LLukas22/scidocs huggingface dataset:
Efficacy and safety of lumbar epidural dexamethasone versus methylprednisolone in the treatment of lumbar radiculopathy: a comparison of soluble versus particulate steroids.

INTRODUCTION
The literature is limited in the comparative efficacy and safety of dexamethasone phosphate (DP) compared with methylprednisolone acetate (MPA) in the treatment of lumbar radiculopathy by epidural injection. This study attempts to test the hypothesis that 2 corticosteroids are equivalent in efficacy and side effects.


METHODS
Patients with lumbar radicular symptoms for at least 6 months were randomized to equipotent doses of MPA 80 mg or DP 15 mg by lumbar translaminar epidurals administered under fluoroscopy. The epidurals were administered by different nonblinded practitioners other than the authors. Preprocedure Visual Analog Scale (VAS) pain scores by preoperative pain clinic nursing staff not involved in the study. On follow-up for the second epidural at 1 to 2 months, VAS scores and any reports of adverse side effects were obtained by pain clinic nursing staff who were blinded to the type of corticosteroid used. Electronic records were also reviewed for intervening changes in medication, additional therapeutic modalities, emergency room visits, and any other complications missed on nursing follow-up.


RESULTS
There were no significant demographic differences between the DP group (N = 30) and MPA group (N = 30). The mean days to follow-up was less for the DP group (41.1) versus the MPA group (51.1), although the difference was not statistically significant (P = 0.4284). Comparing the DP group and MPA group, there was a smaller mean decrease in VAS for the DP group (-19.7%) versus the MPA group (-27.2%), although the difference was not statistically significant (P = 0.3672). Eighty-seven percent of patients in the MPA group and 90% in the DP group had decreases in postprocedure VAS with no statistically significant difference between the 2 groups (P = 0.999). Thirteen percent of the MPA group and 10% of the DP group had increases in postprocedure VAS with no significant difference between the 2 groups (P = 0.999). The percentage increase in postprocedure VAS for those who had increase in pain was 34.3% and 31.7% for the MPA and DP group, respectively with no statistically significant difference noted (P = 0.8657). Review of electronic medical records showed no change in pain medication prescribed, emergency room visits for pain, or any new treatments for pain in either group. No complications were reported by patients on nursing follow-up or seen in review of medical records including new neurological symptoms or new areas of pain.


CONCLUSIONS
Nonparticulate DP seems to be close to the safety and effectiveness of particulate MPA in the treatment of lumbar radiculopathy. There is, however, a statistically nonsignificant trend toward less pain relief and shorter duration of action that may be clarified in a larger and longer duration study.
Postoperative small bowel and colonic anastomotic bleeding. Therapeutic management and complications.

INTRODUCTION
Postoperative small bowel or colic anastomotic bleeding (PSCAB) is often a mild complication and is generally treated by a conservative approach. Other therapeutic options are surgery, endoscopic management and angiographic embolization. Our aim is to review our cases of postoperative anastomotic bleeding in patients with small bowel or colic anastomosis, with special attention to their treatment and complications.


PATIENTS AND METHODS
Observational retrospective study including patients with PSCAB in the department of General and Digestive Surgery in Vall d'Hebron University Hospital, between 2007 and 2012. Demographic and bleeding characteristics as well as therapeutic management were reviewed, including complications derived from the different therapeutic options.


RESULTS
There were 44 cases of bleeding after performing small bowel or colic anastomosis, 25 patients were men (56.8%), with a mean age of 68.2 years (R: 28-92). The mean hematocrit decrease was 8 points (R: 0-17), and hemodynamic instability was detected in 13 patients (29.5%). A conservative management was undertaken in 27 patients (61.3%), surgery in 6 (13.6%), endoscopic treatment in 2 (4.5%) and embolization in 9 (20.5%). 4 patients of cases treated with embolization presented anastomotic leak (44.5%). Mortality was 13.6% (6 patients). A total of 4 of 6 deaths were in the group of patients treated with embolization.


CONCLUSIONS
Most patients with PSCAB have a good response to conservative management. When there is failure of this approach, there are different therapeutic options, including angiographic embolization. In our series, we have seen a high incidence of post embolization anastomotic leak; further trials will be necessary to provide valuable evidence of the risk of this therapeutic option.
Comments to the invited comment “LIFT procedure: a simplified technique for fistula in ano” by P. J. Lunniss

