LLukas22/scidocs huggingface dataset:
Wide variation in the use of thrombolytic therapy among junior doctors in south and central Scotland.

OBJECTIVES
(a) To assess the practice of junior doctors who administer thrombolytic therapy in acute myocardial infarction. (b) To assess whether wider implementation of current guidelines is indicated.


DESIGN
Postal questionnaire survey. Each questionnaire was followed by a reminder.


SETTING
Teaching and district general hospitals in Central and Southern Scotland.


SUBJECTS
Two hundred and twelve junior doctors (excluding JHO's) regularly involved in the early assessment and management of patients with acute myocardial infarction.


RESULTS
One hundred and ten questionnaires were returned (response rate 52%). There was wide inter-individual variation in clinical practice regardless of whether subjects worked in teaching or district general hospitals or as cardiologists or non-cardiologists. As many as 12% of respondents administer thrombolytic therapy in the absence of ST elevation or bundle branch block on the presenting ECG. A high percentage of subjects considered diabetic retinopathy, but not a previous history of cerebrovascular disease, a contraindication to thrombolytic therapy. Only 29% and 32% respectively worked in institutions where formal policies existed for streptokinase readministration and rt-PA administration in preference to streptokinase. The administration of thrombolytic therapy in Accident and Emergency departments is not a popular strategy, and the full efficacy of rt-PA is not realised due to inappropriate use or failure to use intravenous heparin.


CONCLUSIONS
There is wide variation in clinical practice among junior doctors who administer thrombolytic therapy for acute myocardial infarction. Wider implementation and firmer current national guidelines would ensure that patients presenting with suspected acute myocardial infarction receive optimal therapy.
Using mobile phones in education

We present three projects in mobile learning. First, we polled 333 Japanese university students regarding their use of mobile devices. 100% reported owning a mobile phone. 99% send email on their mobile phones, exchanging some 200 email messages each week. 66% email peers about classes; 44% email for studying. In contrast, only 43% email on PCs, exchanging an average of only 2 messages per week. Only 20% had used a PDA. Second, we emailed 100-word English vocabulary lessons at timed intervals to the mobile phones of 44 Japanese university students, hoping to promote regular study. Compared with students urged to regularly study identical materials on paper or Web, students receiving mobile email learned more (p<0.05). 71% of the subjects preferred receiving these lessons on mobile phones rather than PCs. 93% felt this a valuable teaching method. Third, we created a Web site explaining English idioms. Student-produced animation shows each idiom's literal meaning; a video shows the idiomatic meaning. Textual materials include an explanation, script, and quiz. 31 college sophomores evaluated the site using video-capable mobile phones, finding few technical difficulties, and rating highly its educational effectiveness.
Implementation of an image guided intensity-modulated protocol for post-prostatectomy radiotherapy: planning data and acute toxicity outcomes.

INTRODUCTION
There is substantial interest in implementation of image-guided intensity-modulated radiotherapy (IG-IMRT) in the post-prostatectomy setting. We describe our implementation of IG-IMRT, and examine how often published organ-at-risk (OAR) constraints were met. Furthermore, we evaluate the incidence of acute genitourinary and gastrointestinal toxicities when patients were treated according to our protocol.


METHODS
Patients were eligible if they received post-prostatectomy radiotherapy (PPRT). Planning data were collected prospectively, and toxicity assessments were collected before, during and after treatment.


RESULTS
Seventy-five eligible patients received either 64 Gy (19%) or 66 Gy (81%) in a single phase to the prostate bed. Suggested rectal dose-constraints of V40Gy < 60% and V60Gy < 40% were met in 64 (85%) and 75 (100%) patients, respectively. IMRT-specific rectal dose-constraints of V40Gy < 35% and V65Gy < 17% were achieved in 5 (7%) and 57 (76%) of patients. Bladder dose-constraint (V50Gy < 50%) was met in 58 (77%) patients. Two patients (3%) experienced new grade 3 genitourinary toxicity and one patient (1%) experienced new grade 3 gastroinestinal toxicity. All grade 3 toxicities had improved by 3-month review. Overall deterioration in urinary and gastrointestinal symptoms occurred in 33 (44%) and 35 (47%) of patients respectively.


