LLukas22/scidocs huggingface dataset:
A secure distributed logistic regression protocol for the detection of rare adverse drug events

BACKGROUND
There is limited capacity to assess the comparative risks of medications after they enter the market. For rare adverse events, the pooling of data from multiple sources is necessary to have the power and sufficient population heterogeneity to detect differences in safety and effectiveness in genetic, ethnic and clinically defined subpopulations. However, combining datasets from different data custodians or jurisdictions to perform an analysis on the pooled data creates significant privacy concerns that would need to be addressed. Existing protocols for addressing these concerns can result in reduced analysis accuracy and can allow sensitive information to leak.


OBJECTIVE
To develop a secure distributed multi-party computation protocol for logistic regression that provides strong privacy guarantees.


METHODS
We developed a secure distributed logistic regression protocol using a single analysis center with multiple sites providing data. A theoretical security analysis demonstrates that the protocol is robust to plausible collusion attacks and does not allow the parties to gain new information from the data that are exchanged among them. The computational performance and accuracy of the protocol were evaluated on simulated datasets.


RESULTS
The computational performance scales linearly as the dataset sizes increase. The addition of sites results in an exponential growth in computation time. However, for up to five sites, the time is still short and would not affect practical applications. The model parameters are the same as the results on pooled raw data analyzed in SAS, demonstrating high model accuracy.


CONCLUSION
The proposed protocol and prototype system would allow the development of logistic regression models in a secure manner without requiring the sharing of personal health information. This can alleviate one of the key barriers to the establishment of large-scale post-marketing surveillance programs. We extended the secure protocol to account for correlations among patients within sites through generalized estimating equations, and to accommodate other link functions by extending it to generalized linear models.
Hepatic and hematological adverse effects of long-term low-dose methotrexate therapy in rheumatoid arthritis: An observational study

OBJECTIVES
Methotrexate (MTX) is the most commonly used cost-effective disease-modifying antirheumatoid drug (DMARD). Its main dose-limiting adverse effects are hepatic and hematopoietic. This cross-sectional, observational study evaluated the prevalence of hepatic and hematological adverse effects with long-term low-dose MTX therapy.


MATERIALS AND METHODS
Rheumatoid arthritis (RA) patients taking ≤15 mg/week MTX for at least 2 years were enrolled from the rheumatology outpatient department. Demographic, disease, drug treatment profiles, and hematological and hepatic enzyme levels were noted.


RESULTS
Of the 204 patients enrolled, the frequency of raised alanine transaminase level (≥3-fold rise above the upper limit of normal) was 6.37% (95% confidence interval of 3.76-10.59) including two biopsy-proven hepatic fibrosis cases. About 5.4% had severe anemia (<8 g/dl) and 4.4% had leukopenia.


CONCLUSION
Long-term low-dose MTX is safe in RA patients in the Indian population. The patterns of adverse effects were similar to those documented in earlier studies. However, our study results suggest that disease duration, cumulative MTX dose, concomitant DMARD intake are not risk factors associated with hepatic or hematological adverse effects.
Perioperative outcomes and complications of open vs laparoscopic extraperitoneal inguinal hernia repair in a mature surgical practice

Background: Although the laparoscopic totally extraperitoneal (TEP) approach to hernia repair has been associated with less pain and a faster postoperative recovery than traditional open repair, many practicing surgeons have been reluctant to adopt this technique because of the lengthy operative times and the learning curve for this procedure. Methods: Data from all patients undergoing TEP repair since 1997 and open mesh repair (OPEN) since 1999 were collected prospectively. Selection of surgical approach was based on local hernia factors, anesthetic risk, previous abdominal surgery, and patient preference. Statistical analyses were performed using unpaired t-tests and chi-squared tests. Data are mean ± SD. Results: TEP repairs were performed in 147 patients and open repairs in 198 patients. Patients in the OPEN group were significantly older (59 ± 19 years OPEN vs 51 ± 13 years TEP) and had a higher ASA (1.9 ± 0.7 OPEN vs 1.5 ± 0.6 TEP; p < 0.01). TEP repairs were more likely to be carried out for bilateral (33% TEP, 5% OPEN) or recurrent hernias (31% TEP, 11% OPEN) than were open repairs (p < 0.01). Concurrent procedures accompanied 31% of TEP and 12% of OPEN repairs (p < 0.01). Operative times (min) were significantly shorter in the TEP group for both unilateral (63 ± 22 TEP, 70 ± 20 OPEN; p = 0.02) and bilateral (78 ± 27 TEP, 102 ± 27 OPEN; p = 0.01) repairs. Mean operative times decreased over time in the TEP group for both unilateral and bilateral repairs (p < 0.01). Patients undergoing TEP were more likely (p < 0.01) to develop urinary retention (7.9% TEP, 1.1% OPEN), but were less likely (p < 0.01) to have skin numbness (2.8% TEP, 35.8% OPEN) or prolonged groin discomfort (1.4% TEP, 5.3% OPEN). Conclusions: Despite a higher proportion of patients undergoing bilateral repairs, recurrent hernia repair, and concurrent procedures, operative times are shorter for laparoscopic TEP repair than for open mesh repair. TEP repairs can be performed efficiently and without major complications, even when the learning curve is included.
Comments on symmetric key encryption based smart card authentication scheme

