LLukas22/scidocs huggingface dataset:
One year health status benefits following treatment for new onset or exacerbation of peripheral arterial disease symptoms: the importance of patients' baseline health status.

OBJECTIVE/BACKGROUND
Limited information is available on expected health status gains following invasive treatment in peripheral arterial disease (PAD). One year health status outcomes following invasive treatment for PAD were compared, and whether pre-procedural health status was indicative of 1 year health status gains was evaluated.


METHODS
Pre-procedural and 1 year health status (Short Form-12, Physical Component Score [PCS]) was prospectively assessed in a cohort of 474 patients, enrolled from 2 Dutch vascular clinics (March 2006-August 2011), with new or exacerbation of PAD symptoms. One year treatment strategy (invasive vs. non-invasive) and clinical information was abstracted. Quartiles of baseline health status scores and mean 1 year health status change scores were compared by invasive treatment for PAD. The numbers needed to treat (NNT) to obtain clinically relevant changes in 1 year health status were calculated. A propensity weight adjusted linear regression analysis was constructed to predict 1 year PCS scores.


RESULTS
Invasive treatment was performed in 39% of patients. Patients with baseline health status scores in the lowest quartile undergoing invasive treatment had the greatest improvement (mean invasive 11.3 ± 10.3 vs. mean non-invasive 5.3 ± 8.5 [p = .001, NNT = 3]), whereas those in the highest quartile improved less (.8 ± 6.3 vs. -3.0 ± 8.2 [p = .025, NNT = 90]). Undergoing invasive treatment (p < .0001) and lower baseline health status scores (p < .0001) were independently associated with greater 1 year health status gains.


CONCLUSION
Substantial improvements were found in patients presenting with lower pre-procedural health status scores, whereas patients with higher starting health status levels had less to gain by an invasive strategy.
Analysis of an online health social network

With the continued advances of Web 2.0, health-centered Online Social Networks (OSNs) are emerging to provide knowledge and support for those interested in managing their own health. Despite the success of the OSNs for better connecting the users through sharing statuses, photos, blogs, and so on, it is unclear how the users are willing to share health related information and whether these specialpurpose OSNs can actually change the users' health behaviors to become more healthy.
 This paper provides an empirical analysis of a health OSN, which allows its users to record their foods and exercises, to track their diet progress towards weight-change goals, and to socialize and group with each other for community support. Based on about five month data collected from more than 107,000 users, we studied their weigh-in behaviors and tracked their weight-change progress. We found that the users' weight changes correlated positively with the number of their friends and their friends' weight-change performance. We also show that the users' weight changes have rippling effects in the OSN due to the social influence. The strength of such online influence and its propagation distance appear to be greater than those in the real-world social network. To the best of our knowledge, this is the first detailed study of a large-scale modern health OSN.
On the metric properties of discrete space-filling curves

A space-filling curve is a linear traversal of a discrete finite multidimensional space. In order for this traversal to be useful in many applications, the curve should preserve "locality". We quantify "locality" and bound the locality of multidimensional space-filling curves. Classic Hilbert space-filling curves come close to achieving optimal locality.
Trichuris suis therapy in Crohn's disease.

BACKGROUND
Crohn's disease is common in highly industrialised Western countries where helminths are rare and uncommon in less developed areas of the world where most people carry worms. Helminths diminish immune responsiveness in naturally colonised humans and reduce inflammation in experimental colitis. Thus exposure to helminths may help prevent or even ameliorate Crohn's disease.


AIMS
The aim of the study was to determine the safety and possible efficacy of the intestinal helminth Trichuris suis in the treatment of patients with active Crohn's disease.


PATIENTS
Twenty nine patients with active Crohn's disease, defined by a Crohn's disease activity index (CDAI) > or =220 were enrolled in this open label study.


METHODS
All patients ingested 2500 live T suis ova every three weeks for 24 weeks, and disease activity was monitored by CDAI. Remission was defined as a decrease in CDAI to less than 150 while a response was defined as a decrease in CDAI of greater than 100.


