LLukas22/scidocs huggingface dataset:
Treatment maintenance duration of dual therapy with metformin and sitagliptin in type 2 diabetes: The ODYSSEE observational study.

AIM
The study compared the duration of maintenance of treatment in patients with type 2 diabetes (T2D) using dual therapy with either metformin and sitagliptin (M-Sita) or metformin and a sulphonylurea (M-SU).


MATERIALS AND METHODS
This observational study included adult patients with T2D who had responded inadequately to metformin monotherapy and therefore had started de-novo treatment with Met-Sita or Met-SU within the previous eight weeks. Patient follow-up and changes to treatment were performed according to their general practitioner's usual clinical practice. The primary outcome was time to change in treatment for whatever cause. HbA1c and symptomatic hypoglycaemia were also documented.


RESULTS
The median treatment duration for patients in the M-Sita group (43.2 months) was significantly longer (P < 0.0001) than in the M-SU group (20.2 months). This difference persisted after adjusting for baseline differences and confounders. A similar reduction in HbA1c was noted in both arms (-0.6%), and the incidence of hypoglycaemia prior to treatment modification was lower with M-Sita (9.7%) than with M-SU (21.0%). Adverse events potentially related to treatment were reported in 2.8% (n = 52) and 2.7% (n = 20) of patients in the M-Sita and M-SU arms, respectively.


CONCLUSION
Under everyday conditions of primary diabetes care, dual therapy with M-Sita can be maintained for longer than M-SU. In addition, while efficacy, as measured by changes in HbA1c, was similar between treatments, the incidence of hypoglycaemia was lower in patients taking M-Sita.
Randomized controlled trial of a nurse-led rheumatology clinic for monitoring biological therapy

AIM
To compare and evaluate the treatment outcomes of a nurse-led rheumatology clinic and a rheumatologist-led clinic in patients with low disease activity or in remission who are undergoing biological therapy.


BACKGROUND
Patients with chronic inflammatory arthritis treated with biological therapy are usually monitored by rheumatologists. Nurse-led rheumatology clinics have been proposed in patients with low disease activity or in remission.


DESIGN
Randomized controlled trial.


METHODS
A 12-month follow-up trial was conducted between October 2009 and August 2011, where 107 patients were randomized into two groups with a 6-month follow-up to a nurse-led rheumatology clinic based on person-centred care (intervention group; n = 53) or to a rheumatologist-led clinic (control group; n = 54). The hypothesis was that the nurse-led clinic outcomes would not be inferior to those obtained from a rheumatologist-led clinic at the 12-month follow-up. The primary outcome was disease activity measured by Disease Activity Score 28.


RESULTS
A total of 47 patients in the intervention group and 50 in the control group completed the 12-month trial. The trial revealed no statistically significant differences between groups in mean change of Disease Activity Score 28, Visual Analogue Scales for pain, the Health Assessment Questionnaire, satisfaction with or confidence in obtaining rheumatology care.


CONCLUSION
Patients with stable chronic inflammatory arthritis undergoing biological therapy could be monitored by a nurse-led rheumatology clinic without difference in outcome as measured by the Disease Activity Score 28.
The recent excitement about neural networks

The remarkable properties of some recent computer algorithms for neural networks seemed to promise a fresh approach to understanding the computational properties of the brain. Unfortunately most of these neural nets are unrealistic in important respects.
Which sexual abuse victims receive a forensic medical examination? The impact of Children's Advocacy Centers.

OBJECTIVE
This study examines the impact of Children's Advocacy Centers (CAC) and other factors, such as the child's age, alleged penetration, and injury on the use of forensic medical examinations as part of the response to reported child sexual abuse.


METHODS
This analysis is part of a quasi-experimental study, the Multi-Site Evaluation of Children's Advocacy Centers, which evaluated four CACs relative to within-state non-CAC comparison communities. Case abstractors collected data on forensic medical exams in 1,220 child sexual abuse cases through review of case records.


