LLukas22/scidocs huggingface dataset:
The increased risk of adverse outcomes in bilateral deep inferior epigastric artery perforator flap breast reconstruction compared to unilateral reconstruction: a systematic review and meta-analysis.

BACKGROUND
The rate of bilateral mastectomy and bilateral breast reconstruction is increasing. The DIEP flap is an ideal method of breast reconstruction. The difference in risk of adverse outcomes between unilateral and bilateral DIEP flap breast reconstruction is unclear. The aim of this review is to investigate this relationship.


METHODS
Authors searched Ovid EMBASE and MEDLINE from database inception to March 2012, for reports of DIEP flap breast reconstruction studies. After screening, data were extracted on flap-related, donor-site and systemic adverse events. Descriptive statistics were generated for all pooled data. We performed meta-analysis of direct comparisons to generate relative risk (RR) ratios with 95% confidence intervals (CI) using a random-effects model.


RESULTS
Overall, 17 case-series of 2398 women were included. Compared with unilateral DIEP flap breast reconstruction, bilateral reconstruction was associated with a significantly higher risk of total flap failure (RR 3.31 [95% CI 1.50-7.28]; p = 0.003) and breast seroma (RR 7.15 [95% CI 1.21-42.36]; p = 0.03). Differences between other outcomes were non-significant, although descriptive analysis appeared to favour unilateral reconstruction.


CONCLUSIONS
The current literature related to DIEP flap breast reconstruction appears to be of low quality. However, this is the first systematic review confirming that bilateral DIEP flap breast reconstruction is associated with a significantly higher risk of total flap failure compared to unilateral DIEP flap breast reconstruction. This review will allow clinicians to better inform patients of the risks of adverse outcomes in DIEP flap breast reconstruction. It also highlights the need for higher quality research in this area.
Temozolomide chemotherapy alone versus radiotherapy alone for malignant astrocytoma in the elderly: the NOA-08 randomised, phase 3 trial.

BACKGROUND
Radiotherapy is the standard care in elderly patients with malignant astrocytoma and the role of primary chemotherapy is poorly defined. We did a randomised trial to compare the efficacy and safety of dose-dense temozolomide alone versus radiotherapy alone in elderly patients with anaplastic astrocytoma or glioblastoma.


METHODS
Between May 15, 2005, and Nov 2, 2009, we enrolled patients with confirmed anaplastic astrocytoma or glioblastoma, age older than 65 years, and a Karnofsky performance score of 60 or higher. Patients were randomly assigned 100 mg/m(2) temozolomide, given on days 1-7 of 1 week on, 1 week off cycles, or radiotherapy of 60·0 Gy, administered over 6-7 weeks in 30 fractions of 1·8-2·0 Gy. The primary endpoint was overall survival. We assessed non-inferiority with a 25% margin, analysed for all patients who received at least one dose of assigned treatment. This trial is registered with ClinicalTrials.gov, number NCT01502241.


FINDINGS
Of 584 patients screened, we enrolled 412. 373 patients (195 randomly allocated to the temozolomide group and 178 to the radiotherapy group) received at least one dose of treatment and were included in efficacy analyses. Median overall survival was 8·6 months (95% CI 7·3-10·2) in the temozolomide group versus 9·6 months (8·2-10·8) in the radiotherapy group (hazard ratio [HR] 1·09, 95% CI 0·84-1·42, p(non-inferiority)=0·033). Median event-free survival (EFS) did not differ significantly between the temozolomide and radiotherapy groups (3·3 months [95% CI 3·2-4·1] vs 4·7 [4·2-5·2]; HR 1·15, 95% CI 0·92-1·43, p(non-inferiority)=0·043). Tumour MGMT promoter methylation was seen in 73 (35%) of 209 patients tested. MGMT promoter methylation was associated with longer overall survival than was unmethylated status (11·9 months [95% CI 9·0 to not reached] vs 8·2 months [7·0-10·0]; HR 0·62, 95% CI 0·42-0·91, p=0·014). EFS was longer in patients with MGMT promoter methylation who received temozolomide than in those who underwent radiotherapy (8·4 months [95e% CI 5·5-11·7] vs 4·6 [4·2-5·0]), whereas the opposite was true for patients with no methylation of the MGMT promoter (3·3 months [3·0-3·5] vs 4·6 months [3·7-6·3]). The most frequent grade 3-4 intervention-related adverse events were neutropenia (16 patients in the temozolomide group vs two in the radiotherapy group), lymphocytopenia (46 vs one), thrombocytopenia (14 vs four), raised liver-enzyme concentrations (30 vs 16), infections (35 vs 23), and thromboembolic events (24 vs eight).


