LLukas22/scidocs huggingface dataset:
Hyperuricemia and metabolic syndrome in children with overweight and obesity.

OBJECTIVE
To study the prevalence of hyperuricemia in children with overweight or obesity and analyze the relation with metabolic syndrome and the diseases that define it.


MATERIALS AND METHODS
This is a cross-sectional prevalence study in 148 children recruited from pediatric endocrinology consultation, with overweight or obesity (12±3 years, 48% boys, BMI 31.8±6.1). We measured BMI, waist-height, waist circumference, blood pressure with standard instrumentation and glucose (fasting and after overload with 75 g), insulin resistance, cholesterol HDL, triglycerides and uric acid.


RESULTS
The prevalence of hyperuricemia was 53%. Patients with hyperuricemia had greater BMI (33.9 vs 30.6, p=0.003), plus waist circumference (101.4 vs 91.1cm, p<0.001), higher blood pressure: systolic (123.4 vs 111.9 mm Hg, p<0.001), diastolic (78.2 vs 68.7 mm Hg, p<0.001). They presented greater blood glucose after overload oral glucose (107.5 vs 100.7 mg/dl, p=0.03), insulin was higher (29.2 vs 20.7 mg/dl, p=0.001) as well as HOMA IR (6.5 vs 4.4, p<0.001) and HDL levels were lower (49.5 vs 54.4 mg/dl, p=0.02). Uric acid's level which most is the likely diagnosis of metabolic syndrome corresponds to 5.4 mg/dl in our sample (sensitivity: 64% and specificity 62%).


CONCLUSION
The prevalence of hyperuricemia in children with overweight and obesity is high. In the group of patients with obesity and hyperuricemia, we found out that the parameters measured to diagnose with metabolic syndrome were less favorable. Uric acid's level from where there is a higher possibility to see metabolic syndrome is 5.4 mg/dl.
The impact of two multiple-choice question formats on the problem-solving strategies used by novices and experts

BACKGROUND
Pencil-and-paper examination formats, and specifically the standard, five-option multiple-choice question, have often been questioned as a means for assessing higher-order clinical reasoning or problem solving. This study firstly investigated whether two paper formats with differing number of alternatives (standard five-option and extended-matching questions) can test problem-solving abilities. Secondly, the impact of the alternatives number on psychometrics and problem-solving strategies was examined.


METHODS
Think-aloud protocols were collected to determine the problem-solving strategy used by experts and non-experts in answering Gastroenterology questions, across the two pencil-and-paper formats.


RESULTS
The two formats demonstrated equal ability in testing problem-solving abilities, while the number of alternatives did not significantly impact psychometrics or problem-solving strategies utilized.


CONCLUSIONS
These results support the notion that well-constructed multiple-choice questions can in fact test higher order clinical reasoning. Furthermore, it can be concluded that in testing clinical reasoning, the question stem, or content, remains more important than the number of alternatives.
Randomized phase III trial comparing biweekly infusional fluorouracil/leucovorin alone or with irinotecan in the adjuvant treatment of stage III colon cancer: PETACC-3.

PURPOSE The primary objective of this randomized, multicenter, phase III trial was to investigate whether the addition of irinotecan to the de Gramont infusional fluorouracil (FU)/leucovorin (LV) adjuvant regimen (LV5FU2) would improve disease-free survival (DFS) in patients with stage III colon cancer. PATIENTS AND METHODS After curatively intentioned surgery, patients with stage II and III colon cancer were randomly allocated surgery to receive LV5FU2 (LV 200 mg/m(2) as a 2-hour infusion, followed by FU; as a 400 mg/m(2) bolus and then a 600 mg/m(2) continuous infusion over 22 hours, days 1 and 2, every 2 weeks for 12 cycles: de Gramont regimen) with or without irinotecan (180 mg/m(2) as a 30- to 90-minute infusion, day 1, every 2 weeks). In total, 260 (7.9%) of 3,278 patients received an alternative high-dose infusional FU/LV regimen (Arbeitsgemeinschaft Internische Onkologie regimen) with or without irinotecan. Results The principal efficacy analysis was based on 2,094 treated patients with stage III disease, randomly allocated in the LV5FU2 strata. After a median follow-up of 66.3 months, the 5-year DFS rate was 56.7% with irinotecan/LV5FU2 and 54.3% with LV5FU2 alone (primary end point: log-rank P = .106). Combining irinotecan with LV5FU2 did not significantly improve overall survival in this patient group compared with LV5FU2 alone (5-year rate 73.6% v 71.3%, respectively; log-rank P = .094). The addition of irinotecan to LV5FU2 was associated with an increased incidence of grade 3 to 4 GI events and neutropenia. CONCLUSION Irinotecan added to LV5FU2 as adjuvant therapy did not confer a statistically significant improvement in DFS or overall survival in patients with stage III colon cancer compared with LV5FU2 alone.
System modeling using the Parallel DEVS formalism and the Modelica language

