LLukas22/scidocs huggingface dataset:
Prognostic value of the New York Heart Association classification in end-stage renal disease.

BACKGROUND
The New York Heart Association (NYHA) classification is a strong predictor of mortality and an established instrument for risk stratification in patients with heart disease but data on the validity of this classification in end-stage renal disease (ESRD) are sparse.


METHODS
In this study, we tested the predictive value of the NYHA in patients with ESRD and compared it with that of two established indexes of disease severity, i.e. the Khan index and the renal disease severity score (RDSS). The study cohort was composed of 1322 incident patients in a dialysis registry (772 male and 550 female, age 61+/-16 years).


RESULTS
During the follow-up period (41+/-27 months) 551 patients died. A multivariate COX model including the NYHA classification explained 39% of the variation in mortality, a figure almost identical to that of a model based on the RDSS (37%) and superior (P<0.001) to that provided by the Khan index-based model (32%). The area under the receiver operating characteristic curve of NYHA classification, as related to all-cause mortality, was 0.74 (95% CI: 0.71-0.77, P<0.001). Again, RDSS had a predictive value for mortality (0.74, 95% CI: 0.72-0.77) identical to that of NYHA and higher than that of the Khan index (0.70, 95% CI: 0.67-0.72).


CONCLUSION
The NYHA is a powerful predictor of mortality in ESRD and provides prognostic information equal or superior to that given by other established indexes of disease severity. Given the pervasive nature of cardiovascular disease in ESRD, this classification may be recommended for risk stratification in this population.
Pathways to the diagnosis of epithelial ovarian cancer in Australia.

OBJECTIVE
To describe the diagnostic pathways experienced by a large, representative group of Australian women with ovarian cancer, and to document the time between first presentation to a medical professional and clinical diagnosis.


DESIGN, SETTING AND PARTICIPANTS
1463 women with epithelial ovarian cancer from an Australia-wide population-based study (2002-2005) completed a telephone interview in which they described the events that led to the diagnosis of their cancer.


MAIN OUTCOME MEASURES
Number and type of doctors consulted, investigations performed, referral patterns and the time from first presentation to diagnosis.


RESULTS
Of the 1463 women, 145 had their cancer diagnosed incidentally and were excluded from analysis. Most of the remaining 1318 women (1222, 93%) presented first to their general practitioner. As a result of their first medical consultation, 75 women (6%) were given a diagnosis, and 484 (37%) were referred to a gynaecologist, gynaecological oncologist or oncologist for further assessment. Overall, 85% of women visited three or fewer doctors before their cancer was diagnosed; 66% of cancers were diagnosed within 1 month of the initial presentation, and 80% were diagnosed within 3 months. For 12% of women, the diagnostic process took longer than 6 months; this was more likely for women residing in remote Australia, those with lower incomes, and those presenting with abdominal pain or bowel symptoms, or with more than one symptom.


CONCLUSIONS
Despite anecdotal suggestions to the contrary, most women with ovarian cancer in Australia are investigated and diagnosed promptly. The diagnostic process is more protracted for a minority of women, and the factors we found to be associated with diagnostic delay warrant further investigation.
Evaluation of knowledge management tools using AHP

This paper presents an application of the analytic hierarchy process (AHP) used to select the most appropriate tool to support knowledge management (KM). This method adopts a multi-criteria approach that can be used to analyse and compare KM tools in the software market. The method is based on pairwise comparisons between several factors that affect the selection of the most appropriate KM tool. An AHP model is formulated and applied to a real case of assisting decision-makers in a leading communications company in Hong Kong to evaluate a suitable KM tool. We believe that the application shown can be of use to managers and that, because of its ease of implementation, others can benefit from this approach. q 2005 Elsevier Ltd. All rights reserved.
Conservative treatment of spontaneous osteonecrosis of the knee in the early stage: pulsed electromagnetic fields therapy.

BACKGROUND



HYPOTHESIS
pulsed electromagnetic fields treatment might improve symptoms in the early stage of spontaneous osteonecrosis of the knee.