INTERPRETATION
Temozolomide alone is non-inferior to radiotherapy alone in the treatment of elderly patients with malignant astrocytoma. MGMT promoter methylation seems to be a useful biomarker for outcomes by treatment and could aid decision-making.


FUNDING
Merck Sharp & Dohme.
Efficacy of exercise and ultrasound in patients with lumbar spinal stenosis: a prospective randomized controlled trial.

OBJECTIVE
To assess the effectiveness of therapeutic exercises alone and in combination with a single physical agent - ultrasound - in patients with lumbar spinal stenosis.


DESIGN
Randomized, prospective, controlled trial.


SETTING
Department of Physical Medicine and Rehabilitation, University Hospital.


SUBJECTS
Forty-five patients presenting with symptoms of neurological claudication and magnetic resonance image-proven lumbar spinal stenosis were assigned to one of three groups: ultrasound plus exercise group (group 1, n =15), sham ultrasound plus exercise group (group 2, n= 15) and no exercise - no treatment group (control group, n = 15).


INTERVENTIONS
Stretching and strengthening exercises for lumbar, abdominal, leg muscles as well as low-intensity cycling exercises were given as therapeutic exercises. Ultrasound was applied with 1 mHz, 1.5 W/cm(2) intensity, in continuous mode on the back muscle for 10 minutes in group 1 while ultrasound on/off mode was applied in group 2.


MAIN OUTCOME MEASURES
Before and after a three-week period, all subjects were evaluated by pain, disability, functional capacity and consumption of analgesic.


RESULTS
Thirty-two of the participants were women and 13 were men, with an average age of 53.2 +/- 12.68 years (range 25-82 years). After a three-week treatment period, leg pain decreased in group 1 (-1.47 +/- 3.02) and group 2 (-2.47 +/- 3.75) compared with the control group (P<0.05). Disability score decreased in group 1 (-3.94 +/- 7.20) and group 2 (-7.80 +/- 10.26) compared with control group (P<0.05). We did not find any statistically significant difference between groups 1 and 2 (P>0.05). The amount of analgesic consumption is significantly less in the group with ultrasound application compared to that in the control group (P<0.05).


CONCLUSION
The results of our study suggest that therapeutic exercises are effective for pain and disability in patients with lumbar spinal stenosis and that addition of ultrasound to exercise therapy lowers the analgesic intake substantially.
Exploring software cities in virtual reality

Software visualizations, such as the software city metaphor, are usually displayed on 2D screens and controlled by means of a mouse and thus often do not take advantage of more natural interaction techniques. Virtual reality (VR) approaches aim to improve the user experience. Emerging new technologies, like the Oculus Rift, dramatically enhance the VR experience at an affordable price. Therefore, new technologies have the potential to provide even higher immersion - and thus benefits - than previous VR approaches.
CDTA-C current-mode universal 2nd-order filter

Transformation of the classical KHN (Kerwin-Huelsman-Newcomb) 2nd-order filter into the current mode structure containing the CDTA (Current-Differencing Transconductance Amplifier) active elements is described. The resulting structure consists of three CDTAs and two grounded capacitors. The proposed filter has a low-impedance current input and three current outputs, realizing three basic transfer functions (lowpass, highpass, and bandpass), which can easily be combined to implement transfer functions with various transfer zeros.
Evaluation of the Fight Asthma Now (FAN) program to improve asthma knowledge in urban youth and teenagers.

BACKGROUND
School-based asthma education programs targeting disadvantaged youth and teens with asthma are lacking.


OBJECTIVES
To assess the impact of the Fight Asthma Now (FAN) educational program among 2 populations of predominantly low-income minority students: youth (3(rd)-6(th) graders) and teens (7(th)-8(th) graders).