1569-190X/$ see front matter 2010 Elsevier B.V doi:10.1016/j.simpat.2010.03.004 * Corresponding author. Tel.: +34 91 3089469. E-mail addresses: vsanz@dia.uned.es (V. Sanz) (S. Dormido). The analysis and identification of the requirements needed to describe P-DEVS models using the Modelica language are discussed in this manuscript. A new free Modelica package, named DEVSLib, is presented. It facilitates the description of discrete-event models according to the Parallel DEVS formalism and provides components to interface with continuous-time models, which can be composed using other Modelica libraries. In addition, DEVSLib contains models implementing Quantized State System (QSS) integration methods. The model definition capabilities provided by DEVSLib are similar to the ones in the simulation environments specifically designed for supporting the DEVS formalism. The main additional advantage of DEVSLib is that it can be used together with other Modelica libraries in order to compose multi-domain and multi-formalism hybrid models. DEVSLib is included in the DESLib Modelica library, which is freely available for download at http:// www.euclides.dia.uned.es. 2010 Elsevier B.V. All rights reserved.
The striking effect of the Heart Outcomes Prevention Evaluation (HOPE) on ramipril prescribing in Ontario.

BACKGROUND
The Heart Outcomes Prevention Evaluation (HOPE), a Canadian-led, multicentre, randomized controlled trial, demonstrated the effectiveness of the ACE inhibitor ramipril in the secondary prevention of cardiovascular disease in patients who were at high risk for cardiovascular events but did not have left ventricular dysfunction or heart failure. We studied whether HOPE affected the prescribing of ACE inhibitors generally, and ramipril specifically, in Ontario, where the trial was coordinated.


METHODS
We used linked administrative databases to examine prescribing patterns for ACE inhibitors in the 1.29 million to 1.54 million elderly (aged 66 and over) residents of Ontario during the study period and specifically those with diabetes or congestive heart failure. For all new prescriptions for these drugs filled between Jan. 1, 1993, and Mar. 31, 2001, we conducted time-series analyses to measure any association with the release of the HOPE results.


RESULTS
The monthly number of new prescriptions for ramipril from the time it was introduced in 1995 until HOPE's early termination, in April 1999, peaked at 58 per 100,000 elderly Ontario residents. The rate increased to 92/100,000 in May, coincident with newspaper coverage of the trial's early termination, then fell back to 63/100,000 in August. After HOPE's results were formally released, starting Aug. 31, the rate increased significantly; it peaked at 304/100,000 in May 2000 (p < 0.01). The market share of ramipril among ACE inhibitors also increased significantly (p < 0.01), both overall and among patients with diabetes or congestive heart failure.


INTERPRETATION
HOPE led to a striking and unprecedented increase, over 400%, in ramipril prescribing to elderly Ontario residents, including those not eligible for the trial. Many physicians are now prescribing ramipril for patients with diabetes or congestive heart failure.
High-frequency rupture properties of the Mw 9.0 off the Pacific coast of Tohoku Earthquake

The devastating Mw 9.0 earthquake on March 11, 2011 is one of the most complex earthquakes of all the recent large events. Its source region is compact for an earthquake of this size, but it has highly variable amount of energy release from different segments. These conditions prevent conventional back-projection analysis to reveal the details of the rupture process. We incorporate a new metric to assess coherency as a part of back-projection analysis to ensure identification of these weak features. The main features obtained with this new back-projection approach are consistent with previous back-projection results, with strongest energy release downdip and close to the epicentral location. The main rupture propagation is along strike, in southwestern direction giving rise to the length extent of the earthquake. The new coherency function also allows us to investigate rupture characteristics at the beginning of the earthquake, resolving initial updip propagation from the epicentral location. Furthermore, some of very weak energy in the stacks are identified with high coherency. These additional source regions extend the area of the earthquake farther south and north than the region that has been imaged by other back-projection studies.
Ectopic pregnancy.

