LLukas22/scidocs huggingface dataset:
Influence of clinical and demographic variables on mycophenolic acid pharmacokinetics in antineutrophil cytoplasmic antibody-associated vasculitis.

BACKGROUND
Mycophenolic acid (MPA) is used off-label to treat many forms of glomerulonephritis.


OBJECTIVE
To evaluate the pharmacokinetics of MPA and its glucuronide (MPAG) in antineutrophil cytoplasmic antibody (ANCA)-associated vasculitis patients with renal manifestations and to determine the effects of clinical (urinary protein excretion, serum albumin, creatinine clearance) and demographic (age, race, sex) variables on MPA and MPAG pharmacokinetics.


METHODS
Twenty-three patients taking MPA at steady-state were evaluated. Plasma and urine samples were collected over 24 hours. Analyses included noncompartmental pharmacokinetics and statistics including Mann-Whitney U test and univariate/multiple regression.


RESULTS
MPA clearance (Cl/F 288 +/- 154 mL/min) was approximately 2-fold higher than previously reported from transplant patients and predicted by weight and race (ranked MPA Cl/F = -11.766 + 0.2035 [wt] + 4.9578 [race]; R(2) 41.8%; p = 0.005). Creatinine clearance (CrCl) less than 60 mL/min resulted in higher MPA exposure, total area under the curve (AUC)(0-12), and AUC(6-12), as well as unbound AUC(0-12). The metabolic ratio (MPAG(AUC)/MPA(AUC)) of 8.67 +/- 5.57 was lower than that previously reported in renal transplant recipients.


CONCLUSIONS
Diminished kidney function (eg, CrCl <60 mL/min) demonstrated enhanced MPA and MPAG exposure in patients with ANCA vasculitis. However, unlike renal transplant recipients, patients with ANCA vasculitis had enhanced Cl/F and diminished metabolic ratio, suggesting the need to comprehensively evaluate the role of disease-specific factors on MPA pharmacokinetics.
Duration of short-course androgen suppression therapy and the risk of death as a result of prostate cancer.

PURPOSE
We evaluated whether the duration of androgen suppression therapy (AST) had an impact on the risk of prostate cancer-specific mortality (PCSM) in men with unfavorable-risk prostate cancer (PC) within established Gleason score (GS) categories.


PATIENTS AND METHODS
Between February 2, 1996, and December 27, 2001, 761 men with unfavorable-risk PC were treated in Australia, New Zealand, Ireland, or the United States in a randomized trial with radiotherapy and 3, 4, or 6 months of AST (the study cohort). Competing risks regression was used to evaluate whether the duration of AST interacted with GS and was significantly associated with the risk of PCSM, adjusting for age, trial site, and PC prognostic factors.


RESULTS
After a median follow-up of 10.9 years, 263 men died, 111 (42%) from PC. For all men, 6 versus 3 or 4 months of AST was associated with a reduced risk of PCSM (adjusted hazard ratio [AHR], 0.55; 95% CI, 0.36 to 0.82; P = .004). AHRs evaluating the impact of the duration of AST on the risk of PCSM were 0.67 (95% CI, 0.29 to 1.56; P = .35), 0.47 (95% CI, 0.25 to 0.85; P = .01), and 0.59 (95% CI, 0.30 to 1.19; P = .14) for men with GS ≤ 6, 7, and 8 to 10 PC, respectively. Therefore, the strongest evidence for this benefit was in men with GS 7 PC.


CONCLUSION
AST durations of no less than 6 months should be considered when treating GS 7 PC with conventional dose RT.
Gender-informed, psychoeducational programme for couples to prevent postnatal common mental disorders among primiparous women: cluster randomised controlled trial.

OBJECTIVES
Interventions to prevent postpartum common mental disorders (PCMD) among unselected populations of women have had limited success. The aim was to determine whether What Were We Thinking (WWWT) a gender-informed, psychoeducational programme for couples and babies can prevent PCMD among primiparous women 6 months postpartum.


DESIGN
Cluster-randomised controlled trial.


SETTING
48 Maternal and Child Health Centres (MCHCs) from 6 Local Government Areas in Melbourne, Australia were allocated randomly to usual care (24) or usual care plus WWWT (24).