RESULTS
Suspected sexual abuse victims at CACs were two times more likely to have forensic medical examinations than those seen at comparison communities, controlling for other variables. Girls, children with reported penetration, victims who were physically injured while being abused, White victims, and younger children were more likely to have exams, controlling for other variables. Non-penetration cases at CACs were four times more likely to receive exams as compared to those in comparison communities. About half of exams were conducted the same day as the reported abuse in both CAC and comparison communities. The majority of caregivers were very satisfied with the medical professional. Receipt of a medical exam was not associated with offenders being charged.


CONCLUSIONS
Results of this study suggest that CACs are an effective tool for furthering access to forensic medical examinations for child sexual abuse victims.
Sleep and use of electronic devices in adolescence: results from a large population-based study

OBJECTIVES
Adolescents spend increasingly more time on electronic devices, and sleep deficiency rising in adolescents constitutes a major public health concern. The aim of the present study was to investigate daytime screen use and use of electronic devices before bedtime in relation to sleep.


DESIGN
A large cross-sectional population-based survey study from 2012, the youth@hordaland study, in Hordaland County in Norway.


SETTING
Cross-sectional general community-based study.


PARTICIPANTS
9846 adolescents from three age cohorts aged 16-19. The main independent variables were type and frequency of electronic devices at bedtime and hours of screen-time during leisure time.


OUTCOMES
Sleep variables calculated based on self-report including bedtime, rise time, time in bed, sleep duration, sleep onset latency and wake after sleep onset.


RESULTS
Adolescents spent a large amount of time during the day and at bedtime using electronic devices. Daytime and bedtime use of electronic devices were both related to sleep measures, with an increased risk of short sleep duration, long sleep onset latency and increased sleep deficiency. A dose-response relationship emerged between sleep duration and use of electronic devices, exemplified by the association between PC use and risk of less than 5 h of sleep (OR=2.70, 95% CI 2.14 to 3.39), and comparable lower odds for 7-8 h of sleep (OR=1.64, 95% CI 1.38 to 1.96).


CONCLUSIONS
Use of electronic devices is frequent in adolescence, during the day as well as at bedtime. The results demonstrate a negative relation between use of technology and sleep, suggesting that recommendations on healthy media use could include restrictions on electronic devices.
Using Combinatorial Optimization within Max-Product Belief Propagation

In general, the problem of computing a maximum a posteriori (MAP) assignment in a Markov random field (MRF) is computationally intractable. However, in certain subclasses of MRF, an optimal or close-to-optimal assignment can be found very efficiently using combinatorial optimization algorithms: certain MRFs with mutual exclusion constraints can be solved using bipartite matching, and MRFs with regular potentials can be solved using minimum cut methods. However, these solutions do not apply to the many MRFs that contain such tractable components as sub-networks, but also other non-complying potentials. In this paper, we present a new method, called COMPOSE, for exploiting combinatorial optimization for sub-networks within the context of a max-product belief propagation algorithm. COMPOSE uses combinatorial optimization for computing exact maxmarginals for an entire sub-network; these can then be used for inference in the context of the network as a whole. We describe highly efficient methods for computing max-marginals for subnetworks corresponding both to bipartite matchings and to regular networks. We present results on both synthetic and real networks encoding correspondence problems between images, which involve both matching constraints and pairwise geometric constraints. We compare to a range of current methods, showing that the ability of COMPOSE to transmit information globally across the network leads to improved convergence, decreased running time, and higher-scoring assignments.
Effects of caffeine on performance and mood depend on the level of caffeine abstinence

