LLukas22/scidocs huggingface dataset:
Pediatric peripherally inserted central catheters: complication rates related to catheter tip location.

OBJECTIVE
To compare complication rates between central venous catheter tip location and noncentral tip location after peripherally inserted central catheter (PICC) placement in children.


METHODS
Between 1994 and 1998, data from all children who underwent PICC placement were analyzed. Patient demographics, catheter characteristics, catheter duration, infusate composition, and catheter complications were entered prospectively into a computerized database. Catheter tip locations were determined by fluoroscopy and were defined as central if they resided in the superior vena cava, right atrium, or high inferior vena cava at or above the level of the diaphragm, and as noncentral if located elsewhere. Differences in complication rates between the central and noncentral groups were analyzed.


RESULTS
Data from a total of 1266 PICCs were analyzed from 1053 patients with a mean age of 6.49 +/-.2 years (range: 0-45.0 years). Of the 1266 PICCs, 1096 (87%) were central in tip location, and 170 (13%) were noncentral in tip location. The central group had 42 complications of 1096 catheters (3.8%), while the noncentral group had 49 complications of 170 catheters (28.8%). Controlling for patient age, catheter size, gender, and catheter duration with a logistic regression model, there remained a statistically significant increased likelihood of complication in the noncentral group versus the central group (adjusted odds ratio: 8.28; 95% confidence interval: 5.11-13.43).


CONCLUSIONS
Centrally placed catheter tips are associated with fewer complications than are noncentrally placed catheter tips. Clinicians should ensure that catheter tips reside centrally after PICC placement in infants and children.
Hypodontia: genetics and future perspectives

Correspondence to: Pragna I Patel Institute for Genetic Medicine, Keck School of Medicine, University Of Southern California, 2250 Alcazar Street, CSC-240, Los Angeles, CA 90033, USA. Tel: +1 (323) 442 2751 Fax: +1 (323) 442 2764 E-mail: pragna@usc.edu Abstract Tooth development is a complex process of reciprocal interactions that we have only recently begun to understand. With the large number of genes involved in the odontogenic process, the opportunity for mutations to disrupt this process is high. Tooth agenesis (hypodontia) is the most common craniofacial malformation with patients missing anywhere from one tooth to their entire dentition. Hypodontia can occur in association with other developmental anomalies (syndromic) or as an isolated condition (non-syndromic). Recent advances in genetic techniques have allowed us to begin understanding the genetic processes that underlie the odontogenic process and to identify the mechanisms responsible for tooth agenesis. Thus far two genes have been identified by mutational analysis as the major causes of non-syndromic hypodontia; PAX9 and MSX1. Haploinsufficiency of either has been observed to cause the more severe forms of hypodontia whilst point mutations cause hypodontia to varying degrees of severity. With the prevalence of hypodontia having been observed to have increased during the 20th century, the future identification and analysis of its genetic basis is essential to allow us to better treat the condition. The clinician can facilitate this process by collaborating with the human geneticist and referring patients/families with familial hypodontia for investigative research.
Is Dysfunctional Use of the Mobile Phone a Behavioural Addiction? Confronting Symptom-Based Versus Process-Based Approaches.

UNLABELLED
Dysfunctional use of the mobile phone has often been conceptualized as a 'behavioural addiction' that shares most features with drug addictions. In the current article, we challenge the clinical utility of the addiction model as applied to mobile phone overuse. We describe the case of a woman who overuses her mobile phone from two distinct approaches: (1) a symptom-based categorical approach inspired from the addiction model of dysfunctional mobile phone use and (2) a process-based approach resulting from an idiosyncratic clinical case conceptualization. In the case depicted here, the addiction model was shown to lead to standardized and non-relevant treatment, whereas the clinical case conceptualization allowed identification of specific psychological processes that can be targeted with specific, empirically based psychological interventions. This finding highlights that conceptualizing excessive behaviours (e.g., gambling and sex) within the addiction model can be a simplification of an individual's psychological functioning, offering only limited clinical relevance.


