LLukas22/scidocs huggingface dataset:
Phase I pharmacological and bioavailability study of oral diflomotecan (BN80915), a novel E-ring-modified camptothecin analogue in adults with solid tumors.

PURPOSE
Diflomotecan (BN80915) is an E-ring modified camptothecin analogue that possesses greater lactone stability in plasma compared with other topoisomerase I inhibitors, a potential advantage for antitumor activity. As with other camptothecins, oral administration has pharmacological and clinical advantages. This Phase I study was performed to assess the feasibility of the administration of oral diflomotecan, to determine the maximum-tolerated, dose its bioavailability, and to explore the pharmacokinetics.


EXPERIMENTAL DESIGN
An initial i.v. bolus was administered to assess the bioavailability of diflomotecan. Fourteen days later, diflomotecan was administered p.o. once daily for 5 days to adult patients with solid malignant tumors and repeated every 3 weeks. BN80915 and its open lactone form BN80942 were measured.


RESULTS
Twenty-two patients entered the study and received a total of 57 cycles of oral diflomotecan at flat dose levels of 0.10, 0.20, 0.27, and 0.35 mg. The main toxicity was hematological, but some patients experienced alopecia, mild gastrointestinal toxicity, and fatigue. At the 0.35-mg dose level, 2 of 4 patients experienced dose-limiting toxicity comprising grade 3 thrombocytopenia with epistaxis and febrile neutropenia in 1 patient and uncomplicated grade 4 neutropenia lasting for >7 days in another. Toxicity was acceptable at the 0.27-mg dose level at which dose-limiting toxicities were observed in 3 of 12 patients (grade 4 neutropenia > 7 days, complicated by fever in 1 patient but without other signs of infection). After two cycles of diflomotecan, 6 patients had disease stabilization, which was maintained in 2 patients for 9 months and >1 year, respectively. Diflomotecan pharmacokinetics were linear over the dose range studied. Systemic exposure correlated with the fall in WBC counts. The mean oral bioavailability (+/-SD) was 72.24 +/- 59.2% across all dose levels. Urinary excretion of BN80915 was very low.


CONCLUSIONS
The recommended oral diflomotecan dose for Phase II studies is 0.27 mg/day x 5 every 3 weeks. This regimen is convenient and generally well tolerated with a favorable pharmacokinetic profile and high but variable bioavailability.
Speed/Accuracy Trade-Offs for Modern Convolutional Object Detectors

The goal of this paper is to serve as a guide for selecting a detection architecture that achieves the right speed/memory/accuracy balance for a given application and platform. To this end, we investigate various ways to trade accuracy for speed and memory usage in modern convolutional object detection systems. A number of successful systems have been proposed in recent years, but apples-toapples comparisons are difficult due to different base feature extractors (e.g., VGG, Residual Networks), different default image resolutions, as well as different hardware and software platforms. We present a unified implementation of the Faster R-CNN [30], R-FCN [6] and SSD [25] systems, which we view as meta-architectures and trace out the speed/accuracy trade-off curve created by using alternative feature extractors and varying other critical parameters such as image size within each of these meta-architectures. On one extreme end of this spectrum where speed and memory are critical, we present a detector that achieves real time speeds and can be deployed on a mobile device. On the opposite end in which accuracy is critical, we present a detector that achieves state-of-the-art performance measured on the COCO detection task.
Lobar atrophy of the liver

Lobar atrophy of the liver due to causes other than liver tumor or liver cirrhosis is a relatively rare pathological condition, and there are only a few reports in the literature. We report six such cases and try to evaluate the relationship between lobar atrophy and portal flow disturbance. The patients could be divided into two groups according to the site of the atrophy: those with atrophy of the left lobe (two cases) and those with atrophy of the right lobe (four cases). The two cases with atrophy of the right lobe had hepatholithiasis in the involved segments, but the cause was not determined in the remaining four cases. In all six cases, portal flow disturbance was noted, including invisibility of the portal vein in four cases, narrowing in one case, and portal thrombus in one case. Collateral circulation was not recognized in any of our cases. Of interest is the mode of lobar atrophy. Atrophy of the right lobe was always associated with marked enlargement of the left lobe, but that of the left lobe did not induce an enlargement of the right lobe.
The association between the duration of postoperative acute kidney injury and in-hospital mortality in critically ill patients after non-cardiac surgery: an observational cohort study.

