LLukas22/scidocs huggingface dataset:
Deprescribing antipsychotics for behavioural and psychological symptoms of dementia and insomnia: Evidence-based clinical practice guideline.

OBJECTIVE
To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop antipsychotics; to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes.


METHODS
The overall team comprised 9 clinicians (1 family physician, 1 family physician specializing in long-term care, 1 geriatric psychiatrist, 2 geriatricians, 4 pharmacists) and a methodologist; members disclosed conflicts of interest. For guideline development, a systematic process was used, including the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach. Evidence was generated from a Cochrane systematic review of antipsychotic deprescribing trials for the behavioural and psychological symptoms of dementia, and a systematic review was conducted to assess the evidence behind the benefits of using antipsychotics for insomnia. A review of reviews of the harms of continued antipsychotic use was performed, as well as narrative syntheses of patient preferences and resource implications. This evidence and GRADE quality-of-evidence ratings were used to generate recommendations. The team refined guideline content and recommendation wording through consensus and synthesized clinical considerations to address common front-line clinician questions. The draft guideline was distributed to clinicians and stakeholders for review and revisions were made at each stage.


RECOMMENDATIONS
We recommend deprescribing antipsychotics for adults with behavioural and psychological symptoms of dementia treated for at least 3 months (symptoms stabilized or no response to an adequate trial) and for adults with primary insomnia treated for any duration or secondary insomnia in which underlying comorbidities are managed. A decision-support algorithm was developed to accompany the guideline.


CONCLUSION
Antipsychotics are associated with harms and can be safely tapered. Patients and caregivers might be more amenable to deprescribing if they understand the rationale (potential for harm), are involved in developing the tapering plan, and are offered behavioural advice or management. This guideline provides recommendations for making decisions about when and how to reduce the dose of or stop antipsychotics. Recommendations are meant to assist with, not dictate, decision making in conjunction with patients and families.
A Refutation of the Commodity Exploitation Theorem

This note is to show that the generalized commodity exploitation theorem put forward by Bowles and Gintis and Roemer is nothing but an alternative form of the Hawkins-Simon condition for given technical data, and that it has nothing to do with exploitation. That is, the Hawkins-Simon condition means a mere possibility of an economic system to produce a surplus in each commodity, and as such does not guarantee the existence of positive profits. To consider exploitation or the existence of positive profits, we need to introduce prices at which unequal exchanges may be carried out. Copyright © 2008 The Authors. Journal compilation © 2008 Blackwell Publishing Ltd.
Natural Environment, Market Orientation, and Firm Innovativeness: An Organizational Life Cycle Perspective

Drawing upon the corporate social responsibility literature, we investigate the moderating effects of the natural environment and the stage of an organization’s life cycle on the market orientation to firm innovativeness relationship. Through 229 owners or chief executive officer respondents, our results establish evidence of (1) a positive linkage between market orientation and firm innovativeness; (2) natural environmental policy positively moderating the market orientation to firm innovativeness relationship; and (3) organizational life cycle negatively moderating market orientation to innovativeness. Our findings suggest ventures characterized as being early in the organizational life cycle are more likely to have a positive environmental policy toward the natural environment leading to a competitive advantage through firm innovativeness.
360-degree Visual Detection and Target Tracking on an Autonomous Surface Vehicle

This paper describes perception and planning systems of an autonomous sea surface vehicle (ASV) whose goal is to detect and track other vessels at medium to long ranges and execute responses to determine whether the vessel is adversarial. The Jet Propulsion Laboratory (JPL) has developed a tightly integrated system called CARACaS (Control Architecture for Robotic Agent Command and Sensing) that blends the sensing, planning, and behavior autonomy necessary for such missions. Two patrol scenarios are addressed here: one in which the ASV patrols a large harbor region and checks for vessels near a fixed asset on each pass and one in which the ASV circles a fixed asset and intercepts approaching vessels. This paper focuses on the ASV’s central perception and situation awareness system, dubbed Surface Autonomous Visual Analysis and Tracking (SAVAnT), which receives images from an omnidirectional camera head, identifies objects of interest in these images, and probabilistically tracks the objects’ presence over time, even as they may exist outside of the vehicle’s sensor range. The integrated CARACaS/SAVAnT system has been implemented on U.S. Navy experimental ASVs and tested in on-water field demonstrations. C © 2010 Wiley Periodicals, Inc.
Tobacco use and its determinants in HIV-infected patients on antiretroviral therapy in West African countries.

BACKGROUND
Tobacco smoking is common in human immunodeficiency virus (HIV) infected patients from industrialised countries. In West Africa, few data concerning tobacco consumption exist.


