LLukas22/scidocs huggingface dataset:
Causes of death in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial.

OBJECTIVES
This study analyzed the causes of death in the Antiarrhythmics Versus Implantable Defibrillators (AVID) Trial.


BACKGROUND
Both implantable cardioverter-defibrillators (ICDs) and antiarrhythmic drugs (AADs) are used as mainstays of treatment for life-threatening ventricular arrhythmias in patients who have survived either ventricular fibrillation or sustained ventricular tachycardia with hemodynamic compromise and serious symptoms. The AVID Trial compared the effectiveness of these two therapies. Survival was better with the ICD. Assessment of the cause of death should help to determine the mechanism of improvement in survival with the ICD.


METHODS
Of 1,016 patients enrolled in the AVID Trial, 202 patients died. The mode of death was determined by the unblinded Principal Investigator and independently by an Events Committee, which reviewed materials meticulously blinded with respect to treatment. Deaths were classified as cardiac or noncardiac. Cardiac deaths were further classified as arrhythmic or nonarrhythmic, and causes of noncardiac death were identified.


RESULTS
Deaths were more frequent in patients treated with an AAD (n = 122), compared with patients treated with the ICD (n = 80), unadjusted p < 0.001, p = 0.012 adjusted for sequential monitoring. In AVID, 157 deaths were cardiac, and 79 were arrhythmic. The major effect of the ICD was to prevent arrhythmic death (AAD = 55, ICD = 24, nominal unadjusted p < 0.001). Nonarrhythmic cardiac deaths were equal (AAD = 39, ICD = 39). Patients treated with an AAD had a slightly greater incidence of noncardiac deaths (28 vs. 17, p = 0.053), primarily due to pulmonary and renal causes.


CONCLUSIONS
The ICD is more effective than an AAD in reducing arrhythmic cardiac death, while nonarrhythmic cardiac death is unchanged. Of note, apparent arrhythmic death still seems to constitute 38% of all cardiac deaths despite treatment with an ICD. However, the ICD remains superior to an AAD in prolonging survival after life-threatening arrhythmias.
Evaluating the past to improve the future - A qualitative study of ICU patients' experiences.

BACKGROUND
The recovery period for patients who have been in an intensive care unitis often prolonged and suboptimal. Anxiety, depression and post-traumatic stress disorder are common psychological problems. Intensive care staff offer various types of intensive aftercare. Intensive care follow-up aftercare services are not standard clinical practice in Norway.


OBJECTIVE
The overall aim of this study is to investigate how adult patients experience theirintensive care stay their recovery period, and the usefulness of an information pamphlet.


METHOD
A qualitative, exploratory research with semi-structured interviews of 29 survivors after discharge from intensive care and three months after discharge from the hospital.


RESULTS
Two main themes emerged: "Being on an unreal, strange journey" and "Balancing between who I was and who I am" Patients' recollection of their intensive care stay differed greatly. Continuity of care and the nurse's ability to see and value individual differences was highlighted. The information pamphlet helped intensive care survivors understand that what they went through was normal.


CONCLUSIONS
Continuity of care and an individual approach is crucial to meet patients' uniqueness and different coping mechanisms. Intensive care survivors and their families must be included when information material and rehabilitation programs are designed and evaluated.
Figures of finance capitalism : writing, class, and capital in the age of Dickens

Introduction Chapter One: A Historian in the Literary Marketplace: T. B. Macaulay, the English Constitution, and Finance Capitalism Chapter Two: Gentility, Capitalism, and Mapping the Nation in Elizabeth Gaskell's Stanford Chapter Three: The Middle Class and the Novel in W. M. Thackeray's The Newcomes Chapter Four: Banking on Sentiments: A Melodramatic Civil Society in Little Dorrit and A Tale of Two Cities Afterword Works Cited Index
Psychosocial factors modify the association of frailty with adverse outcomes: a prospective study of hospitalised older people

BACKGROUND
Frailty increases the risk of adverse outcomes in older people. The impact of psychosocial factors on frailty and adverse clinical outcomes associated with frailty has not yet been examined in the hospital setting. The aims of this study were to: i) investigate the association between psychosocial factors and frailty, and ii) to establish whether psychosocial factors impact on the association between frailty and adverse outcomes.