Ectopic pregnancy is a high-risk diagnosis that is increasing in frequency and is still commonly missed in the emergency department. The emergency physician needs a high index of suspicion and must understand that the history, physical examination, and a single quantitative beta-hCG level cannot reliably rule out an ectopic pregnancy. Most pregnant patients who present to the emergency department during the first trimester with abdominal or pelvic pain, regardless of the presence of vaginal bleeding, should undergo further evaluation with ultrasonography. Ultrasound findings in conjunction with quantitative beta-hCG levels guide the management of the patient.
Risk factors for nosocomial infection among hospitalised severe influenza A(H1N1)pdm09 patients.

BACKGROUND AND OBJECTIVE
Nosocomial infections following influenza are important causes of death, requiring early implementation of preventive measures, but predictors for nosocomial infection in the early stage remained undetermined. We aimed to determine risk factors that can help clinicians identify patients with high risk of nosocomial infection following influenza on admission.


METHOD
Using a database prospectively collected through a Chinese national network for hospitalised severe influenza A(H1N1)pdm09 patients, we compared the characteristics on admission between patients with and without nosocomial infection.


RESULT
A total of 2146 patients were enrolled in the final analysis with a median age of 36.0 years, male patients comprising 50.2% of the sample and 232 (10.8%) patients complicated with nosocomial infection. Acinetobacter baumannii, Pseudomonas aeruginosa, Stenotrophomonas maltophilia and Staphylococcus aureus were the leading pathogens, and invasive fungal infection was found in 30 cases (12.9%). The in-hospital mortality was much higher in patients with nosocomial infection than those without (45.7% vs 11.8%, P < 0.001). Need for mechanical ventilation (OR: 3.336; 95% CI 2.362-4.712), sepsis (OR: 2.125; 95% CI 1.236-3.651), ICU admission on first day (OR: 2.074; 95% CI 1.425-3.019), lymphocytopenia (OR: 1.906; 95% CI 1.361-2.671), age > 65 years (OR: 1.83; 95% CI 1.04-3.21) and anaemia (OR: 1.39; 95% CI 1.39-2.79) were independently associated with nosocomial infection.


CONCLUSION
Need for mechanical ventilation, sepsis, ICU admission on first day, lymphocytopenia, older age and anaemia were independent risk factors that can help clinicians identify severe influenza A(H1N1)pdm09 patients at high risk of nosocomial infection.
Improved streamflow forecasting using self-organizing radial basis function artificial neural networks

Streamflow forecasting has always been a challenging task for water resources engineers and managers and a major component of water resources system control. In this study, we explore the applicability of a Self Organizing Radial Basis (SORB) function to one-step ahead forecasting of daily streamflow. SORB uses a Gaussian Radial Basis Function architecture in conjunction with the Self-Organizing Feature Map (SOFM) used in data classification. SORB outperforms the two other ANN algorithms, the well known Multi-layer Feedforward Network (MFN) and Self-Organizing Linear Output map (SOLO) neural network for simulation of daily streamflow in the semi-arid Salt River basin. The applicability of the linear regression model was also investigated and concluded that the regression model is not reliable for this study. To generalize the model and derive a robust parameter set, cross-validation is applied and its outcome is compared with the split sample test. Crossvalidation justifies the validity of the nonlinear relationship set up between input and output data. q 2004 Elsevier B.V. All rights reserved.
Resistive Impedance Matching Circuit for Piezoelectric Energy Harvesting

A two-stage power conditioning circuit consisting of an AC DC converter followed by a DC DC converter is proposed for a vibration-based energy harvesting system. The power conditioning circuit intends to maximize the amount of power extracted from a piezoelectric energy harvester by matching the source impedance with the circuit by adaptively adjusting the duty cycle. An equivalent electrical circuit representation derived from a distributed-parameter piezoelectric energy harvester model is adapted to enable the impedance matching method proposed here. For a given piezoelectric energy harvester, there is a theoretical maximum power output that is determined by the mechanical damping, base acceleration, and the effective mass of the harvester structure under base excitation. Experimental results are given to validate the effectiveness of the proposed resistive impedance matching circuit around the first resonance frequency of a cantilevered piezoelectric energy harvester.
IPEX as a Result of Mutations in FOXP3