PARTICIPANTS
English-speaking primiparous women receiving primary care at trial MCHCs were recruited to the intervention (204) and control (196) conditions. Of these, 187 (91.7%) and 177 (90.3%) provided complete data.


INTERVENTION
WWWT is a manualised programme comprising primary care from a trained nurse, print materials and a face-to-face seminar.


MAIN OUTCOME MEASURES
Data sources were standardised and study-specific measures collected in blinded computer-assisted telephone interviews at 6 and 26 weeks postpartum. The primary outcome was PCMD assessed by Composite International Diagnostic Interviews and Patient Health Questionnaire (PHQ) Depression and Generalised Anxiety Disorder modules.


RESULTS
In intention-to-treat analyses the adjusted OR (AOR) of PCMD in the intervention compared to the usual care group was 0.78 (95% CI 0.38 to 1.63, ns), but mild to moderate anxiety symptoms (AOR 0.58, 95% CI 0.35 to 0.97) and poor self-rated health (AOR 0.46, 95% CI 0.22 to 0.97) were significantly lower. In a per protocol analysis, comparing the full (three component) intervention and usual care groups, the AOR of PCMD was 0.36, (95% CI 0.14 to 0.95). The WWWT seminar was appraised as salient, comprehensible and useful by >85% participants. No harms were detected.


CONCLUSIONS
WWWT is readily integrated into primary care, enables inclusion of fathers and addresses modifiable risks for PCMD directly. The full intervention appears a promising programme for preventing PCMD, optimising family functioning, and as the first component of a stepped approach to mental healthcare.


TRIAL REGISTRATION NUMBER
ACTRN12613000506796; Results.
No project is an island: linking projects to history and context

Theories on project management are dominated by a perspective on singular projects, treating the unit of analysis as a lonely phenomenon. Anchored in a comparative case study, this paper discusses how the interior processes of a project are influenced by its historical and organizational context. The paper illustrates how the structures and procedures employed in a project have to be understood in relation to previous and simultaneous courses of activity, to future plans, and to standard operating procedures, traditions, and the norms of its surroundings. The findings suggest that future research on project management needs to extend its temporal scope, analyzing how project practices evolve through history over prior, present, and future projects, as well as its organizational scope, analyzing how project practices relate to long-term institutions as well as simultaneous activities in its environment. © 2002 Elsevier Science B.V. All rights reserved.
DoS and DDoS Attacks: Defense, Detection and Traceback Mechanisms - A Survey

Denial of Service (DoS) or Distributed Denial of Service (DDoS) attacks are typically explicit attempts to exhaust victim’s bandwidth or disrupt legitimate users’ access to services. Traditional architecture of internet is vulnerable to DDoS attacks and it provides an opportunity to an attacker to gain access to a large number of compromised computers by exploiting their vulnerabilities to set up attack networks or Botnets. Once attack network or Botnet has been set up, an attacker invokes a large-scale, coordinated attack against one or more targets. Asa result of the continuous evolution of new attacks and ever-increasing range of vulnerable hosts on the internet, many DDoS attack Detection, Prevention and Traceback mechanisms have been proposed, In this paper, we tend to surveyed different types of attacks and techniques of DDoS attacks and their countermeasures. The significance of this paper is that the coverage of many aspects of countering DDoS attacks including detection, defence and mitigation, traceback approaches, open issues and research challenges. GJCST-E Classification : D.4.6 DoSandDDoSAttacksDefenseDetection andTraceback Mechanisms-A Survey Strictly as per the compliance and regulations of:
Association of inosine triphosphatase 94C>A and thiopurine S-methyltransferase deficiency with adverse events and study drop-outs under azathioprine therapy in a prospective Crohn disease study.

BACKGROUND
Azathioprine (aza) therapy is beneficial in the treatment of inflammatory bowel disease, but 10%-30% of patients cannot tolerate aza therapy because of adverse drug reactions. Thiopurine S-methyltransferase (TPMT) deficiency predisposes to myelotoxicity, but its association with other side effects is less clear. Inosine triphosphatase (ITPA) mutations are other pharmacogenetic polymorphisms possibly involved in thiopurine metabolism and tolerance.