In 1993, Matos et al. described a technique of total anal sphincter preservation in high fistula in ano, which is based on the concept of excision of intersphincteric anal gland infection through the intersphincteric approach [1]. This novel technique was also documented in Corman’s textbook of colon and rectal surgery [2]. However, the technique was not widely adopted [3]. Between 2004 and 2005, we had used an almost similar technique. The technique included coring out the intersphincteric fistula tract from the external opening to the external sphincter, excision of the intersphincteric fistula tract and suture of the internal sphincter defect through the intersphincteric plane. The outcome in 20 patients was disappointing with only 9 (45%) successes. The proposed reasons for the unfavorable outcome include dissection in the intersphincteric plane damaging blood supply to the internal opening area, and suturing delicate ischemic areas with increased risk of suture break-down. We thought that ligation of the intersphincteric tract close to the internal opening might solve the problem. This idea became the essence of our LIFT technique. Later experience supported this hypothesis. We noticed that during intersphincteric plane dissection if the internal sphincter was damaged and the anal mucosa breached, failure was common despite meticulous repair [4]. The comment of Lunniss on the LIFT technique, ‘‘the technique described by Rojanasakul is, at first pioneered and reported by Robin Phillips...’’ may be misleading [3]. Surgeons beginning to use the LIFT technique may use the procedure described by Matos with unsatisfactory results [1]. The differences between the Matos and the Rojanasakul techniques are worth noting [4, 5]. At present, with the experience of more than 300 cases, we rarely encounter difficulty in dealing with the intersphincteric tract, even in complex fistula. We agree that the LIFT technique may cause some injury to internal sphincter, but theoretically LIFT causes less trauma of the internal sphincter than the other fistula operations. We are also aware of the poor levels of evidence in anal fistula surgery including the LIFT technique. We are preparing a report of long term outcome of the LIFT technique in our patients. If the long term results are positive, a randomized trial may be difficult. In conclusion, we realized that Matos et al. reported the technique of excision of the whole fistula tract plus primary repair, with intersphincteric plane approach for excision of the fistula tract and suturing of the internal anal sphincter defect, in 1993 [1]. However, Rojanasakul reported the ligation of intersphincteric fistula tract in 2007 with apparent satisfactory results probably due to secured closure of the internal opening [4]. This represents a significant change from the originally described technique with improved outcomes.
Effects of compression at myofascial trigger points in patients with acute low back pain: A randomized controlled trial.

BACKGROUND
Although there is some evidence that massage therapy, especially compression at myofascial trigger points (MTrPs), is effective for sub-acute and chronic low back pain, the effectiveness of massage therapy with compression at MTrPs for acute low back pain has not been studied.


METHODS
To evaluate the effectiveness of compression at MTrPs for acute low back pain, 63 patients with acute low back pain were randomly assigned to one of three groups: the MTrP group who received compression at MTrPs (N = 23), the non-MTrP group who received compression at non-trigger points (N = 21), and the effleurage massage group who received superficial massage (N = 19). The patients received the assigned treatment 3 times/week for 2 weeks. The subjective pain intensity in static and dynamic conditions and disability caused by low back pain were measured by the visual analogue scale (VAS) and Roland-Morris questionnaire (RMQ), respectively; along with the range of motion (ROM) at the lumbar region and pressure pain threshold (PPT) at trigger points before treatment (baseline), 1 week after the start of treatment, and 1 month after the end of treatment (follow-up).


RESULTS
Static and dynamic VAS score, PPT and ROM were significantly improved in the MTrP group compared with those in the non-MTrP and effleurage groups.


CONCLUSIONS
These results indicate that compression at MTrPs is effective to treat acute low back pain compared with compression at non-MTrPs and superficial massage. For this article, a commentary is available at the Wiley Online Library.
A Grammatical Approach to Automatic Improvisation

We describe an approach to the automatic generation of convincing jazz melodies using probabilistic grammars. Uses of this approach include a software tool for assisting a soloist in the creation of a jazz solo over chord progressions. The method also shows promise as a means of automatically improvising complete solos in real-time. Our approach has been implemented and demonstrated in a free software tool. Keywords— jazz, improvisation, educational software, probabilistic context-free grammar, melody generator.
Likelihood to abort an online transaction: influences from cognitive evaluations, attitudes, and behavioral variables

This study identifies evaluative, attitudinal, and behavioral factors that enhance or reduce the likelihood of consumers aborting intended online transactions (transaction abort likelihood). Path analyses show that risk perceptions associated with eshopping have direct influence on the transaction abort likelihood, whereas benefit perceptions do not. In addition, consumers who have favorable attitudes toward e-shopping, purchasing experiences from the Internet, and high purchasing frequencies from catalogs are less likely to abort intended transactions. The results also show that attitude toward e-shopping mediate relationships between the transaction abort likelihood and other predictors (i.e., effort saving, product offering, control in the information search, and time spent on the Internet per visit). # 2003 Elsevier B.V. All rights reserved.
Autonomous Function of Synaptotagmin 1 in Triggering Synchronous Release Independent of Asynchronous Release