RESULTS
At week 24, 23 patients (79.3%) responded (decrease in CDAI >100 points or CDAI <150) and 21/29 (72.4%) remitted (CDAI <150). Mean CDAI of responders decreased 177.1 points below baseline. Analysis at week 12 yielded similar results. There were no adverse events.


CONCLUSIONS
This new therapy may offer a unique, safe, and efficacious alternative for Crohn's disease management. These findings also support the premise that natural exposure to helminths such as T suis affords protection from immunological diseases like Crohn's disease.
Use of the Physician Orders for Life-Sustaining Treatment (POLST) paradigm program in the hospice setting.

BACKGROUND
The Physician Orders for Life-Sustaining Treatment (POLST) Paradigm Program was designed to ensure the full range of patient treatment preferences are honored throughout the health care system. Data are lacking about the use of POLST in the hospice setting.


OBJECTIVE
To assess use of the POLST by hospice programs, attitudes of hospice personnel toward POLST, the effect of POLST on the use of life-sustaining treatments, and the types of treatments options selected by hospice patients.


DESIGN
A telephone survey was conducted of all hospice programs in three states (Oregon, Wisconsin, and West Virginia) to assess POLST use. Staff at hospices reporting POLST use (n = 71) were asked additional questions about their attitudes toward the POLST. Chart reviews were conducted at a subsample of POLST-using programs in Oregon (n = 8), West Virginia (n = 5), and Wisconsin (n = 2).


RESULTS
The POLST is used widely in hospices in Oregon (100%) and West Virginia (85%) but only regionally in Wisconsin (6%). A majority of hospice staff interviewed believe the POLST is useful at preventing unwanted resuscitation (97%) and at initiating conversations about treatment preferences (96%). Preferences for treatment limitations were respected in 98% of cases and no one received unwanted cardiopulmonary resuscitation (CPR), intubation, intensive care, or feeding tubes. A majority of hospice patients (78%) with do-not-resuscitate (DNR) orders wanted more than the lowest level of treatment in at least one other category such as antibiotics or hospitalization.


CONCLUSIONS
The POLST is viewed by hospice personnel as useful, helpful, and reliable. It is effective at ensuring preferences for limitations are honored. When given a choice, most hospice patients want the option for more aggressive treatments in selected situations.
Contributions of the posterolateral bundle of the anterior cruciate ligament to anterior-posterior knee laxity and ligament forces.

PURPOSE
The purpose of this study was to measure changes in anterior-posterior (AP) laxity and graft forces after cutting the posterolateral (PL) bundle of the anterior cruciate ligament (ACL).


METHODS
Twelve fresh-frozen cadaveric knees underwent AP laxity testing at +/- 100 N of applied tibial force. Resultant forces in the ACL were recorded during passive extension from 120 degrees to 0 degrees with no tibial force, 100 N of anterior tibial force, 100 N of quadriceps force, and 5 Nm of internal tibial torque. The femoral origin of the PL bundle was identified, the ligament fibers were dissected from bone, and tests were repeated.


RESULTS
Cutting the PL bundle significantly increased mean laxity by +1.3 mm (at 0 degrees ), +1.1 mm (at 10 degrees ), and +0.5 mm (at 30 degrees ). For the passive knee extension tests, cutting the PL bundle significantly decreased mean ACL force at 0 degrees for all loading modes; the mean decreases were 31 N (with no tibial force), 50 N (with 100 N of anterior force), 33 N (with 100 N of quadriceps force), and 40 N (with 5 Nm of internal torque).


CONCLUSIONS
The decreases in ACL force at 0 degrees from cutting the PL bundle are consistent with the commonly accepted view that the PL bundle tightens with knee extension. Cutting the taut PL bundle did significantly increase AP laxity between 0 degrees and 30 degrees , but the increases were relatively small. Therefore we conclude that the PL bundle plays a relatively minor role in controlling anterior tibial translation.