Recently smart card authentication scheme based on symmetric key encryption is proposed. It provides mutual authentication between user and server and generates a session key. Its security depends on the one-way hash function and symmetric cryptosystem. It has been claimed that the scheme is secure and provides mutual authentication. In addition, it withstands replay attack, impersonation attack and parallel session attack. This paper shows that the scheme is vulnerable to perfect forward secrecy and Denial-of-Service attack.
The effect of nebulised magnesium sulphate in the management of childhood moderate asthma exacerbations as adjuvant treatment.

BACKGROUND
After the bronchodilator effect of magnesium was shown, the use of magnesium in treatment of asthma exacerbations became common. With the results of recent studies, the use of intravenous magnesium in severe asthma exacerbations took its place. We aimed to examine the effects of adding isotonic magnesium sulphate instead of isotonic saline into nebulised salbutamol on the Modified Pulmonary Index Score (MPIS) and the hospitalisation rate in moderate asthma exacerbations.


METHODS
Our study population included 100 children age between 3 and 15 years with asthma admitted to emergency department due to moderate asthma exacerbations. The patients were randomised to placebo or magnesium, with 50 patients in each arm. All patients received 1mg/kg of systemic methylprednisolone at the beginning of treatment and thereafter received either nebulised salbutamol (0.15mg/kg/dose) and 1ml magnesium sulphate (15%)+1.5ml isotonic saline on three occasions at roughly 20min intervals (Magnesium group) or nebulised salbutamol (0.15mg/kg/dose) and 2.5ml isotonic saline mixture on three occasions at roughly 20min intervals (Placebo group). The MPIS of patients on 0th min, 20th min, 40th and 120th min were calculated and compared. The primary outcome was to compare MPIS values at the end of 120th min.


RESULTS
Both groups have similar demographic, allergic characteristics and baseline MPIS scores. When the MPIS scores in the 120th min and admission rates in the 200th min, there was no significant difference between the two groups.


CONCLUSIONS
The use of nebulised magnesium sulphate in moderate asthma exacerbation as adjuvant treatment showed no benefit to standard treatment in our study.
Object-Oriented Patterns

Object-oriented analysis (OOA) and object-oriented design (OOD) rely on classes and objects as the lowest level building blocks. These classes and objects form patterns with specific relationships between them. Groups of classes in an object-oriented environment are likely to be useful repeatedly. Many patterns may be found by trial-and-error and by observation. Examples of pattern types include item description, time association, event logging, roles played, state across a collection, and broadcast. Patterns standardize small piecework into a larger unit and become building blocks for program design and construction.
Efficacy of rotigotine for treatment of moderate-to-severe restless legs syndrome: a randomised, double-blind, placebo-controlled trial

BACKGROUND
Continuous administration of a dopamine agonist could be used to treat patients with restless legs syndrome. Our aim was to investigate the efficacy of transdermal rotigotine in the treatment of idiopathic restless legs syndrome.