Immunodysregulation, polyendocrinopathy, enteropathy, X-linked (IPEX) syndrome is a rare disorder caused by mutations in the FOXP3 gene that result in the defective development of CD4+CD25+ regulatory T cells which constitute an important T cell subset involved in immune homeostasis and protection against autoimmunity. Their deficiency is the hallmark of IPEX and leads to severe autoimmune phenomena including autoimmune enteropathy, dermatitis, thyroiditis, and type 1 diabetes, frequently resulting in death within the first 2 years of life. Apart from its clinical implications, IPEX illustrates the importance of immunoregulatory cells such as CD4+CD25+ regulatory T cells.
Chondroitin sulfate and sulfated hyaluronan-containing collagen coatings of titanium implants influence peri-implant bone formation in a minipig model.

An improved osseous integration of dental implants in patients with lower bone quality is of particular interest. The aim of this study was to evaluate the effect of artificial extracellular matrix implant coatings on early bone formation. The coatings contained collagen (coll) in conjunction with either chondroitin sulfate (CS) or sulfated hyaluronan (sHya). Thirty-six screw-type, grit-blasted, and acid-etched titanium implants were inserted in the mandible of 6 minipigs. Three surface states were tested: (1) uncoated control (2) coll/CS (3) coll/sHya. After healing periods of 4 and 8 weeks, bone implant contact (BIC), bone volume density (BVD) as well as osteoid related parameters were measured. After 4 weeks, control implants showed a BIC of 44% which was comparable to coll/CS coated implants (48%) and significantly higher compared to coll/sHya coatings (37%, p = 0.012). This difference leveled out after 8 weeks. No significant differences could be detected for BVD values after 4 weeks and all surfaces showed reduced BVD values after 8 weeks. However, at that time, BVD around both, coll/CS (30%, p = 0.029), and coll/sHya (32%, p = 0.015), coatings was significantly higher compared to controls (22%). The osteoid implant contact (OIC) showed no significant differences after 4 weeks. After 8 weeks OIC for controls was comparable to coll/CS, the latter being significantly higher compared to coll/sHya (0.9% vs. 0.4%, p = 0.012). There were no significant differences in osteoid volume density. In summary, implant surface coatings by the chosen organic components of the extracellular matrix showed a certain potential to influence osseointegration in vivo.
Estimation of lung vital capacity before and after coronary artery bypass grafting surgery: a comparison of incentive spirometer and ventilometry

BACKGROUND
Measurement of vital capacity (VC) by spirometry is the most widely used technique for lung function evaluation, however, this form of assessment is costly and further investigation of other reliable methods at lower cost is necessary.


OBJECTIVE
To analyze the correlation between direct vital capacity measured with ventilometer and with incentive inspirometer in patients in pre and post cardiac surgery.


METHODOLOGY
Cross-sectional comparative study with patients undergoing cardiac surgery. Respiratory parameters were evaluated through the measurement of VC performed by ventilometer and inspirometer. To analyze data normality the Kolmogorov-Smirnov test was applied, for correlation the Pearson correlation coefficient was used and for comparison of variables in pre and post operative period Student's t test was adopted. We established a level of ignificance of 5%. Data was presented as an average, standard deviation and relative frequency when needed. The significance level was set at 5%.


RESULTS
We studied 52 patients undergoing cardiac surgery, 20 patients in preoperative with VC-ventilometer: 32.95 ± 11.4 ml/kg and VC-inspirometer: 28.9 ± 11 ml/Kg, r = 0.7 p < 0.001. In the post operatory, 32 patients were evaluated with VC-ventilometer: 28.27 ± 12.48 ml/kg and VC-inspirometer: 26.98 ± 11 ml/Kg, r = 0.95 p < 0.001. Presenting a very high correlation between the evaluation forms studied.