METHODS
A cross-sectional survey of the International Epidemiological Database to Evaluate AIDS (IeDEA) network in West Africa was conducted. Health workers administered a questionnaire assessing tobacco and cannabis consumption among patients receiving antiretroviral treatment. Regular smokers were defined as current smokers who smoked >1 cigarette per day for >or=1 year.


RESULTS
Overall, 2920 patients were enrolled in three countries. The prevalence of ever smokers and regular smokers were respectively 46.2% (95%CI 42.8-49.5) and 15.6% (95%CI 13.2-18.0) in men and 3.7% (95%CI 2.9-4.5) and 0.6% (95%CI 0.3-0.9) in women. Regular smoking was associated with being from Côte d'Ivoire or Mali compared to Benin (OR 4.6, 95%CI 2.9-7.3 and 7.7, 95%CI 4.4-13.6), severely impaired immunological status at highly active antiretroviral treatment initiation (OR 1.5, 95%CI 1.1-2.2) and history of tuberculosis (TB; OR 1.8, 95%CI 1.1-3.0).


CONCLUSION
There are marked differences in smoking prevalence among these West African countries. This survey approach also provides proof of the association between cigarette smoking and TB in HIV-infected patients, a major public health issue in this part of the world.
Attitudes and Preferences towards Self-help Treatments for Depression in Comparison to Psychotherapy and Antidepressant Medication.

BACKGROUND
Self-help is an effective treatment for depression. Less is known, however, about how acceptable people find different self-help treatments for depression.


AIMS
To investigate preferences and attitudes toward different self-help treatments for depression in comparison to psychotherapy and antidepressants.


METHOD
N = 536 people who were not actively seeking treatment for depression were randomly assigned to read about one of five treatment options (bibliotherapy, Internet-based self-help, guided self-help, antidepressants, or psychotherapy) before rating how acceptable they found the treatment. Participants also ranked the treatments in order of preference.


RESULTS
Psychotherapy and guided self-help were found to be the most acceptable and preferred treatment options. Antidepressants and bibliotherapy were found to be the least acceptable treatments, with antidepressants rated as the most likely to have side effects. Preference data reflected the above findings - psychotherapy and guided self-help were the most preferred treatment options.


CONCLUSIONS
The findings highlight differences in attitudes and preferences between guided and unguided self-help interventions; and between self-help interventions and psychotherapy. Future research should focus on understanding why unguided self-help interventions are deemed to be less acceptable than guided self-help interventions for treating depression.
The risk of viral rebound in the year after delivery in women remaining on antiretroviral therapy

OBJECTIVE
The objective of this study is to assess the risk of viral rebound in postpartum women on suppressive combination antiretroviral therapy (cART).


METHODS
Using data from the UK Collaborative HIV Cohort (UK CHIC) study and the UK and Ireland National Study of HIV in Pregnancy and Childhood (NSHPC), women with HIV-RNA 50 copies/ml or less at delivery in 2006-2011, who started life-long cART during pregnancy (n = 321) or conceived on cART (n = 618), were matched by age, duration on cART and time period, with at least one control (non-postpartum). The cumulative probability of viral rebound (HIV-RNA >200 copies/ml) was assessed by Kaplan-Meier analysis; adjusted hazard ratios (aHRs) for the 0-3 and 3-12 months postdelivery (cases)/pseudo-delivery (controls) were calculated in Cox proportional hazards models.


RESULTS
In postpartum women who conceived on cART, 5.9% [95% confidence interval (95% CI) 4.0-7.7] experienced viral rebound by 3 months, and 2.2% (1.4-3.0%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during the first 3 months [aHR 2.63 (1.58-4.39)] but not during the 3-12 months postdelivery/pseudo-delivery. In postpartum women who started cART during pregnancy, 27% (22-32%) experienced viral rebound by 3 months, and 3.0% (1.6-4.4%) of their controls. The risk of viral rebound was higher in postpartum women than in controls during both postdelivery/pseudo-delivery periods [<3 months: aHR 6.63 (3.58-12.29); 3-12 months: aHR 4.05 (2.03-8.09)].


CONCLUSION
In women on suppressive cART, the risk of viral rebound is increased following delivery, especially in the first 3 months, which may be related to reduced adherence, indicating the need for additional adherence support for postpartum women.
JOB SATISFACTION AND ORGANISATIONAL CITIZENSHIP BEHAVIOUR: AN EMPIRICAL STUDY AT HIGHER LEARNING INSTITUTIONS

This study is designed to measure the two dimensions of organisational citizenship behaviour (i.e., OCBI and OCBO) and to examine how these organisational citizenship behaviours are related to the two facets of job satisfaction (intrinsic and extrinsic). To achieve the research objectives, the survey method is employed. Findings of this study reveal that both extrinsic and intrinsic job satisfaction are very important in predicting citizenship behaviour. Implications and limitations of the study are discussed along with suggestions for future research.
Challenges of self-management when living with multiple chronic conditions: systematic review of the qualitative literature.

