LLukas22/scidocs huggingface dataset:
Withdrawal from treatment as an outcome in the ISOLDE study of COPD.

OBJECTIVES
To investigate the determinants of patient withdrawal from our study, and the effect of these withdrawals on the outcome of treatment with inhaled corticosteroids in patients with COPD.


DESIGN
A double-blind, placebo-controlled, randomized trial.


SETTING
Eighteen outpatient centers in the United Kingdom.


PARTICIPANTS
Seven hundred fifty-one patients with stable COPD defined clinically and as baseline postbronchodilator FEV(1) > or = 0.8 L and < 85% predicted, FEV(1)/FVC ratio < 70%, and FEV(1) change after albuterol < 10% of predicted.


INTERVENTION
Random assignment of either 500 microg bid of inhaled fluticasone propionate (FP) using a spacer device or an identical placebo inhaler. Treatment was continued for 3 years or until patients withdrew from follow-up.


MEASUREMENTS AND RESULTS
Postbronchodilator FEV(1) was measured on three occasions before randomization and every 3 months thereafter. Health status was assessed by the disease-specific St. George Respiratory Questionnaire (SGRQ) and the modified short-form 36 questionnaire (SF-36) at baseline and every 6 months. Three hundred thirty-nine patients withdrew, of whom 156 patients received FP. Prescription of frequent courses of oral prednisolone was the most common reason for withdrawing as specified in the protocol (69 patients in the FP group withdrew due to respiratory symptoms, compared with 93 patients in the placebo group). This explained the significantly greater dropout of placebo-treated patients that was most evident when FEV(1) was < 50% predicted. Patients withdrawing had a significantly more rapid decline in health status, measured by both the SGRQ and the SF-36 (p < 0.001). Those withdrawing from the placebo group had a more rapid decline in FEV(1) and more exacerbations than the FP-treated groups. Baseline FEV(1) was lower in dropouts than in patients completing the study receiving placebo, but there was no difference between the respective groups receiving FP.


CONCLUSIONS
Patients who withdrew from follow-up were those with the most rapidly deteriorating health status and lung function. Losing these patients from the final analysis can reduce the power of a study to achieve its primary end point.
Topology and Modulation for a New Multilevel Diode-Clamped Matrix Converter

To expand the matrix converter application in high power area, a new three-level diode-clamped matrix converter topology as well as a related multicarrier-based modulation scheme is proposed. The topology inherits the features from the conventional multilevel inverter and the indirect matrix converter, which is composed of a cascaded-rectifier and a three-level diode-clamped inverter. The proposed topology can overcome the voltage rating limits of the power semiconductors for high-voltage applications to some extent. Meanwhile, except the general advantages, such as bidirectional power flow, sinusoidal input and output currents, simple switch commutation, and a compact structure, it also avoids the voltage balance issue that exists in most conventional multilevel inverters. Finally, the functionality and effectiveness of the proposed topology and modulation scheme are verified by simulation and experimental results.
Power Allocation and Subcarrier Pairing for OFDM-Based AF Cooperative Diversity Systems

In this paper, a two-hop amplify-and-forward cooperative diversity system using OFDM modulation was considered. We proposed an associated waterfilling power allocation scheme under separate power constraints at source and relay, which allocated source and relay power in an associated fashion. The scheme first allocated power to subcarriers uniformly, then gave an approximate equivalent channel gain model, and last employed the classic waterfilling algorithm to optimize the power allocation at relay and source, respectively. Moreover, we investigated the subcarrier pairing problem and presented a modified sorted subcarrier pairing algorithm, which considered the effect of source-destination link as well as source-relay link. The simulation results show that the associated waterfilling power allocation scheme and the modified sorted subcarrier pairing algorithm both could achieve higher average rate alone, and that the combination of them could improve the performance further. Keywordsamplify-and-forward; orthogonal frequency division multiplexing; power allocation; subcarrier pairing.
Prevention of non-contact anterior cruciate ligament injuries in soccer players. Part 1: Mechanisms of injury and underlying risk factors

