LLukas22/scidocs huggingface dataset:
Web-Based STAR E-Learning Course Increases Empathy and Understanding in Dementia Caregivers: Results from a Randomized Controlled Trial in the Netherlands and the United Kingdom

BACKGROUND
The doubling of the number of people with dementia in the coming decades coupled with the rapid decline in the working population in our graying society is expected to result in a large decrease in the number of professionals available to provide care to people with dementia. As a result, care will be supplied increasingly by untrained informal caregivers and volunteers. To promote effective care and avoid overburdening of untrained and trained caregivers, they must become properly skilled. To this end, the European Skills Training and Reskilling (STAR) project, which comprised experts from the domains of education, technology, and dementia care from 6 countries (the Netherlands, Sweden, Italy, Malta, Romania, and the United Kingdom), worked together to create and evaluate a multilingual e-learning tool. The STAR training portal provides dementia care training both for informal and formal caregivers.


OBJECTIVE
The objective of the current study was to evaluate the user friendliness, usefulness, and impact of STAR with informal caregivers, volunteers, and professional caregivers.


METHODS
For 2 to 4 months, the experimental group had access to the STAR training portal, a Web-based portal consisting of 8 modules, 2 of which had a basic level and 6 additional modules at intermediate and advanced levels. The experimental group also had access to online peer and expert communities for support and information exchange. The control group received free access to STAR after the research had ended. The STAR training portal was evaluated in a randomized controlled trial among informal caregivers and volunteers in addition to professional caregivers (N=142) in the Netherlands and the United Kingdom. Assessments were performed with self-assessed, online, standardized questionnaires at baseline and after 2 to 4 months. Primary outcome measures were user friendliness, usefulness, and impact of STAR on knowledge, attitudes, and approaches of caregivers regarding dementia. Secondary outcome measures were empathy, quality of life, burden, and caregivers' sense of competence.


RESULTS
STAR was rated positively by all user groups on both usefulness and user friendliness. Significant effects were found on a person-centered care approach and on the total score on positive attitudes to dementia; both the experimental and the control group increased in score. Regarding empathy, significant improvements were found in the STAR training group on distress, empathic concern, and taking the perspective of the person with dementia. In the experimental group, however, there was a significant reduction in self-reported sense of competence.


CONCLUSIONS
The STAR training portal is a useful and user-friendly e-learning method, which has demonstrated its ability to provide significant positive effects on caregiver attitudes and empathy.
A collective analysis on 54 cases of human myiasis in China from 1995-2001.

PURPOSE
To review 54 cases of human myiasis in China reported from 1995-2001 in order to characterize the current epidemic situation.


DATE SOURCES
All reference data originated from some Chinese literature in Chinese medical journals. Twenty-four short reports published from 1995-2001 were selected according to the stated purpose. Due to the varied outcomes of myiasis at different sites in the body, the present paper is divided into 7 types of infection: ocular, nasal cavity, external auricular, cutaneous, gastrointestinal, urogenital, and traumatic myiasis.


RESULTS
Of these 54 selected cases of myiasis in China from 1995-2001, hypodermic myiasis (31 patients) and ocular myiasis (12 patients) were the most common, comprising 43 cases (80%). The cases were equally distributed amongst both genders. Furthermore, most of the infected were children and infants, totaling 39 cases, or 72%. The regional distribution of myiasis was widespread throughout the sixteen provinces and autonomous regions in question.


CONCLUSIONS
Although not always reported, myiasis is a common zoonotic parasitosis occurring in most of China's territories. Due to its prevalence, preventive measures for myiasis are urgently needed.
The TRAVEE System for a Multimodal Neuromotor Rehabilitation

As more and more people are left disabled by stroke each year, it is of vital importance to progress in the research of new ways to improve their condition and to ensure that they maintain their independence as much as possible in everyday life. A step in this direction of research was taken with TRAVEE, a system dedicated to neuromotor rehabilitation after stroke. To reach this goal, the TRAVEE has benefited from several innovative ideas and technologies—virtual reality, brain–computer interfaces, functional electrical stimulation, robotics, haptics, multimodal feedback, and a novel idea in information and communications technology systems for rehabilitation—visual augmentation as a form of feedback to the patient. Through visual augmentation, the TRAVEE immerses the patient in a virtual environment where his movements are rendered as being better than in the real world, and in this way diminishing his disability. We believe that this process—that is pending for patent—will greatly impact the recovery process after stroke, by providing more motivating sessions, while supporting the cortical reorganization process. This paper presents an overview of the TRAVEE system, the perspectives that supported it, details regarding its development, as well as the results of the clinical tests that were performed with the system.
Automatic Test Case Generation from UML Sequence Diagram