METHODS
We analyzed data from a 6-month prospective study including 71 patients with Crohn disease undergoing first-time aza treatment with respect to aza intolerance. Patients were genotyped for common TPMT and ITPA mutations and had pretherapy TPMT activity measured.


RESULTS
Early drop-out (within 2 weeks) from aza therapy was associated with ITPA 94C > A [P = 0.020; odds ratio (OR), 4.6; 95% confidence interval (95% CI), 1.2-17.4] and low TPMT activity [<10 nmol/(mL erythrocytes . h); P = 0.007; OR = 5.5; 95% CI, 1.6-19.2]. A high-risk group defined by ITPA 94C > A or TPMT <10 nmol/(mL erythrocytes . h) showed significant association with early drop-out (P = 0.001; OR = 11.3; 95% CI, 2.5-50.0) and all drop-outs (P = 0.002; OR = 4.8; 95% CI, 1.8-13.3). For only drop-outs attributable to aza-related side effects (n = 16), there was a significant association with ITPA 94C > A (P = 0.002; OR = 7.8; 95% CI, 2.1-29.1). Time-to-event analysis over the 24-week study period revealed a significant association (P = 0.031) between the time to drop-out and ITPA 94C > A mutant allele carrier status.


CONCLUSIONS
Patients with ITPA 94C > A mutations or low TPMT activity constitute a pharmacogenetic high-risk group for drop-out from aza therapy. ITPA 94C>A appears to be a promising marker indicating predisposition to aza intolerance.
Gated Hierarchical Attention for Image Captioning

Attention modules connecting encoder and decoders have been widely applied in the field of object recognition, image captioning, visual question answering and neural machine translation, and significantly improves the performance. In this paper, we propose a bottomup gated hierarchical attention (GHA) mechanism for image captioning. Our proposed model employs a CNN as the decoder which is able to learn different concepts at different layers, and apparently, different concepts correspond to different areas of an image. Therefore, we develop the GHA in which low-level concepts are merged into high-level concepts and simultaneously low-level attended features pass to the top to make predictions. Our GHA significantly improves the performance of the model that only applies one level attention, e.g., the CIDEr score increases from 0.923 to 0.999, which is comparable to the state-of-theart models that employ attributes boosting and reinforcement learning (RL). We also conduct extensive experiments to analyze the CNN decoder and our proposed GHA, and we find that deeper decoders cannot obtain better performance, and when the convolutional decoder becomes deeper the model is likely to collapse during training. Code is available: https://github.com/qingzwang/GHA-ImageCaptioning.
The phenomenon of micronutrient deficiency among children in China: a systematic review of the literature.

OBJECTIVE
The present study aimed to review the literature on micronutrient deficiency and other factors influencing a deficiency status among children living in China.


DESIGN
A systematic review was performed to analyse the literature.


SETTING
Studies were identified through a search of PubMed and secondary references.


SUBJECTS
Children living in China aged less than 18 years.


RESULTS
Sixty-one articles were included. The prevalence of vitamin A deficiency decreased to approximately 10 % in 1995-2009. It increased with age but no significant difference was found between genders. The prevalence of thiamin and vitamin B12 deficiency was 10·5 % in Yunnan and 4·5 % in Chongqing provinces, respectively. Higher vitamin D deficiency rates were seen in spring and winter. The incidence of bleeding due to vitamin K deficiency was 3·3 % in 1998-2001 and more prevalent in rural areas. Both iodine deficiency and excess iodine intake were observed. Goitre rates were reported in Tibet, Jiangxi, Gansu and Hong Kong (3·5-46 %). Anaemia rates ranged from 20 % to 40 % in 2007-2011. High Se deficiency rates were found in Tibet, Shaanxi and Jiangsu. High Zn deficiency rates were also found (50-70 %) in 1995-2006. Few studies reported Ca deficiency rates (19·6-34·3 %). The degrees of deficiency for vitamin A, vitamin B12, Fe and Zn were more substantial in rural areas compared with urban areas.