METHODS
In this randomised, double-blind, placebo-controlled trial, 458 patients with moderate-to-severe idiopathic restless legs syndrome (average baseline International Restless Legs Syndrome Study Group severity rating scale [IRLS] sum score of 28.1) were randomly assigned to receive transdermal rotigotine 1 mg over 24 h (n=115), 2 mg over 24 h (n=112), or 3 mg over 24 h (n=114), or to receive placebo (n=117). Study medication was delivered via patches, applied once a day for 6 months. Randomisation was done with a computer-generated randomisation list, stratified by centre. Primary efficacy outcomes were absolute change from baseline to end of maintenance in IRLS sum score and in the clinical global impressions (CGI) item 1 score, assessed by analysis of covariance in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00136045.


FINDINGS
Efficacy analyses were done on 112 patients in the 1 mg group, 109 in the 2 mg group, 112 in the 3 mg group, and 114 in the placebo group. Mean change in IRLS sum score from baseline at the end of the maintenance phase was -13.7 (SE 0.9) in the 1 mg group, -16.2 (0.9) in the 2 mg group, -16.8 (0.9) in the 3 mg group, and -8.6 (0.9) in the placebo group (p<0.0001 for treatment difference vs placebo with each dose). Mean change in CGI item 1 score from baseline at the end of the maintenance phase was -2.09 (0.14) in the 1 mg group, -2.41 (0.14) in the 2 mg group, -2.55 (0.14) in the 3 mg group, and -1.34 (0.14) in the placebo group (p<0.0001 for treatment difference vs placebo with each dose). Skin reactions, mostly mild or moderate, were seen in 145 (43%) of 341 patients who received rotigotine and in two (2%) of 117 who received placebo. Ten patients had serious adverse event that were deemed to be related to rotigotine: elevation of liver enzymes (one patient), worsening of tinnitus (one patient), non-response to anticoagulation (one patient), electrocardiogram changes (one patient), and application-site reactions (six patients). No admissions to hospital were needed for the application-site reactions, and they all resolved within a short time of patch removal without any other therapeutic intervention. The rate of typical dopaminergic side-effects in patients who received rotigotine was low; no signs of augmentation were noted.


INTERPRETATION
24 h transdermal delivery of low-dose rotigotine could be used to relieve the night-time and daytime symptoms of restless legs syndrome.


FUNDING
Schwarz Biosciences.
Respiratory response to carbon dioxide stimulation during low flow supplemental oxygen therapy in chronic obstructive pulmonary disease.

BACKGROUND AND PURPOSE
Oxygen supplementation is the treatment most commonly used to relieve dyspnea in chronic obstructive pulmonary disease (COPD). There is a lack of data, however, on the response of the respiratory drive to low flow oxygen in severe stable COPD. The purpose of this investigation was to evaluate the magnitude of chemoresponsiveness to low flow supplemental oxygen in patients with COPD of variable severity in terms of mouth occlusion pressure at 100 msec (P0.1), P0.1 and minute ventilation (MV) response to CO2 stimulation, and blood gas tension.


METHODS
Twenty-six patients with stable COPD of variable severity were divided into two groups: those with mild airway obstruction and normocapnia (n = 14) and those with hyperinflation and hypercapnia (n = 12).


RESULTS
Arterial oxygen tension, oxygen saturation, and arterial CO2 tension were significantly increased after oxygen therapy in COPD patients with or without hypercapnia (all p < 0.01). COPD patients with hypercapnia had a significantly higher P0.1 (0.7 +/- 0.07 kPa) than those with normocapnia (0.3 +/- 0.03 kPa, p < 0.01). Oxygen significantly decreased the P0.1 adjusted by end tidal CO2 pressure (delta P0.1/PETCO2) only in patients with hyperinflation and hypercapnia, from 0.2 +/- 0.05 to 0.1 +/- 0.03 kPa (p < 0.05). There was a weak correlation between P0.1/PETCO2 and forced vital capacity (FVC; r = 0.41, p < 0.05) or forced expiratory volume in 1 second (FEV1; r = 0.45, p < 0.05). In addition, the arterial CO2 tension (PaCO2) was inversely related to P0.1/PETCO2 (r = -0.57, p < 0.01). The MV with 6% CO2 (MVCO2) was also significantly decreased in the hypercapnic group from 17.9 +/- 3.7 to 14.8 +/- 4.9 L after oxygen therapy (p < 0.01). The maximum inspiratory pressure did not change after oxygen usage in either group.