This paper presents a novel approach of generating test cases from UML design diagrams. Our approach consists of transforming a UML sequence diagram into a graph called the sequence diagram graph (SDG) and augmenting the SDG nodes with different information necessary to compose test vectors. These information are mined from use case templates, class diagrams and data dictionary. The SDG is then traversed to generate test cases. The test cases thus generated are suitable for system testing and to detect interaction and scenario faults.
A novel augmented reality system of image projection for image-guided neurosurgery

Augmented reality systems combine virtual images with a real environment. To design and develop an augmented reality system for image-guided surgery of brain tumors using image projection. A virtual image was created in two ways: (1) MRI-based 3D model of the head matched with the segmented lesion of a patient using MRIcro software (version 1.4, freeware, Chris Rorden) and (2) Digital photograph based model in which the tumor region was drawn using image-editing software. The real environment was simulated with a head phantom. For direct projection of the virtual image to the head phantom, a commercially available video projector (PicoPix 1020, Philips) was used. The position and size of the virtual image was adjusted manually for registration, which was performed using anatomical landmarks and fiducial markers position. An augmented reality system for image-guided neurosurgery using direct image projection has been designed successfully and implemented in first evaluation with promising results. The virtual image could be projected to the head phantom and was registered manually. Accurate registration (mean projection error: 0.3 mm) was performed using anatomical landmarks and fiducial markers position. The direct projection of a virtual image to the patients head, skull, or brain surface in real time is an augmented reality system that can be used for image-guided neurosurgery. In this paper, the first evaluation of the system is presented. The encouraging first visualization results indicate that the presented augmented reality system might be an important enhancement of image-guided neurosurgery.
Long-term outcomes of risk-reducing surgery in unaffected women at increased familial risk of breast and/or ovarian cancer

This study prospectively investigated long-term psychosocial outcomes for women who opted for risk-reducing mastectomy (RRM) and/or risk-reducing salpingo-oophorectomy (RRSO). Unaffected women from high-risk breast cancer families who had completed baseline questionnaires for an existing study and subsequently underwent RRM and/or RRSO, completed measures of perceived breast and ovarian cancer risk, anxiety, depression, cancer-related anxiety, body image, sexual functioning, menopausal symptoms, use of hormone replacement therapy and decision regret 3 years post-surgery. Outcomes were compared to age- and risk-matched controls. Participants (N = 233) were 17 women who had RRM (39 controls), 38 women who had RRSO (94 controls) and 15 women who had RRM + RRSO (30 controls). Women who underwent RRM and those who underwent RRM + RRSO reported reductions in perceived breast cancer risk and perceived breast and ovarian cancer risk respectively, compared to their respective controls. RRM women reported greater reductions in cancer-related anxiety compared with both controls and RRSO women. RRSO women reported more sexual discomfort than controls and more urogenital menopausal symptoms than controls and RRM only women. No differences in general anxiety, depression or body image were observed. Regret was associated with greater reductions in body image since surgery and more sexual discomfort, although overall regret levels were low. Women who undergo RRM experience psychological benefits associated with reduced breast cancer risk. Although women who undergo RRSO experience some deterioration in sexual and menopausal symptoms, they do not regret their surgery decision. It is vital that women considering these procedures receive detailed information about potential psychosocial consequences.
Maternal Lipids as Strong Determinants of Fetal Environment and Growth in Pregnancies With Gestational Diabetes Mellitus 

OBJECTIVE
To determine the contribution of maternal glucose and lipids to intrauterine metabolic environment and fetal growth in pregnancies with gestational diabetes mellitus (GDM).


RESEARCH DESIGN AND METHODS
In 150 pregnancies, serum triglycerides (TGs), cholesterol, free fatty acids (FFAs), glycerol, insulin, and glucose were determined in maternal serum and cord blood during the 3rd trimester. Maternal glucose values came from oral glucose tolerance testing and glucose profiles. Measurements of fetal abdominal circumference (AC) were performed simultaneously with maternal blood sampling and birth weight, and BMI and neonatal fat mass were obtained following delivery.