KEY PRACTITIONER MESSAGE
The addiction model, applied to excessive behaviours (e.g., gambling, sex and Internet-related activities) may lead to non-relevant standardized treatments. Clinical case conceptualization allowed identification of specific psychological processes that can be targeted with specific empirically based psychological interventions. The biomedical model might lead to the simplification of an individual's psychological functioning with limited clinical relevance.
5G Edge Resource Federation: Dynamic and Cross-domain Network Slice Deployment

By stating that edge resource federation is crucial in future 5G ecosystems, we demonstrate an architecture, where a network operator can achieve the federation of access and edge resources owned by private third-party actors through B2B relationships. Through a Proof-of-Concept, we illustrate on-demand creation and deployment of network slices dynamically over multiple domains for live content services in a Stadium.
Ecological differentiation in xylem cavitation resistance is associated with stem and leaf structural traits.

Cavitation resistance is a critical determinant of drought tolerance in tropical tree species, but little is known of its association with life history strategies, particularly for seasonal dry forests, a system critically driven by variation in water availability. We analysed vulnerability curves for saplings of 13 tropical dry forest tree species differing in life history and leaf phenology. We examined how vulnerability to cavitation (P₅₀) related to dry season leaf water potentials and stem and leaf traits. P₅₀-values ranged from -0.8 to -6.2 MPa, with pioneers on average 38% more vulnerable to cavitation than shade-tolerants. Vulnerability to cavitation was related to structural traits conferring tissue stress vulnerability, being negatively correlated with wood density, and surprisingly maximum vessel length. Vulnerability to cavitation was negatively related to the Huber-value and leaf dry matter content, and positively with leaf size. It was not related to SLA. We found a strong trade-off between cavitation resistance and hydraulic efficiency. Most species in the field were operating at leaf water potentials well above their P₅₀, but pioneers and deciduous species had smaller hydraulic safety margins than shade-tolerants and evergreens. A trade-off between hydraulic safety and efficiency underlies ecological differentiation across these tropical dry forest tree species.
Health Literacy Mediates the Relationship Between Age and Health Outcomes in Patients With Heart Failure.

BACKGROUND
Previous studies have linked frequent rehospitalizations for heart failure (HF) and increased mortality with older age, higher severity of HF, lack of an evidence-based medication regimen, and inadequate health literacy. However, the pathway between age and health outcomes in patients with HF remains unknown. Therefore, the purpose of this study was to test whether the association between age and health outcomes can be explained by severity of HF, evidence-based medication use, and health literacy in patients with HF.


METHODS AND RESULTS
This was a longitudinal study of 575 rural patients with HF recruited from outpatient clinics and hospitals. Demographics, clinical data, and health literacy were collected at baseline. HF readmissions and cardiac mortality were followed for 2 years; 57% of patients were ≥ 65 years of age. Older patients with HF were more likely to have low health literacy and less likely to be prescribed angiotensin-converting enzyme inhibitors or β-blockers. Using Kaplan-Meier survival curves with log-rank tests, health outcomes were significantly worse in patients who were ≥ 65 years and in those with low health literacy. Separate Cox regressions revealed that age and health literacy predicted worse health outcomes (P = 0.006 and < 0.001, respectively). When health literacy was entered into the model, the hazard ratio for age changed from 1.49 to 1.29 (a 41% reduction); age was no longer a significant predictor of health outcomes, but health literacy remained significant (P < 0.001), demonstrating mediation.


CONCLUSIONS
Health literacy mediates the relationship between age and health outcomes in adults with HF.


CLINICAL TRIAL REGISTRATION
URL: http://www.clinicaltrials.gov. Unique identifier: NCT00415545.
Role of GABAB receptor in alcohol dependence: Reducing effect of baclofen on alcohol intake and alcohol motivational properties in rats and amelioration of alcohol withdrawal syndrome and alcohol craving in human alcoholics