CONCLUSIONS
We report on our implementation of PPRT which takes into account nationally adopted guidelines, with a margin reduction supported by use of daily image guidance. Non-IMRT OAR constraints were met in most cases. IMRT-specific constraints were less often achieved despite margin reductions, suggesting the need for review of guidelines. Severe toxicity was rare, and most patients did not experience deterioration in urinary or bowel function attributable to radiotherapy.
Dose Escalation Methods in Phase I Cancer Clinical Trials

Phase I clinical trials are an essential step in the development of anticancer drugs. The main goal of these studies is to establish the recommended dose and/or schedule of new drugs or drug combinations for phase II trials. The guiding principle for dose escalation in phase I trials is to avoid exposing too many patients to subtherapeutic doses while preserving safety and maintaining rapid accrual. Here we review dose escalation methods for phase I trials, including the rule-based and model-based dose escalation methods that have been developed to evaluate new anticancer agents. Toxicity has traditionally been the primary endpoint for phase I trials involving cytotoxic agents. However, with the emergence of molecularly targeted anticancer agents, potential alternative endpoints to delineate optimal biological activity, such as plasma drug concentration and target inhibition in tumor or surrogate tissues, have been proposed along with new trial designs. We also describe specific methods for drug combinations as well as methods that use a time-to-event endpoint or both toxicity and efficacy as endpoints. Finally, we present the advantages and drawbacks of the various dose escalation methods and discuss specific applications of the methods in developmental oncotherapeutics.
Associations of gestational glycemia and prepregnancy adiposity with offspring growth and adiposity in an Asian population.

BACKGROUND
Maternal obesity and hyperglycemia increase risk of obesity and diabetes in offspring later in life.


OBJECTIVE
We examined the relation between gestational glycemia and prepregnancy body mass index (ppBMI) with offspring growth in an Asian mother-offspring cohort.


DESIGN
Pregnant mothers undertook a 75-g 2-h oral-glucose-tolerance test at 26-28 wk of gestation. In 937 singleton offspring, ≤9 serial measurements of weight and length were obtained from birth until 36 mo of age.


RESULTS
Gestational fasting plasma glucose (FPG) was positively associated with birth weight (B: 0.17; 95% CI: 0.10, 0.24; P < 0.001) and birth BMI (B: 0.15; 95% CI: 0.06, 0.40; P = 0.001) but not at ≥3 mo of age. In contrast, maternal ppBMI was positively associated with birth variables and conditional growth in weight and BMI in the first 36 mo of life. However, gestational FPG and prepregnancy obesity status interacted significantly for the association with offspring growth and overweight status in the first 36 mo of life (P-interaction < 0.01). In nonobese mothers, each unit increase in gestational FPG was associated with increased offspring weight (B: 0.08; 95% CI: 0.008, 0.16; P = 0.03) and BMI (B: 0.08; 95% CI: 0.003, 0.15; P = 0.04) as well as increased risk of overweight in the first 36 mo of life (OR: 1.36; 95% CI: 1.10, 1.68). However, in obese mothers, each unit increase in gestational FPG was associated with decreased offspring weight (B: -0.01; 95% CI: -0.02, -0.003) and BMI (B: -0.008; 95% CI: -0.01, -0.002) velocity (P < 0.01 for both) and decreased risk of overweight (OR: 0.59; 95% CI: 0.41, 0.86) in the first 36 mo of life.


CONCLUSIONS
Prepregnancy adiposity was associated with offspring growth in early childhood. Although pooled analyses showed no demonstrable difference by 3 mo of age, there were contrasting and opposite associations of gestational glycemia with weight and BMI in the first 36 mo of life in offspring of nonobese and obese mothers separately. This study was registered at clinicaltrials.gov as NCT01174875.
A novel diagnostic protocol to identify patients suitable for discharge after a single high-sensitivity troponin

OBJECTIVE
To establish whether a novel accelerated diagnostic protocol (ADP) for suspected acute coronary syndrome (ACS) could successfully identify low-risk patients suitable for discharge after a single high-sensitivity troponin T (hs-cTnT) taken at presentation to the emergency department. We also compared the diagnostic accuracy of this ADP with strategies using initial undetectable hs-cTnT.


METHODS
This prospective observational study evaluated the ability of the Triage Rule-out Using high-Sensitivity Troponin (TRUST) ADP to identify low-risk patients with suspected ACS. The ADP incorporated a single presentation hs-cTnT of <14 ng/L, a non-ischaemic ECG and a modified Goldman risk score. Diagnostic performance of the ADP was compared with the detection limit cut-offs of hs-cTnT (<5 ng/L and <3 ng/L). The primary end point was fatal/non-fatal acute myocardial infarction (AMI) within 30 days.


