evaluation of concussion. Some children with abnormal NPC will recover without any formal intervention after concussion; however, a subset of patients with persistent abnormal NPC after concussion may benefit from interventions including vestibular and/or vision therapy.
Decision points for adoption cloud computing in small, medium enterprises (SMEs)

This study is on adoption of cloud computing by small and medium enterprises (SMEs) in India. With advent of cloud computing technologies, firms are able to concentrate on their core activities while outsourcing the entire technology related supporting processes. This approach has been adopted by many firms which have resulted in lowering operational cost without losing focus on customer needs. However, the adoption has not been high among small and medium enterprises. This paper, through preliminary survey, finds out different situations for adopting cloud computing services. It was found that SMEs can benefit the most if they extend the adoption of cloud services for computation intensive jobs like data mining, modeling and simulation. The regular advantages for SMEs have been re-established such as lowering investment in hardware, more efficient use of computing systems in existing data centers, easier scale-up of the applications and services, cost saving on technology infrastructure and faster software upgrades without much expense. The results can be used by SMEs as decision point for adopting cloud services.
Enhanced eco-driving system based on V2X communication

The concept of Eco-driving is proposed to reduce the fuel consumption of vehicles while maintaining dynamic performance. MPC controller has been introduced to achieve comprehensive goals including safety, fuel consumption and comfort of driving. Yet the information of the surrounded vehicles and road conditions have not been fully utilized. An enhanced algorithm taking the driving style of preceding vehicle, host vehicle drivers and road information into account is proposed in this paper. It is tested by the results of simulation that the controller becomes more flexible and can reduce the fuel consumption of the controlled vehicle in different working conditions with the help of the enhanced algorithm.
Symptomatic posterior vitreous detachment and the incidence of delayed retinal breaks: case series and meta-analysis.

PURPOSE
To establish the necessity for an early follow-up examination after an initial funduscopic examination with negative results for patients with acute, symptomatic posterior vitreous detachment (PVD).


DESIGN
Retrospective case-control study and meta-analysis.


METHODS
Records were reviewed of patients seeking treatment over a 4.5-year period who were diagnosed with an acute, symptomatic PVD. A MEDLINE search to identify all published observational case studies reporting vitreoretinal pathologic features after acute, symptomatic PVD.


RESULTS
The incidence of retinal tears in eyes with a symptomatic PVD was 8.2%. The overall rate of retinal break in the meta-analysis portion of the study was 21.7%. In total, 1.8% of patients had retinal tears that were not seen on initial examination. Of the 29 patients with delayed-onset retinal breaks, 24 (82.8%) had at least one of the following: vitreous hemorrhage at initial examination, hemorrhage in the peripheral retina at initial examination, or new symptoms.


CONCLUSIONS
If the results of an initial examination of a patient with an acute, symptomatic PVD are negative for retinal tears, the necessity of early follow-up may be best determined by the presence of pigmented cells in the vitreous, vitreous hemorrhage, or retinal hemorrhage. Most patients with symptomatic PVD may not need an early follow-up examination.
Effect of asthma management education program on stress and compliance of patients with allergic asthma to house dust mite.

PURPOSE
This study was designed to examine the effect of asthma management education program applied to allergic asthma patients receiving immunotherapy due to house dust mite on their stress and compliance with health care regimens.


METHODS
A quasi experimental design with non-equivalent control group and non-synchronized design was used. The subjects of this study were 61 patients who were receiving immunotherapy at intervals of a week after their symptoms were diagnosed as house dust mite allergic asthma at the pulmonary department of a university hospital in Seoul. They were divided into an experimental group of 29 patients who received asthma management education and a control group of 32 patients. The asthma management education program was composed of group education (once) and reinforcement education (three times) with environmental therapy and immunotherapy to house dust mite.


RESULTS
Stress significantly decreased in the experimental group compared to that in the control group. Compliance with health care regimens significantly increased in the experimental group compared to that in the control group.


CONCLUSIONS
The results suggested that the asthma management education program is effective for the management of stress and the improvement of compliance in patients with allergic asthma to house dust mite.
Nanocauliflower like structure of CdS thin film for solar cell photovoltaic applications: In situ tin doping by chemical bath deposition technique

Abstract We report on surface morphology changes of in situ tin (Sn) doped cadmium sulphide (CdS) thin film nanostructures prepared on a glass substrate using the chemical bath deposition (CBD) technique. Sn-doping in the presence of triethanolammine (TEOA) as complexing agent resulted in the formation of nanocauliflower like structure of CdS thin film. X-ray diffraction (XRD) results indicated that Sn-doped CdS thin films show a hexagonal structure with a preferential orientation growth along the c -axis (0 0 2). The Sn 4+ doping markedly influenced on the evolution of the CdS nanostructures, resulting in the formation of nanocracks due to the substitution of Cd 2+ ions by larger-than-host Sn 4+ ions as well as a drastic increase in electrical conductivity. An improved optical transmittance property was also achieved by the Sn-doping with no considerable change in the energy band gap. Moreover, a large improvement in both electrical conductivity and photosensitivity observed in the Sn-doped CdS thin films suggests that Sn-doping is highly effective for applications as window/buffer layers in future solar cell applications. Structural evolution of cauliflower like nanostructures are also discussed in this paper.
Does Cognitive Function Increase over Time in the Healthy Elderly?

BACKGROUND
In dementia screening, most studies have focused on early cognitive impairment by comparing patients suffering from mild dementia or mild cognitive impairment with normal subjects. Few studies have focused on modifications over time of the cognitive function in the healthy elderly. The objective of the present study was to analyze the cognitive function changes of two different samples, born > 15 years apart.


METHOD
A first sample of 204 cognitively normal participants was recruited in the memory clinic of Broca hospital between 1991 and 1997. A second sample of 177 cognitively normal participants was recruited in 2008-2009 in the same institution. Both samples were from the same districts of Paris and were assessed with the same neuropsychological test battery. Mean cognitive test scores were compared between 1991 and 2008 samples, between < 80 years old and ≥ 80 years old in 1991 and 2008 samples, and finally between subjects < 80 year old of 1991 sample and subjects ≥ 80 years old of the 2008 sample. Means were compared with T-tests stratified on gender, age-groups and educational level.


RESULTS
Cognitive scores were significantly higher in the 2008 sample. Participants < 80 years old outperformed those ≥ 80 in both samples. However, participants < 80 years old in 1991 sample and subjects ≥ 80 in the 2008 sample, born on average in 1923, performed mostly identically.


CONCLUSION
This study showed a significant increase of cognitive scores over time. Further, contemporary octogenarians in the later sample performed like septuagenarians in the former sample. These findings might be consistent with the increase in life expectancy and life span in good health. The study highlights the necessity to take into account factors which may contaminate and artificially inflate the age-related differences in favor of younger to the older adults.
Challenges and Issues in Building Virtual Reality-Based e-Learning System

E-learning is a new teaching model nowadays. It gets further development and improvement with the impetus of the Virtual Reality (VR) technology, which can build a friendly human machine interface. VR is becoming increasingly important as a learning tool in the schools as well as in universities, due to its interactive and animated features. VR can be an effective method for teaching and reinforcing complex concepts by allowing students to interact with the visualization tools. The pattern which integrates the VR and e-learning technology not only riches teaching patterns but also improves learners’ ability of analyzing and solving problems. The virtual learning environment provides a new study method for students to understand certain events which have proven inappropriate and difficult in traditional education. This paper highlights and discusses the issues and challenges associated with implementing a virtual reality based e-learning environment. It explores educational uses of an e-learning environment in combination with VR technology.