LLukas22/scidocs huggingface dataset:
A prospective randomised comparison of cardiotomy suction and cell saver for recycling shed blood during cardiac surgery.

OBJECTIVE
Post-operative neuropsychological complications correlate with intra-operative microemboli in the middle cerebral artery. When severe neurological complications follow cardiac surgery, diffuse cerebral fat emboli are present at autopsy. Recycling shed blood with cardiotomy suction is an important source of cerebral fat microemboli. A cell saver may reduce this.


METHODS
Twenty patients were prospectively randomised to assess the amount of fat in blood salvaged from the pericardium and returned to the patient with either cell saver or cardiotomy suction. Blood samples were taken before and after filtration in the cardiotomy suction group or cell saver processing in the cell saver group. After centrifuging samples, fat content was graded on a scale of 0-3 by a blinded independent observer. Fat content was also quantified by weight.


RESULTS
Compared with cardiotomy suction, cell saver removed significantly more fat from shed blood. Median fat grading after cell saver was 0 (0-1) compared with 1 (1-2) for cardiotomy suction (P=0.0001). Percentage reduction in fat weight achieved by cell saver or cardiotomy suction was 87% compared to 45% (P=0.007). There was no difference in the post-operative use of blood or blood products, haemoglobin, or bleeding between the two groups.


CONCLUSION
Use of cell saver results in less fat being recycled during cardiopulmonary bypass.
A NOVEL ULTRA-WIDE BAND ANTENNA WITH REDUCED RADAR CROSS SECTION

Abstract—A novel printed dual circular ring monopole antenna with low radar cross section (RCS) for ultra-wide band (UWB) application is proposed. The proposed antenna is designed to realize RCS reduction. The two circular rings are connected by several metallic via holes to improve the radiation characteristics of the proposed antenna. Its UWB-related characteristics are simulated and experimentally verified. The RCS performance of the proposed antenna under different loads is studied and compared with that of a commonly used circulardisc monopole antenna. The results show that the proposed antenna has good radiation performances and lower RCS than the reference antenna. The proposed antenna serves as a good candidate in the design of UWB antenna with the requirement of RCS control.
Educational Implication of Piaget and Vygotsky Language Learning Theories in Pakistani Context : A Review

This comprehensive paper aims to explore some of the implications of the works of great theorists to work for a conducive environment for teaching and learning English in Pakistani schools. The theoretical premise for this study is the very early studies of Jean Piaget (1926-1956) and Lev Vygotsky (1934-1962). They remained a standard for language studies for long in the west. Although their names and some of the term such as scaffolding, zone of proximal development may seem exotic to our educational system but they provide some concrete and practical guidelines for language studies. This paper presents the alternative as well as complementary ideas of both Piaget and Vygotsky on different issues such as child’s developmental stages, egocentric speech in children, importance of language and the role of the teacher and student in language learning. The implication of their intersecting ideas for promoting a supportive environment for English language teaching and learning in Pakistan is then discussed in the paper.
Quality improvement and its impact on the use and equality of outpatient health services in India.

This paper examines the impact of quality improvements in conjunction with user fees on the utilization and equality of outpatient services at a range of public sector health facilities in India. Project impact on outpatient visits was estimated via the difference-in-difference method using pooled time series visit data from project and control facilities. The results indicate that the quality improvements significantly increased visits at all facility types. The project effect was largest at primary health center (PHC) and community health center (CHC), followed by district hospital (DH) and female district hospital (FDH). Pro-rich inequalities in outpatient visits increased at DHs and FDHs while at CHCs and PHCs the distribution remained equitable. This suggests that quality improvements at public sector health facilities can increase utilization of outpatient services in the presence of nominal user fees, but can also promote greater inequality favoring the better-off. At the referral hospital level, quality improvements should be made in conjuction with programs which encourage utilization by the poor. In contrast, the benefit of quality improvements at PHCs and CHCs is equitably distributed.
Quality of life is not negatively affected by diet and exercise intervention in healthy men with cardiovascular risk factors

