LLukas22/scidocs huggingface dataset:
Long-term outcome and late effects in patients transplanted with mobilised blood or bone marrow: a randomised trial.

BACKGROUND
Most allogeneic haematopoietic stem cell transplants now use peripheral blood progenitor cell transplantation (PBPCT) instead of bone-marrow transplantation (BMT). Long-term data on outcome and late effects of PBPCT compared with BMT are scarce. Here we present long-term data from a randomised study comparing PBPCT with BMT.


METHODS
Between February, 1995, and September, 1999, 329 patients with leukaemia received either PBPCT (n=163) or BMT (n=166) from HLA-identical sibling donors after central randomisation accounting for stratification criteria. Follow-up data were collected via questionnaires from 87% (176 of 202; 84 PBPCT, 92 BMT) patients who survived for more than 3 years (median of 9.3 years) after transplantation. Efficacy analyses included all patients who received treatment. This study is registered with ClinicalTrials.gov, number NCT01020175.


FINDINGS
10-year overall survival was 49.1% for patients who underwent PBPCT and 56.5% for patients who underwent BMT (HR 0.83, 95% CI 0.60-1.15; p=0.27). Leukaemia-free survival was 28.3% with BMT versus 13.0% with PBPCT (0.61, CI 0.32-1.16; p=0.12) for acute lymphoblastic leukaemia; 62.3% with BMT versus 47.1% with PBPCT for acute myeloid leukaemia (0.67, 0.39-1.16; p=0.16); and 40.2% with BMT versus 48.5% with PBPCT for chronic myeloid leukaemia (1.12, 0.73-1.74; p=0.60). More patients developed chronic graft-versus-host disease after PBPCT (n=56, 73%) than after BMT (n=46, 56%; p=0.021), with more frequent involvement of skin, liver, and oral mucosa, and more patients who underwent PBPCT needed immunosuppressive treatment 5 years after transplantation (n=20, 26%) than patients who had BMT (n=10, 12%; p=0.024). Nonetheless, there was no difference in performance status, return to work, incidence of bronchiolitis obliterans, and haematopoietic function between the two groups. 14 cases of secondary malignancies occurred (five after BMT, nine after PBPCT), resulting in a cumulative incidence of 3% and 7% after BMT and PBPCT (p=0.17), respectively.


INTERPRETATION
More than 9 years after transplantation, overall and leukaemia-free survival remain similar in patients who underwent BMT and PBPCT. Differences in the incidence of chronic graft-versus-host disease and the duration of immunosuppression exist, but do not affect survival, general health status, or late events.


FUNDING
No external funding was received.
Positive anti-citrullinated protein antibody status and small joint arthritis are consistent predictors of chronic disease in patients with very early arthritis: results from the NOR-VEAC cohort

INTRODUCTION
The current 1987 American College of Rheumatology (ACR) classification criteria for rheumatoid arthritis (RA) have proven less useful in early arthritis. The objective of this study was to identify and compare predictors of three relevant outcomes of chronic arthritis in a cohort of very early arthritis patients.


METHODS
The Norwegian Very Early Arthritis Cohort (NOR-VEAC) includes adult patients with at least one swollen joint of < or = 16 weeks' duration. Patients are followed for 2 years with comprehensive clinical and laboratory examinations. Logistic regression analyses were performed to determine independent predictors of three outcomes: persistent synovitis, prescription of disease-modifying anti-rheumatic drugs (DMARDs), and established clinical RA diagnosis within one year.


RESULTS
Of 384 patients eligible for one year follow-up (56.3% females, mean (SD) age 45.8 (14.7) years, median (IQR) duration of arthritis 31 (10-62) days), 14.4% were anti-CCP2 positive, and 11.2% were IgM RF positive. 98 patients (25.5%) had persistent synovitis, 106 (27.6%) had received DMARD treatment during follow-up, while 68 (17.7%) were diagnosed with RA. Consistent independent predictors across all three outcomes were positive anti-citrullinated protein antibody (ACPA) status (odds ratio (OR) 3.2, 5.6 and 19.3), respectively, and small joint arthritis (proximal interphalangeal joint (PIP), metacarpo-phalangeal joint (MCP), and/or metatarso-phalangeal joint (MTP) joint swelling) (OR 1.9, 3.5, and 3.5, respectively).