METHODS
Chicago-area elementary schools were invited to participate in this stratified 2-arm study. Eligible schools were assigned to participate either in the intervention or in the control arm. Within each participating school, eligible students were recruited and grouped (stratified by grade and age) to form teen or youth classes. Participants completed a pre- and post-intervention asthma knowledge questionnaire and observation for spacer technique competency. The treatment group received the FAN curriculum between the evaluations.


RESULTS
A sample of 26 low-income, predominantly minority-serving schools was recruited. Most participating schools were randomized in a 3:1 ratio to form 25 youth classes (19 intervention and 6 control group) and 16 teen classes (11 intervention and 5 control group), resulting in 275 vs 69 youth and 141 vs 51 teens in the intervention and control groups, respectively. Stratified analyses were performed, and clustering within the school and class was taken into consideration in analyses. Multilevel models adjusting for school, class, ethnicity, sex, and pretest score indicate that the FAN intervention significantly increased both knowledge and spacer competency test scores, among both the youth and teen participants (P = .011 with respect to knowledge score among teen students, P < .0001 for all other cases).


CONCLUSIONS
This study suggests that FAN significantly increases asthma knowledge and spacer technique competency within this high-risk population.
Phase II, randomized, multicenter, double-blind, placebo-controlled trial of a polyclonal anti-Staphylococcus aureus capsular polysaccharide immune globulin in treatment of Staphylococcus aureus bacteremia.

New treatment modalities are needed for the treatment of infections due to multidrug-resistant Staphylococcus aureus. S. aureus capsular polysaccharide immune globulin (Altastaph) is a polyclonal immune globulin preparation that is being developed as adjunctive therapy for persons with S. aureus infections complicated by bacteremia. In a phase II, multicenter, randomized, double-blind, placebo-controlled trial, 40 subjects with documented S. aureus bacteremia received standard therapy plus either Altastaph at 200 mg/kg of body weight in each of two infusions 24 h apart or placebo. During the 42-day observation period, antibody pharmacokinetics and safety were the primary characteristics studied. Information regarding the resolution of bacteremia and fever was also analyzed. Anti-type-5 and anti-type-8 capsular antibody levels peaked after the second infusion at 550 mug/ml and 419 mug/ml, respectively, and remained above 100 mug/ml at day 28. A total of 316 adverse events were noted in 39 of 40 subjects. Infusion-related adverse events in Altastaph recipients were infrequent and similar to those among recipients of commercial intravenously administered immunoglobulin G products. Five of 21 (23%) subjects in the Altastaph group died, whereas 2 of 18 (11%) subjects in the placebo group died (P = 0.42). Compared to the control patients, the Altastaph recipients had a shorter median time to the resolution of fever (2 days and 7 days, respectively; P = 0.09) and a shorter length of hospital stay (9 days and 14 days, respectively; P = 0.03). However, these findings are exploratory, and there were few differences in the other variables measured. High levels of opsonizing antibodies were maintained for the initial 4 weeks. Although the study was not powered to show efficacy, these preliminary findings and safety profile suggest that Altastaph may be an effective adjunct to antibiotics and warrants further investigation (ClinicalTrials.gov number NCT00063089).
Allergic disease at the age of 7 years after pertussis vaccination in infancy: results from the follow-up of a randomized controlled trial of 3 vaccines.

OBJECTIVE
To prospectively assess sensitization rates and the development of allergic diseases in a follow-up of a randomized controlled pertussis vaccine trial.


SETTING
Two-month-old infants were the subject of this double-blind study in 1992 in a collaboration between the Pediatric Clinic and the Primary Care Centers in Linköping.


PATIENTS AND INTERVENTION
Allergic diseases were evaluated in 667 children, who were randomized to 1 of 4 vaccine groups: a 2-component, a 5-component, or a whole cell pertussis vaccine (all of which were administered with the diphtheria and tetanus toxoids vaccine) and the diphtheria and tetanus toxoids vaccine alone. Allergy development was assessed by questionnaires (n = 667) and skin prick tests (n = 538) at the age of 7 years.