METHODS
Data was collected from a Geriatric Evaluation and Management Unit (GEMU) in Australia. Frailty was identified using Fried's frailty criteria. Psychosocial factors included wellbeing, sense of control (mastery), social activities, home/neighbourhood satisfaction, social relationships, anxiety and depression. Outcome measures were: mortality at 12 months, long length of GEMU stay (LOS), 1-month emergency rehospitalisation, and a higher level of care needed on discharge. Covariates adjusted for were age, gender and comorbidity.


RESULTS
The mean (SD) age of participants (n = 172) at admission was 85.2 (6.4) years, with 129 (75%) female patients. 96 (56%) patients were classified as frail, with 64 (37%) pre-frail and 12 (7%) robust. Frail patients had an increased likelihood of 12-month mortality (HR, 95% CI = 3.16, 1.36-7.33), discharge to a higher level of care (OR, 95% CI = 2.40, 1.21-4.78), long LOS (OR, 95% CI = 2.04, 1.07-3.88) and 1-month emergency rehospitalisation (OR, 95% CI = 2.53, 1.10-5.82). Psychosocial factors associated with frailty included poor wellbeing, anxiety, depression, and a low sense of control. Several psychosocial factors increased the likelihood of adverse outcomes associated with frailty, including anxiety and low ratings for: wellbeing, sense of control, social activities and home/neighbourhood satisfaction.


CONCLUSIONS
Our results indicate that frail older adults with low psychosocial resources had an elevated risk of mortality, discharge to higher level care, long LOS and rehospitalisation. Consideration of psychosocial factors in comprehensive geriatric assessments will assist in patient care planning.
Cognition in Friedreich's ataxia: a behavioral and multimodal imaging study

OBJECTIVE
Friedreich's ataxia (FRDA) is a spinocerebellar degenerative disorder, in which cognitive deficits are sparsely explored. In this behavioral and multimodal magnetic resonance imaging (MRI) study, we investigated the neurocognitive profile and cortico-cerebellar dysfunctions underlying executive functioning in individuals with FRDA.


METHODS
22 FRDA patients and 22 controls were clinically and neuropsychologically examined. Fifteen of each underwent structural and functional MRI using a verbal-fluency task with phonemic and semantic conditions. Gray (GM) and white matter (WM) alterations were assessed by means of voxel-based morphometry and diffusion-tensor imaging.


RESULTS
The neuropsychological profile demonstrated deficits in verbal fluency, working memory and social cognition. Functional MRI data showed most pronounced group-differences in phonemic fluency with patients exhibiting enhanced activity in the cerebellum (VI, Crus I), fronto-insular, premotor and temporo-occipital regions. The semantic condition only revealed reduced activity in the anterior cerebellum; for overt speech, we found increased activity in the motor cortex. Functional connectivity-analysis showed higher co-activation within cerebellar and cortical regions, respectively, and impaired interregional coupling between the cerebellum and fronto-insular cortex for phonemic processing, which was also related to poorer task performance. GM reduction in FRDA was mainly found in lobule VI, whereas WM degeneration was more pronounced including brainstem, cerebellum, and cortex. Decreased cerebellar GM was associated with enhanced activity in the fronto-insular cortex, while loss of WM integrity may translate cortico-cerebellar pathway disruptions.


INTERPRETATION
The pattern of increased neural response with both cerebellar and cortical involvement underlying executive functioning indicates functional reorganization driven by disease-related structural damage in FRDA.
Intracoronary eptifibatide bolus administration during percutaneous coronary revascularization for acute coronary syndromes with evaluation of platelet glycoprotein IIb/IIIa receptor occupancy and platelet function: the Intracoronary Eptifibatide (ICE) Trial.

BACKGROUND
Eptifibatide reduces major adverse cardiac events in patients with acute coronary syndromes undergoing percutaneous coronary intervention (PCI). Intracoronary bolus administration of eptifibatide may result in higher levels of platelet glycoprotein IIb/IIIa receptor occupancy in the local coronary bed, disaggregate thrombus in the epicardial artery and microvasculature, and thereby improve coronary flow.