CONCLUSIONS
Positive ACPA status and small joint arthritis were consistent predictors of three relevant outcomes of chronic arthritis in very early arthritis patients. This consistency supports DMARD prescription as a valid surrogate endpoint for chronic arthritis. Importantly, this surrogate is used in ongoing efforts to develop new diagnostic criteria for early RA.
Rotation vectors and fixed points of area preserving surface diffeomorphisms

We consider the (homological) rotation vectors for area preserving diffeomorphisms of compact surfaces which are homotopic to the identity. There are two main results. The first is that if 0 is in the interior of the convex hull of the rotation vectors for such a diffeomorphism then f has a fixed point of positive index. The second result asserts that if f has a vanishing mean rotation vector then f has a fixed point of positive index. There are several applications including a new proof of the Arnold conjecture for area preserving diffeomorphisms of compact surfaces. In this paper we investigate area preserving diffeomorphisms of compact surfaces. We are concerned with “rotation vectors” defined in terms of homology which can be associated to the points of the surface. There are two main results. The first is that if f is an area preserving diffeomorphism of a compact surface which is homotopic to the identity and 0 is in the interior of the convex hull of the rotation vectors of f then f has a fixed point of positive index. The second result concerns the mean rotation vector of f . It asserts that if this vector vanishes then f has a fixed point of positive index. A special case of this second result – when the surface in question is a surface of genus zero – was proved in [F5]. In §6 we give several applications including a new proof of the Arnold conjecture for area preserving diffeomorphisms of compact surfaces.
Personal and clinical skin cancer prevention practices of US women physicians.

OBJECTIVE
To document physician clinical and personal skin cancer prevention practices and associated characteristics.


DESIGN
A cross-sectional questionnaire survey of a representative sample of US women physicians.


SETTING
Mail survey.


SUBJECTS
Three thousand thirty-two nondermatologists and 95 dermatologists.


MAIN OUTCOME MEASURE
Personal and clinical practices.


RESULTS
Twenty-seven percent of nondermatologists counseled or screened their typical patients on skin cancer or sunscreen use at least once a year, while 49% did so less frequently, and 24% never counseled or screened at all. Of the 95 dermatologists, two thirds reported counseling or screening their typical patients at every visit. In bivariate analysis of nondermatologists, the distribution of counseling or screening was significantly (P<.05) associated with the following personal and professional characteristics: frequent sunscreen use, recent (within 2 years) skin examination, good health status, a primary care specialty, self-confidence in counseling or screening, extensive training in counseling or screening, high perceived relevance to the practice of the counseling or screening, nonurban practice site, and nonhospital-based or non-medical school-based practice. We found that 48% of all physicians always or nearly always used sunscreen, and 25% had received a clinical skin examination in the previous 2 years.


CONCLUSIONS
Although many primary care physicians report ever counseling or screening their typical patients about skin cancer and sunscreen use, increased professional education for primary care physicians could improve patient counseling about skin cancer prevention.
Longitudinal outcome 6 years after spinal cord injury

Study design: Multicentered follow-up with centralized data collection based on retrospective study.Objectives: To assess the outcome in a population of patients with spinal cord injury (SCI). The assessed outcomes are mortality, state of health, occupation, mobility, autonomy, social and partner relationships, quality of life (QoL), with the identification of any relation between results and demographic–clinical data.Setting: Two rehabilitation centers (Udine and Trevi) and a Spinal Injuries Unit (Torino).Methods: A total of 251 patients with SCI discharged after first hospitalization from rehabilitation facilities between 1989 and 1994 were enrolled. A questionnaire was administered by telephone.Results: During the time between discharge and follow-up, 25 out of the 251 patients had died, yielding a mortality rate of 9.96%. A total of 80 patients did not give their consent. The 146 patients' mean interval from discharge from the rehabilitation facility was 6 years. At least 25% has been hospitalized again. The descriptive analysis also shows that 29.5% of patients were working, 48.6% were able to drive, 63.7% would leave their home alone, 61% would leave home every day, 63% reported of a change in their relationships, 48.6% were happy with their love lives. Significant correlations have emerged between certain items and age: those who had a job, who could drive, were more autonomous and had a higher QoL are generally younger. Level of injury appear to be only associated with the degree of autonomy, which seems to be inferior for tetraplegic subjects. The injury's completeness and etiology do not exhibit any correlation. QoL is associated with a number of items: a higher QoL is linked to the possibility to work, especially if it is a paid job, to the ability to drive, to a good degree of autonomy, to a lack of change in the social and partner relationships, and to a satisfactory love life.Conclusion: At 6 years after discharge from rehabilitations, the effects of trauma on work and social and partner relationships, domains correlated with autonomy and QoL, are evident. Further investigation by means of a prospective study over the years are therefore necessary.
A summary of recent developments in satellite antennas at MDA