Health-related quality of life was assessed in a diet and exercise intervention study among 157 healthy men aged 35–60 years (mean ± s.d.; 46.2 ± 5.0) with moderately raised cardiovascular risk factors. The men were randomized to four groups, diet (D, n=40), exercise (E, n=39), diet plus exercise (DE, n=39), and no active intervention (controls (C) n=39). Quality of life was measured with two self-administered questionnaires; Subjective Symptoms Assessment Profile and Minor Symptom Evaluation Profile, at baseline and after 1.5, 3 and 6 months. Cardiovascular risk factors were investigated at baseline and after 6 months. As a result of changes in dietary habits and physical exercise in the three intervention groups, several important cardiovascular risk factors were significantly reduced. The quality of life/well-being did not differ between the four groups and did not change significantly in any of the groups during the study. There was, however, a tendency towards fewer gastrointestinal symptoms in group D and fewer cardiac symptoms in group DE. We conclude that advice on lifestyle changes in the form of diet and exercise reduce risk factors in middle-aged men without negative effects on their quality of life.
Microvascular Coronary Artery Spasm Presents Distinctive Clinical Features With Endothelial Dysfunction as Nonobstructive Coronary Artery Disease

BACKGROUND
Angina without significant stenosis, or nonobstructive coronary artery disease, attracts clinical attention. Microvascular coronary artery spasm (microvascular CAS) can cause nonobstructive coronary artery disease. We investigated the clinical features of microvascular CAS and the therapeutic efficacy of calcium channel blockers.


METHODS AND RESULTS
Three hundred seventy consecutive, stable patients with suspected angina presenting nonobstructive coronary arteries (<50% diameter) in coronary angiography were investigated with the intracoronary acetylcholine provocation test, with simultaneous measurements of transcardiac lactate production and of changes in the quantitative coronary blood flow. We diagnosed microvascular CAS according to lactate production and a decrease in coronary blood flow without epicardial vasospasm during the acetylcholine provocation test. We prospectively followed up the patients with calcium channel blockers for microvascular coronary artery disease. We identified 50 patients with microvascular CAS who demonstrated significant impairment of the endothelium-dependent vascular response, which was assessed by coronary blood flow during the acetylcholine provocation test. Administration of isosorbide dinitrate normalized the abnormal coronary flow pattern in the patients with microvascular CAS. Multivariate logistic regression analysis indicated that female sex, a lower body mass index, minor-borderline ischemic electrocardiogram findings at rest, limited-baseline diastolic-to-systolic velocity ratio, and attenuated adenosine triphosphate-induced coronary flow reserve were independently correlated with the presence of microvascular CAS. Receiver-operating characteristics curve analysis revealed that the aforementioned 5-variable model showed good correlation with the presence of microvascular CAS (area under the curve: 0.820). No patients with microvascular CAS treated with calcium channel blockers developed cardiovascular events over 47.8±27.5 months.


CONCLUSIONS
Microvascular CAS causes distinctive clinical features and endothelial dysfunction that are important to recognize as nonobstructive coronary artery disease so that optimal care with calcium channel blockers can be provided.


CLINICAL TRIAL REGISTRATION
URL: www.umin.ac.jp/ctr. Unique identifier: UMIN000003839.
Caring Behaviors Inventory: a reduction of the 42-item instrument.

BACKGROUND
Caring traditionally has been at the center of nursing. Effectively measuring the process of nurse caring is vital in nursing research. A short, less burdensome dimensional instrument for patients' use is needed for this purpose.


OBJECTIVES
To derive and validate a shorter Caring Behaviors Inventory (CBI) within the context of the 42-item CBI.


METHODS
The responses to the 42-item CBI from 362 hospitalized patients were used to develop a short form using factor analysis. A test-retest reliability study was conducted by administering the shortened CBI to new samples of patients (n = 64) and nurses (n = 42).


RESULTS
Factor analysis yielded a 24-item short form (CBI-24) that (a) covers the four major dimensions assessed by the 42-item CBI, (b) has internal consistency (alpha =.96) and convergent validity (r =.62) similar to the 42-item CBI, (c) reproduces at least 97% of the variance of the 42 items in patients and nurses, (d) provides statistical conclusions similar to the 42-item CBI on scoring for caring behaviors by patients and nurses, (e) has similar sensitivity in detecting between-patient difference in perceptions, (f) obtains good test-retest reliability (r = .88 for patients and r=.82 for nurses), and (g) confirms high internal consistency (alpha >.95) as a stand-alone instrument administered to the new samples.


