Miracle-dz/UniFAR-FTUs huggingface dataset:
Expanding the roles of outpatient pharmacists: effects on health services utilisation, costs, and patient outcomes.

BACKGROUND In recent years pharmacists' roles have expanded from packaging and dispensing medications to working with other health care professionals and the public. OBJECTIVES To examine the effect of expanding outpatient pharmacists' roles on health services utilisation, costs, and patient outcomes. SEARCH STRATEGY We searched the Cochrane Effective Practice and Organisation of Care Group specialised register, MEDLINE, EMBASE, Pharmline, and International Pharmaceutical Abstracts (January 1966 to March 1999), the published abstracts of three meetings, hand searched five journals and two bibliographies, and reference lists of articles. SELECTION CRITERIA Randomised trials, controlled clinical trials, controlled before and after studies and interrupted time series analyses comparing 1. Pharmacist services targeted at patients versus services delivered by other health professionals; 2. Pharmacist services targeted at patients versus the delivery of no comparable service; 3. Pharmacist services targeted at health professionals versus services delivered by other health professionals; 4. Pharmacist services targeted at health professionals versus the delivery of no comparable service. DATA COLLECTION AND ANALYSIS Two reviewers independently extracted data and assessed study quality. MAIN RESULTS Twenty-five studies were included involving more than 40 pharmacists and 16,000 patients. For comparison 1 (one study), scheduled service utilisation was slightly increased, whereas hospital admissions and emergency room admissions were decreased. For comparison 2, pharmacist services decreased the use of non-scheduled health services, the number of specialty physician visits or the number and costs of drugs, compared to control patients (six studies). Improvements in the targeted patient condition were reported in 10 of 13 studies that measured patient outcomes but patients' quality of life did not seem to change. For comparison 3 (one study), the intervention delivered by the pharmacist was less successful than that delivered by physician counsellors in decreasing inappropriate prescribing. For comparison 4, all studies demonstrated that pharmacist interventions produced the intended effects on physicians prescribing practices. The one study measuring patient outcomes was unable to show a difference in patients' quality of life. REVIEWER'S CONCLUSIONS Only two studies compared pharmacist services with other health professional services. Both had some bias and did not allow us to draw conclusions about comparisons 1 and 3. The other studies supported the expanded roles of pharmacists in patient counselling and physician education. However, doubts about the generalisability of the studies, the poorly defined interventions, and the lack of cost assessments and patient outcome data, indicate that more rigorous research is needed to document the effects of outpatient pharmacist interventions.
Holarctic genetic structure and range dynamics in the woolly mammoth

Ancient DNA analyses have provided enhanced resolution of population histories in many Pleistocene taxa. However, most studies are spatially restricted, making inference of species-level biogeographic histories difficult. Here, we analyse mitochondrial DNA (mtDNA) variation in the woolly mammoth from across its Holarctic range to reconstruct its history over the last 200 thousand years (kyr). We identify a previously undocumented major mtDNA lineage in Europe, which was replaced by another major mtDNA lineage 32–34 kyr before present (BP). Coalescent simulations provide support for demographic expansions at approximately 121 kyr BP, suggesting that the previous interglacial was an important driver for demography and intraspecific genetic divergence. Furthermore, our results suggest an expansion into Eurasia from America around 66 kyr BP, coinciding with the first exposure of the Bering Land Bridge during the Late Pleistocene. Bayesian inference indicates Late Pleistocene demographic stability until 20–15 kyr BP, when a severe population size decline occurred.
Performance Analysis of Single-Multiplier Digital Sine-Cosine Generators

In this paper, second order structures satisfying single-multiplier digital sine-cosine generators are derived analytically, resulting in four different realizations. Some important characteristics of these generator structures, like total harmonic distortion percentage (THD%), frequency error ( and frequency resolution are defined and examined as performance measures. The four generator realizations are simulated using Matlab7.0 program. The simulation results show that better performance (THD% and are very low or negligible) can be obtained for these realizations by using 32 bits to represent the single-multiplier coefficient and other the outputs of arithmetic operations. The rounding-off method is applied as a quantization process after multiplication process. A comparison is made between one of the best-derived structures and other two recent structures implemented in previous researches. The comparison results indicate that better performance measures can be achieved from the proposed realization for the single-multiplier digital sine-cosine generator.
Promoting patient participation and shortening cancer consultations: a randomised trial