This document presents a summary of the latest developments in satellite antennas at MDA. It covers high-performance multibeam antennas used in geostationary missions, low-cost dual-band gimballed Ka-band antennas used in non-geostationary constellations and reconfigurable antennas.
A survey on optical character recognition for Bangla and Devanagari scripts

Abstract. The past few decades have witnessed an intensive research on optical character recognition (OCR) for Roman, Chinese, and Japanese scripts. A lot of work has been also reported on OCR efforts for various Indian scripts, like Devanagari, Bangla, Oriya, Tamil, Telugu, Malayalam, Kannada, Gurmukhi, Gujarati, etc. In this paper, we present a review of OCR work on Indian scripts, mainly on Bangla and Devanagari—the two most popular scripts in India. We have summarized most of the published papers on this topic and have also analysed the various methodologies and their reported results. Future directions of research in OCR for Indian scripts have been also given.
Comparison of hypothermia and normothermia after severe traumatic brain injury in children (Cool Kids): a phase 3, randomised controlled trial

BACKGROUND
On the basis of mixed results from previous trials, we assessed whether therapeutic hypothermia for 48-72 h with slow rewarming improved mortality in children after brain injury.


METHODS
In this phase 3, multicenter, multinational, randomised controlled trial, we included patients with severe traumatic brain injury who were younger than 18 years and could be enrolled within 6 h of injury. We used a computer-generated randomisation sequence to randomly allocate patients (1:1; stratified by site and age [<6 years, 6-15 years, 16-17 years]) to either hypothermia (rapidly cooled to 32-33°C for 48-72 h, then rewarmed by 0·5-1·0°C every 12-24 h) or normothermia (maintained at 36·5-37·5°C). The primary outcome was mortality at 3 months, assessed by intention-to-treat analysis; secondary outcomes were global function at 3 months after injury using the Glasgow outcome scale (GOS) and the GOS-extended pediatrics, and the occurrence of serious adverse events. Investigators assessing outcomes were masked to treatment. This trial is registered with ClinicalTrials.gov, number NCT00222742.


FINDINGS
The study was terminated early for futility after an interim data analysis on data for 77 patients (enrolled between Nov 1, 2007, and Feb 28, 2011): 39 in the hypothermia group and 38 in the normothermia group. We detected no between-group difference in mortality 3 months after injury (6 [15%] of 39 patients in the hypothermia group vs two [5%] of 38 patients in the normothermia group; p=0·15). Poor outcomes did not differ between groups (in the hypothermia group, 16 [42%] patients had a poor outcome by GOS and 18 [47%] had a poor outcome by GOS-extended paediatrics; in the normothermia group, 16 [42%] patients had a poor outcome by GOS and 19 [51%] of 37 patients had a poor outcome by GOS-extended paediatrics). We recorded no between-group differences in the occurrence of adverse events or serious adverse events.


INTERPRETATION
Hypothermia for 48 h with slow rewarming does not reduce mortality of improve global functional outcome after paediatric severe traumatic brain injury.


FUNDING
National Institute of Neurological Disorders and Stroke and National Institutes of Health.
Relationship between anxiety, depression, and quality of life in adult patients with cystic fibrosis.

BACKGROUND
The impact of anxiety and depression on quality of life (QOL) in adult patients with cystic fibrosis (CF) is fully unknown. We investigated the prevalence and factors associated with anxiety and depression, including QOL, in adult CF patients.