CONCLUSIONS
The prevalence of micronutrient deficiency rates varied. Socio-economic status, environmental factors and the Chinese diet may influence micronutrient deficiency. Public health policies should consider implementing programmes of supplementation, food fortification and nutrition education to address these deficiencies among Chinese children.
Incremental Learning Algorithms for Classification and Regression: local strategies

We present a new local strategy to solve incremental learning tasks. Applied to Support Vector Machines based on local kernel, it allows to avoid re-learning of all the parameters by selecting a working subset where the incremental learning is performed. Automatic selection procedure is based on the estimation of generalization error by using theoretical bounds that involve the margin notion. Experimental simulation on three typical datasets of machine learning give promising results.
Exploring the reliability of the modified rankin scale.

BACKGROUND AND PURPOSE
The modified Rankin Scale (mRS) is the most prevalent outcome measure in stroke trials. Use of the mRS may be hampered by variability in grading. Previous estimates of the properties of the mRS have used diverse methodologies and may not apply to contemporary trial populations. We used a mock clinical trial design to explore inter- and intraobserver variability of the mRS.


METHODS
Consenting patients with stroke attending for outpatient review had the mRS performed by 2 independent assessors with pairs of assessors selected from a team of 3 research nurses and 4 stroke physicians. Before formal assessment, interviewers estimated disability based only on initial patient observation. Each patient was then randomized to undergo the mRS using standard assessment or a prespecified structured interview. The second interviewer in the pair reassessed the patient using the same method blinded to the colleague's score. For each patient assessed, one rater was randomly assigned to video record their interview. After 3 months, this interviewer reviewed and regraded their original video assessment.


RESULTS
Across 100 paired assessments, interobserver agreement was moderate (k=0.57). Intraobserver variability was good (k=0.72) but less than would be expected from previous literature. Forty-nine assessments were performed using the structured interview approach with no significant difference between structured and standard mRS. Researchers were unable to reliably predict mRS from initial limited patient assessment (k=0.16).


CONCLUSIONS
Despite availability of training and structured interview, there remains substantial interobserver variability in mRS grades awarded even by experienced researchers. Additional methods to improve mRS reliability are required.
Association of Insurance Status with Severity and Management in ED Patients with Asthma Exacerbation

INTRODUCTION
Previous studies have demonstrated an association of low socioeconomic status with frequent asthma exacerbations. However, there have been no recent multicenter efforts to examine the relationship of insurance status - a proxy for socioeconomic status - with asthma severity and management in adults. The objective is to investigate chronic and acute asthma management disparities by insurance status among adults requiring emergency department (ED) treatment in the United States.


METHODS
We conducted a multicenter chart review study (48 EDs in 23 U.S. states) on ED patients, aged 18-54 years, with acute asthma between 2011 and 2012. Each site underwent training (lecture, practice charts, certification) before reviewing randomly selected charts. We categorized patients into three groups based on their primary health insurance: private, public, and no insurance. Outcome measures were chronic asthma severity (as measured by ≥2 ED visits in one-year period) and management prior to the index ED visit, acute asthma management in the ED, and prescription at ED discharge.


RESULTS
The analytic cohort comprised 1,928 ED patients with acute asthma. Among these, 33% had private insurance, 40% had public insurance, and 27% had no insurance. Compared to patients with private insurance, those with public insurance or no insurance were more likely to have ≥2 ED visits during the preceding year (35%, 49%, and 45%, respectively; p<0.001). Despite the higher chronic severity, those with no insurance were less likely to have guideline-recommended chronic asthma care - i.e., lower use of inhaled corticosteroids (ICS [41%, 41%, and 29%; p<0.001]) and asthma specialist care (9%, 10%, and 4%; p<0.001). By contrast, there were no significant differences in acute asthma management in the ED - e.g., use of systemic corticosteroids (75%, 79%, and 78%; p=0.08) or initiation of ICS at ED discharge (12%, 12%, and 14%; p=0.57) - by insurance status.


CONCLUSION
In this multicenter observational study of ED patients with acute asthma, we found significant discrepancies in chronic asthma severity and management by insurance status. By contrast, there were no differences in acute asthma management among the insurance groups.
Physical therapy and chiropractic use among childhood cancer survivors with chronic disease: impact on health-related quality of life.

INTRODUCTION
The use of rehabilitation services to address musculoskeletal, neurological and cardiovascular late effects among childhood cancer survivors could improve physical function and health-related quality-of-life (HRQL). We describe physical therapy (PT) and chiropractic utilization among childhood cancer survivors and their association with HRQL.