METHODS AND RESULTS
Patients undergoing PCI for an acute coronary syndrome were randomized to either intracoronary or intravenous bolus administration of eptifibatide. The primary end point was the local glycoprotein IIb/IIIa receptor occupancy measured in the coronary sinus. There were no angiographic, electrophysiological, or other adverse findings attributable to intracoronary eptifibatide. Platelet glycoprotein IIb/IIIa receptor occupancy was significantly greater with intracoronary versus intravenous administration: first bolus, 94+/-9% versus 51+/-15% (P<0.001); and second bolus, 99+/-2% versus 91+/-4% (P=0.001), respectively. Microvascular perfusion was significantly improved as measured by the corrected thrombolysis in myocardial infarction frame count (cTFC) with intracoronary versus intravenous administration: pre-PCI, 36 (median) (25th and 75th percentiles, 16 and 64) versus 31 (25th and 75th percentiles, 23 and 45; P=0.8); and post-PCI, 18 (25th and 75th percentiles, 10 and 22) versus 25 (25th and 75th percentiles, 22 and 35; P=0.007), respectively. The only multivariate predictor associated with a post-PCI cTFC rank score was the first bolus glycoprotein IIb/IIIa receptor occupancy (P<0.001).


CONCLUSIONS
Intracoronary bolus administration of eptifibatide during PCI in patients with acute coronary syndromes results in higher local platelet glycoprotein IIb/IIIa receptor occupancy, which is associated with improved microvascular perfusion demonstrated by an improved cTFC.
A grid-interfacing power quality compensator for three-phase three-wire microgrid applications

This paper proposes a grid-interfacing power quality compensator for three-phase three-wire microgrid applications with consideration of both the power quality of the microgrid and the quality of currents flowing between the microgrid and utility system. It is proposed that two inverters connected in shunt and series are used for each distributed generation (DG) system in the microgrid. In each inverter, both positive- and negative-sequence components are controlled to compensate for the effects caused by the unbalanced utility grid voltages. Specifically, the shunt inverter is controlled to ensure balanced voltages within the microgrid and to regulate power dispatches among parallel-connected DG systems, while the series inverter balances the line currents by injecting appropriate voltage components. A current-limiting algorithm is also proposed and integrated within the inverter control schemes to protect the microgrid from large fault currents during utility voltage sags. The proposed compensator has been tested in simulations and experimentally using a laboratory hardware prototype.
PERFORMANCE OF INTEREST-FREE ISLAMIC BANKS VIS-À-VIS INTEREST-BASED CONVENTIONAL BANKS OF BAHRAIN

This paper examines the comparative performance of Bahrain’s interest-free Islamic banks and the interest-based conventional commercial banks during the post Gulf War period with respect to (a) profitability, (b) liquidity risk, and (c) credit risk. Nine financial ratios are used in measuring these performances. Applying Student’s t-test to financial ratios for Islamic and conventional commercial banks in Bahrain for the period 1991-2001, the paper concludes that there is no major difference in performance between Islamic and conventional banks with respect to profitability and liquidity. However, the study finds that there exists a significant difference in credit performance. JEL classification: G20, G21
Primary generalized and localized hypertrichosis in children.

OBJECTIVE
To review the causes, presentation, and therapy of primary generalized and localized symmetrical hypertrichosis in children.


DESIGN
Retrospective medical record review.


SETTING
Academic specialty referral clinic for pediatric dermatological disorders.


PATIENTS
Case series of 11 prepubertal male and female patients who had idiopathic hypertrichosis between July 1, 1990, and November 30, 1999.


INTERVENTIONS
None.


MAIN OUTCOME MEASURES
Clinical distribution of increased hair growth and types of hair removal methods used.


RESULTS
Seven girls and 4 boys, ranging in age from 4 months to 11 years, were evaluated. Four patients showed generalized hypertrichosis. The other 7 patients had localized symmetrical hypertrichosis, representing the subsets of hypertrichosis cubiti, anterior cervical hypertrichosis, posterior cervical hypertrichosis, and faun tail deformity. All patients with generalized hypertrichosis manifested the condition at birth; the age of onset in children with localized symmetrical primary hypertrichosis ranged from birth to 4 years. One girl with generalized hypertrichosis had gingival hyperplasia and the girl with faun tail deformity had bony diastematomyelia with spina bifida occulta. The medical histories and physical examination findings of all of the children were otherwise unremarkable. All patients were referred for diagnostic and therapeutic considerations.