MAIN OUTCOME MEASURES
Allergic diseases and skin prick test results at the age of 7 years.


RESULTS
The cumulative incidence of allergic diseases was 34.9%, and was similar in the 4 groups (33.3%-37.3%, P =.89), even after adjusting for family history, sex, pets, dampness, environmental smoking at home, and other living conditions. Positive skin prick test results were more prevalent, however, after vaccination with the 2-component acellular vaccine (19.4%) than in the other 3 groups (11.1%-13.5%, adjusted for confounding factors, P =.01). Furthermore, allergic rhinoconjunctivitis was more common in children who were initially immunized with the 2-component pertussis vaccine and received a booster dose with an acellular vaccine compared with those who received no booster vaccination (relative risk, 3.6; 95% confidence interval, 1.1-12.0).


CONCLUSION
Pertussis vaccination in infancy with any of these vaccines was not associated with allergic manifestations at the age of 7 years, apart from a higher prevalence of positive skin prick test results after an experimental 2-component vaccine, which is no longer in use.
A Protective Process Model of Parent-Child Affective Quality and Child Mastery Effects on Oppositional Behaviors

Abstract This article examines a model of the effects of parent-child affective quality and young adolescent sense of mastery on young adolescent oppositional behaviors. In addition to a direct effect of sense of mastery on oppositional behaviors, the model includes direct and indirect effects of parent-child affective quality on those behaviors, as well as across-time effects of oppositional behaviors on affective quality. Because the data were obtained from family competency-building intervention studies, the model controls for family attendance in the intervention. Results from covariance structure modeling, using data from a sample of families participating in an initial intervention study ( n = 171), generally supported the hypothesized model. The model was then tested with an independent sample of 361 families. Results from the second sample were consistent with results from the initial model test.
Media Optimization for Hyper-production of Carboxymethyl Cellulase using proximally analyzed agro-industrial residue with Trichoderma harzianum under SSF -

Now a day’s enzyme production is a growing field of biotechnology especially related to industrially important enzymes. The present study was carried out to investigate the potential of a filamentous fungus, Trichoderma harzianum for hyper-production of third most demanded industrial enzyme carboxymethyl cellulase using cheap and easily available agro-industrial residue wheat straw as growth supporting substrate under still culture solid state fermentation technique. Production of carboxymethyl cellulase was substantially enhanced through media optimization process. To promote carboxymethyl cellulase production, we evaluated the effect of several kinetic parameters like pretreatment, substrate concentration, initial moisture content, pH, incubation temperature and inoculum size on carboxymethyl cellulase production. Samples were harvested after every 24 hrs to study the profile of cellulase enzyme produced by the fungus on proximally analyzed wheat straw. By optimizing the SSF medium containing 2 % HCl pretreated wheat straw; maximum carboxymethyl cellulase activity (480±4.22 μM /mL/min) was recorded after 7 day of incubation at pH 5.5; temperature, 35°C; moisture, 40 % and inoculum size, 10 %, using optimum substrate concentration (3%). Outcome of the research will be supportive in the improvement of low cost system for hyper-production of carboxymethyl cellulose for industrial application.
Guiding of Long-Range Hybrid Plasmon Polariton in a Coupled Nanowire Array at Deep-Subwavelength Scale

A novel type of hybrid plasmonic waveguiding structure that integrates semiconductor and metallic nanowires has been proposed and investigated at telecommunication wavelengths. Semiconductor nanowires symmetrically placed on both sides of a metallic nanowire provide an additional degree of freedom for tuning the characteristics of the plasmonic nanowire mode. Theoretical analysis reveals that at appropriate geometrical parameters, the symmetric hybrid plasmonic mode of the waveguide could achieve subwavelength mode confinement with ultra-long propagation distance (even exceeding the millimeter range). Such a hybrid plasmonic nanowire structure could facilitate ultra-strong light-matter interaction between semiconductor and metal materials, and enable important applications in nanolasers and nonlinear photonics.
Smithian Perspective on the Markets of Beliefs: Public Policies and Religion