RESULTS
960 participants were recruited, mean age 58.0 years, 80 (8.3%) had an AMI. The TRUST ADP classified 382 (39.8%) as low-risk with a sensitivity for identifying AMI of 98.8% (95% CI 92.5% to 99.9%). hs-cTnT detection limits (<5 ng/L and <3 ng/L) had a sensitivity of 100% (94.3 to 100) and 100% (94.4 to 100), respectively. The TRUST ADP identified more patients suitable for early discharge at 39.8% vs 29.3% (<5 ng/L) and 7.9% (<3 ng/L) (p<0.001) with a lower false-positive rate for AMI detection; specificity 43.3% (95% CI 42.7% to 43.4%) vs 32.0% (95% CI 31.5% to 32.0%) and 8.6% (95% CI 8.1% to 8.6%), respectively.


CONCLUSIONS
The TRUST ADP, which incorporates structured risk-assessment and a single presentation hs-cTnT blood draw, has potential to allow early discharge in 40% of patients with suspected ACS and has greater clinical utility than undetectable hs-cTnT strategies.


TRIAL REGISTRATION NUMBER
ISRCTN No. 21109279.
Reflection : journals and reflective questions : a strategy for professional learning

Reflective journals have been used widely in teacher education programs to promote reflective thinking (Freidus, 1998; Carter & Francis, 2000; Yost, Senter & ForlenzoBailey, 2000). Smyth (1992) advocated that posing a series of questions to be answered in written journals could enhance reflective thinking. It was for this reason that reflective responses to directed questions were introduced in 2002 and subsequently in 2003 in the Bachelor of Education 4th year primary internship program at the University of Western Sydney, Australia. The internship program provided a sustained ten-week period of time in a school that afforded student teachers the opportunity to examine their practice in an authentic setting of teaching. This paper reports on the process undertaken to assist internship students to understand the reflection process and their responses to reflective questions. These responses are analysed in relation to the internship students’ professional learning using a framework described by Dietz (1998).
The effect of sucrose on the thermodynamic properties of ovalbumin and sodium caseinate in bulk solution and at air–water interface

Abstract This paper presents a study of the effect of sucrose on the molecular parameters and thermodynamic properties in a bulk aqueous medium and at the air–water interface for two proteins differing both in nature and structure, that is Na-caseinate and ovalbumin. To get more insight into the molecular nature of the effect of sucrose, mixing calorimetry, light scattering and tensiometry measurements have been made under different pHs (7.0 and 5.5) and temperatures (20–55°C) at an ionic strength of 0.005 mol dm −3 . Combined temperature dependencies of light scattering and mixing calorimetry testify to hydrogen bonding (sucrose-protein and/or sucrose-water) as being the primary basis of the effect of sucrose on the molecular and thermodynamic properties of the proteins in the bulk and at interface of an aqueous medium. At pH 7.0, in the case of ovalbumin, the interaction with sucrose causes an increase in the protein hydrophilicity in the bulk aqueous medium followed by a decrease in the protein surface activity, whilst for Na-caseinate, there is an increase in the protein hydrophobicity due to Na-caseinate micelle dissociation and, consequently, to an increase in the protein surface activity. Lowering the pH to 5.5, accompanied by a strengthening of the competition between less charged proteins and sucrose for water molecules, induces a rise in the protein hydrophobic aggregation in the bulk. The special features of the latter process are probably mainly responsible for the changes in the surface activity of the proteins under influence of sucrose at pH 5.5.
Video Key Frame Extraction Based on Spatial-Temporal Color Distribution

Video key frame extraction is a type of video abstraction, which is one of the key problems in video content indexing and retrieval. Key frame extraction aims at finding a small collection of salient images extracted from a video sequence for visual content summarization. In this paper we propose a video key frame extraction method based on spatial-temporal color distribution. First we construct a temporally maximum occurrence frame which considers the spatial and temporal distribution of the pixels throughout the video shot. Then a weighted distance is computed between frames in the shot and the constructed reference frame. Key frames are extracted at the peaks of the distance curve and can achieve high compression ratio and high fidelity.
Quantification of major morphological abnormalities of the levator ani.