CONCLUSION
CBI-24 appears to be equivalent to the 42-item CBI in psychometric properties, validity, reliability, and scoring for caring behaviors among patients and nurses. These results recommend the use of CBI-24 to reduce response burden and research costs.
Manipulation of microRNA expression to improve nitrogen use efficiency.

Nitrogen is the key limiting nutrient required for plant growth. The application of nitrogen-based fertilizers to crops has risen dramatically in recent years, resulting in significant yield increases. However, increased production has come at the cost of substantial negative environmental consequences. Higher crop production costs, increased consumption of food and fertilizer, and a growing global population have led to calls for a "second green revolution" using modern genetic manipulation techniques to improve the production, yield, and quality of crops. Considerable research is being directed toward the study and engineering of nitrogen use efficiency in crop plants. The end goal is to reduce the amount of nitrogen-based fertilizer used and thereby reduce production costs and environmental damage while increasing yields. In this review, we present an overview of recent advances in understanding the regulation of nitrogen metabolism by the action of microRNAs with a view toward engineering crops with increased nitrogen use efficiency.
Indoor Office Wideband Millimeter-Wave Propagation Measurements and Channel Models at 28 and 73 GHz for Ultra-Dense 5G Wireless Networks

Ultra-wideband millimeter-wave (mmWave) propagation measurements were conducted in the 28- and 73-GHz frequency bands in a typical indoor office environment in downtown Brooklyn, New York, on the campus of New York University. The measurements provide large-scale path loss and temporal statistics that will be useful for ultra-dense indoor wireless networks for future mmWave bands. This paper presents the details of measurements that employed a 400 Megachips-per-second broadband sliding correlator channel sounder, using rotatable highly directional horn antennas for both co-polarized and cross-polarized antenna configurations. The measurement environment was a closed-plan in-building scenario that included a line-of-sight and non-line-of-sight corridor, a hallway, a cubicle farm, and adjacent-room communication links. Well-known and new single-frequency and multi-frequency directional and omnidirectional large-scale path loss models are presented and evaluated based on more than 14 000 directional power delay profiles acquired from unique transmitter and receiver antenna pointing angle combinations. Omnidirectional path loss models, synthesized from the directional measurements, are provided for the case of arbitrary polarization coupling, as well as for the specific cases of co-polarized and cross-polarized antenna orientations. The results show that novel large-scale path loss models provided here are simpler and more physically based compared to previous 3GPP and ITU indoor propagation models that require more model parameters and offer very little additional accuracy and lack a physical basis. Multipath time dispersion statistics for mmWave systems using directional antennas are presented for co-polarization, crosspolarization, and combined-polarization scenarios, and show that the multipath root mean square delay spread can be reduced when using transmitter and receiver antenna pointing angles that result in the strongest received power. Raw omnidirectional path loss data and closed-form optimization formulas for all path loss models are given in the Appendices.
Impact of prophylactic platelet transfusions on bleeding events in patients with hematologic malignancies: a subgroup analysis of a randomized trial.

BACKGROUND
A recent randomized trial compared a policy of no prophylaxis with a policy of prophylactic platelet (PLT) transfusions at counts of fewer than 10 × 10(9) /L in patients with hematologic malignancies. The results suggested the effectiveness of prophylactic PLT transfusions may vary according to patient diagnosis and treatment plan.


STUDY DESIGN AND METHODS
This article presents full subgroup analyses and compares treatment effects between autologous hematopoietic stem cell transplantation (autoHSCT; n = 421) and chemotherapy/allogeneic HSCT (chemo/alloHSCT; n = 179) patients.