Patient participation in medical consultations has been demonstrated to benefit their subsequent psychological well being. Question asking is one way in which patients can be active. We investigated 2 means of promoting cancer patient question asking. One was the provision of a question prompt sheet to patients prior to their initial consultation with their oncologist. The second was the active endorsement and systematic review of the question prompt sheet by their oncologist. 318 patients with heterogeneous cancers, seeing one of 5 medical and 4 radiation oncologists for the first time, were randomised to either receive or not receive a question prompt sheet. Doctors were randomised to either proactively address or passively respond to the question prompt sheet in the subsequent consultation. Anxiety was assessed prior to the consultation. Consultations were audiotaped and content analysed. Anxiety was assessed again immediately following the consultation. Within the next 10 days patients completed questionnaires assessing information needs, anxiety and satisfaction and were given a structured telephone interview assessing information recall. Patients provided with a question prompt sheet asked more questions about prognosis compared with controls and oncologists gave significantly more prognostic information to these patients. Provision of the question prompt sheet prolonged consultations and increased patient anxiety; however, when oncologists specifically addressed the prompt sheet, anxiety levels were significantly reduced, consultation duration was decreased and recall was significantly improved. A patient question prompt sheet, used proactively by the doctor, is a powerful addition to the oncology consultation. © 2001 Cancer Research Campaign www.bjcancer. com
Finite Abstractions of Max-Plus-Linear Systems

This work puts forward a novel technique to generate finite abstractions of autonomous and nonautonomous Max-Plus-Linear (MPL) models, a class of discrete-event systems used to characterize the dynamics of the timing related to successive events that synchronize autonomously. Nonautonomous versions of MPL models embed within their dynamics nondeterminism, namely a signal choice that is usually regarded as an exogenous control or schedule. In this paper, abstractions of MPL models are characterized as finite-state Labeled Transition Systems (LTS). LTS are obtained first by partitioning the state space (and, for the nonautonomous model, by covering the input space) of the MPL model and by associating states of the LTS to the introduced partitions, then by defining relations among the states of the LTS based on dynamical transitions between the corresponding partitions of the MPL state space, and finally by labeling the LTS edges according to the one-step timing properties of the events of the original MPL model. In order to establish formal equivalences, the finite abstractions are proven to either simulate or to bisimulate the original MPL model. This approach enables the study of general properties of the original MPL model by verifying (via model checking) equivalent logical specifications over the finite LTS abstraction. The computational aspects related to the abstraction procedure are thoroughly discussed and its performance is tested on a numerical benchmark.
Clinical impact of rapid in vitro susceptibility testing and bacterial identification

During the past decade, a variety of instrument-assisted bacterial identification and antimicrobial susceptibility test systems have been developed which permit provision of test results in a matter of hours rather than days, as has been the case with traditional overnight procedures. These newer rapid techniques are much more expensive than older methods. It has been presumed but not proven that the clinical benefits of rapid testing to patients with infection offset the added cost. The intent of this study was to objectively define the clinical impact of rapid bacterial identification and antimicrobial susceptibility testing. A 1-year study was performed in which infected, hospitalized patients in a tertiary-care, teaching, medical center were randomly assigned to one of two groups: patients for whom identification and susceptibility testing was performed by using a semi-automated, rapid, same-day procedure and those for whom testing was accomplished by using traditional overnight techniques. The two groups were compared with respect to numerous demographic descriptors, and then patients were monitored prospectively through the end of their hospitalization with the aim of determining whether there existed objectively defineable differences in management and outcome between the two groups. The mean lengths of time to provision of susceptibility and identification test results in the rapid test group were 11.3 and 9.6 h, respectively. In the overnight test group, these values were 19.6 and 25.9 h, respectively (P < 0.0005). There were 273 evaluable patients in the first group and 300 in the second group. Other than the length of time required to provide susceptibility and identification test results, no significant differences were noted between the two groups with respect to > 100 demographic descriptors. With regard to measures of outcome, the mean lengths of hospitalization were also the same in both groups. Mortality rates were however, lower in the rapid test group (i.e., 8.8% versus 15.3%). Similarly, statistically significantly fewer laboratory studies, imaging procedures, days of intubation, and days in an intensive or intermediate-care area were observed with patients in the rapid test group. Rapid testing was also associated with significantly shortened lengths of elapsed time prior to alterations in antimicrobial therapy. Lastly, patient costs for hospitalization were significantly lower in the rapid test group. The results of this study indicate the rapid same-day bacterial identification and susceptibility testing in the microbiology laboratory can have a major impact on the care and outcome of hospitalized patients with infection.
Clinical factors related with helicobacter pylori infection--is there an association with gastric cancer history in first-degree family members?

