Miracle-dz/UniFAR-FTUs huggingface dataset:
Randomised controlled trial of Alexander technique lessons, exercise, and massage (ATEAM) for chronic and recurrent back pain: economic evaluation

Objective An economic evaluation of therapeutic massage, exercise, and lessons in the Alexander technique for treating persistent back pain. Design Cost consequences study and cost effectiveness analysis at 12 month follow-up of a factorial randomised controlled trial. Participants 579 patients with chronic or recurrent low back pain recruited from primary care. Interventions Normal care (control), massage, and six or 24 lessons in the Alexander technique. Half of each group were randomised to a prescription for exercise from a doctor plus behavioural counselling from a nurse. Main outcome measures Costs to the NHS and to participants. Comparison of costs with Roland-Morris disability score (number of activities impaired by pain), days in pain, and quality adjusted life years (QALYs). Comparison of NHS costs with QALY gain, using incremental cost effectiveness ratios and cost effectiveness acceptability curves. Results Intervention costs ranged from £30 for exercise prescription to £596 for 24 lessons in Alexander technique plus exercise. Cost of health services ranged from £50 for 24 lessons in Alexander technique to £124 for exercise. Incremental cost effectiveness analysis of single therapies showed that exercise offered best value (£61 per point on disability score, £9 per additional pain-free day, £2847 per QALY gain). For two-stage therapy, six lessons in Alexander technique combined with exercise was the best value (additional £64 per point on disability score, £43 per additional pain-free day, £5332 per QALY gain). Conclusions An exercise prescription and six lessons in Alexander technique alone were both more than 85% likely to be cost effective at values above £20 000 per QALY, but the Alexander technique performed better than exercise on the full range of outcomes. A combination of six lessons in Alexander technique lessons followed by exercise was the most effective and cost effective option. How does the Alexander Technique work? What are the authors findings about the clinical and cost effectiveness of the treatment? Watch this video to find out (12 mins). 10.1136/bmj.a2656V1
Geographic, demographic, and socioeconomic variations in the investigation and management of coronary heart disease in Scotland

OBJECTIVE To determine whether age, sex, level of deprivation, and area of residence affect the likelihood of investigation and treatment of patients with coronary heart disease. DESIGN, PATIENTS, AND INTERVENTIONS Routine discharge data were used to identify patients admitted with acute myocardial infarction (AMI) between 1991 and 1993 inclusive. Record linkage provided the proportion undergoing angiography, percutaneous transluminal coronary angioplasty (PTCA), and coronary artery bypass grafting (CABG) over the following two years. Multiple logistic regression analysis was used to determine whether age, sex, deprivation, and area of residence were independently associated with progression to investigation and revascularisation. SETTING Mainland Scotland 1991 to 1995 inclusive. MAIN OUTCOME MEASURES Two year incidence of angiography, PTCA, and CABG. Results—36 838 patients were admitted with AMI. 4831 (13%) underwent angiography, 587 (2%) PTCA, and 1825 (5%) CABG. Women were significantly less likely to undergo angiography (p < 0.001) and CABG (p < 0.001) but more likely to undergo PTCA (p < 0.05). Older patients were less likely to undergo all three procedures (p < 0.001). Socioeconomic deprivation was associated with a reduced likelihood of both angiography and CABG (p < 0.001). There were significant geographic variations in all three modalities (p < 0.001). CONCLUSION Variations in investigation and management were demonstrated by age, sex, geography, and socioeconomic deprivation. These are unlikely to be accounted for by differences in need; differences in clinical practice are, therefore, likely.
The influence of dopamine &bgr;-hydroxylase gene polymorphism rs1611115 on levodopa/carbidopa treatment for cocaine dependence: a preliminary study

Recent studies have suggested that heterogeneity in the level of dopamine activity and function might be useful for identifying a subgroup of cocaine-dependent patients responding better to dopamine-enhancement pharmacotherapy. Here we hypothesized that response to levodopa/carbidopa treatment would be greater in patients with genetically determined low levels of the dopamine metabolizing enzyme dopamine &bgr;-hydroxylase (D&bgr;H). Seventy-one cocaine-dependent patients who participated in a 12-week randomized double-blind placebo-controlled trial of levodopa/carbidopa were genotyped for the D&bgr;H gene (DBH) polymorphism rs1611115. Our results showed that for patients with the low D&bgr;H activity genotypes (CT/TT) who received levodopa, the odds of having cocaine-positive urine decreased significantly over treatment compared with placebo-treated patients with the CT/TT genotypes (P=0.004). Individuals with the normal D&bgr;H activity genotype (CC) showed no differential response to levodopa. These preliminary results need to be confirmed in a larger sample focusing on the DBH polymorphism.
A Project Driven Approach for Enhanced Maturity Model Development for EAM Capability Evaluation