OBJECTIVES
The severity of acute kidney injury (AKI) has been a well-known predictor for in-hospital mortality. Whether AKI duration could predict in-hospital mortality is not clear. This study determines the association between the in-hospital mortality and AKI duration in patients after non-cardiac surgery.


MATERIALS AND METHODS
Surgical patients who were admitted to the ICU were enrolled. AKI cases were defined using KDIGO guidelines and categorized according to the tertiles of AKI duration (1st tertile: 2 days, 2nd tertile: 3-6 days and 3rd tertile: 7 days). The adjusted hazard ratios (HRs) for in-hospital mortality are compared to those without AKI. The predictability of mortality is accessed by calculating the area under the curve (AUC) for the receiver operating characteristic (ROC) curve.


RESULTS
From a total of 318 postoperative patients, 98 developed AKI (1st tertile: 34 cases, 2nd tertile: 30 cases and 3rd tertile: 34 cases) and 220 had no AKI. The in-hospital mortality rates are 6.8% (non-AKI), 50% (1st tertile), 46.7% (2nd tertile) and 47% (3rd tertile). The HR's for in-hospital mortality are 7.92, 6.68 and 1.68, compared to the non-AKI group (p = 0.006, 0.021 and 0.476). Cumulative in-hospital survival rates are significantly different for the non-AKI group and the AKI groups (p < 0.001). The AUC for AKI duration and stage together (0.804) is higher than that for AKI stage and AKI duration alone (0.803 and 0.777) (both ps < 0.001).


CONCLUSION
In addition to severity, the duration of AKI may be a predictor of in-hospital mortality in patients, after non-cardiac surgery.
Investigating the link between self directed learning readiness and project based learning outcomes: the case of international Masters Students in an engineering management course

Modern learning approaches increasingly have fewer structured learning activities and more self directed learning tasks guided through consultation with academics. Such tasks are predominately project/problem based where the student is required to follow a freely guided road map to self discovery whilst simultaneously achieving desired learning outcomes for a particular course. However, many international students struggle to adjust to an Australian higher learning environment where they are being increasingly encouraged to undertake self directed learning (SDL). Thus, this paper proposes the concept that international students who have higher readiness for SDL gain greater learning outcomes from project based learning (PBL) approaches. To achieve this objective, a questionnaire survey of 26 students (65 per cent of class) completing an engineering management course was conducted. Linear regression analysis provided evidence that SDL readiness was a key enabler for achieving learning outcomes from PBL. In particular, having high self management skills was shown to be the most significant and reliable predictor for achieving learning outcomes from PBL. Through understanding students SDL readiness at the commencement of their engineering programs, academics can better tailor PBL support mechanisms to achieve desired learning outcomes.
The physiology/life-history nexus

histories. However, many potential combinations of life-history traits do not actually occur in nature [1,2]. Indeed, the few major axes of life-history variation stand in stark contrast to the variety of selective pressures on life histories: physical conditions, seasonality and unpredictability of the environment, food availability, predators and disease organisms, and relationships within social and family groups. Most life-history thinking has been concerned with constrained evolutionary responses to the environment. Differences among the life histories of species are viewed commonly as having a genetic basis and reflecting the optimization of phenotypes with respect to their environments. The optimal balance between parental investment and adult self-maintenance is also influenced by the life table of the population, particularly the relative value of present and future reproduction [1,3–5]. Constraints on adaptive responses are established by the allocation of limited time, energy and nutrients among competing functions [6,7]. Relatively less attention has been paid to nongenetic responses to the environment, such as adjustment of parental investment in response to perceived risk, except for the study of phenotypic flexibility (the reaction norm) as a life-history character itself [4,8,9]. Here we argue that physiological function, including endocrine control mechanisms, mediates the relationship of the organism to its environment and therefore is essential to our understanding of the diversification of life histories. Much of the variation in life histories, particularly variation in parental investment and self-maintenance, reflects phenotypic responses of individuals to environmental stresses and perceived risks. As a result, the organization of behavioral and physiological control mechanisms might constrain individual (and evolutionary) responses and limit life-history variation among species.
MOGCLASS: evaluation of a collaborative system of mobile devices for classroom music education of young children