RESULTS
Maternal TGs and FFAs correlated with fetal AC size (at 28 weeks: triglycerides, P = 0.001; FFAs, P = 0.02), and at delivery they correlated with all neonatal anthropometric measures (FFA: birth weight, P = 0.002; BMI, P = 0.001; fat mass, P = 0.01). After adjustment for confounding variables, maternal FFAs and TGs at delivery remained the only parameters independently related to newborns large for gestational age (LGA) (P = 0.008 and P = 0.04, respectively). Maternal FFA levels were higher in mothers with LGA newborns than in those with appropriate for gestational age (AGA) newborns (362.8 +/- 101.7 vs. 252.4 +/- 10.1, P = 0.002). Maternal levels of TGs, FFAs, and glycerol at delivery correlated with those in cord blood (P = 0.003, P = 0.004, and P = 0.005, respectively). Fetal triglyceride and cholesterol levels were negatively correlated with newborn birth weight (P = 0.001), BMI (P = 0.004), and fat mass (P = 0.001). TGs were significantly higher in small for gestational age (SGA) newborns compared with AGA or LGA newborns, while insulin-to-glucose ratio and FFAs were the highest in LGA newborns.


CONCLUSIONS
In well-controlled GDM pregnancies, maternal lipids are strong predictors for fetal lipids and fetal growth. Infants with abnormal growth seem to be exposed to a distinct intrauterine environment compared with those with appropriate growth.
Strength and Conditioning for Soccer Players

SOCCER IS CHARACTERIZED AS A HIGH-INTENSITY, INTERMITTENT, CONTACT TEAM SPORT THAT REQUIRES A NUMBER OF PROFICIENT PHYSICAL AND PHYSIOLOGICAL CAPABILITIES TO PERFORM SUCCESSFULLY. APART FROM THE NECESSARY TECHNICAL AND TACTICAL SKILLS REQUIRED, SOCCER PLAYERS MUST ALSO DEVELOP AND RETAIN A HIGH LEVEL OF AEROBIC AND ANAEROBIC CONDITIONING, SPEED, AGILITY, STRENGTH, AND POWER. THESE ARE BEST DEVELOPED THROUGH HIGH-INTENSITY INTERVAL TRAINING, SMALL-SIDED GAMES, REPEATED SPRINTS, COACHED SPEED AND AGILITY SESSIONS AND STRENGTH AND POWER-BASED GYM SESSIONS. SOCCER COACHES AND STRENGTH AND CONDITIONING COACHES MUST WORK COHESIVELY TO ENSURE A STRUCTURED AND EFFECTIVE PROGRAM IS ADHERED TO.
Mortality in healthcare-associated pneumonia in a low resistance setting: a prospective observational study

BACKGROUND
The classification of pneumonia as community-acquired pneumonia (CAP) or healthcare-associated pneumonia (HCAP) has implications for selection of initial antimicrobial therapy. HCAP has been associated with an increased prevalence of multidrug-resistant (MDR) pathogens and with high mortality leading to recommendations for broad empiric therapy.


METHODS
We performed a prospective, population-based study on consecutive adults (≥ 18 years) admitted for pneumonia over 1 calendar year. Patients were classified by pneumonia type and severity. Microbial etiologic testing was performed on all patients. Treatment, length of stay, and mortality rates were compared.


RESULTS
A total of 373 admissions were included, 94% of all eligible patients. They were classified as CAP (n = 236, 63%) or HCAP (n = 137, 37%). Chronic underlying disease was more commonly found among patients with HCAP compared with CAP (74% vs 51%, p < 0.001). Mycoplasma pneumoniae was more common among CAP patients (p < 0.01), while gram-negative bacteria were more often found among HCAP patients (p = 0.02). No MDR pathogens were detected, and rates of Staphylococcus aureus were similar in the two groups. HCAP patients were not more likely to receive ineffective initial antimicrobial therapy. HCAP patients had worse prognostic scores on admission and higher in-house mortality than CAP patients (10% vs 1%, respectively, p < 0.01).


CONCLUSIONS
Even in a low resistance setting, patients with HCAP have increased mortality compared with patients with CAP. This is most likely explained by a higher prevalence of co-morbidities. Our data do not support broad-spectrum empiric antibiotic therapy for HCAP.
Late chest wall toxicity after MammoSite breast brachytherapy.