OBJECTIVE
To explore the perspectives of patients who live with multiple chronic conditions as they relate to the challenges of self-management.


DATA SOURCES
On September 30, 2013, we searched MEDLINE, EMBASE, and CINAHL using relevant key words including chronic disease, comorbidity, multimorbidity, multiple chronic conditions, self-care, self-management, perspective, and perception.


STUDY SELECTION
Three reviewers assessed and extracted the data from the included studies after study quality was rated. Qualitative thematic synthesis method was then used to identify common themes. Twenty-three articles met the inclusion criteria, with most coming from the United States.


SYNTHESIS
Important themes raised by people living with multiple chronic conditions related to their ability to self-manage included living with undesirable physical and emotional symptoms, with pain and depression highlighted. Issues with conflicting knowledge, access to care, and communication with health care providers were raised. The use of cognitive strategies, including reframing, prioritizing, and changing beliefs, was reported to improve people's ability to self-manage their multiple chronic conditions.


CONCLUSION
This study provides a unique view into patients' perspectives of living with multiple chronic conditions, which are clearly linked to common functional challenges as opposed to specific diseases. Future policy and programming in self-management support should be better aligned with patients' perspectives on living with multiple chronic conditions. This might be achieved by ensuring a more patient-centred approach is adopted by providers and health service organizations.
Long-term effects of outpatient rehabilitation of COPD: A randomized trial.

OBJECTIVE
To examine the short- and long-term effects of an outpatient pulmonary rehabilitation program for COPD patients on dyspnea, exercise, health-related quality of life, and hospitalization rate.


SETTING
Secondary-care respiratory clinic in Barcelona.


METHODS
We conducted a randomized controlled trial with blinding of outcome assessment and follow-up at 3, 6, 9, 12, 18, and 24 months. Sixty patients with moderate to severe COPD (age 65 +/- 7 years; FEV(1) 35 +/- 14%) were recruited. Thirty patients randomized to rehabilitation received 3 months of outpatient breathing retraining and chest physiotherapy, 3 months of daily supervised exercise, and 6 months of weekly supervised breathing exercises. Thirty patients randomized to the control group received standard care.


RESULTS
We found significant differences between groups in perception of dyspnea (p < 0.0001), in 6-min walking test distance (p < 0.0001), and in day-to-day dyspnea, fatigue, and emotional function measured by the Chronic Respiratory Questionnaire (p < 0. 01). The improvements were evident at the third month and continued with somewhat diminished magnitude in the second year of follow-up. The PR group experienced a significant (p < 0.0001) reduction in exacerbations, but not the number of hospitalizations. The number of patients needed to treat to achieve significant benefit in health-related quality of life for a 2-year period was approximately three.


CONCLUSION
Outpatient rehabilitation programs can achieve worthwhile benefits that persist for a period of 2 years.
"Right Time, Right Place" Health Communication on Twitter: Value and Accuracy of Location Information

BACKGROUND
Twitter provides various types of location data, including exact Global Positioning System (GPS) coordinates, which could be used for infoveillance and infodemiology (ie, the study and monitoring of online health information), health communication, and interventions. Despite its potential, Twitter location information is not well understood or well documented, limiting its public health utility.


OBJECTIVE
The objective of this study was to document and describe the various types of location information available in Twitter. The different types of location data that can be ascertained from Twitter users are described. This information is key to informing future research on the availability, usability, and limitations of such location data.


METHODS
Location data was gathered directly from Twitter using its application programming interface (API). The maximum tweets allowed by Twitter were gathered (1% of the total tweets) over 2 separate weeks in October and November 2011. The final dataset consisted of 23.8 million tweets from 9.5 million unique users. Frequencies for each of the location options were calculated to determine the prevalence of the various location data options by region of the world, time zone, and state within the United States. Data from the US Census Bureau were also compiled to determine population proportions in each state, and Pearson correlation coefficients were used to compare each state's population with the number of Twitter users who enable the GPS location option.


RESULTS
The GPS location data could be ascertained for 2.02% of tweets and 2.70% of unique users. Using a simple text-matching approach, 17.13% of user profiles in the 4 continental US time zones were able to be used to determine the user's city and state. Agreement between GPS data and data from the text-matching approach was high (87.69%). Furthermore, there was a significant correlation between the number of Twitter users per state and the 2010 US Census state populations (r ≥ 0.97, P < .001).