Soccer is the most commonly played sport in the world, with an estimated 265 million active soccer players by 2006. Inherent to this sport is the higher risk of injury to the anterior cruciate ligament (ACL) relative to other sports. ACL injury causes the most time lost from competition in soccer which has influenced a strong research focus to determine the risk factors for injury. This research emphasis has afforded a rapid influx of literature defining potential modifiable and non-modifiable risk factors that increase the risk of injury. The purpose of the current review is to sequence the most recent literature that reports potential mechanisms and risk factors for non-contact ACL injury in soccer players. Most ACL tears in soccer players are non-contact in nature. Common playing situations precluding a non-contact ACL injury include: change of direction or cutting maneuvers combined with deceleration, landing from a jump in or near full extension, and pivoting with knee near full extension and a planted foot. The most common non-contact ACL injury mechanism include a deceleration task with high knee internal extension torque (with or without perturbation) combined with dynamic valgus rotation with the body weight shifted over the injured leg and the plantar surface of the foot fixed flat on the playing surface. Potential extrinsic non-contact ACL injury risk factors include: dry weather and surface, and artificial surface instead of natural grass. Commonly purported intrinsic risk factors include: generalized and specific knee joint laxity, small and narrow intercondylar notch width (ratio of notch width to the diameter and cross sectional area of the ACL), pre-ovulatory phase of menstrual cycle in females not using oral contraceptives, decreased relative (to quadriceps) hamstring strength and recruitment, muscular fatigue by altering neuromuscular control, decreased “core” strength and proprioception, low trunk, hip, and knee flexion angles, and high dorsiflexion of the ankle when performing sport tasks, lateral trunk displacement and hip adduction combined with increased knee abduction moments (dynamic knee valgus), and increased hip internal rotation and tibial external rotation with or without foot pronation. The identified mechanisms and risk factors for non-contact ACL injuries have been mainly studied in female soccer players; thus, further research in male players is warranted. Non-contact ACL injuries in soccer players likely has a multi-factorial etiology. The identification of those athletes at increased risk may be a salient first step before designing and implementing specific pre-season and in-season training programs aimed to modify the identified risk factors and to decrease ACL injury rates. Current evidence indicates that this crucial step to prevent ACL injury is the only option to effectively prevent the sequelae of osteoarthritis associated with this traumatic injury.
Education and Dementia in the Context of the Cognitive Reserve Hypothesis: A Systematic Review with Meta-Analyses and Qualitative Analyses

BACKGROUND
Cognitive reserve (CR) or brain reserve capacity explains why individuals with higher IQ, education, or occupational attainment have lower risks of developing dementia, Alzheimer's disease (AD) or vascular dementia (VaD). The CR hypothesis postulates that CR reduces the prevalence and incidence of AD or VaD. It also hypothesizes that among those who have greater initial cognitive reserve (in contrast to those with less reserve) greater brain pathology occurs before the clinical symptoms of disease becomes manifest. Thus clinical disease onset triggers a faster decline in cognition and function, and increased mortality among those with initial greater cognitive reserve. Disease progression follows distinctly separate pathological and clinical paths. With education as a proxy we use meta-analyses and qualitative analyses to review the evidence for the CR hypothesis.


METHODOLOGY/PRINCIPAL FINDINGS
We searched PubMed, PsycoINFO, EMBASE, HealthStar, and Scopus databases from January 1980 to June 2011 for observational studies with clear criteria for dementia, AD or VaD and education. One hundred and thirty-three articles with a variety of study designs met the inclusion criteria. Prevalence and incidence studies with odds ratios (ORs), relative risks or original data were included in the meta-analyses. Other studies were reviewed qualitatively. The studies covered 437,477 subjects. Prevalence and incidence studies with pooled ORs of 2.61 (95%CI 2.21-3.07) and 1.88 (95%CI 1.51-2.34) respectively, showed low education increased the risk of dementia. Heterogeneity and sensitivity tests confirmed the evidence. Generally, study characteristics had no effect on conclusions. Qualitative analyses also showed the protective effects of higher education on developing dementia and with clinical disease onset hastening a decline in cognition and function, and greater brain pathology.