METHODS
Twenty-eight patients (19M/9F, age 49.8±16.4 years) suffering from symptomatic (pain) Koshino stage I spontaneous osteonecrosis of the knee, confirmed by magnetic resonance imaging (MRI) were treated with local pulsed electromagnetic fields therapy (6 h daily for 90 days). Clinical evaluation: baseline, 6- and 24-month follow-up by VAS for pain, knee society score (KSS), Tegner and EQ-5D scales. MRI evaluation: baseline and 6-month follow-up, measuring bone marrow lesion's areas and grading these lesions by WORMS score. Failures: patients undergoing knee arthroplasty.


RESULTS
Pain significantly reduced at 6 months (from 73.2±20.7 to 29.6±21.3, p<0.0001), which remained almost unchanged at final follow-up (27.0±25.1). KSS significantly increased in first 6 months (from 34.0±13.3 to 76.1±15.9, p<0.0001) and was slightly reduced at final follow-up (72.5±13.5, p=0.0044). Tegner median level increased from baseline to 6-month follow-up (1(1-1) and 3(3-4), respectively, p<0.0001) and remained stable. EQ-5D improved significantly throughout the 24 months (0.32±0.33, baseline; 0.74±0.23, 6-month follow-up (p<0.0001); 0.86±0.15, 24-month follow-up (p=0.0071)). MRI evaluation: significant reduction of total WORMS mean score (p<0.0001) and mean femoral bone marrow lesion's area (p<0.05). This area reduction was present in 85% and was correlated to WORMS grading both for femur, tibia and total joint (p<0.05). Four failures (14.3%) at 24-month follow-up.


CONCLUSIONS
Pulsed electromagnetic fields stimulation significantly reduced knee pain and necrosis area in Koshino stage I spontaneous osteonecrosis of the knee already in the first 6 months, preserving 86% of knees from prosthetic surgery at 24-month follow-up. No correlation was found between MRI and clinical scores.


LEVEL OF EVIDENCE
Level IV; case series.
Cell invasion by Trypanosoma cruzi amastigotes of distinct infectivities: studies on signaling pathways

Trypanosoma cruzi metacyclic trypomastigotes of the major phylogenetic lineages use specific signaling pathways to invade host cells. Using a panel of drugs, we studied if the differences in the ability of extracellular amastigotes (EA) from G (T. cruzi I) and CL (T. cruzi II) strains to invade host cells could be associated to activation of specific signaling routes. Sonicated extracts from G or CL strain EA induced transient raises in HeLa cell intracellular Ca2+ levels in a dose-dependent manner. Treatment of EA with drugs that affect Ca2+ release from inositol-1,4,5-triphosphate-sensitive stores did not significantly affect the infectivity of either strain, whereas EA of both strains treated with ionomycin plus NH4Cl or nigericin that release Ca2+ from acidocalcisomes had their infectivity reduced. Treatment of parasites with adenylate cyclase activator forskolin increased the infectivity of both strains towards HeLa cells. These data, taken together, suggest that, for host cell invasion, G and CL strain EA engage signaling pathways that lead to an increase of cyclic adenosine monophosphate and Ca2+ mobilization from acidocalcisomes. Moreover, treatment of EA with genistein reduced by ∼45% the invasion of HeLa cells by G but not by CL strain, implicating a protein tyrosine kinase in the process. In line with this, HeLa cell extracts contained a protein tyrosine kinase activity that mediated the phosphorylation of 87- and 175-kDa polypeptides of EA from G but not from CL strain. Regarding the target cell response, the activation of host PI3 kinase appears to be required for invasion by either strain as treatment of HeLa cells with wortmannin reduced EA infectivity. These data overall reinforce the concept that cell invasion by T. cruzi EA markedly differs from the process involving metacyclic trypomastigotes.
Drainage water management for water quality protection