CLINICAL RELEVANCE
In view of our findings, the need to reconstruct the PL bundle for better restoration of a normal AP laxity profile is questioned.
Medication errors of nurses in the emergency department

Patient safety is one of the main concepts in the field of healthcare provision and a major component of health services quality. One of the important stages in promotion of the safety level of patients is identification of medication errors and their causes. Medical errors such as medication errors are the most prevalent errors that threaten health and are a global problem. Execution of medication orders is an important part of the treatment and care process and is regarded as the main part of the nurses' performance. The purpose of this study was to explore the medication error reporting rate, error types and their causes among nurses in the emergency department. In this descriptive study, 94 nurses of the emergency department of Imam Khomeini Hospital Complex were selected based on census in 2010-2011. Data collection tool was a researcher-made questionnaire consisting of two parts: demographic information, and types and causes of medication errors. After confirming content-face validity, reliability of the questionnaire was determined to be 0.91 using Cronbach's alpha test. Data analyses were performed by descriptive statistics and inferential statistics. SPSS-16 software was used in this study and P values less than 0.05 were considered significant. The mean age of the nurses was 27.7 ± 3.4 years, and their working experience was 7.3 ± 3.4 years. Of participants 46.8% had committed medication errors in the past year, and the majority (69.04%) had committed the errors only once. Thirty two nurses (72.7%) had not reported medication errors to head nurses or the nursing office. The most prevalent types of medication errors were related to infusion rates (33.3%) and administering two doses of medicine instead of one (23.8%). The most important causes of medication errors were shortage of nurses (47.6%) and lack of sufficient pharmacological information (30.9%). This study showed that the risk of medication errors among nurses is high and medication errors are a major problem of nursing in the emergency department. We recommend increasing the number of nurses, adjusting the workload of the nursing staff in the emergency department, retraining courses to improve the staff's pharmacological information, modification of the education process, encouraging nurses to report medical errors and encouraging hospital managers to respond to errors in a constructive manner in order to enhance patient safety.
BASIC ASPECTS OF DIFFERENTIAL GEOMETRY

This is a very partial description of differential geometry as elaborated by Elie Cartan and expressed in a suitable language by Charles Ehresmann. As this new language has become classical, I apologize to those who know it better than myself: this text is not written for them. I am entirely responsable for the selection of materials and for the mistakes, if any. The framework is that of smooth1 (finite dimensional) manifolds and maps, whose definition is taken for granted—most of the notions we consider “pass” without any problem to the real analytic and (replacing R by C) complex and/or Banach categories. The kth derivative of a map f is denoted by Dkf as in [10]. Paths are defined on intervals.
When complexity science meets implementation science: a theoretical and empirical analysis of systems change

BACKGROUND
Implementation science has a core aim - to get evidence into practice. Early in the evidence-based medicine movement, this task was construed in linear terms, wherein the knowledge pipeline moved from evidence created in the laboratory through to clinical trials and, finally, via new tests, drugs, equipment, or procedures, into clinical practice. We now know that this straight-line thinking was naïve at best, and little more than an idealization, with multiple fractures appearing in the pipeline.


DISCUSSION
The knowledge pipeline derives from a mechanistic and linear approach to science, which, while delivering huge advances in medicine over the last two centuries, is limited in its application to complex social systems such as healthcare. Instead, complexity science, a theoretical approach to understanding interconnections among agents and how they give rise to emergent, dynamic, systems-level behaviors, represents an increasingly useful conceptual framework for change. Herein, we discuss what implementation science can learn from complexity science, and tease out some of the properties of healthcare systems that enable or constrain the goals we have for better, more effective, more evidence-based care. Two Australian examples, one largely top-down, predicated on applying new standards across the country, and the other largely bottom-up, adopting medical emergency teams in over 200 hospitals, provide empirical support for a complexity-informed approach to implementation. The key lessons are that change can be stimulated in many ways, but a triggering mechanism is needed, such as legislation or widespread stakeholder agreement; that feedback loops are crucial to continue change momentum; that extended sweeps of time are involved, typically much longer than believed at the outset; and that taking a systems-informed, complexity approach, having regard for existing networks and socio-technical characteristics, is beneficial.