CONCLUSION/SIGNIFICANCE
This systematic review and meta-analyses covering a wide range of observational studies and diverse settings provides robust support for the CR hypothesis. The CR hypothesis suggests several avenues for dementia prevention.
End-to-End Cervical Esophagogastric Anastomoses Are Associated with a Higher Number of Strictures Compared with End-to-Side Anastomoses

Leakage and benign strictures occur frequently after esophagectomy. The objective of this study was to analyze the outcome of hand-sewn end-to-end versus end-to-side cervical esophagogastric anastomoses. A series of 390 consecutive patients who underwent esophagectomy with gastric conduit reconstruction was analyzed. The end-to-end technique was performed in 112 (29 %) patients and the end-to-side in 278 (71 %) patients. Anastomotic leakage occurred in 20 (18 %) patients with an end-to-end anastomosis versus 58 (21 %) patients with an end-to-side anastomosis (p = 0.50). A higher incidence in anastomotic strictures was seen in end-to-end anastomoses (48 (43 %)) compared with end-to-side anastomoses (89 (32 %); p = 0.04). Moreover, a median of 11 (7–17) dilations was necessary in patients with a benign anastomotic stricture in the end-to-end group compared with four (2–8) dilations in patients with a benign anastomotic stricture in the end-to-end group (p < 0.036). After multivariate analysis, the difference in anastomotic leakage rates remained nonsignificant (p = 0.74), whereas anastomotic stricture rate and number of dilations were higher in the end-to-end group (p = 0.03 and p = 0.01, respectively). The technique of anastomosis is not significantly related to anastomotic leakage rate. However, patients with end-to-end anastomoses develop postoperative strictures more frequently, requiring a higher number of dilations compared to end-to-side anastomoses.
Steroid permeation into the artificial ulcer by combined steroid gel application and balloon dilatation: prevention of esophageal stricture.

BACKGROUND AND AIM
Local steroid injection therapy is effective for preventing esophageal stricture after endoscopic submucosal dissection (ESD) but is associated with the risk of puncture-related complications, such as bleeding. We evaluated the effectiveness of the application of triamcinolone acetonide gel following permeation into a large artificial ESD ulcer by balloon dilatation compared with steroid injection.


METHODS
Forty-three patients who underwent ESD for early esophageal cancer approved by the institutional ethics committee and provided consent to participate in this prospective study were divided into two groups using a sealed-envelope randomization method as follows: 23 patients who were treated with local steroid injection and balloon dilatation and 20 patients were treated with steroid application and balloon dilatation. The stricture rate, the number of endoscopic balloon dilatation, and the mean procedure time on postoperative days (PODs) 5, 8, 12, 15, 20, 30, and 60 were analyzed.


RESULTS
No significant difference was found in the stricture rate on PODs 5, 8, 12, 15, 20, 30, and 60 between the two groups. The mean number of endoscopic balloon dilatation procedures performed for treating dysphagia that appeared on or after POD 30 was significantly different between groups (P=0.011). The mean procedure time showed no significant difference. Procedure-related bleeding during the first 30 days was observed more in the local steroid injection group than the gel application group (P=0.02).


CONCLUSIONS
Steroid gel application is an effective way for preventing esophageal stricture after ESD and is more effective compared with local injection in terms of prevention of stricture.
Effects of N : P loading ratios on phytoplankton community composition, primary production and N fixation in a eutrophic lake

TOBIAS VREDE*, ASHLEY BALLANTYNE, CECILIA MILLE-LINDBLOM*, GRETE ALGESTEN*, CRISTIAN GUDASZ , SANDRA LINDAHL* AND ANNA KRISTINA BRUNBERG* *Department of Ecology and Evolution ⁄Limnology, Evolutionary Biology Centre, Uppsala University, Uppsala, Sweden Department of Civil and Environmental Engineering, University of Washington, Seattle, WA, U.S.A. Department of Taxonomy and Ecology, Babes-Bolyai University, Cluj-Napoca, Romania
The Anatomy of Big Data Computing

Advances in information technology and its widespread growth in several areas of business, engineering, medical, and scientific studies are resulting in information/data explosion. Knowledge discovery and decision-making from such rapidly growing voluminous data are a challenging task in terms of data organization and processing, which is an emerging trend known as big data computing, a new paradigm that combines large-scale compute, new data-intensive techniques, and mathematical models to build data analytics. Big data computing demands a huge storage and computing for data curation and processing that could be delivered from on-premise or clouds infrastructures. This paper discusses the evolution of big data computing, differences between traditional data warehousing and big data, taxonomy of big data computing and underpinning technologies, integrated platform of big data and clouds known as big data clouds, layered architecture and components of big data cloud, and finally open-technical challenges and future directions. Copyright © 2015 John Wiley & Sons, Ltd.
Serum interleukin 6 and interleukin 12 levels in children with chronic hepatitis HBV treated with interferon alpha.