METHODS
One hundred twenty-one adult CF subjects, age ≥ 18 years were recruited from our out-patient clinic. Participants self-completed the Hospital Anxiety Depression Scale and the Cystic Fibrosis Quality of Life Questionnaire (CF-QOL). Socio-demographic data and values for lung function were extracted from the medical notes.


RESULTS
Mean ± SD age was 30 ± 8.8 years, and age ranged 18-70 years. Forty (33%) were identified with anxiety symptoms, 20 (17%) with depressive symptoms. Factors related with depression were impaired QOL and low lung function. Anxiety was associated with difficulty in interpersonal relationships and severity of chest symptoms. The CF-QOL sub-domains (physical functioning, social functioning, treatment issues, chest symptoms, emotional functioning, concerns for the future, interpersonal relationships, body image, future/career concerns, and total CF-QOL) were all significantly correlated with anxiety (P < .001) and with depression (P < .001), respectively.


CONCLUSIONS
Anxiety and depressive symptoms are common in adult CF patients. They are associated with poorer QOL, low lung function, reduced physical functioning, and severity of chest symptoms. Therefore, routine screening for symptoms of anxiety and depression is a worthy endeavor, and those identified with elevated clinical symptoms should be referred to receive appropriate treatment.
Spinal cord pharmacology of pain.

The transmission of pain from peripheral tissues through the spinal cord to the higher centres of the brain is clearly not a passive simple process using exclusive pathways. Rather, circuitry within the spinal cord has the potential to alter, dramatically, the relation between the stimulus and the response to pain in an individual. Thus an interplay between spinal neuronal systems, both excitatory and inhibitory, will determine the messages delivered to higher levels of the central nervous system. The incoming messages may be attenuated or enhanced, changes which may be determined by the particular circumstances. The latter state, termed central hypersensitivity [61], whereby low levels of afferent activity are amplified by spinal pharmacological mechanisms has attracted much attention [13, 15]. However, additionally, inhibitory controls are subject to alteration so that opioid sensitivity in different pain states is not fixed [14]. This plasticity, the capacity for transmission in nociceptive systems to change, can be induced over very short time courses. Recent research on the pharmacology of nociception has started to shed some well-needed light on this rapid plasticity which could have profound consequences for the pharmacological treatment of pain [8, 13, 15, 23, 24, 35, 36, 41, 62]. The pharmacology of the sensory neurones in the dorsal horn of the spinal cord is complex, so much so that most of the candidate neurotransmitters and their receptors found in the CNS are also found here [4, 32]. The transmitters are derived from either the afferent fibres, intrinsic neurones or descending fibres. The majority of the transmitters and receptors are concentrated in the substantia gelatinosa, one of the densest neuronal areas in the CNS and crucial for the reception and modulation of nociceptive messages transmitted via the peripheral fibres [4]. Nociceptive C-fibres terminate in the outer lamina 1 and the underlying substantia gelatinosa, whereas the large tactile fibres terminate in deeper laminae. However, in addition to the lamina 1 cells which send long ascending axons to the brain, deep dorsal horn cells also give rise to ascending axons and respond to C-fibre stimulation. In the case of these deep cells the C-fibre input may be relayed via
Planning for Disruptions in Supply Chain Networks

Recent events have highlighted the need for planners to consider the risk of disruptions when designing supply chain networks. Supply chain disruptions have a number of causes and may take a number of forms. Once a disruption occurs, there is very little recourse regarding supply chain infrastructure because these strategic decisions cannot be changed quickly. Therefore, it is critical to account for disruptions during the design of supply chain networks so that they perform well even after a disruption. Indeed, these systems can often be made substantially more reliable with only small additional investments in infrastructure. Planners have a range of options available to them in designing resilient supply chain networks, and their choice of approaches will depend on the financial resources available, the decision maker’s risk preference, the type of network under consideration, and other factors. In this tutorial, we present a broad range of models for designing supply chains resilient to disruptions. We first categorize these models by the status of the existing network: A network may be designed from scratch, or an existing network may be modified to prevent disruptions at some facilities. We next divide each category based on the underlying optimization model (facility location or network design) and the risk measure (expected cost or worst-case cost).
A practical MRI grading system for lumbar foraminal stenosis.

OBJECTIVE
This study aimed to evaluate the reproducibility of a new grading system for lumbar foraminal stenosis.