Ca(2+) triggers neurotransmitter release in at least two principal modes, synchronous and asynchronous release. Synaptotagmin 1 functions as a Ca(2+) sensor for synchronous release, but its role in asynchronous release remains unclear. We now show that in cultured cortical neurons stimulated at low frequency (<or.1 Hz), deletion of synaptotagmin 1 blocks synchronous GABA and glutamate release without significantly increasing asynchronous release. At higher stimulation frequencies (>or Hz), deletion of synaptotagmin 1 also alters only synchronous, not asynchronous, release during the stimulus train, but dramatically enhances "delayed asynchronous release" following the stimulus train. Thus synaptotagmin 1 functions as an autonomous Ca(2+) sensor independent of asynchronous release during isolated action potentials and action potential trains, but restricts asynchronous release induced by residual Ca(2+) after action potential trains. We propose that synaptotagmin 1 occupies release "slots" at the active zone, possibly in a Ca(2+)-independent complex with SNARE proteins that are freed when action potential-induced Ca(2+) influx activates synaptotagmin 1.
A new family of matrix converters

A new family of matrix converters is introduced, that employs relatively simple voltage-clamped buses and can generate multilevel voltage waveforms of arbitrary magnitude and frequency. The basic configuration includes a nine-switch matrix that uses four-quadrant switch cells. Each four-quadrant switch cell resembles a full-bridge inverter and can assume three voltage levels during conduction. Semiconductor devices in a switch cell are clamped to a known constant dc voltage of a capacitor. Control of the input and output voltage waveforms of the proposed converter can be achieved through space vector modulation. Simulation results show how the converter can operate with any input and output voltages, currents, frequencies, and power factors while maintaining constant dc voltages across all switch cell capacitors. SUMMARY A new family of matrix converters is introduced, which are fundamentally different from existing known approaches. These converters can both increase and decrease the voltage amplitude and can operate with arbitrary power factors. With series connection of switch cells in each branch of the matrix, multilevel switching can be attained with device voltages locally clamped to dc capacitor voltages. The advantages of conventional multilevel converters can therefore be attained in a matrix converter, including reduced switching loss and reduced waveform harmonic content. In principle, the number of voltage levels can be increased arbitrarily, by increasing the number of switch cells in each branch. The basic configuration of the proposed new converter is illustrated in Fig. 1; extension to additional levels is described in the full paper. Even in the basic version having one switch cell per matrix branch, multilevel operation (five line-line voltage levels) can be attained. Space vector modulation to control the input and output voltage waveforms is demonstrated. It is also demonstrated that the controller can stabilize the dc voltages of the capacitors. Operation of the basic version of the new family of matrix converters has been confirmed. Typical waveforms are illustrated in Fig. 3. The proposed converters may find use in variable-speed ac drives, variable-speed wind power generation, and other polyphase ac-to-ac applications. They can take advantage of the substantial and ongoing advances in packaging and microcontroller technology, to improve the performances of ac–ac power converters. This work was supported in part by the DOE National Renewable Energy Laboratory under contract no. XCX-9-29204-01. + – + – + –
Multiple Operating Points Model-Based Control of a Two-Wheeled Inverted Pendulum Mobile Robot

Abstract – Literature review shows that, most of the linear controllers proposed for control of a Two-Wheeled Inverted Pendulum (TWIP) mobile robot are based on dynamic models that are linearized around a single operating point. Thus, this paper presents the controller design for a TWIP mobile robot based on its multiple operating point linearized model. The nonlinear dynamical equations of motion of the TWIP mobile robot were firstly obtained. The nonlinear equations were then linearized around different operating points resulting in a number of linear models with each represented a local region of the original nonlinear system. Based on the multiple operating points linearized models a state feedback control scheme was proposed using pole placement technique for balancing and tracking control of the TWIP mobile robot. The performance of the proposed controller investigated in terms of reference command tracking, parameter variation and external disturbance rejection via simulations. The simulation result shows the effectiveness of the proposed control scheme.
Failure of Noninvasive Ventilation for De Novo Acute Hypoxemic Respiratory Failure: Role of Tidal Volume.

OBJECTIVES
A low or moderate expired tidal volume can be difficult to achieve during noninvasive ventilation for de novo acute hypoxemic respiratory failure (i.e., not due to exacerbation of chronic lung disease or cardiac failure). We assessed expired tidal volume and its association with noninvasive ventilation outcome.


DESIGN
Prospective observational study.


SETTING
Twenty-four bed university medical ICU.


PATIENTS
Consecutive patients receiving noninvasive ventilation for acute hypoxemic respiratory failure between August 2010 and February 2013.


INTERVENTIONS
Noninvasive ventilation was uniformly delivered using a simple algorithm targeting the expired tidal volume between 6 and 8 mL/kg of predicted body weight.


MEASUREMENTS
Expired tidal volume was averaged and respiratory and hemodynamic variables were systematically recorded at each noninvasive ventilation session.


