LLukas22/scidocs huggingface dataset:
Regional perfusion during venoarterial extracorporeal membrane oxygenation: a case report and educational modules on the concept of dual circulations.

UNLABELLED
A challenging aspect of managing patients on venoarterial extracorporeal membrane oxygenation (V-A ECMO) is a thorough understanding of the relationship between oxygenated blood from the ECMO circuit and blood being pumped from the patient's native heart. We present an adult V-A ECMO case report, which illustrates a unique encounter with the concept of "dual circulations." Despite blood gases from the ECMO arterial line showing respiratory acidosis, this patient with cardiogenic shock demonstrated regional respiratory alkalosis when blood was sampled from the right radial arterial line. In response, a sample was obtained from the left radial arterial line, which mimicked the ECMO arterial blood but was dramatically different from the blood sampled from the right radial arterial line. A retrospective analysis of patient data revealed that the mismatch of blood gas values in this patient corresponded to an increased pulse pressure. Having three arterial blood sampling sites and data on the patient's pulse pressure provided a dynamic view of blood mixing and guided proper management, which contributed to a successful patient outcome that otherwise may not have occurred. As a result of this unique encounter, we created and distributed graphics representing the concept of "dual circulations" to facilitate the education of ECMO specialists at our institution.


KEYWORDS
ECMO, education, cardiopulmonary bypass, cannulation.
Fingerprinting RFID Tags

Radio frequency identification (RFID) tags are low-cost devices that are used to uniquely identify the objects to which they are attached. Due to the low cost and small size that are driving the technology, a tag has limited computational capabilities and resources. These limitations constrain the use of conventional encryption algorithms and security protocols to prevent cloning and counterfeiting of an RFID tag. Therefore, we propose to create an electronic fingerprint of a tag based upon the physical attributes of the tag. We have fingerprinted RFID tags based upon their minimum power responses measured at multiple frequencies. The fingerprint can be used effectively to identify the tags in the future with high probability and to detect counterfeit tags. This mechanism does not increase the cost of the tag and can be applied to any existing tag, because it is independent of the computational capabilities and resources of the RFID tag.
Evaluation of rationality in prescribing, adherence to treatment guidelines, and direct cost of treatment in intensive cardiac care unit: A prospective observational study

BACKGROUND
Cardiovascular diseases (CVDs) remain the most common cause of sudden death. Hence, appropriate drug therapy in intensive cardiac care unit (ICCU) is crucial in managing cardiovascular emergencies and to decrease morbidity and mortality.


OBJECTIVE
To evaluate prescribing pattern of drugs and direct cost of therapy in patients admitted in ICCU.


MATERIALS AND METHODS
Patients admitted in ICCU of a tertiary care teaching hospital were enrolled. Demographic data, clinical history, and complete drug therapy received during their stay in ICCU were noted. Data were analyzed for drug utilization pattern and direct cost of treatment calculated using patient's hospital and pharmacy bills. Rationality of therapy was evaluated based on American College of Cardiology/American Heart Association (ACC/AHA) guidelines.


RESULT
Data of 170 patients were collected over 2 months. Mean age of patients was 54.67 ± 13.42 years. Male to female ratio was 2.33:1. Most common comorbid condition was hypertension 76 (44.7%). Most common diagnosis was acute coronary syndrome (ACS) 49.4%. Mean stay in ICCU was 4.42 ± 1.9 days. Mean number of drugs prescribed per patient was 11.43 ± 2.85. Antiplatelet drugs were the most frequently prescribed drug group (86.5%). Mean cost of pharmacotherapy per patient was '2701.24 ± 3111.94. Mean direct cost of treatment per patient was '10564.74 ± 14968.70. Parenteral drugs constituted 42% of total drugs and 90% of total cost of pharmacotherapy. Cost of pharmacotherapy was positively correlated with number of drugs (P = 0.000) and duration of stay (P = 0.027).