CONCLUSIONS
Health researchers exploring ways to use Twitter data for disease surveillance should be aware that the majority of tweets are not currently associated with an identifiable geographic location. Location can be identified for approximately 4 times the number of tweets using a straightforward text-matching process compared to using the GPS location information available in Twitter. Given the strong correlation between both data gathering methods, future research may consider using more qualitative approaches with higher yields, such as text mining, to acquire information about Twitter users' geographical location.
Older Age and Steroid Use Are Associated with Increasing Polypharmacy and Potential Medication Interactions Among Patients with Inflammatory Bowel Disease

BACKGROUND
Comorbidity and polypharmacy, more prevalent among older persons, may impact the treatment of patients with inflammatory bowel disease (IBD). The aims of this study were to assess the frequency of polypharmacy and medication interactions within a cohort of older patients with IBD and describe IBD treatment patterns.


METHODS
Cohort study of 190 patients with IBD 65 years or older followed at a tertiary IBD referral center from 2006 to 2012. Data collected included demographics, IBD-specific characteristics including disease activity, and comorbidity. Medication histories were extracted from medical records, and data were used to classify polypharmacy, frequency, and severity of potential medication interactions and inappropriate medication use.


RESULTS
Older patients with IBD were prescribed an average of 9 routine medications. Severe polypharmacy (≥10 routine medications) was present in 43.2% of studied patients and associated with increasing age, greater comorbidity, and steroid use. Overall, 73.7% of patients had at least 1 potential medication interaction, including 40% of patients with potential IBD medication-associated interactions. Chronic steroids were prescribed to 40% of the older patients including 24% who were in remission or with mild disease activity. Only 39.5% of patients were on immunomodulators and 21.1% on biologics. Approximately, 35% of patients were given at least 1 Beers inappropriate medication and almost 10% were receiving chronic narcotics.


CONCLUSIONS
Older patients with IBD are at increased risk for severe polypharmacy and potential major medication interactions especially with increasing comorbidity and chronic steroid use. Steroid-maintenance therapies are prevalent among the older patients with IBD with lower utilization of steroid-sparing regimens.
Social status regulates kisspeptin receptor mRNA in the brain of Astatotilapia burtoni.

The brain controls reproduction in response to relevant external and internal cues. Central to this process in vertebrates is gonadotropin-releasing hormone (GnRH1) produced in neurons of the hypothalamic-preoptic area (POA). GnRH1 released from the POA stimulates pituitary release of gonadotropins, which in males causes sperm production and concomitant steroid hormone release from the testes. Kisspeptin, a neuropeptide acting via the kisspeptin receptor (Kiss1r), increases GnRH1 release and is linked to development of the reproductive system in mammals and other vertebrates. In both fish and mammals, kiss1r mRNA levels increase in the brain around the time of puberty but the environmental and other stimuli regulating kisspeptin signaling to GnRH1 neurons remain unknown. To understand where kiss1r is expressed and how it is regulated in the brain of a cichlid fish, Astatotilapia burtoni, we measured expression of a kiss1r homolog mRNA by in situ hybridization and quantitative reverse transcription-PCR (qRT-PCR). We found kiss1r mRNA localized in the olfactory bulb, specific nuclei in the telencephalon, diencephalon, mesencephalon, and rhombencephalon, as well as in GnRH1 and GnRH3 neurons. Since males' sexual physiology and behavior depend on social status in A. burtoni, we also tested how status influenced kiss1r mRNA levels. We found higher kiss1r mRNA levels in whole brains of high status territorial males and lower levels in low status non-territorial males. Our results are consistent with the hypothesis that Kiss1r regulates many functions in the brain, making it a strong candidate for mediating differences in reproductive physiology between territorial and non-territorial phenotypes.
Contemporary Family Portrait: The Hidden Uncomfortable Truth of Family Dynamics

This thesis examines the hidden aspect of family dynamic and questions the idealized convention of family portraits. Based on Erving Goffman’s theatrical theory of community, family as a relaxing intimate group in the backstage, the underlying tensions, conflicts, and power play are discussed. This thesis draws upon the familial issues and treatments of Leon J. Saul and Rhee Dong Shick to evaluate the family dynamic present in our domestic settings. As the lineage of family portraits from history changed reflecting the differing family values and uncomfortable truths, the idealized family portraits are re-evaluated and questioned to offer a truer description of our family. Backstage Community: Edge of intimacy and respect We are always surrounded by people and immersed in social relationships. Such diverse relationships between individuals and the society are necessary and interdependent but repressive. As our existence requires the presence of others, Erving Goffman’s The Presentation of Self in Everyday Life describes the dichotomy of our everyday selves. As he applies theatrical language to state the different aspects of social life, he uses the term ‘performance’ to describe our social roles and calls society the ‘front stage’, where one “puts on his show ‘for the benefit of other people’”(Goffman 10). In the front stage, individuals wear an appropriate manner for the audience who observes the performance on stage. Goffman discusses how playing a social role places a character and defines a person. The social roles that each of us play becomes a “collective representation” (Goffman 17).