MAIN RESULTS
Sixty-two patients were enrolled, including 47 meeting criteria for acute respiratory distress syndrome, and 32 failed noninvasive ventilation (51%). Pneumonia (n = 51, 82%) was the main etiology of acute hypoxemic respiratory failure. The median (interquartile range) expired tidal volume averaged over all noninvasive ventilation sessions (mean expired tidal volume) was 9.8 mL/kg predicted body weight (8.1-11.1 mL/kg predicted body weight). The mean expired tidal volume was significantly higher in patients who failed noninvasive ventilation as compared with those who succeeded (10.6 mL/kg predicted body weight [9.6-12.0] vs 8.5 mL/kg predicted body weight [7.6-10.2]; p = 0.001), and expired tidal volume was independently associated with noninvasive ventilation failure in multivariate analysis. This effect was mainly driven by patients with PaO2/FIO2 up to 200 mm Hg. In these patients, the expired tidal volume above 9.5 mL/kg predicted body weight predicted noninvasive ventilation failure with a sensitivity of 82% and a specificity of 87%.


CONCLUSIONS
A low expired tidal volume is almost impossible to achieve in the majority of patients receiving noninvasive ventilation for de novo acute hypoxemic respiratory failure, and a high expired tidal volume is independently associated with noninvasive ventilation failure. In patients with moderate-to-severe hypoxemia, the expired tidal volume above 9.5 mL/kg predicted body weight accurately predicts noninvasive ventilation failure.
Forest plots in reports of systematic reviews: a cross-sectional study reviewing current practice.

BACKGROUND
Forest plots are graphical displays of findings of systematic reviews and meta-analyses. Little is known about the style and content of these plots and whether published plots maximize the graphic's potential for information exchange.


METHODS
We examine the number, style and content of forest plots presented in a previously studied cross-sectional sample of 300 systematic reviews. We studied all forest plots in non-Cochrane reviews and a sample of forest plots in Cochrane reviews.


RESULTS
The database contained 129 Cochrane reviews and 171 non-Cochrane reviews. All the Cochrane reviews had forest plots (2197 in total), and a random sample of 500 of these plots were included. In total, 28 of the non-Cochrane reviews had forest plots (139 in total), all of which were included. Plots in Cochrane reviews were standardized but often contained little data (80% had three or fewer studies; 10% had no studies) and always presented studies in alphabetical order. Non-Cochrane plots depicted a larger number of studies (60% had four or more studies) and 59% ordered studies by a potentially meaningful characteristic, but important information was often missing. Of the 28 reviews that had a forest plots with at least 10 studies, 3 (11%) had funnel plots.


CONCLUSIONS
Forest plots in Cochrane reviews were highly standardized but some of the standards do not optimize information exchange, and many of the plots had too little data to be useful. Forest plots in non-Cochrane reviews often omitted key elements but had more data and were often more thoughtfully constructed.
Supply noise induced jitter modeling and optimization for high-speed interfaces

Presents a collection of slides covering the following topics:issues and challenges in power distribution network design; basics of power supply induced jitter (PSIJ) modeling; PSIJ design and modeling for key applications; and memory and parallel bus interfaces (serial links and digital logic timing).
Predictors of hospital admission in exacerbations of chronic obstructive pulmonary disease.

OBJECTIVE
To identify factors predictive of hospital admission among patients attending an emergency department (ED) with exacerbation of chronic obstructive pulmonary disease (COPD) and to determine if these were consistent with Global Initiative for Chronic Obstructive Lung Disease (GOLD) recommendations.


DESIGN
In a prospective cohort of 2487 COPD patients with exacerbations conducted in 16 EDs, clinical data were obtained and physical examination and blood gas analyses were performed on arrival at the ED and at decision time about hospitalisation. Multivariate analyses were performed using hospital admission as the dependent measure.


RESULTS
In multivariate analysis, factors predictive of hospital admission on ED arrival were previous hospitalisation for COPD exacerbation (OR 2.03, 95%CI 1.32-3.11), resting dyspnoea (OR 3.05, 95%CI 2.39-3.88) and altered blood gas (PaO2 = 45-60 mmHg, OR 2.7, 95%CI 2.12-3.44; PaO2 < 45 mmHg, OR 3.24, 95%CI 2.14-4.92; PaCO2 = 56-65 mmHg, OR 2.35, 95%CI 1.58-3.51; and PaCO2 > 65 mmHg, OR 6.98, 95%CI 4.03-12.09). The predictive capacity of the model using variables available at decision time was better than for those at ED arrival (area under the receiver operating characteristic curve 0.89 and 0.83). These factors are included in the GOLD recommendations.


CONCLUSION
Among COPD patients presenting to the ED with exacerbation, factors immediately associated with episode severity were independent predictors of hospitalisation. Our criteria for hospitalisation are in line with GOLD recommendations.