In today's rapidly changing markets, organizations have to make the best use of their capabilities and knowledge to reach their goals. Enterprise Architecture Management identifies such specific combination of know-how by planning, transforming and monitoring the complex structures, processes and relationships. Still, there is a need to evaluate the capabilities in terms of their qualitative requirements. Notwithstanding the criticism in academia and practice, the maturity models are proven to be a management instrument for capability assessment and improvement. In this respective, this paper proposes a preliminary approach to maturity model development that (a) aims to eliminate the drawbacks of maturity models and (b) fulfills the quality requirements in developing a maturity model as well as (c) meets specific demands provided by a research project partner.
Comparative germination ecology of two altitudinal vicariant Saxifraga species endemic to the north of Spain.

Seeds of high-mountain species are thought to germinate rapidly, synchronously and at high percentages after a cold period, with limited dependence on the external environment; yet, empirical evidence only partially supports this behaviour. We performed a comparative study of the germination response of two closely related taxa along an altitude gradient in northern Spain. Seeds from several maternal families of six populations of Saxifraga trifurcata (lowland species) and S. canaliculata (highland species) were subjected to temperature and stratification treatments. Germination percentages and germination rates were analysed using generalised linear mixed modelling and accelerated failure-time modelling. We found that germination percentages and germination rates were high and dependent on incubation temperature in both species. Within species, seeds from higher altitudes had higher germination percentages under all conditions. Cold-wet stratification negatively affected germination success, particularly in the lowland species. Overall, the highland species was less responsive to the experimental treatments and showed more synchronous germination patterns. We conclude that seeds from these two Saxifraga species germinate as efficiently as species from other habitats, but have a narrower germination response, probably due to the stronger selective pressures in their harsh environments. Finally, a cold, wet stratification period is not a prerequisite for the germination of high-mountain S. canaliculata, and its strong negative effect on the germination of its lowland relative S. trifurcata may contribute to the altitudinal segregation of these two species.
Human Langerhans Cells Express a Specific TLR Profile and Differentially Respond to Viruses and Gram-Positive Bacteria1

Dendritic cells (DC) are APCs essential for the development of primary immune responses. In pluristratified epithelia, Langerhans cells (LC) are a critical subset of DC which take up Ags and migrate toward lymph nodes upon inflammatory stimuli. TLR allow detection of pathogen-associated molecular patterns (PAMP) by different DC subsets. The repertoire of TLR expressed by human LC is uncharacterized and their ability to directly respond to PAMP has not been systematically investigated. In this study, we show for the first time that freshly purified LC from human skin express mRNA encoding TLR1, TLR2, TLR3, TLR5, TLR6 and TLR10. In addition, keratinocytes ex vivo display TLR1–5, TLR7, and TLR10. Accordingly, highly enriched immature LC efficiently respond to TLR2 agonists peptidoglycan and lipoteichoic acid from Gram-positive bacteria, and to dsRNA which engages TLR3. In contrast, LC do not directly sense TLR7/8 ligands and LPS from Gram-negative bacteria, which signals through TLR4. TLR engagement also results in cytokine production, with marked differences depending on the PAMP detected. TLR2 and TLR3 ligands increase IL-6 and IL-8 production, while dsRNA alone stimulates TNF-α release. Strikingly, only peptidoglycan triggers IL-10 secretion, thereby suggesting a specific function in tolerance to commensal Gram-positive bacteria. However, LC do not produce IL-12p70 or type I IFNs. In conclusion, human LC are equipped with TLR that enable direct detection of PAMP from viruses and Gram-positive bacteria, subsequent phenotypic maturation, and differential cytokine production. This implies a significant role for LC in the control of skin immune responses.
Thrombolysis as a factor associated with favorable outcomes in patients with unclear‐onset stroke

Background and purpose: Clinical and radiological features of patients with unclear‐onset stroke do not differ significantly from those with known‐onset stroke. There is a lack of evidence for the safety and efficacy of thrombolysis in patients with unclear‐onset stroke. We sought to provide supportive data on the safety and efficiency of thrombolysis in patients with unclear‐onset stroke.
An investigation of the perceptions' of occupational therapists of their team work practice

