Miracle-dz/UniFAR-FTUs huggingface dataset:
GP Practices as a One-Stop Shop: How Do Patients Perceive the Quality of Care? A Cross-Sectional Study in Thirty-Four Countries.

OBJECTIVE To contribute to the current knowledge on how a broad range of services offered by general practitioners (GPs) may contribute to the patient perceived quality and, hence, the potential benefits of primary care. STUDY SETTING Between 2011 and 2013, primary care data were collected among GPs and their patients in 31 European countries, plus Australia, Canada, and New Zealand. In these countries, GPs are the main providers of primary care, mostly specialized in family medicine and working in the ambulatory setting. STUDY DESIGN In this cross-sectional study, questionnaires were completed by 7,183 GPs and 61,931 visiting patients. Moreover, 7,270 patients answered questions about what they find important (their values). In the analyses of patient experiences, we adjusted for patients' values in each country to measure patient perceived quality. Perceived quality was measured regarding five areas: accessibility and continuity of care, doctor-patient communication, patient involvement in decision making, and comprehensiveness of care. The range of GP services was measured in relation to four areas: (1) to what extent they are the first contact to the health care system for patients in need of care, (2) their involvement in treatment and follow-up of acute and chronic conditions, in other words treatment of diseases, (3) their involvement in minor technical procedures, and (4) their involvement in preventive treatments. EXTRACTION METHODS Data of the patients were linked to the data of the GPs. Multilevel modeling was used to construct scale scores for the experiences of patients in the five areas of quality and the range of services of GPs. In these four-level models, items were nested within patients, nested in GP practices, nested in countries. The relationship between the range of services and the experiences of patients was analyzed in three-level multilevel models, also taking into account the values of patients. PRINCIPAL FINDINGS In countries where GPs offer a broader range of services patients perceive better accessibility, continuity, and comprehensiveness of care, and more involvement in decision making. No associations were found between the range of services and the patient perceived communication with their GP. The range of GP services mostly explained the variation between countries in the areas of patient perceived accessibility and continuity of care. CONCLUSIONS This study showed that in countries where GP practices serve as a "one-stop shop," patients perceive better quality of care, especially in the areas of accessibility and continuity of care. Therefore, primary care in a country is expected to benefit from investments in a broader range of services of GPs or other primary care physicians.
Treatment with Growth Hormone for Adults with Growth Hormone Deficiency Syndrome: Benefits and Risks

Pharmacological treatment of growth hormone deficiency (GHD) in adults began in clinical practice more than 20 years ago. Since then, a great volume of experience has been accumulated on its effects on the symptoms and biochemical alterations that characterize this hormonal deficiency. The effects on body composition, muscle mass and strength, exercise capacity, glucose and lipid profile, bone metabolism, and quality of life have been fully demonstrated. The advance of knowledge has also taken place in the biological and molecular aspects of the action of this hormone in patients who have completed longitudinal growth. In recent years, several epidemiological studies have reported interesting information about the long-term effects of GH replacement therapy in regard to the possible induction of neoplasms and the potential development of diabetes. In addition, GH hormone receptor polymorphism could potentially influence GH therapy. Long-acting GH are under development to create a more convenient GH dosing profile, while retaining the excellent safety, efficacy, and tolerability of daily GH. In this article we compile the most recent data of GH replacement therapy in adults, as well as the molecular aspects that may condition a different sensitivity to this treatment.
Trabecular Anisotropy in the Primate Mandibular Condyle Is Associated with Dietary Toughness

Past attempts to establish a relationship between mandibular morphology and different dietary categories (e.g., frugivore, folivore, insectivore) have had mixed results, possibly because descriptive dietary categories are too broad and obscure variation within primate diets. Another potential reason is that not all aspects of skeletal architecture, especially trabecular anisotropy, have factored into functional assessments of dietary inputs into jaw form. Recent emphasis on quantifying food mechanical properties (FMPs) has provided an alternative to reliance on dietary categories. We used data on FMPs to test for correlations among dietary toughness and Young's modulus and the trabecular structure of the mandibular condyle, which is loaded during feeding and should reflect differences in masticatory stresses associated with different dietary FMPs. Adult primate mandibles from 11 species were imaged using high‐resolution X‐ray computed tomography, and trabecular structure was analyzed with BoneJ and Quant3D to assess common three‐dimensional trabecular parameters. Results of phylogenetic generalized least squares analysis suggested a positive correlation between the degree of anisotropy (DA) and toughness, and weaker correlations between FMPs and various other trabecular variables. Because the DA contributes to the mechanical properties of bone, these results suggest a functional relationship between dietary toughness and trabecular anisotropy in the mandibular condyle. Such a perspective underscores the need to consider all aspects of skeletal morphology in evaluating the links between diet and jaw biomechanics. Anat Rec, 2018. © 2018 Wiley Periodicals, Inc.
Caffeine and Exercise Performance