Composition, listening, and performance are essential activities in classroom music education, yet conventional music classes impose unnecessary limitations on students' ability to develop these skills. Based on in-depth fieldwork and a user-centered design approach, we created MOGCLASS, a multimodal collaborative music environment that enhances students' musical experience and improves teachers' management of the classroom.
 We conducted a two-round system evaluation to improve the prototype and evaluate the system: Improvements were made based on the results from an iterative design evaluation, in which a trial system was implemented. The system then underwent a second round of evaluation through a three-week between-subject controlled experiment in a local primary school. Results showed that MOGCLASS is effective in motivating students to learn music, improving the way they collaborate with other students as well as helping teachers manage the classroom.
National evidence on the use of shared decision making in prostate-specific antigen screening.

PURPOSE
Recent clinical practice guidelines on prostate cancer screening using the prostate-specific antigen (PSA) test (PSA screening) have recommended that clinicians practice shared decision making-a process involving clinician-patient discussion of the pros, cons, and uncertainties of screening. We undertook a study to determine the prevalence of shared decision making in both PSA screening and nonscreening, as well as patient characteristics associated with shared decision making.


METHODS
A nationally representative sample of 3,427 men aged 50 to 74 years participating in the 2010 National Health Interview Survey responded to questions on the extent of shared decision making (past physician-patient discussion of advantages, disadvantages, and scientific uncertainty associated with PSA screening), PSA screening intensity (tests in past 5 years), and sociodemographic and health-related characteristics.


RESULTS
Nearly two-thirds (64.3%) of men reported no past physician-patient discussion of advantages, disadvantages, or scientific uncertainty (no shared decision making); 27.8% reported discussion of 1 to 2 elements only (partial shared decision making); 8.0% reported discussion of all 3 elements (full shared decision making). Nearly one-half (44.2%) reported no PSA screening, 27.8% reported low-intensity (less-than-annual) screening, and 25.1% reported high-intensity (nearly annual) screening. Absence of shared decision making was more prevalent in men who were not screened; 88% (95% CI, 86.2%-90.1%) of nonscreened men reported no shared decision making compared with 39% (95% CI, 35.0%-43.3%) of men undergoing high-intensity screening. Extent of shared decision making was associated with black race, Hispanic ethnicity, higher education, health insurance, and physician recommendation. Screening intensity was associated with older age, higher education, usual source of medical care, and physician recommendation, as well as with partial vs no or full shared decision making.


CONCLUSIONS
Most US men report little shared decision making in PSA screening, and the lack of shared decision making is more prevalent in nonscreened than in screened men. Screening intensity is greatest with partial shared decision making, and different elements of shared decision making are associated with distinct patient characteristics. Shared decision making needs to be improved in decisions for and against PSA screening.
Examining five- and ten-year survival in older women with breast cancer using cancer-specific geriatric assessment.

PURPOSE
To examine five- and ten-year survival based on cancer-specific geriatric assessment (C-SGA) in older women with early stage breast cancer.


METHODS
We evaluated 660 women ≥65-years old diagnosed with stage I-IIIA primary breast cancer and attending physician permission to contact in four geographic regions in the United States of America (USA). Data were collected over ten-years of follow-up from consenting women's medical records, telephone interviews, National Death Index and Social Security Death Index. C-SGA was described by four domains using six measures: socio-demographic (financial resources); clinical (comorbidity, obesity); function (physical function limitations); and psychosocial (general mental health, social support). Survival from all-cause and breast-cancer-specific mortality and receipt of guideline-recommended therapy was assessed for different groups of subjects with C-SGA domain deficits (cut-off ≥3 deficits).