PURPOSE
Accelerated partial breast irradiation (APBI) with the MammoSite breast brachytherapy (MBB) system is being investigated as an alternative to whole breast radiation in breast conservation therapy (BCT) at multiple centers worldwide. The newness of MBB means a complete understanding of long-term toxicity, particularly involving the chest wall, has yet to be completely articulated. We report the first pathologic rib fractures associated with MBB and dosimetric analysis of the original treatment plans.


METHODS AND MATERIALS
As part of ongoing quality assurance, we reviewed the records of 129 sequential patients who underwent MBB for breast cancer and identified those who subsequently had clinically significant and radiographically documented rib fracture(s) involving the ipsilateral chest wall. Equivalent tolerance doses yielding a 5% and 50% risk of rib toxicity within 5 years from treatment with 10 fractions (as with MBB) were previously calculated using the linear quadratic equation based on 2Gy per fraction treatments delivered to one-third of the rib volume (TD5/5=37Gy; TD50/5=44Gy). The original radiation therapy plans were evaluated vis-à-vis the plane films or PET/CT images documenting the osseous abnormalities and presenting complaints to find the specific fractured ribs. The specific effected ribs were contoured on the planning CT in "bone windows" using the Nucletron MicroSelectron-classic V2 (Nucletron B.V., Veenendaal, The Netherlands) for this analysis and the original patient treatments. With these datasets, we determined the dose-volume characteristics of the effected ribs including maximal dose encompassing the entire rib on one CT slice, V(20Gy), V(30Gy), V(37Gy), V(44Gy), D(50), D(25), and D(5) (the mean dose to 50%, 25%, and 5% of the rib).


RESULTS
Between May 2002 and August 2007, three of 105 patients with a minimum of 6-months follow-up who underwent adjuvant APBI by MBB were found to have a total of five treatment-related rib fractures. The average dose-volume characteristics from the original plans were as follows: D(50)=22.1Gy, D(25)=32.2Gy, D(5)=41.6Gy, max dose to 1cc=34.8, D(max) (to 0.1cc)=45.6Gy, V(20)Gy=57.4%, V(30)Gy=30.8%, V(37)Gy=15.9%, V(44)Gy=6.6%, and max dose through rib=35.8Gy. Two patients sustained two rib fractures and 1 patient had a single rib fracture. Four of five fractures occurred in postmenopausal patients and two of five fractures occurred in a patient with a history of osteoporosis and exposure to adjuvant chemotherapy.


CONCLUSIONS
Fractures occurred in ribs with V(37)Gy and V(44)Gy each well below 33%. As long-term toxicity data accrue from APBI series, the traditional models for estimating the biologic equivalent dose may benefit from refinements that specifically address the unique radiobiologic and physical properties intrinsic to high-dose-rate brachytherapy for breast conservation therapy.
Efficacy of cognitive behavioural therapy for sleep improvement in patients with persistent delusions and hallucinations (BEST): a prospective, assessor-blind, randomised controlled pilot trial

BACKGROUND
Sleep disturbance occurs in most patients with delusions or hallucinations and should be treated as a clinical problem in its own right. However, cognitive behavioural therapy (CBT)-the best evidence-based treatment for insomnia-has not been tested in this patient population. We aimed to pilot procedures for a randomised trial testing CBT for sleep problems in patients with current psychotic experiences, and to provide a preliminary assessment of potential benefit.


METHODS
We did this prospective, assessor-blind, randomised controlled pilot trial (Better Sleep Trial [BEST]) at two mental health centres in the UK. Patients (aged 18-65 years) with persistent distressing delusions or hallucinations in the context of insomnia and a schizophrenia spectrum diagnosis were randomly assigned (1:1), via a web-based randomisation system with minimisation to balance for sex, insomnia severity, and psychotic experiences, to receive either eight sessions of CBT plus standard care (medication and contact with the local clinical team) or standard care alone. Research assessors were masked to group allocation. Assessment of outcome was done at weeks 0, 12 (post-treatment), and 24 (follow-up). The primary efficacy outcomes were insomnia assessed by the Insomnia Severity Index (ISI) and delusions and hallucinations assessed by the Psychotic Symptoms Rating Scale (PSYRATS) at week 12. We did analysis by intention to treat, with an aim to provide confidence interval estimation of treatment effects. This study is registered with ISRCTN, number 33695128.