INTRODUCTION
The course of HBV infection and the outcome of interferon alpha (IFNalpha) therapy of patients with chronic hepatitis B, is determined by the antiviral immune response of the host. The aim of the study was to investigate 1) the correlation between IL-6 and IL-12 serum levels and biochemical and histopathological changes in children with chronic hepatitis B, 2) predictive value of pre-treatment serum levels of these cytokines in patients treated with interferon alpha and 3) changes in serum levels of these cytokines after interferon alpha treatment.


METHODS
Serum levels of IL-6, IL-12 (heterodimer p70) and IL-12 (heterodimer p70 & p40 subunit) were determined by specific ELISA in 39 children with chronic hepatitis B on the first and the last day of IFNalpha therapy.


RESULTS
Serum levels of IL-6, IL-12 (p70) and IL-12 (p70&p40) were respectively within the following ranges of values: 0-1.7 pg/mL, 3.0-85.1pg/mL, 93.7-442.7 pg/mL and they showed no correlation with biochemical and histopathological changes. The pre-treatment cytokines levels in patients who responded and those who did not respond to IFNa therapy did not differ statistically. There was no statistical difference between the end and pre-treatment cytokines levels in both groups.


CONCLUSIONS
Serum levels of IL-6 and IL-12 do not reflect the inflammatory activity of hepatitis and have no predictive value of positive response to the IFNalpha therapy in children with chronic hepatitis B. Serum IL-6 and IL-12 levels at the end of INFalpha treatment do not inform of their role in immunological changes which take place while inhibition of HBV replication or virus clearance.
Organisational culture and change: implementing person-centred care.

PURPOSE
The purpose of this paper is to explore the connection between organisational cultures and the employee's resistance to change at five hospital wards in Western Sweden. Staff had experienced extensive change during a research project implementing person-centred care (PCC) for patients with chronic heart failure.


DESIGN/METHODOLOGY/APPROACH
Surveys were sent out to 170 nurses. The survey included two instruments--the Organisational Values Questionnaire (OVQ) and the Resistance to Change Scale (RTC).


FINDINGS
The results indicate that a culture with a dominating focus on social competence decreases "routine seeking behaviour", i.e. tendencies to uphold stable routines and a reluctance to give up old habits. The results indicate that a culture of flexibility, cohesion and trust negatively covariate with the overall need for a stable and well-defined framework.


PRACTICAL IMPLICATIONS
An instrument that pinpoints the conditions of a particular healthcare setting can improve the results of a change project. Managers can use instruments such as the ones used in this study to investigate and plan for change processes.


ORIGINALITY/VALUE
Earlier studies of organisational culture and its impact on the performance of healthcare organisations have often investigated culture at the highest level of the organisation. In this study, the culture of the production units--i.e. the health workers in different hospital wards--was described. Hospital wards develop their own culture and the cultures of different wards are mirrored in the hospital.
Effect of epinephrine on lidocaine clearance in vivo: a microdialysis study in humans.

BACKGROUND
Local anesthetic nerve block prolonged by epinephrine is thought to result from local vasoconstriction and consequent decreased local anesthetic clearance from the injection site. However, no study has yet confirmed this directly in humans by measuring tissue concentrations of local anesthetic over time. In addition, recent studies have shown that the alpha2-adrenergic receptor agonist, clonidine, also prolongs nerve block without altering local anesthetic clearance. Because epinephrine is also an alpha2-adrenergic receptor agonist, it is possible that epinephrine prolongs local anesthetic block by a pharmacodynamic mechanism and not a pharmacokinetic one. This study was designed to address this issue.