CONCLUSION
We conclude that short-term oxygen therapy may blunt respiratory response to CO2 in COPD with chronic hypercapnia. Cautious observation of respiratory response is needed during oxygen therapy in COPD patients with a higher magnitude of air-trapping and hypercapnia.
Quality of life during rehabilitation: Rectal cancer patient and partner experiences with altered bowel function.

468 Background: In 2010, the American Cancer Society has estimated rectal cancer affects over 39,670 adult patients in the United States. Five-year disease-free survival for rectal cancer patients with stage II/III disease ranges from 60-70%. Current gaps exist regarding long-term effects after treatment including altered bowel function and health-related quality of life (HR-QOL) concerns from rectal cancer patient and partners' perspectives both individually and together during rehabilitation and as cancer survivors. The purpose of this study was to: (1) describe the experiences of adult rectal cancer patients and their partners during rehabilitation from cancer treatment, including long- term effects; (2) examine health-related quality of life (HR-QOL) issues for rectal cancer patients and their partners including well-being and coping during their rehabilitation and as survivors.


METHODS
A qualitative descriptive study for a planned sample of 20 adult rectal cancer patients, stage II/III, and their partners from an academic health science hospital and cancer center has been conducted. Twelve patients and their partners have currently completed face to face semi-structured interviews. Patient participants were at least 6 months to 5 years post treatment. Qualitative descriptive design used purposive sampling to obtain broad information on rectal cancer patients' and partners' perspectives for content analysis.


RESULTS
Preliminary findings have revealed unexpected difficulties; chronic bowel function alterations; symptom unpredictability; nutrition intolerances; patient/partner adjustments; social concerns in going places, reactions by friends, work and financial strains; and, acceptance in living with it or chronic life changes as survivors. Partners acknowledged their own needs for information and support to assist their spouse or significant other. Further rich, thick descriptions will be presented in presentation of findings for 20 patient and partner responses.


CONCLUSIONS
Survivorship follow-up regarding these concerns should be emphasized for rectal cancer patients and their partners to formalize interventions for study to enhance HR-QOL well-being. No significant financial relationships to disclose.
Leveraging SDN to provide an in-network QoE measurement framework

Online video streaming using HTTP Adaptive Streaming (HAS) is becoming the most popular content delivery mechanism for media services. Network and content providers would like to ensure a high degree of video Quality of Experience (QoE) for their end-users. However, traditional network-level metrics do not necessarily reflect the end-users' true perception of delivered content.We introduce an in-network QoE measurement framework (IQMF) that provides QoE monitoring for HAS streams as a service. The framework leverages Software Defined Networking for its control plane functionality to streamline non-intrusive quality monitoring and to offer a closed control loop for QoE-aware service management. IQMF adopts two specifically designed QoE metrics to capture the user experience of HAS streams with respect to video fidelity and switching impact. Finally, we used a pan-European SDN testbed to demonstrate how IQMF can be used as a foundation for in-network QoE measurement and service optimisation.
Hybrid processes — a versatile technique to match process requirements and coating needs

Abstract The properties of thin hard coatings and consequently their functionality are influenced by microstructural characteristics such as phase composition and grain size distribution. Recent studies indicate that microlaminated hybrid coatings offer an opportunity to establish unique and controllable microstructural characteristics. A variety of interlayers has been used in hybrid coatings for various purposes: (1) to enhance the adherence between coatings and substrates, (2) to prevent crack initiation, (3) to give good shock resistance, (4) to tailor the thermal expansion characteristics, which leads to good interfacial strength, (5) to prevent diffusion of substrate species into coatings or vice versa during annealing, (6) to enhance corrosion protection of coating and substrate, and (7) to enhance sliding wear resistance or lower sliding friction. In order to obtain the above mentioned properties, various surface modification techniques such as (1) electrodeposition, (2) thermal treatment, (3) ion plating, (4) ion implantation, and (5) sputtering can be used to prepare hybrid coatings. This review includes a discussion on surface modification techniques and properties of different hybrid coatings.
Coefficients of Relations for Probabilistic Reasoning

Definitions and notations with historical references are given for some numerical coefficients commonly used to quantify relations among collections of objects for the purpose of expressing approximate knowledge and probabilistic reasoning.
Radiological correlates and clinical implications of the paradoxical lung function response to β₂ agonists: an observational study.