A three part research method was employed to investigate occupational therapists experiences of and perceptions of working in teams. A review of literature was completed to determine what was already known about and could be postulated about occupational therapists’ practice in health care teams. Semi structured interviews were conducted with therapists working in a variety of health care teams to explore their experiences in teams and to refine a list of potential continuing education topics related to working in teams. Their preferred delivery methods for each topic were also determined. The results of the interviews and the literature search informed the development of a questionnaire which was completed by just under 200 occupational therapists in clinical positions, working in health care teams in New South Wales, Australia. The major results of this study are: 1. A conceptual model of the factors affecting occupational therapists attitudes towards working in teams. The model includes therapists’ attitudes towards their own power, their team work and political skills as well as their scores on a number of factors titled powerlessness, team valuing and instrumentality. 2. A model of the personal and professional skills influencing therapists’ self rating of their role confidence. These are assertion skills, presentation skills for meetings, skills to maintain a professional identity in a team environment and to explain your role clearly. 3. An ordered set of potential learning needs in the area of team work practice which indicates the importance of specialised communication and political skills over direct client related skills in this area. 4. Lastly a series of recommendations are made for occupational therapy managers and educators, for team leaders and for occupational therapists working in teams. Content and structure for a continuing professional education course addressing team work practice is presented.
Comprehensive Gene Expression Analysis of Human Embryonic Stem Cells during Differentiation into Neural Cells

Global gene expression analysis of human embryonic stem cells (hESCs) that differentiate into neural cells would help to further define the molecular mechanisms involved in neurogenesis in humans. We performed a comprehensive transcripteome analysis of hESC differentiation at three different stages: early neural differentiation, neural ectoderm, and differentiated neurons. We identified and validated time-dependent gene expression patterns and showed that the gene expression patterns reflect early ESC differentiation. Sets of genes are induced in primary ectodermal lineages and then in differentiated neurons, constituting consecutive waves of known and novel genes. Pathway analysis revealed dynamic expression patterns of members of several signaling pathways, including NOTCH, mTOR and Toll like receptors (TLR), during neural differentiation. An interaction network analysis revealed that the TGFβ family of genes, including LEFTY1, ID1 and ID2, are possible key players in the proliferation and maintenance of neural ectoderm. Collectively, these results enhance our understanding of the molecular dynamics underlying neural commitment and differentiation.
Motivational Design for Learning and Performance: The ARCS Model Approach

Dedication Preface Acknowledgements Chapter 1. The Study of Motivation Forethought Introduction What is Motivation? ARCS-V: An Expansion of the Traditional ARCS Model Conceptual Challenges in the Study of Motivation Summary Chapter 2. What is Motivational Design? Forethought Introduction Characteristics of Design Motivational Design Models Process versus Models: Benefits of a Holistic, Systems Approach Design Challenges With Regard to Motivation The Limitations of Motivational Design Summary Chapter 3. The ARCS Model of Motivational Design Forethoughts Introduction Categories of the ARCS Model Subcategories and Major Supporting Strategies The Systematic Process of Motivational Design Integration of Motivational Design and Instructional Design Summary Chapter 4. Generating and Sustaining Attention Forethought Introduction Psychological Basis for Attention Strategies for Attention and Curiosity Summary Chapter 5. Establishing and Supporting Relevance Forethought Introduction What is Meant by Relevance? Psychological Basis for Relevance Strategies for Relevance Summary Chapter 6. Building Confidence Forethoughts Introduction Psychological Basis for Confidence Strategies for Building Confidence Summary Chapter 7. Managing Outcomes for Satisfaction Forethought Introduction Psychological Basis for Satisfaction Strategies to Promote Feelings of Satisfaction Summary Chapter 8. Identifying Motivational Problems Forethought Introduction: Beginning the Design Process Step 1: Obtain Course Information Step 2: Obtain Audience Information Step 3: Analyze Audience Step 4: Analyze Existing Materials Summary Chapter 9. Identifying Motivational Goals and Tactics Forethoughts Introduction Step 5: List Objectives and Assessments Step 6: List Potential Tactics Step 7: Select and Design Tactics Summary Chapter 10. Integrating Motivational and Instructional Strategies Forethought Introduction Step 8: Integrate With Instructional Design Step 9: Select and Develop Materials Step 10: Evaluation and Revision Summary Chapter 11: Tools to Support Motivational Design Forethought Introduction Motivational Design Matrix: A Simplified Approach Motivational Idea Worksheet ARCS-Based Measures of Motivation Motivational Tactics Checklist Motivational Delivery Checklist Summary Chapter 12: Motivational Design Research and Development Forethoughts Introduction Motivational Messages Instructor-Facilitated Learning Environments Self-Directed Learning Environments Motivational Design of Job Aids & Manuals Summary
Manifold-valued Dirichlet Processes