OBJECTIVES
Morphological abnormalities of the levator ani are found in a significant minority of women presenting with symptoms of pelvic floor dysfunction. In this study quantification of such injuries using tomographic three-dimensional (3D) pelvic floor ultrasound was attempted.


METHODS
In a prospective observational study undertaken at two tertiary urogynecological clinics, 262 consecutive women referred for complaints of lower urinary tract dysfunction and prolapse underwent an interview, clinical assessment and 3D translabial ultrasound imaging. Blinded offline analysis of volume datasets was performed at a later date using 4D View software. Main outcome measures were craniocaudal and ventrodorsal extent of defects of the pubovisceral muscle.


RESULTS
Avulsion injuries were diagnosed in 50 women (19%; 21.3% of the vaginally parous). Defects were found unilaterally (right, n = 17; left, n = 12) and bilaterally (n = 21). In some women they affected the entire volume; in others defects were visible in only two of 16 slices. Hiatal area on Valsalva was correlated weakly with defect score (r = 0.28, P = 0.05) and total defect width (r = 0.4, P = 0.005). Defect score (P = 0.001) and maximum width (P = 0.002) were significantly higher in women who presented with symptoms of prolapse. Defect score was associated with cystocele as assessed clinically (P = 0.021) and on ultrasound (P = 0.014).


CONCLUSIONS
Depth and width of levator ani defects can be quantified by tomographic pelvic floor ultrasound. These parameters are associated with the likelihood of symptoms of prolapse and cystocele descent, but not with incontinence.
Beneficial Effects of Early Enteral Nutrition After Major Rectal Surgery: A Possible Role for Conditionally Essential Amino Acids? Results of a Randomized Clinical Trial.

OBJECTIVES
To investigate direct postoperative outcome and plasma amino acid concentrations in a study comparing early enteral nutrition versus early parenteral nutrition after major rectal surgery. Previously, it was shown that a low plasma glutamine concentration represents poor prognosis in ICU patients.


DESIGN
A preplanned substudy of a previous prospective, randomized, open-label, single-centre study, comparing early enteral nutrition versus early parenteral nutrition in patients at high risk of postoperative ileus after surgery for locally advanced or locally recurrent rectal cancer. Early enteral nutrition reduced postoperative ileus, anastomotic leakage, and hospital stay.


SETTING
Tertiary referral centre for locally advanced and recurrent rectal cancer.


PATIENTS
A total of 123 patients with locally advanced or recurrent rectal carcinoma requiring major rectal surgery.


INTERVENTIONS
Patients were randomized (ALEA web-based external randomization) preoperatively into two groups: early enteral nutrition (early enteral nutrition, intervention) by nasojejunal tube (n = 61) or early parenteral nutrition (early parenteral nutrition, control) by jugular vein catheter (n = 62). Eight hours after the surgical procedure artificial nutrition was started in hemodynamically stable patients, stimulating oral intake in both groups. Blood samples were collected to measure plasma glutamine, citrulline, and arginine concentrations using a validated ultra performance liquid chromatography-tandem mass spectrometric method.


MEASUREMENTS AND MAIN RESULTS
Baseline concentrations were comparable for both groups. Directly after rectal surgery, a decrease in plasma amino acids was observed. Plasma glutamine concentrations were higher in the parenteral group than in the enteral group on postoperative day 1 (p = 0.027) and day 5 (p = 0.008). Arginine concentrations were also significantly increased in the parenteral group at day 1 (p < 0.001) and day 5 (p = 0.001).


CONCLUSIONS
Lower plasma glutamine and arginine concentrations were measured in the enteral group, whereas a better clinical outcome was observed. We conclude that plasma amino acids do not provide a causal explanation for the observed beneficial effects of early enteral feeding after major rectal surgery.
High-density MIM capacitors using Al2O3 and AlTiOx dielectrics

We have investigated the electrical characteristics of Al/sub 2/O/sub 3/ and AlTiO/sub x/ MIM capacitors from the IF (100 KHz) to RF (20 GHz) frequency range. Record high capacitance density of 0.5 and 1.0 /spl mu/F/cm/sup 2/ are obtained for Al/sub 2/O/sub 3/ and AlTiO/sub x/ MIM capacitors, respectively, and the fabrication process is compatible to existing VLSI backend integration. However, the AlTiO/sub x/ MIM capacitor has very large capacitance reduction at increasing frequencies. In contrast, good device integrity has been obtained for the Al/sub 2/O/sub 3/ MIM capacitor as evidenced from the small frequency dependence, low leakage current, good reliability, small temperature coefficient, and low loss tangent.
Investigation in Wireless Power Transmission for UAV Charging