The present paper describes the results of recent preclinical and clinical studies conducted in this laboratory in order to characterize the anti-alcohol properties of the GABAB receptor agonist, baclofen. At a preclinical level, the repeated administration of non-sedative doses of baclofen dose-dependently suppressed the acquisition and maintenance of alcohol drinking behavior in selectively bred Sardinian alcohol-preferring (sP) rats tested under the homecage, 2-bottle “alcohol vs water” choice regimen. Acute injection of baclofen completely blocked the temporary increase in voluntary alcohol intake occurring after a period of alcohol abstinence (the so-called alcohol deprivation effect, which models alcohol relapses in human alcoholics). Acute treatment with baclofen also dose-dependently suppressed extinction responding for alcohol (an index of motivation to consume alcohol) in sP rats trained to lever-press for oral alcohol self-administration. Taken together, these results suggest the involvement of the GABAB receptor in the neural substrate mediating alcohol intake and alcohol motivational properties in an animal model of excessive alcohol consumption. Further, acutely administered baclofen dose-dependently reduced the severity of alcohol withdrawal signs in Wistar rats made physically dependent upon alcohol. Preliminary clinical surveys suggest that the antialcohol properties of baclofen observed in rats may generalize to human alcoholics. Indeed, a doubleblind survey demonstrated that repeated daily treatment with baclofen was associated, when compared to placebo, with a higher percentage of subjects totally abstinent from alcohol and a higher number of days of total abstinence. Treatment with baclofen also suppressed the number of daily drinks and decreased the obsessive and compulsive components of alcohol craving. Finally, a single non-sedative dose of baclofen resulted in the rapid disappearance of alcohol withdrawal symptomatology, including delirium tremens, in alcohol-dependent patients. In both clinical studies, baclofen was well tolerated with minimal side effects. These results suggest that baclofen may represent a potentially effective medication in the treatment of alcohol-dependent patients.
The stellar cusp around the supermassive black hole in the galactic center

We analyze deep near-IR adaptive optics imaging (taken with NAOS/CONICA on the VLT) 1 as well as new proper motion data of the nuclear star cluster of the Milky Way. The surface density distribution of faint (H≤ 20, Ks ≤ 19) stars peaks within 0.2′′ of the black hole candidate SgrA. The radial density distribution of this stellar ’cusp’ follows a power law of exponent α ∼ 1.3 − 1.4. The K-band luminosity function of the overall nuclear stellar cluster (within 9′′ of SgrA) resembles that of the large scale, Galactic bulge, but shows an excess of stars at Ks ≤ 14. It fits population synthesis models of an old, metal rich stellar population with a contribution from young, early and late-type stars at the bright end. In contrast, the cusp within ≤ 1.5′′ of SgrA appears to have a featureless luminosity function, suggesting that old, low mass horizontal branch/red clump stars are lacking. Likewise there appear to be fewer late type giants. The innermost cusp also contains a group of moderately bright, early type stars that are tightly bound to the black hole. We interpret these results as evidence that the stellar properties change significantly from the outer cluster (≥ a few arcsecs) to the dense innermost region around the black hole. We find that most of the massive early type stars at distances 1-10” from SgrA are located in two rotating and geometrically thin disks. These disks are inclined at large angles and counter-rotate with respect to each other. Their stellar content is essentially the same, indicating that they formed at the same time. We conclude that of the possible formation scenarios for these massive stars the most probable one is that 5-8 million years ago two clouds fell into the center, collided, were shock compressed and then formed two rotating (accretion) disks orbiting the central black hole. For the OB-stars in the central arcsecond, on the other hand, a stellar merger model is the most appealing explanation. These stars may thus be ’super-blue-stragglers’, formed and ‘rejuvenated’ through mergers of lower mass stars in the very dense (≥ 10 M pc−3) environment of the cusp. The ‘collider model’ also accounts for the lack of giants within the central few arcseconds. The star closest to SgrA in 2002, S2, exhibits a 3.8 μm excess. We propose that the mid-IR emission either comes from the accretion flow around the black hole itself, or from dust in the accretion flow that is heated by the ultra-violet emission of S2. Subject headings: Galaxy: center galaxies: nuclei star: formation
The inhaled phosphodiesterase 4 inhibitor GSK256066 reduces allergen challenge responses in asthma

UNLABELLED
GSK256066 is a selective phosphodiesterase 4 inhibitor that can be given by inhalation, minimising the potential for side effects. We evaluated the effects of GSK256066 on airway responses to allergen challenge in mild asthmatics.