l and drainage has been central to the development of North America since colonial times, with the first organized drainage efforts occurring as early as the 1600s (Evans et al. 1996). Drainage has been encouraged to improve public highways, reduce public health risks, promote increased crop yield and reduced yield variability, reduce surface runoff and erosion, and increase land value. Agricultural drainage includes artificial subsurface drainage and surface drainage. Most agricultural producers improve the drainage on their land for better trafficability, to enhance field conditions, to facilitate timely planting and harvesting operations, and to help decrease crop damage from saturated soil and standing water during the growing season. Agricultural drainage improvement also decreases year-to-year variability in crop yield, ensuring consistent production. Increasingly, agricultural drainage is being targeted as a conduit for pollution, particularly nutrient pollution (Needelman et al. 2007). Considerable resistance exists in some regions to the expansion of drainage systems despite their importance to food production, with up to 50% of the cropland in some states under artificial drainage. However, because drainage ditches and subsurface drainage systems convert diffuse flows from the landscape into concentrated flows, they also provide opportunities for precision conservation, the targeting of specific practices to improve downstream water quality (Delgado and Berry 2008). Drainage water management has emerged with the objective of balancing production and conservation goals. To be effective, drainage water management strategies must account for the many facets of today’s farming systems. Neither one practice alone constitutes drainage water management nor does one strategy fit all systems. The export of agricultural drainage water and associated pollutants to surface water can be managed and controlled, to an extent, using a combination of infield, edge-of-field, and off-site practices. With all practices, their applicability and performance depends upon the context (physiography, management systems, and pollutants of concern) in which they are to be implemented. We seek to highlight major areas within drainage water management that show promise from the standpoint of water quality protection, emphasizing the array of options, established and nascent. What follows are eight components of drainage water management where land managers can positively impact water quality. Our intent is not to prescribe a strict set of practices, but rather to showcase areas within drainage water management that provide opportunities for water quality protection and enhancement.
Morning Home Blood Pressure Is a Strong Predictor of Coronary Artery Disease: The HONEST Study.

BACKGROUND
Few studies have evaluated out-of-office blood pressure (BP) measurements as predictors of coronary artery disease (CAD) events.


OBJECTIVES
The aim of this study was to determine morning home blood pressure (HBP) as a predictor of CAD events.


METHODS
Using data from the HONEST (Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure) study, we investigated the relationship between morning HBP and incidence of stroke and CAD events.


RESULTS
In 21,591 treated hypertensive patients (mean age 64.9 years; mean follow-up 2.02 years), 127 stroke events (2.92 per 1,000 patient-years), and 121 CAD events (2.78 per 1,000 patient-years) occurred. The incidence of stroke events was significantly higher in patients with morning home systolic blood pressure (HSBP) ≥145 mm Hg compared with <125 mm Hg, and in patients with clinic systolic blood pressure (CSBP) ≥150 mm Hg compared with <130 mm Hg. Hazard ratios (HRs) were 6.01 (95% confidence interval [CI]: 2.85 to 12.68) between patients with morning HSBP ≥155 mm Hg and those with morning HSBP <125 mm Hg and 5.82 (95% CI: 3.17 to 10.67) between patients with CSBP ≥160 mm Hg and those with CSBP <130 mm Hg; morning HSBP predicted stroke events similarly to CSBP. Incidence of CAD events was significantly higher in patients with morning HSBP ≥145 mm Hg compared with <125 mm Hg and in patients with CSBP ≥160 mm Hg compared with <130 mm Hg. The HR for morning HSBP ≥155 mm Hg was 6.24 (95% CI: 2.82 to 13.84) and for CSBP ≥160 mm Hg was 3.51 (95% CI: 1.71 to 7.20); therefore, compared with morning HSBP, CSBP may underestimate CAD risk. Goodness-of-fit analysis showed that morning HSBP predicted CAD events more strongly than CSBP.