METHODS
The sample included 5+ year survivors from the Childhood Cancer Survivor Study (N = 9,289). Questions addressing use of PT or chiropractic services and HRQL (Medical Outcomes Survey Short Form (SF-36)) were evaluated. Multivariable regression models compared PT and/or chiropractic utilization between survivors and siblings, and by diagnosis, treatment and demographic characteristics; associations between chronic disease, PT/chiropractic use, and HRQL were similarly evaluated.


RESULTS
Survivors were not more likely to use PT (OR 1.0; 95% CI 0.8-1.2) or chiropractic (OR 0.8; 95% CI 0.7-1.0) services than siblings. More survivors reported using chiropractic (12.4%) than PT (9.2%) services. Older age and having health insurance were associated with utilization of either PT or chiropractic services. Grade 3-4 chronic conditions and a CNS tumor or sarcoma history were associated with PT but not with chiropractic service utilization. Survivors with musculoskeletal (OR 1.8; 95% CI 1.1-2.9), neurological (OR 3.4; 95% CI 1.6-6.9), or cardiovascular (OR 3.3; 95% CI 1.6-6.9) chronic conditions who used PT/chiropractic services were more likely to report poor physical health than survivors who did not use services.


CONCLUSIONS
The reported prevalence of PT/chiropractic among survivors is consistent with that reported by siblings. Severity of late effects is associated with service use and with reporting poor physical health.


IMPLICATIONS FOR CANCER SURVIVORS
Long-term childhood cancer survivors do not appear to utilize rehabilitation services to optimize physical function and support increased HRQL.
A Study of Style in Machine Translation: Controlling the Formality of Machine Translation Output

Stylistic variations of language, such as formality, carry speakers’ intention beyond literal meaning and should be conveyed adequately in translation. We propose to use lexical formality models to control the formality level of machine translation output. We demonstrate the effectiveness of our approach in empirical evaluations, as measured by automatic metrics and human assessments.
Detection of review spam: A survey

In recent years, online reviews have become the most important resource of customers’ opinions. These reviews are used increasingly by individuals and organizations to make purchase and business decisions. Unfortunately, driven by the desire for profit or publicity, fraudsters have produced deceptive (spam) reviews. The fraudsters’ activities mislead potential customers and organizations reshaping their businesses and prevent opinion-mining techniques from reaching accurate conclusions. The present research focuses on systematically analyzing and categorizingmodels that detect review spam. Next, the study proceeds to assess them in terms of accuracy and results. We find that studies can be categorized into three groups that focus on methods to detect spam reviews, individual spammers and group spam. Different detection techniques have different strengths and weaknesses and thus favor different detection contexts. 2014 Published by Elsevier Ltd.
Beneficial effects of statins after percutaneous coronary intervention.

BACKGROUND
Evidence about the efficacy of statin treatment among patients after percutaneous coronary intervention (PCI) is very limited. The rapid advancement in PCI technology and near universal use of adjunctive cardioprotective medications make it necessary to formally assess the effect of statin therapy on cardiac events after PCI.


DESIGN
This was a multicenter prospective cohort study.


METHODS
Patients who received stent implantation and survived to hospital discharge from the National Heart, Lung, and Blood Institute Dynamic Registry from 2004 to 2006 formed the study cohort. Patients with cardiogenic shock, in-hospital adverse events [including myocardial infarction and coronary artery bypass graft surgery (CABG)], liver disease, renal disease, alcoholism, or drug abuse were excluded. The occurrences of death, CABG, and repeat PCI, and repeat revascularization were collected over 1-year follow-up.


RESULTS
Of the 3227 patients evaluated, 2737 (85%) were prescribed a statin at discharge. By 1-year follow-up, incident events were 98 deaths, 44 CABG, 290 repeat PCI procedures, and 328 repeat revascularizations. After propensity score adjustment, postdischarge statin therapy was associated with lower risks of death [hazard ratio (HR): 0.58, 95% confidence interval (CI): 0.36-0.93, P = 0.02], CABG (HR: 0.49, 95% CI: 0.24-1.00, P = 0.05), and repeat revascularization (HR: 0.74, 95% CI: 0.56-1.00, P = 0.05).


CONCLUSION
These results support the routine use of statin therapy after PCI.