CONCLUSION
Antiplatelet drugs were the most frequently prescribed drug group. Mean number of drugs per encounter were high, which contributed to the higher cost of pharmacotherapy. ACC/AHA guidelines were followed in majority of the cases.
Subgoals, Context, and Worked Examples in Learning Computing Problem Solving

Recent empirical results suggest that the instructional material used to teach computing may actually overload students' cognitive abilities. Better designed materials may enhance learning by reducing unnecessary load. Subgoal labels have been shown to be effective at reducing the cognitive load during problem solving in both mathematics and science. Until now, subgoal labels have been given to students to learn passively. We report on a study to determine if giving learners subgoal labels is more or less effective than asking learners to generate subgoal labels within an introductory CS programming task. The answers are mixed and depend on other features of the instructional materials. We found that student performance gains did not replicate as expected in the introductory CS task for those who were given subgoal labels. Computer science may require different kinds of problem-solving or may generate different cognitive demands than mathematics or science.
Fordyce Spots

Fordyce spots, also known as Fordyce glands, are enlarged sebaceous glands. They lack an association with hair follicles and have ducts opening directly onto the cutaneous surface. Although these sebaceous glands are present at birth, they are not obvious until puberty when they enlarge in response to the gonadal and adrenal androgenic hormones. The prevalence in adults is 70 to 80%. The male to female ratio is approximately 2:1. Clinically, Fordyce spots appear as asymptomatic, isolated or scattered, minute, creamy yellow, discrete papules. They occur most commonly and most conspicuously on the vermilion lips and oral mucosa and, less commonly, on the penis, scrotum, and labia. The lesions are usually bilateral and symmetrical. Treatment is usually not necessary apart from reassurance about the benign nature of the condition. Various destructive modalities have been employed by dermatologists with some success. Correspondence to: Alexander K.C. Leung, Clinical Professor of Pediatrics, University of Calgary, Pediatric Consultant, Alberta Children’s Hospital, #200, 233-16th Avenue NW, Calgary, Alberta, Canada T2M 0H5, Tel: (403) 230-3322, E-mail: aleung@ucalgary.ca
Radial PCI and the obesity paradox: Insights from Blue Cross Blue Shield of Michigan Cardiovascular Consortium (BMC2).

OBJECTIVE
To examine if transradial approach (TRA) negates the increased risk associated with femoral access in lean and morbidly obese patients undergoing percutaneous coronary intervention (PCI).


BACKGROUND
Patients at extremes of body mass are at increased risk of bleeding after PCI. TRA has been associated with lower overall rates of bleeding compared to femoral approach.


METHODS AND RESULTS
We studied patients undergoing emergent and elective PCI from 2010 to 2012 across 47 hospitals in Michigan who participate in the Blue Cross Blue Shield of Michigan Cardiovascular Consortium PCI registry. The primary outcomes were the incidences of bleeding and postprocedure transfusion. Propensity matching (PM) was used to adjust for nonrandomized use of TRA. TRA was used in 10,235 procedures. In PM analyses, use of TRA was associated with a reduction in bleeding (0.80 vs. 1.9%, odds ratio [OR] = 0.41, 95% confidence interval [CI] = 0.32-0.54, P < 0.001) and need for transfusion (1.4 vs. 2.5%, OR = 0.56, 95% CI = 0.45-0.69, P < 0.001) compared with femoral access. The absolute difference in bleeding and transfusion associated with TRA was largest in patients with lean body mass (BMI < 25 kg/m(2)) and morbid obesity (BMI ≥ 40 kg/m(2)): Lean patients undergoing TRA had a rate of bleeding of 1.2 versus 2.8% for femoral access (OR = 0.43, 95% CI = 0.24-0.77, P = 0.002); and rate of transfusion of 2.4 versus 3.9% (OR = 0.61, 95% CI = 0.40-0.94, P = 0.019). The morbidly obese had a rate of bleeding of 0.8% for TRA versus 2.4% for femoral access (OR = 0.33, 95% CI = 0.44-0.72, P = 0.004); and rate of transfusion of 1.7 versus 3.0%, (OR = 0.55, 95% CI = 0.30-1.0, P = 0.051).


CONCLUSIONS
Compared with the femoral approach, TRA is associated with a reduction in bleeding across all patients undergoing PCI and the absolute benefit was greatest in those with extremely low or high BMI.
Inflammation and the Intestinal Barrier: Leukocyte-Epithelial Cell Interactions, Cell Junction Remodeling, and Mucosal Repair.