Caffeine may be the most widely used stimulant in the world. It is found in a variety of plants, dietary sources (including coffee, tea, chocolate, cocoa, and colas), and non-prescription medications. The average caffeine consumption in the USA is approximately 2 cups of coffee per day (200 mg); 10% of the population ingests more than 1000 mg per day. Caffeine is a socially acceptable, legal drug consumed by all groups in society. Caffeine is often referred to as a nutritional ergogenic aid, but it has no nutritional value. Ingested caffeine is quickly absorbed from the stomach and peaks in the blood in 1-2 hours. Caffeine has the potential to affect all systems of the body, as it is absorbed by most tissue. The remaining caffeine is broken down in the liver and byproducts are excreted in urine. CAFFEINE AND ENDURANCE EXERCISE PERFORMANCE Laboratory studies from the 1970's suggested that caffeine enhanced endurance performance by increasing the release of adrenaline into the blood stimulating the release of free fatty acids from fat tissue and/or skeletal muscle. The working muscles use this extra fat early in exercise, reducing the need to use muscle carbohydrate (glycogen). The " sparing " of muscle glycogen made more available later in exercise to delay fatigue. In the 1980's, many studies found that caffeine did not alter exercise metabolism, and implied that it had no ergogenic effect, without actually measuring performance. A few reports did examine caffeine and performance during endurance exercise and generally found no ergogenic effect. By the end of the decade, it was suggested that caffeine did not alter metabolism during endurance exercise and may not be ergogenic. Recent work reported that ingestion of 3-9 mg of caffeine per kilogram (kg) of body weight one hour prior to exercise increased endurance running and cycling performance in the laboratory. To put this into perspective, 3 mg per kg body weight equals approximately one mug or 2 regular size cups of drip-percolated coffee; and 9 mg/kg = approximately 3 mugs of 5-6 regular size cups of coffee. These studies employed well-trained, elite or serious, recreational athletes. Studies with untrained individuals cannot be performed due to their inability to reliably exercise to exhaustion. The mechanism to explain these endurance improvements is unclear. Muscle glycogen is spared early during submaximal exercise following caffeine ingestion (5-9 mg/kg). It is unknown whether glycogen sparing occurs as a result of caffeine's …
Crisis and Emergency Risk Messaging in Mass Media News Stories: Is the Public Getting the Information They Need to Protect Their Health?

ABSTRACT The mass media provide an important channel for delivering crisis and emergency risk information to the public. We conducted a content analysis of 369 newspaper and television broadcast stories covering natural disaster and foodborne outbreak events and coded for seven best practices in crisis and emergency risk messaging. On average, slightly less than two (1.86) of the seven best practices were included in each story. The proportion of stories including individual best practices ranged from 4.6% for “expressing empathy” to 83.7% for “explaining what is known” about the event’s impact to human health. Each of the other five best practices appeared in less than 25% of stories. These results suggest much of the risk messaging the public receives via mass media does not follow best practices for effective crisis and emergency communication, potentially compromising public understanding and actions in response to events.
Strategies for Utilizing Neuroimaging Biomarkers in CNS Drug Discovery and Development: CINP/JSNP Working Group Report

Abstract Despite large unmet medical needs in the field for several decades, CNS drug discovery and development has been largely unsuccessful. Biomarkers, particularly those utilizing neuroimaging, have played important roles in aiding CNS drug development, including dosing determination of investigational new drugs (INDs). A recent working group was organized jointly by CINP and Japanese Society of Neuropsychopharmacology (JSNP) to discuss the utility of biomarkers as tools to overcome issues of CNS drug development. The consensus statement from the working group aimed at creating more nuanced criteria for employing biomarkers as tools to overcome issues surrounding CNS drug development. To accomplish this, a reverse engineering approach was adopted, in which criteria for the utilization of biomarkers were created in response to current challenges in the processes of drug discovery and development for CNS disorders. Based on this analysis, we propose a new paradigm containing 5 distinct tiers to further clarify the use of biomarkers and establish new strategies for decision-making in the context of CNS drug development. Specifically, we discuss more rational ways to incorporate biomarker data to determine optimal dosing for INDs with novel mechanisms and targets, and propose additional categorization criteria to further the use of biomarkers in patient stratification and clinical efficacy prediction. Finally, we propose validation and development of new neuroimaging biomarkers through public-private partnerships to further facilitate drug discovery and development for CNS disorders.
Taking a position on intramembrane proteolysis