CONCLUSIONS
Morning HBP is a strong predictor of future CAD and stroke events, and may be superior to clinic BP in this regard. There does not appear to be a J-curve in the relationship between morning HBP and stroke or CAD events. (Home blood pressure measurement with Olmesartan Naive patients to Establish Standard Target blood pressure Study [HONEST]; UMIN000002567).
Diversity in context: how organizational culture shapes reactions to workers with disabilities and others who are demographically different.

Successfully integrating workers with disabilities into their organizations is both a challenge and an opportunity facing managers today. Despite laws and business practices prohibiting discrimination against those with disabilities, people with disabilities are consistently underutilized in organizations. This article applies theories of demographic diversity in organizations to assert that a richer understanding of organizational cultures and their implications for workers with disabilities may shed light on the question of how and why workers with disabilities may be excluded from mainstream work experiences and career progression. The article briefly reviews business arguments that support integration of workers with disabilities into organizations based on their contribution to the overall diversity within the organization, and reviews complications in the research on diversity to date that leave important questions of the potential gains or detriments from increasing this diversity unanswered. The article then goes on to introduce organizational culture as an underinvestigated but likely potent tool in explaining how and when workers who are demographically different, in general, and with disabilities, specifically, may be successfully integrated into an organization's work force. The article introduces three types of organizational culture: culture of differentiation, culture of unity, and culture of integration. Each is explained in terms of its content and its implications for managing diversity. A discussion of the implications of culture as a primary tool for managing the integration of workers with disabilities concludes the paper.
(Cost)-effectiveness of self-treatment of exacerbations on the severity of exacerbations in patients with COPD: the COPE II study.

BACKGROUND
Chronic obstructive pulmonary disease (COPD) is a chronic disease with a high prevalence and rapidly increasing incidence rates. The effect of self-treatment of COPD exacerbations on the severity of exacerbations during a 1-year period was examined and a cost-effectiveness analysis was performed.


METHODS
Patients were randomly allocated to four 2-hour self-management sessions, with or without training in self-treatment of exacerbations. Patients in the self-treatment group received an action plan with the possibility to initiate a course of prednisolone (with or without antibiotics). During follow-up, all participants kept a daily symptom diary. These provided the data to calculate the frequency of exacerbations, the number of exacerbation days and mean daily severity scores.


RESULTS
Data were analysed for 142 randomised patients (self-treatment: n = 70; control: n = 72). The frequency of exacerbations was identical in both study groups (mean (SD) 3.5 (2.7)). Patients in the self-treatment group reported fewer exacerbation days (median 31 (interquartile range (IQR) 8.9-67.5) in the self-treatment group vs 40 (IQR 13.3-88.2) in the control group; p = 0.064); the difference was significant in the group of patients with a high number of exacerbation days per year (>137 (90th percentile of the whole study population); p = 0.028). The mean severity score of an exacerbation day was equal in both groups. No between-group differences were found in health-related quality of life. Cost-effectiveness analyses showed that applying self-treatment saved euro154 per patient, with a trend towards a lower probability for hospital admissions (0.20/patient/year in the self-treatment group vs 0.33/patient/year in the control group; p = 0.388) and a significant reduction of health care contacts (5.37/patient/year in the self-treatment group vs 6.51/patient/year in the control group; p = 0.043).


CONCLUSION
Self-treatment of exacerbations incorporated in a self-management programme leads to fewer exacerbation days and lower costs.
There is a Will, There is a Way: A New Mechanism for Traffic Control Based on VTL and VANET

Traffic light is regarded as one of the most effective ways to alleviate traffic congestion and carbon emission problems. However, traditional traffic light cannot meet the challenges in traffic regulation posed by the fast growing number of vehicles and increasing complexity of road conditions. In this paper, we propose a dynamic traffic regulation method based on virtual traffic light (VTL) for Vehicle Ad Hoc Network (VANET). In our framework, each vehicle can express its "will" - the desire of moving forward - and share among one another its "will" - value and related traffic information at a traffic light controlled intersection. Based on the traffic information collected in real time, the virtual traffic light in our scheme can be adaptive to the changing environment. We conducted a number of simulation experiments with different scenarios using network simulator NS3 combined with traffic simulator SUMO. The results demonstrate the viability of our solution in reducing waiting time and improving the traffic efficiency.
Labor Market Developments in China: A Neoclassical View