METHODS
In a randomised, double blind, cross-over study, 24 steroid naive atopic asthmatics with both early (EAR) and late (LAR) responses to inhaled allergen received inhaled GSK256066 87.5 mcg once per day and placebo for 7 days, followed by allergen challenge. Methacholine reactivity was measured 24 h post-allergen. Plasma pharmacokinetics were measured. The primary endpoint was the effect on LAR.


RESULTS
GSK256066 significantly reduced the LAR, attenuating the fall in minimum and weighted mean FEV1 by 26.2% (p = 0.007) and 34.3% (p = 0.005) respectively compared to placebo. GSK256066 significantly reduced the EAR, inhibiting the fall in minimum and weighted mean FEV1 by 40.9% (p = 0.014) and 57.2% (p = 0.014) respectively compared to placebo. There was no effect on pre-allergen FEV1 or methacholine reactivity post allergen. GSK256066 was well tolerated, with low systemic exposure; plasma levels were not measurable after 4 hours in the majority of subjects.


CONCLUSIONS
GSK256066 demonstrated a protective effect on the EAR and LAR. This is the first inhaled PDE4 inhibitor to show therapeutic potential in asthma.
UWB Vivaldi antenna for impulse radio beamforming

In this paper, two different types of Vivaldi antenna are designed and tested suitable for electromagnetic beamforming. The first is an antipodal Vivaldi antenna, while the other is a tapered slot Vivaldi antenna. They are both ultra wideband antennas for the 1 GHz to 5 GHz frequency band. They have low impulse distortion and the voltage standing wave ratio (VSWR) less than 2 throughout the entire bandwidth. The antennas are used for impulse radio beamforming.
OWNERSHIP , COMPETITION , AND CORRUPTION : BRIBE TAKERS VERSUS BRIBE PAYERS

Over the past few years, many studies have looked the macroeconomic, cultural and institutional determinants of corruption. This study complements these existing cross-country studies by focusing on microeconomic factors that affect bribes paid in a single sector of the economy. Using enterpriselevel data on bribes paid to utilities in 21 transition economies in Eastern Europe and Central Asia, we look at how characteristics of the firms paying bribes (e.g., ownership, profitability and size) and characteristics of the utilities taking bribes (e.g., competition and utility capacity) affect the equilibrium level of corruption in the sector. On the side of bribe payers, enterprises that are more profitable, enterprises that have greater overdue payment to utilities, and de novo private firms pay higher bribes. On the side of bribe takers, bribes paid to utilities are higher in countries with greater constraints on utility capacity, lower levels of competition in the utility sector, and where utilities are state-owned. Bribes in the utility sector are also correlated with many of the macroeconomic and political factors that previous studies have found to affect the overall level of corruption.
Power-Gated Differential Logic Style Based on Double-Gate Controllable-Polarity Transistors

This brief presents a novel power-gating technique for differential cascade voltage switch logic (DCVSL) based on double-gate (DG) controllable-polarity field-effect transistors (FETs). DG controllable-polarity FETs, commonly referred to as ambipolar transistors, are devices whose polarity is online reconfigurable by changing the second gate bias. In this brief, we exploit the online control of ambipolar device polarity to achieve intrinsically power-gated DCVSL circuits bypassing the use of series sleep transistors. We perform circuit-level simulations and comparisons at 22-nm technology node, considering silicon nanowire -based DG controllable-polarity FETs. Experimental results show that ambipolar DCVSL circuits power gated by the proposed technique have on average 6× smaller standby power with only 1.1× timing penalty with respect to their non-power-gated versions. As compared with unipolar FinFET-based realizations, our proposal is capable to reduce up to 1.9× the standby power consumption of a low-standby-power process and, at the same time, increase up to 10% the performance of a high-performance process.
Collaboration: foundation for a successful practice.