The intestinal tract is lined by a single layer of columnar epithelial cells that forms a dynamic, permeable barrier allowing for selective absorption of nutrients, while restricting access to pathogens and food-borne antigens. Precise regulation of epithelial barrier function is therefore required for maintaining mucosal homeostasis and depends, in part, on barrier-forming elements within the epithelium and a balance between pro- and anti-inflammatory factors in the mucosa. Pathologic states, such as inflammatory bowel disease, are associated with a leaky epithelial barrier, resulting in excessive exposure to microbial antigens, recruitment of leukocytes, release of soluble mediators, and ultimately mucosal damage. An inflammatory microenvironment affects epithelial barrier properties and mucosal homeostasis by altering the structure and function of epithelial intercellular junctions through direct and indirect mechanisms. We review our current understanding of complex interactions between the intestinal epithelium and immune cells, with a focus on pathologic mucosal inflammation and mechanisms of epithelial repair. We discuss leukocyte-epithelial interactions, as well as inflammatory mediators that affect the epithelial barrier and mucosal repair. Increased knowledge of communication networks between the epithelium and immune system will lead to tissue-specific strategies for treating pathologic intestinal inflammation.
Femoral cortical index: an indicator of poor bone quality in patient with hip fracture.

BACKGROUND
Osteoporosis is a common disease in elderly, characterized by poor bone quality as a result of alterations affecting trabecular bone. However, recent studies have described also an important role of alterations of cortical bone in the physiopathology of osteoporosis. Although dual-energy X-ray absorptiometry (DXA) is a valid method to assess bone mineral density, in the presence of comorbidities real bone fragility is unable to be evaluated. The number of hip fractures is rising, especially in people over 85 years old.


AIMS
The aim is to evaluate an alternative method so that it can indicate fracture risk, independent of bone mineral density (BMD). Femoral cortical index (FCI) assesses cortical bone stock using femur X-ray.


METHODS
A retrospective study has been conducted on 152 patients with hip fragility fractures. FCI has been calculated on fractured femur and on the opposite side. The presence of comorbidities, osteoporosis risk factors, vitamin D levels, and BMD have been analyzed for each patient.


RESULTS
Average values of FCI have been 0.42 for fractured femurs and 0.48 at the opposite side with a statistically significant difference (p = 0.002). Patients with severe hypovitaminosis D had a minor FCI compared to those with moderate deficiency (0.41 vs. 0.46, p < 0.011). 42 patients (27.6%) with osteopenic or normal BMD have presented low values of FCI.


DISCUSSION AND CONCLUSION
A significant correlation among low values of FCI, comorbidities, severe hypovitaminosis D. and BMD in patients with hip fractures has been found. FCI could be a useful tool to evaluate bone fragility and to predict fracture risk even in the normal and osteopenic BMD patients.
Efficacy of inhaled salmeterol in the management of smokers with chronic obstructive pulmonary disease: a single centre randomised, double blind, placebo controlled, crossover study.

BACKGROUND
The acute response to bronchodilators in patients with chronic obstructive pulmonary disease (COPD) is modest; it has, however, been suggested that these patients may benefit from long term treatment.


METHODS
To investigate the efficacy of salmeterol in smokers with moderate to severe COPD a double blind, randomised, crossover comparison was performed between salmeterol (50 micrograms twice daily) and placebo in 63 patients with stable COPD (mean age 65 years). Prior to inclusion, all patients had a forced expiratory volume in one second (FEV1) of < 60% of predicted and an improvement in FEV1 of < 15% following 400 micrograms inhaled salbutamol. Patients received four weeks of therapy with each of the treatment regimens. Assessment of efficacy was made with recording of morning and evening peak expiratory flow rates (PEF), respiratory symptoms, and use of rescue salbutamol. FEV1 was measured before and after nebulised salbutamol prior to randomisation and at the end of each treatment period.