BACKGROUND
Bronchodilator response has been noted in a significant proportion of patients with chronic obstructive pulmonary disease (COPD). However, there are also reports of a paradoxical response to β₂ agonists resulting in bronchoconstriction. Asymptomatic bronchoconstriction is likely to be far more common than is symptomatic bronchoconstriction with β₂ agonists, but no systematic studies have been done. We assessed the prevalence of paradoxical response in current and former smokers with and without COPD, and its radiological correlates and clinical implications.


METHODS
Non-Hispanic white and African-American patients (aged 45-80 years) from a large multicentre study COPDGene were classified into two groups on the basis of a paradoxical response, defined as at least a 12% and 200 mL reduction in forced expiratory volume in 1 sec (FEV₁) or forced vital capacity (FVC), or both, after administration of a shortacting β₂ agonist (180 μg salbutamol).


FINDINGS
Patients were recruited from January, 2008, to June, 2011. 9986 (96%) of 10,364 patients enrolled in the COPDGene study were included in the analysis population (mean age 59·6 years [SD 9·0]). Paradoxical response was noted in 453 (5%) of 9986 patients and the frequency was similar in patients with COPD (198 [4%] of 4439) and smokers without airflow obstruction (255 [5%] of 5547). Compared with white patients, a paradoxical response was twice as common in African-American patients (227 [7%] of 3282 vs 226 [3%] of 6704; p<0·0001). In the multivariate analyses, African-American ethnic origin (adjusted odds ratio 1·89, 95% CI 1·50-2·39; p<0·0001), less emphysema (0·96, 0·92-0·99; p=0·023), and increased wall-area percentage of the segmental airways (1·04, 1·01-1·08; p=0·023) were independently associated with a paradoxical response. A paradoxical response was independently associated with worse dyspnoea (adjusted β for Modified Medical Research Council Dyspnoea Scale 0·12 [95% CI 0·00 to 0·24]; p=0·05), lower 6 min walk distance (-45·8 [-78·5 to -13·2]; p=0·006), higher Body Mass Index, Airflow Obstruction, Dyspnea, and Exercise Capacity (BODE) index (0·31 [0·19 to 0·43]; p<0·0001), and a greater frequency of severe exacerbations (increased by a factor of 1·35, 1·00-1·81; p=0·048).


INTERPRETATION
Paradoxical response to β₂ agonists is associated with respiratory morbidity and is more common in African-Americans. These findings might have implications for the use of β2agonists in some patients.


FUNDING
National Institutes of Health.
Determinants of Pre-eclampsia: A Case–control Study in a District Hospital in South India

OBJECTIVE
The objective was to study the determinants of pre-eclampsia among pregnant women admitted for delivery in a district hospital.


MATERIALS AND METHODS
A case-control study was conducted at District Lady Goschen Hospital, Dakshina Kannada district, Karnataka, South India. The group of pregnant women with pre-eclampsia comprised those with hypertension after the 20th week of gestation with associated proteinuria, and controls were pregnant women not diagnosed with pre-eclampsia. A total of 100 cases and 100 controls were selected for the year 2006. Study variables included mother's age, parity, body mass index, history of chronic hypertension, history of diabetes, history of renal disease, family history of hypertension, and history of pre-eclampsia in earlier pregnancy.


STATISTICAL ANALYSIS
Chi-square test, and crude and adjusted odds ratio with 95% confidence intervals were used for statistical analysis.


RESULTS
Significant risk factors identified in univariate analysis included prepregnancy body mass index (BMI > 25) (OR = 11.27), history of chronic hypertension (OR = 8.65), history of diabetes (OR = 11.0), history of renal disease (OR = 7.98), family history of hypertension (OR = 5.4), history of pre-eclampsia in earlier pregnancy (OR = 9.63), and multiple pregnancy (OR = 4.85). Multiple logistic regression analysis revealed that the prepregnancy BMI of >25 (OR = 7.56), history of chronic hypertension (OR = 6.69), history of diabetes (OR = 8.66), history of renal disease (OR = 5.6), family history of hypertension (OR = 5.48), and multiple pregnancy (OR = 5.73) are the significant risk factors of pre-eclampsia.


CONCLUSION
Pregnant women at risk of pre-eclampsia should be identified and high-quality antenatal care should be given in order to minimize the complications of pre-eclampsia both for the mother and the fetus.