Labor Market Developments in China: A Neoclassical View This paper assesses the applicability of two alternative theories in understanding labor market developments in China: the classical view featuring a Lewis turning point in wage growth versus a neoclassical framework emphasizing rational choices of individuals and equilibrating forces of the market. Empirical evidence based on multiple data sources fails to validate the arrival of the Lewis turning point in China, showing continuous and coordinated wage growth across rural and urban sectors instead. Consistent with the neoclassical view, we find that rural workers expanded off-farm work when mobility restrictions were lifted, interprovincial migration responded to expected earnings and local employment conditions, and returns to education converged gradually to the international standard. These findings suggest major progresses in the integration of labor markets in China. JEL Classification: J31, J21, O11
Increasing incidence of multiple sclerosis in the province of Sassari, northern Sardinia.

Sardinia is a high-risk area for multiple sclerosis (MS), with prevalence rates of 150 per 100,000 population. The study included 689 MS patients (female-male ratio 2.6) with disease onset between 1965 and 1999 in the province of Sassari. The mean annual incidence rate increased significantly from 1.1 per 100,000 population in 1965-1969 to 5.8 in 1995-1999, with no significant difference for gender and province sub-areas. The mean age at onset increased significantly during the same period from 25.7 to 30.6 years, while the proportion of patients with progressive initial course declined over time. The marked increase of MS incidence and the change of MS clinical phenotype over time cannot be explained by ascertainment bias only, thus pointing to a corresponding change in the distribution of exogenous risk factors in this highly genetically stable population.
A Phase 3 Trial of Sebelipase Alfa in Lysosomal Acid Lipase Deficiency.

BACKGROUND
Lysosomal acid lipase is an essential lipid-metabolizing enzyme that breaks down endocytosed lipid particles and regulates lipid metabolism. We conducted a phase 3 trial of enzyme-replacement therapy in children and adults with lysosomal acid lipase deficiency, an underappreciated cause of cirrhosis and severe dyslipidemia.


METHODS
In this multicenter, randomized, double-blind, placebo-controlled study involving 66 patients, we evaluated the safety and effectiveness of enzyme-replacement therapy with sebelipase alfa (administered intravenously at a dose of 1 mg per kilogram of body weight every other week); the placebo-controlled phase of the study was 20 weeks long and was followed by open-label treatment for all patients. The primary end point was normalization of the alanine aminotransferase level. Secondary end points included additional disease-related efficacy assessments, safety, and side-effect profile.


RESULTS
Substantial disease burden at baseline included a very high level of low-density lipoprotein cholesterol (≥190 mg per deciliter) in 38 of 66 patients (58%) and cirrhosis in 10 of 32 patients (31%) who underwent biopsy. A total of 65 of the 66 patients who underwent randomization completed the double-blind portion of the trial and continued with open-label treatment. At 20 weeks, the alanine aminotransferase level was normal in 11 of 36 patients (31%) in the sebelipase alfa group and in 2 of 30 (7%) in the placebo group (P=0.03), with mean changes from baseline of -58 U per liter versus -7 U per liter (P<0.001). With respect to prespecified key secondary efficacy end points, we observed improvements in lipid levels and reduction in hepatic fat content (P<0.001 for all comparisons, except P=0.04 for triglycerides). The number of patients with adverse events was similar in the two groups; most events were mild and were considered by the investigator to be unrelated to treatment.


CONCLUSIONS
Sebelipase alfa therapy resulted in a reduction in multiple disease-related hepatic and lipid abnormalities in children and adults with lysosomal acid lipase deficiency. (Funded by Synageva BioPharma and others; ARISE ClinicalTrials.gov number, NCT01757184.).