RESULTS
Prespecified subgroup analysis found that the reduction in proportion of patients experiencing WHO Grade 2 to 4 bleeds (main trial outcome) seen in the prophylaxis arm was of greater magnitude in chemo/alloHSCT than autoHSCT patients (interaction p = 0.04). Analysis of secondary outcomes showed a shorter time to first bleeding episode with no prophylaxis in the chemo/alloHSCT group (hazard ratio, 1.84; 95% confidence interval CI, 1.21-2.79; p = 0.004) compared to the autoHSCT group (hazard ratio, 1.12; 95% CI, 0.85-1.48; p = 0.4; interaction p = 0.08). The increased number of days with Grade 2 to 4 bleeds with a no-prophylaxis policy was similar in chemo/alloHSCT (rate ratio, 1.89; 95% CI, 1.10-3.26) and in autoHSCT patients (rate ratio, 1.43; 95% CI, 1.04-1.97). Both subgroups showed significant reductions in PLT transfusions with a no-prophylaxis strategy.


CONCLUSION
There is evidence that the effectiveness of prophylactic PLT transfusions may differ between subgroups, with chemo/alloHSCT patients receiving prophylactic PLT transfusions appearing to show a greater reduction in bleeding outcomes compared to patients following a no-prophylaxis policy.
Housing and the Macroeconomy : The Role of Bailout Guarantees for Government Sponsored Enterprises ∗

This paper evaluates the macroeconomic and distributional effects of government bailout guarantees for Government Sponsored Enterprises (such as Fannie Mae and Freddy Mac) in the mortgage market. In order to do so we construct a model with heterogeneous, infinitely lived households and competitive housing and mortgage markets. Households have the option to default on their mortgages, with the consequence of having their homes foreclosed. We model the bailout guarantee as a government provided and tax-financed mortgage interest rate subsidy. We find that eliminating this subsidy leads to substantially lower equilibrium mortgage origination and increases aggregate welfare, but has little effect on foreclosure rates and housing investment. The interest rate subsidy is a regressive policy: eliminating it benefits low-income and low-asset households who did not own homes or had small mortgages, while lowering the welfare of high-income, high-asset households.
Classic and unusual appearances of hydatid disease in children

Abstract Background. In endemic regions, hydatid disease is commoner in children than in adults. The hydatid cysts may have classic appearances, but unusual sites and appearances may cause diagnostic difficulties. Objective. To assess the classic and unusual appearances of hydatid disease in children. Materials and methods. A 3-year retrospective review of available imaging of proven hydatid disease at a tertiary paediatric institution. Results. Review of imaging of 21 children (9 boys, 12 girls), with a mean age of 8 years and 1 month, demonstrated cysts in the liver (n=9), lung (n=8), brain (n=7), spleen (n=2), heart (n=1), orbit (n=1) and soft tissues (n=1). Multi-organ involvement occurred in eight cases with two cases that did not involve the liver. Complicated cysts were found in 13 cases and usually involved the liver (n=8) and lung (n=5). An unusual case of spontaneous cerebrospinal fluid (CSF) spread was also documented. Conclusions. Hydatid disease in children classically involves the liver, lung and brain but can involve almost any organ and numerous organs simultaneously. Whether hydatid disease is discovered incidentally or by intentional imaging, extended imaging is recommended to identify multifocal disease which may also display complicated cysts that may assist in the diagnostic process. All patients with one known site should undergo a minimum of an abdominal US and CT scan of the chest and brain. CT may be used instead of US of the abdomen, and MRI may be used to replace CT of the brain. Over 50% of cases in our study showed complicated cysts. Unique findings of this study include multi-organ involvement without liver cysts. Multiplicity and complications of cysts can assist diagnosis. Intraventricular and intrathecal CSF spread of a spontaneously ruptured intracerebral cyst has not, to our knowledge, been previously reported.
A phase I study of VS-6063, a second-generation focal adhesion kinase inhibitor, in patients with advanced solid tumors