BACKGROUND The aim of this study was to assess clinical factors associated with Helicobacter pylori positivity and to evaluate the incidence of gastric carcinoma in first-degree family members of infected patients. A total of 580 patients (mean age:38±17) with gastrointestinal complaints underwent C-14 urea breath test (UBT). Patients were grouped as: Group-1, untreated patients (n:384); and Group-2, patients who previously treated with eradication triple therapy (n:196). C-14 UBT was performed 1-2 months after the completion of eradication therapy. Associations of H pylori positivity with age, gender, ABO and Rhesus groups, smoking, dietary habits, and history of gastric cancer in first-degree family members were evaluated. The frequency of H pylori positivity was significantly higher in group-1 (58%) compared to group-2 (20%), p=0.001. There were no correlations between H pylori positivity and age, gender, ABO groups, Rhesus subgroups, smoking and dietary habits in both patient groups. The frequency of gastric cancer in family members was significantly higher in patients with H pylori infection among group-1, compared to infected patients among group-2 (56% vs. 28.6% respectively, p=0.03). We observed a significant association between H pylori positivity and the presence of gastric cancer in first-degree relatives of group-1 patients. Our results provide some confirmation of the presence of a link between gastric cancer development and H pylori. C-14 UBT is a sensitive, reliable and a widely recommended test for the detection of H pylori infection and recurrence. We suggest that detection and eradication of H pylori may contribute to a reduced risk of gastric cancer in the family members of infected patients.
Beyond the single gene: How epistasis and gene-by-environment effects influence crop domestication

Significance Recent archaeological studies of crop domestication have suggested a relatively slow spread and fixation of some key domestication traits, such as the loss of seed shattering. In contrast, genetic studies often indicate that domestication traits have a fairly simple genetic basis, which should facilitate their rapid evolution under selection. Here we examine previously underexplored factors that could account for this apparent disconnect: the roles of gene-by-gene interactions (epistasis) and gene-by-environment effects in shaping the rate of phenotypic evolution during domestication. Analysis of a Setaria mapping population, together with a review of evidence from the literature, suggests that these genetic factors, although important, are unlikely to have played a major role in constraining the rate of phenotypic evolution during domestication. Domestication is a multifaceted evolutionary process, involving changes in individual genes, genetic interactions, and emergent phenotypes. There has been extensive discussion of the phenotypic characteristics of plant domestication, and recent research has started to identify the specific genes and mutational mechanisms that control domestication traits. However, there is an apparent disconnect between the simple genetic architecture described for many crop domestication traits, which should facilitate rapid phenotypic change under selection, and the slow rate of change reported from the archeobotanical record. A possible explanation involves the middle ground between individual genetic changes and their expression during development, where gene-by-gene (epistatic) and gene-by-environment interactions can modify the expression of phenotypes and opportunities for selection. These aspects of genetic architecture have the potential to significantly slow the speed of phenotypic evolution during crop domestication and improvement. Here we examine whether epistatic and gene-by-environment interactions have shaped how domestication traits have evolved. We review available evidence from the literature, and we analyze two domestication-related traits, shattering and flowering time, in a mapping population derived from a cross between domesticated foxtail millet and its wild progenitor. We find that compared with wild progenitor alleles, those favored during domestication often have large phenotypic effects and are relatively insensitive to genetic background and environmental effects. Consistent selection should thus be able to rapidly change traits during domestication. We conclude that if phenotypic evolution was slow during crop domestication, this is more likely due to cultural or historical factors than epistatic or environmental constraints.
A recurrent neural network for closed-loop intracortical brain–machine interface decoders

Recurrent neural networks (RNNs) are useful tools for learning nonlinear relationships in time series data with complex temporal dependences. In this paper, we explore the ability of a simplified type of RNN, one with limited modifications to the internal weights called an echostate network (ESN), to effectively and continuously decode monkey reaches during a standard center-out reach task using a cortical brain–machine interface (BMI) in a closed loop. We demonstrate that the RNN, an ESN implementation termed a FORCE decoder (from first order reduced and controlled error learning), learns the task quickly and significantly outperforms the current state-of-the-art method, the velocity Kalman filter (VKF), using the measure of target acquire time. We also demonstrate that the FORCE decoder generalizes to a more difficult task by successfully operating the BMI in a randomized point-to-point task. The FORCE decoder is also robust as measured by the success rate over extended sessions. Finally, we show that decoded cursor dynamics are more like naturalistic hand movements than those of the VKF. Taken together, these results suggest that RNNs in general, and the FORCE decoder in particular, are powerful tools for BMI decoder applications.
The Domestic Basis for the Managerial Career