CONCLUSIONS
Primary hypertrichotic conditions, whether localized or generalized, are rare in pediatric patients and of unknown origin. Although otherwise benign, these disorders may result in cosmetic disfigurement and psychosocial trauma for patients and families. Patients and their families should be adequately advised of the available treatment methods for both temporary and permanent hair removal.
Effect of the World Health Organization checklist on patient outcomes: a stepped wedge cluster randomized controlled trial.

OBJECTIVES
We hypothesized reduction of 30 days' in-hospital morbidity, mortality, and length of stay postimplementation of the World Health Organization's Surgical Safety Checklist (SSC).


BACKGROUND
Reductions of morbidity and mortality have been reported after SSC implementation in pre-/postdesigned studies without controls. Here, we report a randomized controlled trial of the SSC.


METHODS
A stepped wedge cluster randomized controlled trial was conducted in 2 hospitals. We examined effects on in-hospital complications registered by International Classification of Diseases, Tenth Revision codes, length of stay, and mortality. The SSC intervention was sequentially rolled out in a random order until all 5 clusters-cardiothoracic, neurosurgery, orthopedic, general, and urologic surgery had received the Checklist. Data were prospectively recorded in control and intervention stages during a 10-month period in 2009-2010.


RESULTS
A total of 2212 control procedures were compared with 2263 SCC procedures. The complication rates decreased from 19.9% to 11.5% (P < 0.001), with absolute risk reduction 8.4 (95% confidence interval, 6.3-10.5) from the control to the SSC stages. Adjusted for possible confounding factors, the SSC effect on complications remained significant with odds ratio 1.95 (95% confidence interval, 1.59-2.40). Mean length of stay decreased by 0.8 days with SCC utilization (95% confidence interval, 0.11-1.43). In-hospital mortality decreased significantly from 1.9% to 0.2% in 1 of the 2 hospitals post-SSC implementation, but the overall reduction (1.6%-1.0%) across hospitals was not significant.


CONCLUSIONS
Implementation of the WHO SSC was associated with robust reduction in morbidity and length of in-hospital stay and some reduction in mortality.
Long Coronary Lesions Treated With Thin Strut Bioresorbable Polymer Drug Eluting Stent: Experience From Multicentre Randomized CENTURY II Study.

OBJECTIVES
To assess performance of new, bioresorbable polymer sirolimus-eluting stent (BP-SES), in patients with long coronary lesions (LL) and to compare it to permanent polymer everolimus-eluting stent (PP-EES).


BACKGROUND
LL have been associated with worse clinical outcomes in percutaneous coronary interventions (PCI). The impact of lesion length on the outcomes of drug eluting stent (DES) implantations is not as clear.


METHODS
In the frame of a randomized, multicentre CENTURY II study, out of 1119 patients enrolled, 182 patients had LL (defined as ≥25 mm), and were assigned randomly to treatment with BP-SES (101) or PP-EES (81). Primary endpoint was target lesion failure (TLF, composite of cardiac death, target vessel related myocardial infarction [MI], and target lesion revascularization [TLR]) at 9 months. All data were 100% monitored and adverse events were adjudicated by an independent clinical event committee.


RESULTS
The baseline patient and lesion characteristics were similar in the 2 study arms. At 9-months, the rates of cardiac death (2.0% vs 1.2%; P = 0.70), MI (3.0% vs 4.9%; P = 0.49) and clinically driven TLR (2.0% vs 3.7%; P = 0.48) and TLF (6.9% vs 8.6%; P = 0.67) were similar for BP-SES and PP-EES, respectively. There was no stent thrombosis (ST) in BP-SES group up to 9 months, while 1 case (1.2%) of ST was recorded in PP-EES group (P = 0.44).


CONCLUSIONS
Patients with LL showed similar clinical outcomes when treated with Ultimaster BP-SES and Xience PP-EES.
A 4× 25-to-28Gb/s 4.9mW/Gb/s −9.7dBm high-sensitivity optical receiver based on 65nm CMOS for board-to-board interconnects