RESULTS
The proportion of women with ≥3 C-SGA deficits surviving ten-years was consistently statistically significantly lower (all-cause 26% versus 46% and breast-cancer-specific 76% versus 89%, p≤0.04). The proportion significantly decreased as number of C-SGA deficits increased (linear trend p<0.0001). Receipt of guideline-recommended therapy decreased with age but not consistently by number of C-SGA deficits. The all-cause and breast-cancer-specific death rate at five- and ten-years was consistently approximately two times higher in women with ≥3 C-SGA deficits even when fully adjusted for confounding factors (HR(5-yrAllCauseFullyAdjusted)=1.87 [1.36-2.57], HR(10-yrAllCauseFullyAdjusted)=1.74 [1.35-2.15], HR(5-yrBreastCancerFullyAdjusted)=1.95 [1.18-3.20], HR(10-yrBreastCancerFullyAdjusted)=1.99 [1.21-3.28]).


CONCLUSION
Regardless of age and stage of disease, C-SGA predicts five- and ten-year all-cause and breast-cancer-specific survival in older women. Hence, C-SGA may provide an effective strategy to guide treatment decision-making and to identify risk factors for intervention.
Randomized controlled trial to investigate the impact of anticoagulation on the incidence of splenic or portal vein thrombosis after laparoscopic splenectomy.

BACKGROUND
Splenic and portal vein thrombosis (SPVT) is a potentially life-threatening complication of splenectomy. There is a paucity of studies examining the role of prophylactic pre- and postoperative anticoagulation in the prevention of this complication. We designed a prospective randomized controlled trial (RCT) to more rigorously address the impact of prophylactic anticoagulation on the incidence of asymptomatic or symptomatic SPVT, detected on Doppler ultrasound, after laparoscopic splenectomy.


METHODS
This 2-centre, phase II, prospective, open-label, parallel-assignment RCT compared no postoperative anticoagulation to a regimen of 40 mg of enoxaparin subcutaneously once daily for 21 days. All patients underwent Doppler ultrasonography of the splenoportal system preoperatively and again 14-28 days after surgery to screen for nonocclusive or occlusive thrombosis.


RESULTS
From November 2006 to November 2008, 35 patients were enrolled in the RCT. Four patients withdrew, 1 required conversion to an open procedure and 1 died at 3 months (the cause of death was not related to the study). Of the 29 patients remaining, 15 were randomly assigned to the anticoagulation group and 14 to the nonanticoagulation group. One (3.4%) patient in the treatment group experienced portal thrombosis. Rates of postoperative bleeding were similar in both groups.


CONCLUSION
This RCT of anticoagulation found a low overall risk of SPVT after laparoscopic splenectomy; however, this is an underpowered study, and further multicentred clinical trials are needed.
Progressive resistance strength training for improving physical function in older adults.

BACKGROUND
Muscle weakness in old age is associated with physical function decline. Progressive resistance strength training (PRT) exercises are designed to increase strength.


OBJECTIVES
To assess the effects of PRT on older people and identify adverse events.


SEARCH STRATEGY
We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialized Register (to March 2007), the Cochrane Central Register of Controlled Trials (The Cochrane Library 2007, Issue 2), MEDLINE (1966 to May 01, 2008), EMBASE (1980 to February 06 2007), CINAHL (1982 to July 01 2007) and two other electronic databases. We also searched reference lists of articles, reviewed conference abstracts and contacted authors.


SELECTION CRITERIA
Randomised controlled trials reporting physical outcomes of PRT for older people were included.


DATA COLLECTION AND ANALYSIS
Two review authors independently selected trials, assessed trial quality and extracted data. Data were pooled where appropriate.


MAIN RESULTS
One hundred and twenty one trials with 6700 participants were included. In most trials, PRT was performed two to three times per week and at a high intensity. PRT resulted in a small but significant improvement in physical ability (33 trials, 2172 participants; SMD 0.14, 95% CI 0.05 to 0.22). Functional limitation measures also showed improvements: e.g. there was a modest improvement in gait speed (24 trials, 1179 participants, MD 0.08 m/s, 95% CI 0.04 to 0.12); and a moderate to large effect for getting out of a chair (11 trials, 384 participants, SMD -0.94, 95% CI -1.49 to -0.38). PRT had a large positive effect on muscle strength (73 trials, 3059 participants, SMD 0.84, 95% CI 0.67 to 1.00). Participants with osteoarthritis reported a reduction in pain following PRT(6 trials, 503 participants, SMD -0.30, 95% CI -0.48 to -0.13). There was no evidence from 10 other trials (587 participants) that PRT had an effect on bodily pain. Adverse events were poorly recorded but adverse events related to musculoskeletal complaints, such as joint pain and muscle soreness, were reported in many of the studies that prospectively defined and monitored these events. Serious adverse events were rare, and no serious events were reported to be directly related to the exercise programme.