RESULTS
Morning PEF values were higher during the salmeterol than during the placebo period, although the mean treatment difference was small (12 l/min (95% confidence limits 6 to 17)). No difference in mean evening PEF values was found. Diurnal variation in PEF, assessed as the difference between the morning PEF and that of the previous evening, was more pronounced during the placebo than during the salmeterol period. The mean spirometric values (including reversibility in FEV1) obtained at the end of the two treatment periods were similar. Compared with placebo, treatment with salmeterol was associated with lower daytime and night time symptom scores and less use of rescue salbutamol both during the day and the night. The patients rated the treatment with salmeterol better than treatment with placebo.


CONCLUSIONS
This study shows that, compared with placebo, treatment with salmeterol produces an improvement in respiratory symptoms and morning PEF values in patients with moderate to severe COPD. Treatment with long acting beta agonists may therefore result in an improvement in functional status, even in patients suffering from apparently nonreversible obstructive pulmonary disease.
RFID Data Management: Challenges and Opportunities

Radio-frequency identification (RFID) technology promises to revolutionize the way we track items in supply chain, retail store, and asset management applications. The size and different characteristics of RFID data pose many interesting challenges in the current data management systems. In this paper, we provide a brief overview of RFID technology and highlight a few of the data management challenges that we believe are suitable topics for exploratory research.
Infant Feeding Attitudes and Knowledge among Socioeconomically Disadvantaged Women in Glasgow

Objectives This study: (1) investigated infant feeding attitudes and knowledge among socioeconomically disadvantaged mothers in an urban community with historically low breastfeeding rates, (2) examined the influence of women’s social networks on infant feeding attitudes and decisions, and (3) validated a measure of infant feeding attitudes and knowledge in this population (Iowa Infant Feeding Attitude Scale, IIFAS). Methods Women attending a prenatal clinic (n = 49) reported on: (1) demographics, (2) infant feeding attitudes and knowledge (IIFAS), (3) feeding intent, (4) opinions about breastfeeding in public, and (5) social networks. Feeding method at discharge was abstracted from hospital charts. Social network members (n = 47) identified by the prenatal sample completed interviews covering: (1) demographics, (2) infant feeding attitudes and knowledge (IIFAS), (3) prior infant feeding methods and recommendations, and (4) opinions about breastfeeding in public. Results Mean IIFAS scores were low in both groups, indicating neutral to negative breastfeeding attitudes; mothers’ scores were lower than social network members. Higher maternal IIFAS score was significantly associated with intended and actual breastfeeding. A social network positive towards breastfeeding was significantly associated with mothers’ positive attitude towards breastfeeding. Both mothers and social network members support breastfeeding in public. IIFAS internal consistency was robust for both mothers and social network members. Predictive validity was demonstrated by significant positive association between score and intended and actual feeding methods. Conclusions Knowledge and attitude predict breastfeeding initiation in this population. Social network members may influence mothers’ feeding choices. This research is important because attitudes and knowledge derived from the IIFAS can be used to develop and evaluate breastfeeding promotion programs.
Offshoring and the Onshore Composition of Occupations , Tasks and Skills ∗

Using plant data that distinguish between occupations, tasks, and workforce skills, this paper investigates the relationship between offshoring and the onshore workforce composition at German multinational enterprises (MNEs) in manufacturing and services. There is no statistically significant association between offshoring and the share of whiteand blue-collar jobs in the onshore wage bill. The proportion of non-routine and interactive tasks, however, increases with offshoring, especially at services MNEs. In excess of what is implied by changes in either the occupational or task composition, offshoring predicts an increase in the wage-bill share of workers with upper-secondary education. While this excess educational upgrading beyond occupational and task recomposition is statistically significant, the economic effect of offshoring on the wage-bill composition is small. ∗We thank Heinz Herrmann, Alexander Lipponer, Beatrix Stejskal-Passler, and Elisabetta Fiorentino for support with BuBa firm data, and Stefan Bender, Iris Koch and Stephan Heuke at BA for assistance with the plant records. Karin Herbst and Thomas Wenger kindly shared string-matching expertise, and Alexandra Spitz-Oener generously contributed task classifications for robustness checks. Ming Zeng provided excellent research assistance. We gratefully acknowledge financial support from the VolkswagenStiftung, the Fritz-Thyssen-Stiftung, the Wallander Foundation, the Swedish Council for Working Life and Social Research, and the Ifo Institute. ¶sbecker@lmu.de (www.sobecker.de), corresponding. Ph: +49 (89) 2180-6252.
A single port surgical robot system with novel elbow joint mechanism for high force transmission.