This article studies the economic analysis of the religious facts present in Smith’s work from the perspective of regulation economics. This marks the starting point of a new research program that focuses on the existence of markets of beliefs and questions the secularization processes and public performances on religion. In the first part, two basic problems are tackled: (1) the rationality of the agents within this market and (2) the economic effects of the different market structures on the behavior of the agents. The second part deals with the normative consequences that are possible from the previous exposition on the regulation of the markets of religion. Overall, our approach allows us to establish the fundamental components of the economic analysis of the religious facts and their consequences on that regulation. Jose Atilano Pena Lopez and Jose Manuel Sanchez Santos, "Smithian Perspective on the Markets of Beliefs: Public Policies and Religion," Journal of Markets & Morality 11, no. 1 (Spring 2008): 59-76
The Terebridae and teretoxins: Combining phylogeny and anatomy for concerted discovery of bioactive compounds

The Conoidea superfamily, comprised of cone snails, terebrids, and turrids, is an exceptionally promising group for the discovery of natural peptide toxins. The potential of conoidean toxins has been realized with the distribution of the first Conus (cone snail) drug, Prialt (ziconotide), an analgesic used to alleviate chronic pain in HIV and cancer patients. Cone snail toxins (conotoxins) are highly variable, a consequence of a high mutation rate associated to duplication events and positive selection. As Conus and terebrids diverged in the early Paleocene, the toxins from terebrids (teretoxins) may demonstrate highly divergent and unique functionalities. Recent analyses of the Terebridae, a largely distributed family with more than 300 described species, indicate they have evolutionary and pharmacological potential. Based on a three gene (COI, 12S and 16S) molecular phylogeny, including ~50 species from the West-Pacific, five main terebrid lineages were discriminated: two of these lineages independently lost their venom apparatus, and one venomous lineage was previously unknown. Knowing the phylogenetic relationships within the Terebridae aids in effectively targeting divergent lineages with novel peptide toxins. Preliminary results indicate that teretoxins are similar in structure and composition to conotoxins, suggesting teretoxins are an attractive line of research to discover and develop new therapeutics that target ion channels and receptors. Using conotoxins as a guideline, and innovative natural products discovery strategies, such as the Concerted Discovery Strategy, the potential of the Terebridae and their toxins are explored as a pioneering pharmacological resource.
Medicines availability for non-communicable diseases: the case for standardized monitoring

Background: In response to the global burden of non-communicable diseases (NCDs), the World Health Organization (WHO) has developed a Global Action Plan that includes a voluntary medicines target of 80% availability and affordability of essential medicines for the prevention and treatment of diabetes, cardiovascular disease and respiratory disease both in public and private health facilities. Reliable measures of medicines availability are needed to track progress towards meeting this target. The results of three studies measuring the availability of medicines for hypertension and diabetes conducted in Tanzania in 2012–2013 were compared to assess the consistency of the results across the studies. Methods: Availability was defined by observation of the medicine (no minimum quantity) on the day of the survey. The three studies involved 24, 107 and 1297 health facilities. Estimates of the availability of medicines for hypertension and diabetes were compared for medicines availability overall, by managing authority (government, mission/faith-based, private-for-profit), by facility level (hospital, health centre, dispensary) and by setting (urban, rural). Results: Comparisons of the availability of medicines were limited by differences in the definitions of the medicines and the classifications of the facilities surveyed. Metformin was variously reported as available in 33%, 39%, 46%, and 57% of facilities. Glibenclamide availability ranged from 19% to 52%. One study reported low levels of insulin availability (9-16% depending on insulin type) compared to 34% in a second study. Captopril (or angiotensin converting enzyme [ACE] inhibitor) availability ranged from 13% to 48%while availability of calcium channel blockers was 29% to 57% and beta-blockers 15% to 50%. Trends were similar across studies with lower availability in government compared to mission or private facilities, in dispensary and health centres compared to hospitals, and in rural compared to urban facilities. Conclusions: All three studies showed suboptimal availability of NCD medicines, however the estimates of availability differed. Regular monitoring using reproducible methods and measuring key medicines must replace ad-hoc studies, small selected samples and differences in definitions. Low and middle-income countries need to implement monitoring and evaluation systems to track progress towards meeting the NCD medicines target and to inform country-level interventions to improve access to NCD medicines.