Abstract Rationale. Most studies of the effects of caffeine on performance have used regular caffeine consumers who are deprived at test. Thus the reported effects of caffeine could be explained through reversal of caffeine withdrawal. Objectives. To test how preloading deprived caffeine consumers with 0, 1 or 2 mg/kg caffeine altered the subsequent ability of caffeine to modify mood and performance. Methods. Thirty moderate caffeine consumers were given a drink containing 0, 1 or 2 mg/kg caffeine at breakfast followed 60 min later by a second drink containing either 0 or 1 mg/kg caffeine. Performance on a measure of sustained attention and mood were measured before and after each drink. Results. Administration of both 1 and 2 mg/kg caffeine at breakfast decreased reaction time and 1 mg/kg caffeine also increased performance accuracy on the sustained attention (RVIP) task relative to placebo. Both breakfast doses of caffeine also improved rated mental alertness. Similarly, 1 mg/kg caffeine administered 60 min after breakfast decreased reaction time and increased rated mental alertness in the group who had not been given caffeine at breakfast. However, this second dose of caffeine had no effect on subsequent performance or mood in the two groups who had received caffeine at breakfast. Conclusions. Caffeine reliably improved performance on a sustained attention task, and increased rated mental alertness, in moderate caffeine consumers who were tested when caffeine-deprived. However, caffeine had no such effects when consumers were no longer caffeine deprived. These data are consistent with the view that reversal of caffeine withdrawal is a major component of the effects of caffeine on mood and performance.
Bendamustine in patients with rituximab-refractory indolent and transformed non-Hodgkin's lymphoma: results from a phase II multicenter, single-agent study.

PURPOSE
Bendamustine hydrochloride is an alkylating agent with novel mechanisms of action. This phase II multicenter study evaluated the efficacy and toxicity of bendamustine in patients with B-cell non-Hodgkin's lymphoma (NHL) refractory to rituximab.


PATIENTS AND METHODS
Patients received bendamustine 120 mg/m(2) intravenously on days 1 and 2 of each 21-day cycle. Outcomes included response, duration of response, progression-free survival, and safety.


RESULTS
Seventy-six patients, ages 38 to 84 years, with predominantly stage III/IV indolent (80%) or transformed (20%) disease were treated; 74 were assessable for response. Twenty-four (32%) were refractory to chemotherapy. Patients received a median of two prior unique regimens. An overall response rate of 77% (15% complete response, 19% unconfirmed complete response, and 43% partial) was observed. The median duration of response was 6.7 months (95% CI, 5.1 to 9.9 months), 9.0 months (95% CI, 5.8 to 16.7) for patients with indolent disease, and 2.3 months (95% CI, 1.7 to 5.1) for those with transformed disease. Thirty-six percent of these responses exceeded 1 year. The most frequent nonhematologic adverse events included nausea and vomiting, fatigue, constipation, anorexia, fever, cough, and diarrhea. Grade 3 or 4 reversible hematologic toxicities included neutropenia (54%), thrombocytopenia (25%), and anemia (12%).


CONCLUSION
Single-agent bendamustine produced durable objective responses with acceptable toxicity in heavily pretreated patients with rituximab-refractory, indolent NHL. These findings are promising and will serve as a benchmark for future clinical trials in this novel patient population.
Multivariate spatial U-quantiles: A Bahadur–Kiefer representation, a Theil–Sen estimator for multiple regression, and a robust dispersion estimator

A leading multivariate extension of the univariate quantiles is the so-called “spatial” or “geometric” notion, for which sample versions are highly robust and conveniently satisfy a Bahadur-Kiefer representation. Another extension of univariate quantiles has been to univariate U-quantiles, on the basis of which, for example, the well-known Hodges-Lehmann location estimator has a natural formulation. Generalizing both extensions, we introduce multivariate spatial U-quantiles and develop a corresponding Bahadur-Kiefer representation. New statistics based on spatial U-quantiles are presented for nonparametric estimation of multiple regression coefficients, extending the classical Theil-Sen nonparametric simple linear regression slope estimator, and for robust estimation of multivariate dispersion. Some other applications are mentioned as well. AMS 2000 Subject Classification: Primary 62G99 Secondary 60F15.
Dupilumab treatment in adults with moderate-to-severe atopic dermatitis.

BACKGROUND
Dupilumab, a fully human monoclonal antibody that blocks interleukin-4 and interleukin-13, has shown efficacy in patients with asthma and elevated eosinophil levels. The blockade by dupilumab of these key drivers of type 2 helper T-cell (Th2)-mediated inflammation could help in the treatment of related diseases, including atopic dermatitis.


METHODS
We performed randomized, double-blind, placebo-controlled trials involving adults who had moderate-to-severe atopic dermatitis despite treatment with topical glucocorticoids and calcineurin inhibitors. Dupilumab was evaluated as monotherapy in two 4-week trials and in one 12-week trial and in combination with topical glucocorticoids in another 4-week study. End points included the Eczema Area and Severity Index (EASI) score, the investigator's global assessment score, pruritus, safety assessments, serum biomarker levels, and disease transcriptome.