MATERIALS AND METHODS
Four grades were developed for lumbar foraminal stenosis on the basis of sagittal MRI. Grade 0 refers to the absence of foraminal stenosis; grade 1 refers to mild foraminal stenosis showing perineural fat obliteration in the two opposing directions, vertical or transverse; grade 2 refers to moderate foraminal stenosis showing perineural fat obliteration in the four directions without morphologic change, both vertical and transverse directions; and grade 3 refers to severe foraminal stenosis showing nerve root collapse or morphologic change. A total of 576 foramina in 96 patients were analyzed (from L3-L4 to L5-S1). Two experienced radiologists independently assessed the sagittal MR images. Interobserver agreement between the two radiologists and intraobserver agreement by one reader were analyzed using kappa statistics.


RESULTS
According to reader 1, grade 1 foraminal stenosis was found in 33 foramina, grade 2 in six, and grade 3 in seven. According to reader 2, grade 1 foraminal stenosis was found in 32 foramina, grade 2 in six, and grade 3 in eight. Interobserver agreement in the grading of foraminal stenosis between the two readers was found to be nearly perfect (kappa value: right L3-L4, 1.0; left L3-L4, 0.905; right L4-L5, 0.929; left L4-L5, 0.942; right L5-S1, 0.919; and left L5-S1, 0.909). In intraobserver agreement by reader 1, grade 1 foraminal stenosis was found in 34 foramina, grade 2 in eight, and grade 3 in seven. Intraobserver agreement in the grading of foraminal stenosis was also found to be nearly perfect (kappa value: right L3-L4, 0.883; left L3-L4, 1.00; right L4-L5, 0.957; left L4-L5, 0.885; right L5-S1, 0.800; and left L5-S1, 0.905).


CONCLUSION
The new grading system for foraminal stenosis of the lumbar spine showed nearly perfect interobserver and intraobserver agreement and would be helpful for clinical study and routine practice.
Spatial Awareness: A Function of the Posterior Parietal Lobe?

Chronic unilateral visuo-spatial neglect is usually ‘defined’ clinically as a condition in which patients ignore objects and events in contralesional space. As such, ‘it’ has been observed after lesion to many distinct right hemisphere loci (and much more rarely after left hemisphere lesion). After cortico-subcortical damage, left neglect can be consequent upon right posterior parietal (Vallar and Perani, 1986), right temporal (Samuelsson et al., 1997), and right frontal (e.g., Damasio et al., 1980; Husain and Kennard, 1996) lesions. Neglect has also been reported after subcortical lesions of the thalamus (e.g., Watson and Heilman, 1979; Rafal and Posner, 1987), the basal ganglia (e.g., Damasio et al., 1980; Ferro et al., 1987) and the white matter/internal capsule (e.g., Healton et al., 1982; Ferro and Kertesz, 1984). There is, nonetheless, reasonable consensus that severe visuo-spatial neglect is most typically associated with lesion of the supramarginal gyrus of the right inferior parietal lobule – Brodmann’s area 39/40 (Vallar, 2001). Consensus is, of course, no guarantee of truth and some students have even argued that the detailed manifestations of so-called visuospatial neglect are too variable (both withinand between-patients) to be meaningfully united into one clinical entity (Halligan and Marshall, 1992; Stone et al., 1998). A recent report by Karnath et al. (2001) confirms that unilateral visuo-spatial neglect (in patients who meet the customary clinical features thereof) can result from lesions of right temporal cortex and from lesions of right parietal cortex (Vallar, 2001). But, more controversially, Karnath et al. then make a partially novel functional and anatomical distinction between two types of spatial neglect. In “pure” spatial neglect there is purportedly loss of “spatial awareness” contralateral to the lesion; the locus of the responsible lesion is exclusively superior temporal, without extension into occipital cortex or the optic radiations (and hence the patients do not manifest visual field deficits). By contrast, in ‘impure’ spatial neglect, there is a disorder of “directly coding space for action” (but not apparently of spatial awareness); here the lesion includes the inferiorposterior parietal cortex but also extends into regions which, when damaged, produce visual field deficits (see also Karnath, 2001, for further discussion). The functional distinction that Karnath et al. (2001) draw has some similarities with the contrast that Poppelreuter (1917) made between the roles of attentional