METHODS
Microdialysis probes were placed adjacent to the superficial peroneal nerve in both feet of eight volunteers. Plain lidocaine (1%) was injected along one peroneal nerve and lidocaine with epinephrine (2.5 microg/ml) was injected along the other nerve in a double-blinded, randomized manner. The concentration of lidocaine in tissue was measured at 5-min intervals, and sensory block and cutaneous blood flow were assessed by laser Doppler at 10-min intervals for 5 h. The resulting data for lidocaine concentration versus time were fit to a two-compartment model using modeling software.


RESULTS
Epinephrine prolonged sensory block by decreasing local blood flow and slowing clearance. There was no evidence of a pharmacodynamic effect of epinephrine.


CONCLUSION
Although epinephrine activates alpha2-adrenergic receptors, its mechanism for prolonging the duration of local anesthetic block rests on its ability to decrease local anesthetic clearance and not on a pharmacodynamically mediated potentiation of local anesthetic effect.
The impact of smallholder irrigation on household welfare: The case of Tugela Ferry irrigation scheme in KwaZulu-Natal, South Africa

The potential of smallholder irrigated agriculture to enhance food security and alleviate rural poverty has led the South African Government to prioritise and invest significantly in irrigation establishment, rehabilitation and revitalisation. The question addressed in this study pertains to the extent to which smallholder irrigation has been able to reduce poverty in the rural communities to justify this investment. Using a sample of 251 farmers, this study found that factors such as land size, perceived soil fertility, household size, and access to support services were significant predictors of irrigation participation. The results from the treatment effect model indicated that access to irrigation plays a positive role in the welfare of rural households, with irrigators spending about ZAR2 000 per adult equivalent on consumption more than the non-irrigators. The study, therefore, concluded that government investments in smallholder irrigation for poverty reduction are justified. The other factors that influenced household consumption were off-farm income, land size, livestock size, education level, family size and access to support services and infrastructure. The study recommends that investments in smallholder irrigation continue for poverty reduction, and that priority should also be on finding other feasible rural micro-projects and development initiatives to complement smallholder irrigation and significantly reduce rural poverty.
Readout electronics for multianode photomultiplier tubes with pad matrix anode layout

We have developed economical readout concept for multianode photomultiplier tubes which have a matrix type pad anode layout. This style of anode layout is used in many position sensitive photomultiplier tubes such as R5900-M64 and recently available flat panel H8500 PMT from Hamamatsu Photonics, as well as the Burle PLANACO/spl trade/ 85011 PSPMT. All these PMTs have a matrix of 8/spl times/8 anode pads requiring signal readout from 64 outputs. The number of readout channels quickly increases in systems utilizing many of these PMTs. In order to reduce the number of active channels to be read we have employed a two-dimensional decoupling resistive matrix circuit. A decoupling resistive matrix was designed to convert the 2-D area readout into a projective two single coordinate readout, and, thereby, to simplify readout electronics. In the case of PMT array, the circuit permits ganging together signals from several of the photomultipliers in the same way as done in the cross-wire photomultiplier tube anode layout. We tested this readout concept in several compact gamma cameras designed and built at Jefferson Lab. The largest size array consists of 3/spl times/4 (12 total) of H8500 photomultiplier tubes with 768 individual anode pad outputs, which were decoupled into 32x+24y (56 total) readout channels, a reduction by factor - 14.
Physical properties and termite durability of maritime pine Pinus pinaster Ait., heat-treated under vacuum pressure

An original heat treatment performed under vacuum pressure was investigated. Maritime pine samples were treated at six different temperatures: 140, 160, 180, 200, 230 and 260°C. The physical and mechanical consequences, i.e. bending strength (MOR), modulus of elasticity (MOE), hygroscopic behaviour, equilibrium moisture contents and anti-swelling efficiency (ASE) were studied. A no-choice feeding test according to the NF EN 117 standard was achieved. Temperatures up to 200°C had no significant effect on wood properties. However, at 230 and 260°C, the decrease in MOR was severe, reaching 42.5 and 62.5%, respectively. Whatever the treatment conditions, wood samples were still highly degraded by termites, revealing no increase in their durability.