RESULTS
In the 4-week monotherapy studies, dupilumab resulted in rapid and dose-dependent improvements in clinical indexes, biomarker levels, and the transcriptome. The results of the 12-week study of dupilumab monotherapy reproduced and extended the 4-week findings: 85% of patients in the dupilumab group, as compared with 35% of those in the placebo group, had a 50% reduction in the EASI score (EASI-50, with higher scores in the EASI indicating greater severity of eczema) (P<0.001); 40% of patients in the dupilumab group, as compared with 7% in the placebo group, had a score of 0 to 1 (indicating clearing or near-clearing of skin lesions) on the investigator's global assessment (P<0.001); and pruritus scores decreased (indicating a reduction in itch) by 55.7% in the dupilumab group versus 15.1% in the placebo group (P<0.001). In the combination study, 100% of the patients in the dupilumab group, as compared with 50% of those who received topical glucocorticoids with placebo injection, met the criterion for EASI-50 (P=0.002), despite the fact that patients who received dupilumab plus glucocorticoids used less than half the amount of topical glucocorticoids used by those who received placebo plus the topical medication (P=0.16). Adverse events, such as skin infection, occurred more frequently with placebo; nasopharyngitis and headache were the most frequent adverse events with dupilumab.


CONCLUSIONS
Patients treated with dupilumab had marked and rapid improvement in all the evaluated measures of atopic dermatitis disease activity. Side-effect profiles were not dose-limiting. (Funded by Regeneron Pharmaceuticals and Sanofi; ClinicalTrials.gov numbers, NCT01259323, NCT01385657, NCT01639040, and NCT01548404.).
Caffeine can decrease insulin sensitivity in humans.

OBJECTIVE
Caffeine is a central stimulant that increases the release of catecholamines. As a component of popular beverages, caffeine is widely used around the world. Its pharmacological effects are predominantly due to adenosine receptor antagonism and include release of catecholamines. We hypothesized that caffeine reduces insulin sensitivity, either due to catecholamines and/or as a result of blocking adenosine-mediated stimulation of peripheral glucose uptake.


RESEARCH DESIGN AND METHODS
Hyperinsulinemic-euglycemic glucose clamps were used to assess insulin sensitivity. Caffeine or placebo was administered intravenously to 12 healthy volunteers in a randomized, double-blind, crossover design. Measurements included plasma levels of insulin, catecholamines, free fatty acids (FFAs), and hemodynamic parameters. Insulin sensitivity was calculated as whole-body glucose uptake corrected for the insulin concentration. In a second study, the adenosine reuptake inhibitor dipyridamole was tested using an identical protocol in 10 healthy subjects.


RESULTS
Caffeine decreased insulin sensitivity by 15% (P < 0.05 vs. placebo). After caffeine administration, plasma FFAs increased (P < 0.05) and remained higher than during placebo. Plasma epinephrine increased fivefold (P < 0.0005), and smaller increases were recorded in plasma norepinephrine (P < 0.02) and blood pressure (P < 0.001). Dipyridamole did not alter insulin sensitivity and only increased plasma norepinephrine (P < 0.01).


CONCLUSIONS
Caffeine can decrease insulin sensitivity in healthy humans, possibly as a result of elevated plasma epinephrine levels. Because dipyridamole did not affect glucose uptake, peripheral adenosine receptor antagonism does not appear to contribute to this effect.
Randomised trial of ambulatory oxygen in oxygen-dependent COPD.