FINDINGS
Between Dec 14, 2012, and May 22, 2013, and Nov 7, 2013, and Aug 26, 2014, we randomly assigned 50 patients to receive CBT plus standard care (n=24) or standard care alone (n=26). The last assessments were completed on Feb 10, 2015. 48 (96%) patients provided follow-up data. 23 (96%) patients offered CBT took up the intervention. Compared with standard care, CBT led to reductions in insomnia in the large effect size range at week 12 (adjusted mean difference 6.1, 95% CI 3.0-9.2, effect size d=1.9). By week 12, nine (41%) of 22 patients receiving CBT and one (4%) of 25 patients receiving standard care alone no longer had insomnia, with ISI scores lower than the cutoff for insomnia. The treatment effect estimation for CBT covered a range from reducing but also increasing delusions (adjusted mean difference 0.3, 95% CI -2.0 to 2.6) and hallucinations (-1.9, -6.5 to 2.7). Three patients, all in the CBT group, had five adverse events, although none were regarded as related to study treatment.


INTERPRETATION
Our findings show that CBT for insomnia might be highly effective for improving sleep in patients with persistent delusions or hallucinations. A larger, suitably powered phase 3 study is now needed to provide a precise estimate of the effects of CBT for sleep problems, both on sleep and psychotic experiences.


FUNDING
Research for Patient Benefit Programme, National Institute for Health Research.
Exam performance and attitudes toward multitasking in six, multimedia-multitasking classroom environments

Although many colleges and universities have implemented laptop programs, the use of these technologies in the classroom doesn't guarantee increases in exam performance. Used improperly, these technologies can hinder the learning process. An experiment was conducted comparing how the use or non-use of technology affected exam performance between six different classroom environments. Consistent with predictions based on theories of multitasking and multimedia processing, participants performed worst on an exam when distracted with social media. Moreover, having had this experience, participants in five of the six conditions showed a decrease in perceptions of their abilities to efficiently multitask from pre-test to post-test. Results are discussed in terms of theory and recommendations are made for the integration of experiential learning sessions into orientation programs to help promote a healthy classroom learning environment. © 2015 Elsevier Ltd. All rights reserved.
Comparing the effects of self-myofascial release with static stretching on ankle range-of-motion in adolescent athletes.

BACKGROUND
Increased flexibility is often desirable immediately prior to sports performance. Static stretching (SS) has historically been the main method for increasing joint range-of-motion (ROM) acutely. However, SS is associated with acute reductions in performance. Foam rolling (FR) is a form of self-myofascial release (SMR) that also increases joint ROM acutely but does not seem to reduce force production. However, FR has never previously been studied in resistance-trained athletes, in adolescents, or in individuals accustomed to SMR.


OBJECTIVE
To compare the effects of SS and FR and a combination of both (FR+SS) of the plantarflexors on passive ankle dorsiflexion ROM in resistance-trained, adolescent athletes with at least six months of FR experience.


METHODS
Eleven resistance-trained, adolescent athletes with at least six months of both resistance-training and FR experience were tested on three separate occasions in a randomized cross-over design. The subjects were assessed for passive ankle dorsiflexion ROM after a period of passive rest pre-intervention, immediately post-intervention and after 10, 15, and 20 minutes of passive rest. Following the pre-intervention test, the subjects randomly performed either SS, FR or FR+SS. SS and FR each comprised 3 sets of 30 seconds of the intervention with 10 seconds of inter-set rest. FR+SS comprised the protocol from the FR condition followed by the protocol from the SS condition in sequence.


RESULTS
A significant effect of time was found for SS, FR and FR+SS. Post hoc testing revealed increases in ROM between baseline and post-intervention by 6.2% for SS (p < 0.05) and 9.1% for FR+SS (p < 0.05) but not for FR alone. Post hoc testing did not reveal any other significant differences between baseline and any other time point for any condition. A significant effect of condition was observed immediately post-intervention. Post hoc testing revealed that FR+SS was superior to FR (p < 0.05) for increasing ROM.


CONCLUSIONS
FR, SS and FR+SS all lead to acute increases in flexibility and FR+SS appears to have an additive effect in comparison with FR alone. All three interventions (FR, SS and FR+SS) have time courses that lasted less than 10 minutes.


LEVEL OF EVIDENCE
2c.