Statistical models for manifold-valued data permit capturing the intrinsic nature of the curved spaces in which the data lie and have been a topic of research for several decades. Typically, these formulations use geodesic curves and distances defined locally for most cases - this makes it hard to design parametric models globally on smooth manifolds. Thus, most (manifold specific) parametric models available today assume that the data lie in a small neighborhood on the manifold. To address this 'locality' problem, we propose a novel nonparametric model which unifies multivariate general linear models (MGLMs) using multiple tangent spaces. Our framework generalizes existing work on (both Euclidean and non-Euclidean) general linear models providing a recipe to globally extend the locally-defined parametric models (using a mixture of local models). By grouping observations into sub-populations at multiple tangent spaces, our method provides insights into the hidden structure (geodesic relationships) in the data. This yields a framework to group observations and discover geodesic relationships between covariates X and manifold-valued responses Y, which we call Dirichlet process mixtures of multivariate general linear models (DP-MGLM) on Riemannian manifolds. Finally, we present proof of concept experiments to validate our model.
Towards Machine Comprehension of Spoken Content: Initial TOEFL Listening Comprehension Test by Machine

Multimedia or spoken content presents more attractive information than plain text content, but it's more difficult to display on a screen and be selected by a user. As a result, accessing large collections of the former is much more difficult and time-consuming than the latter for humans. It's highly attractive to develop a machine which can automatically understand spoken content and summarize the key information for humans to browse over. In this endeavor, we propose a new task of machine comprehension of spoken content. We define the initial goal as the listening comprehension test of TOEFL, a challenging academic English examination for English learners whose native language is not English. We further propose an Attention-based Multi-hop Recurrent Neural Network (AMRNN) architecture for this task, achieving encouraging results in the initial tests. Initial results also have shown that word-level attention is probably more robust than sentence-level attention for this task with ASR errors.
Electrical Resistivity Tomography and Induced Polarization for Mapping the Subsurface of Alluvial Fans: A Case Study in Punata (Bolivia)

Conceptual models of aquifer systems can be refined and complemented with geophysical data, and they can assist in understanding hydrogeological properties such as groundwater storage capacity. This research attempts to use geoelectrical methods, Electrical Resistivity Tomography and Induced Polarization parameters, for mapping the subsurface in alluvial fans and to demonstrate its applicability; the Punata alluvial fan was used as a case study. The resistivity measurements proved to be a good tool for mapping the subsurface in the fan, especially when used in combination with Induced Polarization parameters (i.e., Normalized Chargeability). The Punata alluvial fan characterization indicated that the top part of the subsurface is composed of boulders in a matrix of finer particles and that the grain size decreases with depth; the electrical resistivity of these deposits ranged from 200 to 1000 Ωm, while the values of normalized chargeability were lower than 0.05 mS/m. The bottom of the aquifer system consisted of a layer with high clay content, and the resistivity ranged from 10 to 100 Ωm, while the normalized chargeability is higher than 0.07 mS/m. With the integration of these results and lithological information, a refined conceptual model is proposed; this model gives a more detailed description of the local aquifer system. It can be concluded that geoelectrical methods are useful for mapping aquifer systems in alluvial fans.
Characterization, GFP Gene Nucleofection, and Allotransplantation in Injured Tendons of Ovine Amniotic Fluid-Derived Stem Cells

Amniotic fluid has drawn increasing attention in the recent past as a cost-effective and accessible source of fetal stem cells. Amniotic fluid-derived mesenchymal stem cells (AFMSCs) that display high proliferation rate, large spectrum of differentiation potential, and immunosuppressive features are considered optimal candidates for allogeneic repair of mesenchymal damaged tissues. In this study, ovine AFMSCs (oAFMSCs) isolated from 3-month-old sheep fetuses were characterized for their proliferation rate, specific surface antigen and pluripotency marker expression, genomic stability, and mesenchymal lineage differentiation during their in vitro expansion (12 passages) and after nucleofection. The high proliferation rate of oAFMSCs gradually decreased during the first six subculture passages while the expression of surface molecules (CD29, CD58, CD166) and of pluripotency-associated markers (OCT4, TERT, NANOG, SOX2), the in vitro osteogenic differentiation potential, and a normal karyotype were maintained. Afterwards, oAFMSCs were nucleofected with a selectable plasmid coding for green fluorescent protein (GFP) using two different programs, U23 and C17, previously optimized for human mesenchymal stem cells. Transfection efficiencies were ~63% and ~37%, while cell recoveries were ~10% and ~22%, respectively. Nucleofected oAFMSCs expressing the GFP transgene conserved their pluripotency marker profile and retained a normal karyotype and the osteogenic differentiation ability. Seven single clones with a GFP expression ranging from 80% to 97% were then isolated and expanded over 1 month, thus providing stably transfected cells with long-term therapeutic potential. The in vivo behavior of GFP-labeled oAFMSCs was tested on a previously validated preclinical model of experimentally induced Achille's tendon defect. The allotransplanted oAFMSCs were able to survive within the host tissue for 1 month enhancing the early phase of tendon healing as indicated by morphological and biomechanical results. Altogether these data suggest that genetically modified oAFMSCs might represent a valuable tool for in vivo preclinical studies in a highly valid translational model.