CONCLUSION
Construing healthcare as a complex adaptive system implies that getting evidence into routine practice through a step-by-step model is not feasible. Complexity science forces us to consider the dynamic properties of systems and the varying characteristics that are deeply enmeshed in social practices, whilst indicating that multiple forces, variables, and influences must be factored into any change process, and that unpredictability and uncertainty are normal properties of multi-part, intricate systems.
TVT and Sparc suburethral slings: a case–control series

Two midurethral slings, TVT and Sparc, are the subject of this case–control series aimed at assessing sling placement, voiding function, bladder symptoms and patient satisfaction. Thirty-seven Sparc and 69 TVT patients were matched for age, body weight, pre-existing urge incontinence, preoperative voiding, concomitant surgery and length of follow-up (mean 0.6, range 0.1–1.5 years). There were no significant differences for subjective cure/improvement, satisfaction or symptoms of incontinence. The clinical stress test was positive in 8/37 Sparc vs 4/69 TVT patients (p=0.019). The TVT had a more negative effect (p=0.001) on postoperative voiding. The Sparc was situated more cranially at rest and further from the symphysis pubis, and was more mobile (p<0.001) on Valsalva. There are significant differences in medium-term outcomes after TVT and Sparc, affecting tape placement, mobility, effect on voiding function and objective stress continence. Patient satisfaction and subjective cure rates seem similar.
Risk Management in Construction Project

Risks have a significant impact on a construction project’s performance in terms of cost, time and quality. As the size and complexity of the projects have increased, an ability to manage risks throughout the construction process has become a central element preventing unwanted consequences. How risks are shared between the project actors is to a large extent governed by the procurement option and the content of the related contract documents. Therefore, selecting an appropriate project procurement option is a key issue for project actors. The overall aim of this research is to increase the understanding of risk management in the different procurement options: design-bid-build contracts, designbuild contracts and collaborative form of partnering. Deeper understanding is expected to contribute to a more effective risk management and, therefore, a better project output and better value for both clients and contractors. The study involves nine construction projects recently performed in Sweden and comprises a questionnaire survey and a series of interviews with clients, contractors and consultants involved in these construction projects. The findings of this work show a lack of an iterative approach to risk management, which is a weakness in current procurement practices. This aspect must be addressed if the risk management process is to serve projects and, thus, their clients. The absence of systematic risk management is especially noted in the programme phase, where it arguably has the greatest potential impact. The production phase is where most interest and activity are to be found. As a matter of practice, the communication of risks between the actors simply does not work to the extent that it must if projects are to be delivered with certainty, irrespective of the form of procurement. A clear connection between the procurement option and risk management in construction projects has been found. Traditional design-bid-build contracts do not create opportunities for open discussion of project risks and joint risk management. A number of drivers of and obstacles to effective risk management have been explored in the study. Every actor’s involvement in dialogue, effective communication and information exchange, open attitudes and trustful relationship are the factors that support open discussion of project risks and, therefore, contribute to successful risk management. Based on the findings, a number of recommendations facilitating more effective risk management have been developed for the industry practitioners. Keywords--Risk Management, Risk Allocation, Construction Project, Construction Contract, Design-BidBuild, Design-Build, Partnering
Improvements in confidence, sexual relationship and satisfaction measures: results of a randomized trial of tadalafil 5 mg taken once daily