Although there are now many studies of managers, there has been little research on how gender relations in the private sphere are lived to accommodate the managerial career. The organisation of domestic life and the household division of labour has largely been neglected. This article examines the domestic basis of the managerial career. The data are drawn from a larger study of women and men senior managers in five multinational companies. The analysis reveals that the domestic arrangements necessary to sustain the life of a senior manager are very different for men and women, giving the lie to the myth that equality has been achieved. My argument is that for all the company initiatives designed to promote equal opportunities, the managerial career is still largely dependent upon the services of a wife at home, or a housewife substitute in the form of paid domestic services.
Novel Curcumin Intravenous Injection System: Preparation,Characterization, Improved Bioavailability and Safety In Vitroand In Vivo

Curcumin (CUR), a naturally bioactive component in the Curcuma longa have a wide range of biological and pharmacological actions. However, the poor water solubility with poor bioavailability limits its application. The aim of this study was to develop a novel CUR intravenous injection to improve CUR absorption and enhance drug therapy effect. The physical characteristics of CUR intravenous injection such as particle size, zeta potential and drug content were all investigated in detail. This formulation did not cause hemolysis and intravenous irritation. Pharmacokinetics results showed the Cmax and area under the curve (AUC) of CUR after intravenous administration was than those of oral administration. This study demonstrated the CUR intravenous injection may be a promising delivery system of CUR to improve bioavailability and clinical therapeutic effect in the future.
Implementing a collaborative model of action research for teacher development

Abstract In this article the authors develop and implement a collaborative model of action research. An academic and a teacher collaborate with the purpose of improving the teaching practice and the teaching abilities of the teacher in mixed ability classes, and the collaborative ability of both academic and teacher. After a year of collaboration certain themes, related to the improvement of the teacher's practice arose. Specifically, the teacher developed a larger repertoire of teaching techniques and began to develop collaborations with other teachers and ‘outsiders’. She also developed techniques for investigating her practice, and was better prepared for her lessons. Generally, in her classroom, more authentic relationships were developed.
The Caregiver Strain Questionnaire

The impact on the family of having a family member with serious emotional problems has been an area of concern as deinstitutionalitation and managed care have shifted treatment to the community and primary caregiving to the family. Measures are needed to assess caregiver strain in a way that can lead to a better understanding of the phenomena, improve clinical interventions, and examine the outcomes of new treatment modalities on the client's family. In order to study the effects of this treatment shift, the Caregiver Strain Questionnaire (formerly the Burden of Care Questionnaire) was developed for use with families of children and adolescents with emotional and behavioral disorders. Findings from exploratory and confirmatory factor analyses support the existence of three related but unique dimensions of strain experienced by parents of this population. This study adds to the current body of knowledge by suggesting that subjective caregiver strain has two components, and not the single form claimed in previous research. The results also indicate that the Caregiver Strain Questionnaire is a reliable and valid scale for the measurement of caregiver strain among families of children with emotional or behavioral disorders.
Effects of Anthocyanins on Active Avoidance Test of Rats Exposed to Disruption of Diurnal Rhythm

The present study was undertaken to assess the effects of the natural antioxidant anthocyanins on learning and memory of rats in experimental model of oxidative stress. Our preliminary experiments demonstrated that disruption of diurnal rhythm via exposition of rats to constant light for 14 days caused excessive generation of free radicals in their brains. It is known that free radicals impair cognitive functions. This study investigated the effects of anthocyanins on cognitive functions of rats in a shuttle-box active avoidance test. In the shuttle-box, stressed rats showed significantly increased latency time and decreased number of avoidances and escapes in the learning sessions. Rats treated with anthocyanins had increased number of avoidances and escapes and significantly decreased latency time during the learning sessions. Our results demonstrated that this model of oxidative stress impaired learning and memory of experimental rats. Moreover, chronic administration of anthocyanins (200 mg/kg orally) improved brain functions of the rats. Our data suggest that anthocyanins have a protective role on rat brain and improve cognitive functions in this model of oxidative stress.
Implicit Visuomotor Processing for Quick Online Reactions Is Robust against Aging

It is well established that humans can react more quickly to a visual stimulus in the visual field center than to one in the visual periphery and that the reaction to a stimulus in the visual periphery markedly deteriorates with aging. These tendencies are true in conventional discrimination-reaction tasks. Surprisingly, however, we found that they are entirely different when reactions are induced by the same visual stimuli during reaching movements. The reaction time for a stimulus in the visual periphery was significantly faster than in the central vision, and age-related slowing of reactions to the stimulus in the visual periphery were quite small, compared to that observed in the conventional reaction tasks. This inconsistent slowing of reactions in different motor conditions underscores a distinctive visuomotor pathway for online control, which is more robust against age-related deterioration.