Decades of work have contributed to our in-depth mechanistic understanding of soluble proteases, but much less is known about the catalytic mechanism of intramembrane proteolysis due to inherent difficulties in both preparing and analyzing integral membrane enzymes and transmembrane substrates. New work from Naing et al. tackles this challenge by examining the catalytic parameters of an aspartyl intramembrane protease homologous to the enzyme that cleaves amyloid precursor protein, finding that both chemistry and register contribute to specificity in substrate cleavage.
The Rules of Aggression: How Genetic, Chemical and Spatial Factors Affect Intercolony Fights in a Dominant Species, the Mediterranean Acrobat Ant Crematogaster scutellaris

Nest-mate recognition plays a key role in the biology of ants. Although individuals coming from a foreign nest are, in most cases, promptly rejected, the degree of aggressiveness towards non nest-mates may be highly variable among species and relies on genetic, chemical and environmental factors. We analyzed intraspecific relationships among neighboring colonies of the dominant Mediterranean acrobat ant Crematogaster scutellaris integrating genetic, chemical and behavioral analyses. Colony structure, parental relationships between nests, cuticular hydrocarbons profiles (CHCs) and aggressive behavior against non nest-mates were studied in 34 nests located in olive tree trunks. Bayesian clustering analysis of allelic variation at nine species-specific microsatellite DNA markers pooled nests into 14 distinct clusters, each representing a single colony, confirming a polydomous arrangement of nests in this species. A marked genetic separation among colonies was also detected, probably due to long distance dispersion of queens and males during nuptial flights. CHCs profiles varied significantly among colonies and between nests of the same colony. No relationship between CHCs profiles and genetic distances was detected. The level of aggressiveness between colonies was inversely related to chemical and spatial distance, suggesting a ‘nasty neighbor’ effect. Our findings also suggest that CHCs profiles in C. scutellaris may be linked to external environmental factors rather than genetic relationships.
Economic Dispatch in Microgrid using Stochastic Fractal Search Algorithm

102 Abstract— This paper presents the method using Stochastic Fractal Search Algorithm (SFSA) for solving the Economic dispatch (ED) problem in Microgrid. The SFSA is based on two main processes: diffusion process and updating process. The diffusion process is similar to Fractal Search about diffusion of new particle, but only the best generated particle from the diffusing process is considered, and the others are discarded. It uses Levy flight and Gaussian statistical methods to control new particles creation process. In the updating process, using the algorithm which simulates how a point in the group updates its position based on the position of other points in the group, through random methods. The proposed method has been applied on 3 problems in microgrid system: System with 140 diesel generators and solved fuel constrained economic dispatch (ED) problem; system with 40 generators with valve-point loading; system with two conventional generators (synchronous generators), one combined heat and power (CHP), wind generator, solar generator in the islanded mode. The objective of the ED problem is to minimize the total generation cost of a power system over some appropriate period while satisfying various constraints. This paper gives effective solutions for these 3 problems and compares their results with those obtained by other evolutionary methods. It is found that Stochastic Fractal Search Algorithm is able to provide better solution.
Training for intense exercise performance: high‐intensity or high‐volume training?

Performance in intense exercise events, such as Olympic rowing, swimming, kayak, track running and track cycling events, involves energy contribution from aerobic and anaerobic sources. As aerobic energy supply dominates the total energy requirements after ∼75 s of near maximal effort, and has the greatest potential for improvement with training, the majority of training for these events is generally aimed at increasing aerobic metabolic capacity. A short‐term period (six to eight sessions over 2–4 weeks) of high‐intensity interval training (consisting of repeated exercise bouts performed close to or well above the maximal oxygen uptake intensity, interspersed with low‐intensity exercise or complete rest) can elicit increases in intense exercise performance of 2–4% in well‐trained athletes. The influence of high‐volume training is less discussed, but its importance should not be downplayed, as high‐volume training also induces important metabolic adaptations. While the metabolic adaptations that occur with high‐volume training and high‐intensity training show considerable overlap, the molecular events that signal for these adaptations may be different. A polarized approach to training, whereby ∼75% of total training volume is performed at low intensities, and 10–15% is performed at very high intensities, has been suggested as an optimal training intensity distribution for elite athletes who perform intense exercise events.
The Influence of Freshwater Biofilms on Drag in Hydroelectric Power Schemes

Freshwater biofilms are currently being studied to determine their effect on the capacity of hydroelectric power scheme canals and the structure of their turbulent wall layers. Mean velocity boundary layer profiles and total drag measurements have been conducted in a purpose built recirculating water tunnel on freshwater biofilms grown in a hydroelectric canal. Two different fouled surfaces were compared with a smooth painted surface to determine the effects of the physical characteristics of a biofilm on skin friction drag. A 310% increase in local skin friction coefficient was measured for a biofilm dominated by long filamentous algae streamers, and a 50% increase was measured for a biofilm dominated by a low-form gelatinous diatom.
Children's understanding of anticipatory regret and disappointment