We would like to thank T.L. Petty for his interesting comments regarding our trial of ambulatory oxygen (AO) in chronic obstructive pulmonary disease (COPD) [1]. The question raised by T.L. Petty was the following: when is the best time to initiate AO in oxygen-dependent COPD? He suggested AO should be provided as early as possible after the introduction of long-term oxygen therapy (LTOT) to avoid rapid adjustment to the limitations imposed by the stationary oxygen delivery system.
CRCTOL: A semantic-based domain ontology learning system

Keywords: ontologies < controlled vocabularies < index languages < language types < (language), knowledge acquisition < knowledge engineering < artificial intelligence < computer applications < computer operations < (activities and operations)
APPLICATION OF SELF-TUNING FUZZY PID CONTROLLER ON INDUSTRIAL HYDRAULIC ACTUATOR USING SYSTEM IDENTIFICATION APPROACH

In this paper, Self Tuning Fuzzy PID controller is developed to improve the performance of the electro-hydraulic actuator. The controller is designed based on the mathematical model of the system which is estimated by using System Identification technique. The model is performed in linear discrete model to obtain a discrete transfer function for the system. Model estimation procedures are done by using System Identification Toolbox in Matlab. Data for model estimation is taken from an experimental works. Fuzzy logic is used to tune each parameter of PID controller. Through simulation in Matlab by selecting appropriate fuzzy rules are designed to tune the parameters Kp, Ki and Kd of the PID controller, the performance of the hydraulic system has improved significantly compare to conventional PID controller.
Zooming in on Barrett oesophagus using narrow-band imaging: an international observer agreement study.

BACKGROUND
Several classifications of mucosal morphology have been proposed in Barrett oesophagus using narrow-band imaging (NBI). We evaluated a simplified classification in which only the regularity of mucosal and vascular patterns were evaluated.


AIM
To assess the inter and intraobserver agreement and the correlation with histology of a simplified NBI classification of mucosal morphology in Barrett oesophagus combining the experience of two referral centres.


METHODS
Two hundred NBI images [57 high-grade intraepithelial neoplasia (HGIN)/early cancer (EC)] were evaluated twice by four NBI-experienced and four nonexperienced endoscopists in the field of NBI. Endoscopists assessed each image for: quality, suspicion for dysplasia, and regularity of mucosal and vascular patterns. Observer agreement was assessed using kappa statistics.


RESULTS
Overall interobserver agreement for the items evaluated was 'moderate' and varied between 0.42 and 0.44. Overall intraobserver agreement was 'moderate' to 'substantial' (kappa 0.60-0.62). There were no significant differences in agreement between expert and nonexpert endoscopists. Endoscopist correctly identified 71% of the images containing HGIN/EC. Of the areas without HGIN/EC, 68% were correctly identified as not suspicious. Again, there were no significant differences between experts and nonexperts.


CONCLUSION
Our proposed, simplified classification for Barrett mucosal morphology has a moderate interobserver and a moderate to substantial intraobserver agreement. The lack of differences in agreements between expert and nonexpert endoscopists suggests a short learning curve. The disappointing rate for correctly indentifying HGIN/EC, questions, however, whether detailed inspection of Barrett oesophagus with NBI can replace histological sampling.
Development and validation of the Italian version of the Spinal Cord Independence Measure III.

PURPOSE
To provide a translation and cultural adaptation of the Spinal Cord Independence Measure version III scale for Italy (i-SCIM3) and to validate this version of the scale.


METHOD
i-SCIM3 was developed involving a forward-backward translation and administered to patients with spinal cord lesions (SCL) admitted to two centers. Two raters for each center evaluated patients at admission and discharge. Psychometric testing included reliability by internal consistency (Cronbach's alpha) and test-retest reliability. The validity of i-SCIM3 was assessed by comparing it with the Italian version of Functional Independence Measure (FIM).


RESULTS
One hundred three adult patients with SCL (84 males) with a mean age of 50.33+/-15.35 years were recruited. Seventy-four patients were paraplegic and 29 patients were tetraplegic. The median time elapsed between the two evaluations was 77.5 days (interquartile range, 53-144 days). Internal consistency, inter-rater reliability, and test-retest reliability were satisfactory overall, showing values higher than 0.90. The validity of i-SCIM3 was confirmed by the close correlation with FIM results both at admission and discharge (r=0.91, p<0.01). The sensitivity to change of i-SCIM3 was similar to that of FIM.


CONCLUSION
i-SCIM3 was found to be a consistent, reliable, and valid scale for use in the clinical setting. It is the first validated scale in Italian for patients with SCL.