AUTHORS' CONCLUSIONS
This review provides evidence that PRT is an effective intervention for improving physical functioning in older people, including improving strength and the performance of some simple and complex activities. However, some caution is needed with transferring these exercises for use with clinical populations because adverse events are not adequately reported.
Outcomes of children at 2 years after planned cesarean birth versus planned vaginal birth for breech presentation at term: the International Randomized Term Breech Trial.

OBJECTIVE
The purpose of this study was to determine whether planned cesarean delivery for the singleton fetus in breech presentation at term reduces the risk of death or neurodevelopmental delay at 2 years of age.


STUDY DESIGN
In selected centers in the Term Breech Trial, children were screened for abnormalities at > or =2 years of age with the Ages and Stages Questionnaire, followed by a neurodevelopmental assessment if the Ages and Stages Questionnaire score was abnormal.


RESULTS
A total of 923 of 1159 children (79.6%) from 85 centers were followed to 2 years of age. The risk of death or neurodevelopmental delay was no different for the planned cesarean than for the planned vaginal birth groups (14 children [3.1%] vs 13 children [2.8%]; relative risk, 1.09; 95% CI, 0.52- 2.30; P = .85; risk difference, +0.3%; 95% CI, -1.9%, +2.4%).


CONCLUSION
Planned cesarean delivery is not associated with a reduction in risk of death or neurodevelopmental delay in children at 2 years of age.
A Self-Repair Algorithm for Ad Hoc On-Demand Distance Vector Routing

In this paper we propose SRAODV, a self-repair algorithm for ad Hoc on-demand distance vector routing in mobile ad hoc networks. Due to the ever changing topology and limited bandwidth, it is very hard to maintain good routes, and link break frequently occurs in mobile ad hoc networks. In AODV, the source node broadcasts RREQ message to find a new route to the destination when the link break occurs. As an improvement of AODV, SRAODV takes the intermediate node, which detects the link break, to repair the break route. Once the intermediate node cannot repair the route in time, the backward pre-hop node tends to find a new route instead. Obviously, the routing mechanism in the worst situation of the new algorithm is AODV, the source node finding a new route to the destination again. Simulations results show that SRAODV improves the throughput and decreases the latency of package delivery. And it is quite suitable for such a dynamic network
Comparative study of control selection in a national population-based case-control study: Estimating risk of smoking on cancer deaths in Chinese men

PURPOSE
To assess the validation of a novel control selection design by comparing the consistency between the new design and a routine design in a large case-control study that was incorporated into a nationwide mortality survey in China.


METHODS
A nationwide mortality study was conducted during 1989-1991. Surviving spouses or other relatives of all adults who died during 1986-1988 provided detailed information about their own as well as the deceased person's smoking history. In this study, 130,079 males who died of various smoking-related cancers at age 35 or over were taken as cases, while 103,248 male surviving spouses (same age range with cases) of women who died during the same period and 49,331 males who died from causes other than those related to smoking were used as control group 1 and control group 2, respectively. Consistency in the results when comparing cases with each of the control groups was assessed.


RESULTS
Consistency in the results was observed in the analyses using different control groups although cancer deaths varied with region and age. Equivalence could be ascertained using a 15% criterion in most cancer deaths which had high death rates in urban areas, but they were uncertain for most cancers in rural areas irrespective of whether the hypothesis testing showed significant differences or not.


CONCLUSIONS
Sex-matched living spouse control design as an alternative control selection for a case-control study is valid and feasible, and the basic principles of the equivalence study are also supported by epidemiological survey data.