This paper proposes application of wireless power transfer for charging of electric-powered Unmanned Air Vehicles (UAV)s. Multi-rotor systems, such as quadrotors, are light-weight and easy to operate. They are available in different sizes and with the wide range of capabilities. The main limitation of electric-powered UAVs is their range and endurance, due the limited battery capacity. Increasing battery system size is not a viable solution as its weight becomes a limiting factor. Supercapacitors are not an option, because of their low energy density. An alternative is to recharge UAV on the job, using wireless energy transfer (WET). WET was originally investigated by Nikola Tesla in the beginning of the 20 century. His patents are now common ground for any power transmission technology research, both wired and wireless. Investigations in resonance-based wireless energy transfer promise efficient wireless power transmission over several meters. This offers an ability to recharge moving vehicles, such as cars, trains and UAVs, wirelessly. For example, this technology can be applied to extend the range of UAVs used for the inspection of power transmission lines and towers. Presented project investigate capabilities and limitations of the wireless power transmission, for particular UAV application, i.e. for the infrastructure inspections. © 2015 The Authors. Published by Elsevier B.V. Peer-review under responsibility of KES International.
Cost-effectiveness of evidence-based pharmacotherapy or cognitive behavior therapy compared with community referral for major depression in predominantly low-income minority women.

BACKGROUND
Few clinical trials have evaluated interventions for major depressive disorder in samples of low-income minority women, and little is known about the cost-effectiveness of depression interventions for this population.


OBJECTIVE
To evaluate the cost-effectiveness of pharmacotherapy or cognitive behavior therapy (CBT) compared with community referral for major depression in low-income minority women.


DESIGN, SETTING, AND PARTICIPANTS
A randomized clinical trial was conducted in 267 women with current major depression.


INTERVENTIONS
Participants were randomly assigned to pharmacotherapy (paroxetine hydrochloride or bupropion hydrochloride) (n = 88), CBT (n = 90), or community referral (n = 89).


MAIN OUTCOME MEASURES
The main outcomes were intervention and health care costs, depression-free days, and quality-adjusted life years based on Hamilton Depression Rating Scale scores and Medical Outcomes Study 36-Item Short-Form Health Survey summary scores for 12 months. Cost-effectiveness ratios were estimated to compare incremental patient outcomes with incremental costs for pharmacotherapy relative to community referral and for CBT relative to community referral.


RESULTS
Compared with the community referral group, the pharmacotherapy group had significantly lower adjusted mean Hamilton Depression Rating Scale scores from the 3rd month through the 10th month (P = .04 to P<.001) of the study, and the CBT group had significantly lower adjusted mean scores from the 5th month through the 10th month (P = .03 to P = .049). There were significantly more depression-free days in the pharmacotherapy group (mean, 39.7; 95% confidence interval, 12.9-66.5) and the CBT group (mean, 25.80; 95% confidence interval, 0.04-51.50) than in the community referral group. The cost per additional depression-free day was USD 24.65 for pharmacotherapy and USD 27.04 for CBT compared with community referral.


CONCLUSIONS
Effective treatment for depression in low-income minority women reduces depressive symptoms but increases costs compared with community referral. The pharmacotherapy and CBT interventions were cost-effective relative to community referral for the health care system.
A Temperature Compensated Smart Nitrate-Sensor for Agricultural Industry

Extended research on the design and development of a smart nitrate sensor for monitoring nitrate concentration in surface and groundwater are reported in this paper. The developed portable sensing system consists of a planar interdigital sensor, associated electronics, instrumentation, and electrochemical impedance spectroscopy based analysis. The system is capable of measuring nitrate concentrations in the range of 0.01–0.5 mg/L in ground and surface water. This paper extends our earlier work by including a temperature compensation capacity within the sensor. WiFi-based Internet of Things (IoT) has been included, making it a connected sensing system. The system is capable of sending data directly to an IoT-based web server, which will be useful to develop distributed monitoring systems in the future. The developed system has the potential to monitor the impact of industrial, agricultural, or urban activity on water quality, in real time.