Growing data traffic requires low-power 25Gb/s-class optical interconnects for board-to-board transmission inside ICT systems [1-4]. The main power consumption of an optical link strongly depends on the sensitivity of the TIA; thus, development of a high-sensitivity TIA is a key to creating a low-power optical link., There are two challenges concerning the design of such a TIA: (1) improving the sensitivity of TIA without sacrificing bandwidth and (2) suppressing ISI due to insertion loss. To address these two issues, a 4×25Gb/s CMOS optical receiver (RX), which includes a four-channel TIA and a PD array operating at 1.3μm wavelength, is developed. The key components of the TIA are an automatic-decision-threshold control (ATC) with an offset canceller and low-voltage output driver (Drv) with peaking value of 7.7dB at 12.5GHz, achieved by separating equalizer (EQ) function and output buffer (BUF). The TIA attains a sensitivity of -9.7dBm (86μApp) optical modulation amplitude (OMA) and an eye opening of 65% at 25Gb/s. Operation at 28Gb/s with sensitivity of -8.2dBm (121μApp) OMA is also confirmed.
Conceptual graph operations for formal visual reasoning in the medical domain

Objective.!–!Conceptual!graphs!(CGs)!are!used!to!represent!clinical!guidelines!because!they!support!visual!reasoning!with!a!logical!background,! making!them!a!potentially!valuable!representation!for!guidelines. Materials!and!methods.!–!Conceptual!graph!formalism!has!an!essential!and!basic!component:!a!formal!vocabulary! that!drives!all!of! the!other! mechanisms,!notably!specialization!and!projection.!The!graph’s!theoretical!operations,!such!as!projection,!rules,!derivation,!constraints,!probabilities! and!uncertainty,!support!diagrammatic!reasoning. Results.!–!A!conceptual!graph’s!graphical!user!interface!includes!a!multilingual!vocabulary!management,!some!query!and!decision-making!facilities! and!visual!graph!representations!that!are!simple!and!interesting!for!user!interactions.!The!described!proposition!using!the!Conceptual!Graph!user! interface!(CoGui)!improves!the!performance!of!the!actors!in!the!diagnostic!context!of!heart!failure!with!preserved!ejection!fraction. Discussion.!–!CGs!capture! the!essential! features!of! the!medical!processes!underlying!clinical! reasoning.!CGs!are! indeed!useful!as!a!way! for! the!physician!to!represent!guidelines,!and!well-defined!semantic!representations!allow!users!to!have!a!maximal!understanding!of!the!knowledge! reasoning!process. Conclusion.!–!CG!operations!of!visual!representations!that!uncover!some!of!the!actual!complexities!of!clinicians’!reasoning!have!been!tested!in! clinical!guideline!comprehension!and!used!to!translate!text!and!diagrammatic!guidelines!into!computer!interpretable!representations.
Randomized study to compare valsartan ± HCTZ versus amlodipine ± HCTZ strategies to maximize blood pressure control

OBJECTIVE
Delays in achieving blood pressure (BP) control may increase morbidity and mortality in patients with hypertension. Thus, deciding which antihypertensive agent to use and at what dosage, in addition to determining when to initiate combination therapy and which agents to combine, is important for achieving BP control.


METHODS
This randomized, double-blind, 14-week study was conducted to compare the efficacy and tolerability of various doses of valsartan +/- hydrochlorothiazide (HCTZ) versus amlodipine +/- HCTZ for maximizing BP control in 1,285 patients with uncontrolled hypertension. Patients with stage 1 hypertension and naïve to antihypertensive therapy (33.9%) started valsartan 160 mg or amlodipine 5 mg. Treatment-naïve patients with stage 2 hypertension (13.5%) or those uncontrolled on current antihypertensive monotherapy (52.6%) started valsartan 160 mg/HCTZ 12.5 mg or amlodipine 10 mg. At weeks 4, 8, and 11, patients not achieving BP control were up-titrated (maximum: valsartan 320 mg/HCTZ 25 mg, amlodipine 10 mg/HCTZ 25 mg).


RESULTS
At study end, 78.8% of patients on valsartan +/- HCTZ were controlled (BP <140/90 mmHg) and still on study medication versus 67.8% on amlodipine +/- HCTZ (P < 0.0001). Amlodipine-treated patients had a higher incidence of peripheral edema (22.4% vs 2.2%) and associated discontinuations (7.3% vs <1%). Initiating therapy earlier with valsartan/HCTZ, rather than titrating monotherapy to its maximum dose before adding a second agent, was superior to amlodipine monotherapy or amlodipine +/- HCTZ for achieving BP control, and avoided excessive treatment adjustments and maintained tolerability.