Objective VS-6063 (also known as defactinib or PF-04554878) is a second-generation inhibitor of focal adhesion kinase (FAK) and proline-rich tyrosine kinase-2 (Pyk2). This phase I dose-escalation study was conducted in patients with advanced solid malignancies. Methods Using a traditional 3 + 3 design, VS-6063 was administered orally twice daily (b.i.d.) in 21-day cycles to cohorts of three to six patients. In cycle 1, a lead-in dose was administered to assess single-dose pharmacokinetics; steady-state pharmacokinetics was assessed after 15 days of continuous dosing. Dose escalation was performed in the fasted state, and repeated in two additional cohorts in the fed state. Results Forty-six patients were treated across nine dose levels (12.5–750 mg b.i.d.). Dose-limiting toxicities, comprising headache (n = 1), fatigue (n = 1) and unconjugated hyperbilirubinemia (n = 3), occurred at the 300- or 425-mg b.i.d. dose level and were reversible. Frequent adverse events included nausea (37 %), fatigue (33 %), vomiting (28 %), diarrhea (22 %) and headache (22 %). A maximum-tolerated dose was not defined. Dose escalation was stopped at the 750-mg b.i.d. dose due to decreased serum exposure in the 500- and 750-mg versus 300- and 425-mg groups. Food delayed the time to peak serum concentration without affecting serum drug exposure. No radiographic responses were reported. Disease stabilization at ~12 weeks occurred in six of 37 (16 %) patients receiving doses ≥100 mg b.i.d. Conclusions VS-6063 has an acceptable safety profile. Treatment-related adverse events were mild to moderate, and reversible. The recommended phase II fasting dose of VS-6063 is 425 mg b.i.d.
Viral load monitoring and antiretroviral treatment outcomes in a pediatric HIV cohort in Ghana

BACKGROUND
HIV-infected children in sub-Saharan Africa may be at a high risk of staying on a failing first-line regimen and developing drug-resistance HIV variants due to lack of routine viral load monitoring. We investigated whether cumulative viral load, measured as viremia copy-years (VCY) could predict morbidity in a setting where viral load is not routinely monitored.


METHODS
This was a single-center prospective observational longitudinal study of HIV-infected children initiating antiretroviral therapy (ART) at the Pediatric HIV/AIDS Care program at Korle-Bu Teaching Hospital in Accra, Ghana. The main outcome was morbidity measured as frequency of hospitalizations, opportunistic infections, and outpatient sick visits. The main explanatory variable was viral load measured as VCY.


RESULTS
The study included 140 children who initiated ART between September 2009 and May 2013 and had at least 2 viral load measurements. There were 184 hospitalizations, with pneumonia being the most common cause (22.8 %). A total of 102 opportunistic infections was documented, with tuberculosis being the most common opportunistic infection (68 %). A total of 823 outpatient sick visits was documented, with upper respiratory infections (14.2 %) being the most common cause. Forty-four percent of our study participants had >4 log10 VCY. Children in this sub-cohort had a higher frequency of sick visits compared with those with <4 log10 VCY (p = 0.03). Only 6.5 % of children with >4 log10 VCY had been identified as treatment failure using WHO clinical and immunological treatment failure criteria.


CONCLUSIONS
High level of cumulative viral load may translate to virological failure and subsequent increased all-cause morbidity. Our finding of potential utility of VCY in pediatrics warrants further investigations. VCY may be a good alternate to routine viral load measurement as its determination may be less frequent and could be personalized to save cost.
Psychology of Violence The Effect of Video Game Competition and Violence on Aggressive Behavior : Which Characteristic Has the Greatest Influence ?

Objective: This study is the first to our knowledge to isolate the effect of video game violence and competitiveness on aggressive behavior. Method: In Pilot Study 1, a violent and nonviolent video game were matched on competitiveness, difficulty, and pace of action, and the effect of each game on aggressive behavior was then compared using an unambiguous measure of aggressive behavior (i.e., the Hot Sauce Paradigm) in Experiment 1. In Pilot Study 2, competitiveness was isolated by matching games on difficulty and pace of action, and systematically controlling for violence. The effect of video game competition on aggressive behavior was then examined in Experiment 2. Results: We found that video game violence was not sufficient to elevate aggressive behavior compared with a nonviolent video game, and that more competitive games produced greater levels of aggressive behavior, irrespective of the amount of violence in the games. Conclusion: It appears that competition, not violence, may be the video game characteristic that has the greatest influence on aggressive behavior. Future research is needed to explore the mechanisms through which video game competitiveness influences aggressive behavior, as well as whether this relation holds in the long-term.