BACKGROUND
Despite its evident clinical benefits, single-incision laparoscopic surgery (SILS) imposes inherent limitations of collision between external arms and inadequate triangulation because multiple instruments are inserted through a single port at the same time.


METHODS
A robot platform appropriate for SILS was developed wherein an elbowed instrument can be equipped to easily create surgical triangulation without the interference of robot arms. A novel joint mechanism for a surgical instrument actuated by a rigid link was designed for high torque transmission capability.


RESULTS
The feasibility and effectiveness of the robot was checked through three kinds of preliminary tests: payload, block transfer, and ex vivo test. Measurements showed that the proposed robot has a payload capability >15 N with 7 mm diameter.


CONCLUSIONS
The proposed robot is effective and appropriate for SILS, overcoming inadequate triangulation and improving workspace and traction force capability.
Impact of androgen-deprivation therapy on physical function and quality of life in men with nonmetastatic prostate cancer.

PURPOSE
This prospective longitudinal study evaluated the effect of androgen deprivation therapy (ADT) on objective and self-reported physical function.


PATIENTS AND METHODS
Men with nonmetastatic prostate cancer (PC) starting continuous ADT were enrolled in this matched cohort study. Physical function was assessed with the 6-minute walk test (6MWT), grip strength, and the timed-up-and-go (TUG) test, representing endurance and upper and lower extremity strength, respectively. Quality of life (QOL) was measured with the Medical Outcomes Study Short-Form 36 (SF-36) questionnaire. Subjects were assessed at baseline, 3, 6, and 12 months. Two control groups (PC without ADT; no PC), matched on age, education, and baseline function were enrolled. Mixed effects regression models were fitted, adjusting for baseline covariates.


RESULTS
We enrolled 87 patients on ADT, 86 PC controls, and 86 healthy controls; groups were similar in age (mean, 69.1 years; range, 50 to 87) and physical function. The 6MWT distance remained stable in the ADT group (P = .96) but improved in both control groups (P < .05). Grip strength declined in the ADT group (P = .04), remained stable in PC controls (P = .31), and improved in healthy controls (P = .008). TUG scores remained stable over time and across groups (P > .10). The SF-36 physical function summary score declined in the ADT group (P < .001), but increased in both control groups (P < .001). Negative effects on outcomes were observed within 3 months of starting ADT and were generally independent of age.


CONCLUSION
Endurance, upper extremity strength, and physical components of QOL are affected within 3 months of starting ADT. Up-front exercise interventions to counteract these losses are warranted.
Crustal motion in Indonesia from Global Positioning System measurements

[1] We present the crustal motion velocity field for the Indonesian archipelago based on Global Positioning System (GPS) field surveys conducted from 1991 to 1997, and 2001, totaling more than 150 sites, as well as on a reanalysis of global tracking data in the Scripps Orbit and Permanent Array Center archive from 1991 to 2001 in International Terrestrial Reference Frame 2000. We compute poles of rotation for the Australia, Eurasia, and Pacific plates based on our analysis of the global GPS data. We find that regional tectonics is dominated by the interaction of four discrete, rotating blocks spanning significant areas of the Sunda Shelf, the South Banda arc, the Bird’s Head region of New Guinea, and East Sulawesi. The largest, the Sunda Shelf block (SSH), is estimated to be moving 6 ± 3 mm/yr SE relative to Eurasia. The South Banda block (SBB) rotates clockwise relative to both the SSH and Australia plate, resulting in 15 ± 8 mm/yr of motion across the Timor trough and 60 ± 3 mm/yr of shortening across the Flores Sea. Southern New Guinea forms part of the Australia plate from which the Bird’s Head block (BHB) moves rapidly WSW, subducting beneath the Seram trough. The East Sulawesi block rotates clockwise about a nearby axis with respect to the Sunda Shelf, thereby transferring east-west shortening between the Pacific and Eurasia plates into north-south shortening across the North Sulawesi trench. Except for the Sunda Shelf, the crustal blocks are all experiencing significant internal deformation. In this respect, crustal motion in those regions does not fit the microplate tectonics model.