CONCLUSION
There was a high correlation between DVC measures with ventilometer and incentive spirometer in pre and post CABG surgery. Despite this, arises the necessity of further studies to evaluate the repercussion of this method in lowering costs at hospitals.
A time-frequency domain approach of heart rate estimation from photoplethysmographic (PPG) signal

ObjectiveHeart rate monitoring using wrist type Photoplethysmographic (PPG) signals is getting popularity because of construction simplicity and low cost of wearable devices. The task becomes very difficult due to the presence of various motion artifacts. The objective is to develop algorithms to reduce the effect of motion artifacts and thus obtain accurate heart rate estimation. MethodsProposed heart rate estimation scheme utilizes both time and frequency domain analyses. Unlike conventional single stage adaptive filter, multi-stage cascaded adaptive filtering is introduced by using three channel accelerometer data to reduce the effect of motion artifacts. Both recursive least squares (RLS) and least mean squares (LMS) adaptive filters are tested. Moreover, singular spectrum analysis (SSA) is employed to obtain improved spectral peak tracking. The outputs from the filter block and SSA operation are logically combined and used for spectral domain heart rate estimation. Finally, a tracking algorithm is incorporated considering neighbouring estimates. ResultsThe proposed method provides an average absolute error of 1.16 beat per minute (BPM) with a standard deviation of 1.74 BPM while tested on publicly available database consisting of recordings from 12 subjects during physical activities. ConclusionIt is found that the proposed method provides consistently better heart rate estimation performance in comparison to that recently reported by TROIKA, JOSS and SPECTRAP methods. SignificanceThe proposed method offers very low estimation error and a smooth heart rate tracking with simple algorithmic approach and thus feasible for implementing in wearable devices to monitor heart rate for fitness and clinical purpose.
The effects of the novel SHIP1 activator AQX-1125 on allergen-induced responses in mild-to-moderate asthma.

BACKGROUND
SH2-containing inositol-5'-phosphatase 1 (SHIP1) is an endogenous inhibitor of the phosphoinositide-3-kinase pathway that is involved in the activation and chemotaxis of inflammatory cells. AQX-1125 is a first-in-class, oral SHIP1 activator with a novel anti-inflammatory mode of action.


OBJECTIVE
To evaluate the effects of AQX-1125 on airway responses to allergen challenge in mild-to-moderate asthmatic patients.


METHODS
A randomized, double-blind, placebo-controlled, two-way crossover study was performed in 22 steroid-naïve mild-to-moderate asthmatics with a documented late-phase response to inhaled allergen (LAR). AQX-1125 (450 mg daily) or placebo was administered orally for 7 days. Allergen challenge was performed on day 6 (2 h postdose), followed by methacholine challenge (day 7), and induced sputum collection and fractional exhaled nitric oxide (FeNO).


RESULTS
AQX-1125 significantly attenuated the late-phase response compared with placebo (FEV1 4-10 h: mean difference 150 mL, 20%; P = 0.027) and significantly increased the minimum FEV1 during LAR (mean difference 180 mL; P = 0.014). AQX-1125 had no effect on the early-phase response. AQX-1125 showed a trend in reduction of sputum eosinophils, neutrophils and macrophages although this did not achieve significance as there were only 11 paired samples for analysis. There was no effect on methacholine responsiveness or FeNO. Pharmacokinetic data showed AQX-1125 was rapidly absorbed with geometric mean Cmax and AUC0-24 h values of 1417 ng/mL and 16 727 h ng/mL, respectively. AQX-1125 was well tolerated, but mild GI side-effects (dyspepsia, nausea and abdominal pain) were described in 4/22 subjects on active treatment. These side-effects were mild self-limiting, required no further treatment and did not lead to discontinuation of therapy.


CONCLUSION AND CLINICAL RELEVANCE
AQX-1125, a novel oral SHIP1 activator, significantly reduces the late response to allergen challenge, with a trend to reduce airway inflammation. AQX-1125 was safe and well tolerated and merits further investigation in inflammatory disorders.
Anatomy for nurses: providing students with the best learning experience.

A good understanding of human anatomy is clinically relevant for many health care professionals. A detailed knowledge of where, as well as how, to palpate, percuss or auscultate is essential for adequate assessment, provision of treatment and ongoing care of patients. Thus, the linking of human anatomy and clinical assessment is essential. However, Australian nursing students are often excluded from experiences, such as exposure to cadaveric material, which might enable them to gain a good working knowledge of internal human anatomy. Herein systematic student feedback from nursing students who were provided with a single exposure to prosected human anatomical material and were able to manipulate and interact with that material is presented, in the context of the integrative educational aims and goals of this learning and teaching activity. Thus, this study aims to add to the literature informing ongoing dialog regarding the best set of tools to teach anatomy to students of nursing.