An efficacy study of tadalafil (5 mg once daily) for treating erectile dysfunction included sexual satisfaction and psychosocial outcome measures such as Treatment satisfaction (THX) domain of Sexual Life Quality Questionnaire, Self-Esteem And Relationship (SEAR) questionnaire, Sexual Encounter Profile questions 4 (SEP4; hardness satisfaction) and 5 (SEP5; overall satisfaction), intercourse satisfaction (IS) and overall satisfaction (OS) domains of International Index of Erectile Function (IIEF), and partner SEP question 3 (pSEP3). After a 4-week run-in phase, participants were randomized to receive either tadalafil (N=264) or placebo (N=78) for 12 weeks. Participants and partners were more satisfied (THX) with tadalafil (75 and 73, respectively) than with placebo (51 and 55, respectively, P<0.001). Statistically significant improvements in sexual relationship, confidence, self-esteem and overall relationship (SEAR), in addition to IS, OS, SEP5 and pSEP3 for tadalafil compared with placebo (P<0.001) correlated with erectile function (EF) improvement (assessed by change from baseline in IIEF-EF score). Tadalafil significantly improved treatment and sexual satisfaction, while improving multiple outcomes measured by SEAR.
Unsupervised Intrusion Detection System

This thesis evolves around Intrusion Detection System (IDS) and Neural Network (NN). Intrusion detection systems are gaining more and more territory in the field of secure networks and new ideas and concepts regarding the intrusion detection process keep surfacing. One idea is to use a neural network algorithm for detecting intrusions. The neural network algorithms have the ability to be trained and ’learn’ socalled patterns in a given environment. This feature can be used in connection with an intrusion detection system, where the neural network algorithm can be trained to detect intrusions by recognizing patterns of an intrusion. This thesis outlines an investigation on the unsupervised neural network models and choice of one of them for evaluation and implementation. The thesis also includes works on computer networks, providing a description and analysis of the structure of the computer network in order to generate network features. A design proposal for such a system is documented in this thesis together with an implementation of an unsupervised intrusion detection system.
Symptoms and the distress they cause: comparison of an aldosterone antagonist and a calcium channel blocking agent in patients with systolic hypertension.

BACKGROUND
Although there has been increasing recognition that a substantial part of the cardiovascular, central nervous system, and renal conditions induced by renin-angiotensin-aldosterone system activation reflects an action of aldosterone, the potential influence of therapy designed to block aldosterone has been limited by the fact that spironolactone (until recently the only aldosterone antagonist available) exerts a substantial array of adverse effects. We sought to compare the magnitude of the distress induced by a widely used calcium channel blocking agent, amlodipine, and a new aldosterone antagonist, eplerenone, in patients treated for systolic hypertension.


METHODS
A total of 269 patients older than 50 years with systolic hypertension were randomized to either eplerenone, 50 mg/d, or amlodipine, 2.5 mg/d, and titrated to a maximum 200-mg eplerenone dose or 10-mg amlodipine dose. Patients were followed up for 24 weeks. Quality-of-life questionnaires (SF-36 Health Survey) and a validated instrument for assessing symptom distress (Symptom Distress Index) were administered at randomization and 24 weeks after starting treatment.


RESULTS
The systolic blood pressure response to eplerenone and amlodipine did not differ (eplerenone = -20.5 mm Hg and amlodipine = -20.1 mm Hg). For the quality-of-life analysis, 119 patients were randomized to eplerenone and 122 to amlodipine. No significant treatment group differences in the Symptom Distress Index were detected at baseline. There was an overall significant treatment effect on symptom distress in favor of eplerenone (P =.03). Indeed, Symptom Distress Index showed significant worsening distress in 36 of 71 symptoms in the amlodipine arm and none in the eplerenone arm. Significant treatment effect in favor of eplerenone was observed in 5 symptoms: ankle swelling, weight gain, nocturia, increased urination, and shortness of breath. Patients with symptom distress also showed an erosion of psychosocial measures of quality of life (P<.001).


CONCLUSIONS
The aldosterone antagonist eplerenone is substantially better tolerated than the widely used calcium-channel blocking agent amlodipine, with comparable reductions in systolic blood pressure. This feature should improve therapeutics in patients in whom blockade of aldosterone's effect would be helpful.