Collaboration, by definition, is a joint and cooperative enterprise that integrates the individual perspectives and expertise of various team members. Some commonly identified themes of collaborative relationships include collegiality, teamwork, open communication, recognition of one another’s expertise, and a strong level of trust and respect. However, the development of an individual collaborative practice is unique to the practice, should optimize the skills of each party, and allow each participant to provide care within his or her scope of practice. Despite the potential benefits of a collaborative physician-nurse practitioner practice, several barriers also exist. Collaboration should be distinguished from supervision, which implies direct physician oversight of the nurse practitioner (NP) and is a requirement for nurse practitioner practice in some states. This article describes collaborative physician-nurse practitioner relationships in geriatric practice, and guidelines for implementation of a collaborative practice agreement.
Prevention of depression in at-risk adolescents: longer-term effects.

IMPORTANCE
Adolescent offspring of depressed parents are at high risk for experiencing depressive disorders themselves.


OBJECTIVE
To determine whether the positive effects of a group cognitive-behavioral prevention (CBP) program extended to longer-term (multiyear) follow-up.


DESIGN
A 4-site randomized clinical trial with 33 months of follow-up was conducted. Recruitment of participants was from August 2003 through February 2006.


SETTING
The study settings included a health maintenance organization, university medical centers, and a community mental health center.


PARTICIPANTS
Three hundred sixteen adolescent (aged 13-17 years) offspring of parents with current and/or prior depressive disorders; adolescents had histories of depression, current elevated depressive symptoms, or both but did not currently meet criteria for a depressive disorder.


INTERVENTIONS
The CBP program consisted of 8 weekly 90-minute group sessions followed by 6 monthly continuation sessions. Adolescents were randomly assigned to either the CBP program or usual care (UC).


MAIN OUTCOMES AND MEASURES
The primary outcome was a probable or definite episode of depression (Depression Symptom Rating score ≥4) for at least 2 weeks through the month 33 follow-up evaluation.


RESULTS
Over the 33-month follow-up period, youths in the CBP condition had significantly fewer onsets of depressive episodes compared with those in UC. Parental depression at baseline significantly moderated the intervention effect. When parents were not depressed at intake, CBP was superior to UC (number needed to treat, 6), whereas when parents were actively depressed at baseline, average onset rates between CBP and UC were not significantly different. A 3-way interaction among intervention, baseline parental depression, and site indicated that the impact of parental depression on intervention effectiveness varied across sites.


CONCLUSIONS AND RELEVANCE
The CBP program showed significant sustained effects compared with UC in preventing the onset of depressive episodes in at-risk youth over a nearly 3-year period. Important next steps will be to strengthen the CBP intervention to further enhance its preventive effects, improve intervention outcomes when parents are currently depressed, and conduct larger implementation trials to test the broader public health impact of the CBP program for preventing depression in youth.


TRIAL REGISTRATION
clinicaltrials.gov Identifier: NCT00073671.
Vulnerable populations and the association between periodontal and chronic kidney disease.

BACKGROUND AND OBJECTIVES
Recent studies suggest an overall association between chronic kidney disease (CKD) and periodontal disease, but it is unknown whether this association is similar across various subpopulations.


DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS
This study was a cross-sectional analysis of 2001 to 2004 National Health and Nutrition Examination Survey data. CKD was defined as a urinary albumin-to-creatinine ratio ≥30 mg/g or estimated GFR of 15 to 59 ml/min per 1.73 m(2). Adjusted odds ratios were calculated using multivariable logistic regression with U.S. population-based weighting.


RESULTS
These analyses included 6199 dentate adult participants (aged 21 to 75 years) with periodontal exams. The estimated prevalences of moderate/severe periodontal disease and CKD were 5.3% and 10.6%, respectively. Periodontal disease was associated with >2-fold higher risk of CKD that was moderately attenuated after adjustment for age, gender, race/ethnicity, tobacco use, hypertension, diabetes, educational attainment, poverty index ratio, and dental care use. There were no statistically significant interactions between periodontal disease and race/ethnicity, educational attainment, or poverty status. Less-than-recommended dental care use was associated with periodontal disease and CKD and was increasingly prevalent among nonwhites, lower educational attainment, and lower poverty status.


CONCLUSIONS
The association between periodontal disease and CKD is not significantly different among subgroups. However, because nonwhites, those with a lower educational level, and the poor less frequently report use of recommended dental care, the association between periodontal disease and kidney function over time may become stronger among these groups and warrants further investigation.