The anticipation of regret and disappointment plays an important role in decision making by adults. The anticipation of regret may also lead to a desire to avoid feedback about likely outcomes of non-chosen courses of action, while the anticipation of disappointment is associated with avoidance of risk-taking and the deliberate dampening of expectations. The present study used the context of a simple game to examine children's understanding of these anticipatory regret and disappointment emotion-regulation strategies. It was found that even though children 7/8 years of age were able to understand the situational factors that produce disappointment and regret, it was not until 9/10 years of age that children exhibited an understanding of anticipatory regret emotion-regulation strategies, and even at this age children did not exhibit an understanding of the use of dampening of expectations as a strategy for coping with the anticipation of disappointment.
Effectiveness of a trauma‐focused group intervention for young refugees: a randomized controlled trial

BACKGROUND As access to evidence-based treatments for young refugees with posttraumatic stress symptoms (PTSS) is limited, we developed the trauma-focused group intervention Mein Weg to be delivered by trained social workers. A recently published pilot study delivered preliminary evidence of the intervention with regard to symptom reduction and its feasibility. The aim of this study was, therefore, to determine whether the intervention, in addition to usual care (UC), is more effective in reducing PTSS (primary outcome) compared to UC alone. METHODS A parallel group randomized controlled trial was conducted in seven German child and adolescent welfare agencies. Participants were randomly assigned to either six sessions Mein Weg (n = 50; Mage = 17.00, 94% male) or UC (n = 49; Mage = 16.92, 92% male). Mixed effect models, with fixed effects of group and time as well as their interaction, were performed on the relevant outcome measures. This trial was registered in the German Clinical Trials Registry (#DRKS00010915, https://www.drks.de/drks_web/). RESULTS Intention-to-treat analyses showed that Mein Weg was significantly superior to UC regarding symptom improvement of self-reported PTSS (Mein Weg: d = .61, UC: d = .15) and depression (Mein Weg: d = .63, UC: d = -.06), but not regarding caregiver-reported symptoms and self-reported dysfunctional posttraumatic cognitions. CONCLUSIONS Mein Weg is effective for young refugees according to self-reports and can be viewed as a valuable component in a stepped care approach for this vulnerable population. The findings need to be replicated with independent clinical assessments.
Effects of Knee Position on the Reliability and Production of Maximal and Rapid Strength Characteristics During an Isometric Squat Test.

This study aimed to examine the effects of knee position on the reliability and production of peak force (PF) and rate of force development (RFD) characteristics during an isometric squat. Fourteen resistance-trained females performed isometric squats at 90, 120, and 150° knee angles (corresponding to parallel, half, and quarter squat positions, respectively) on 2 different occasions, from which PF, peak RFD, and early (RFD30, RFD50, RFD100) and late (RFD200) phase RFD variables were extracted. PF and RFD200 were highly consistent across trials for all 3 squat positions, with intraclass correlation coefficients (ICCs) ranging between 0.812-0.904 and coefficients of variation (CVs) between 6.6-19.4%. For peak and early RFD characteristics, higher ICCs and lower CV values were observed for the quarter squat (ICCs = 0.818-0.852, CVs = 17.3-19.4%) compared to the parallel (ICCs = 0.591-0.649, CVs = 30.1-55.9%) and half squats (ICCs = 0.547-0.598,CVs = 31.1-34.2%). In addition, isometric PF and RFD200 increased (P ≤ .001-0.04) with squat position (parallel < half < quarter); however, there were no differences for peak RFD (P ≥ .27), RFD30 (P ≥ .99), RFD50 (P ≥ .99), and RFD100 (P ≥ .09). These findings suggest that performing isometric squats at higher (150°) rather than lower knee joint angles (90-120°) may provide for an improved capacity to produce greater PF and RFD200 as well as a more reliable testing position for measuring peak and early RFD characteristics.
Molecular Phylogeny of Weakfish Species of the Stellifer Group (Sciaenidae, Perciformes) of the Western South Atlantic Based on Mitochondrial and Nuclear Data

The phylogenetic relationships within the Stellifer group of weakfishes (Stellifer, Odontoscion, Ophioscion, and Bairdiella) were evaluated using 2723 base pairs comprising sequences of nuclear (rhodopsin, TMO-4C4, RAG-1) and mitochondrial (16S rRNA and COI) markers obtained from specimens of nine species. Our results indicate a close relationship between Bairdiella and Odontoscion, and also that the genus Stellifer is not monophyletic, but rather that it consists of two distinct lineages, one clade containing S. microps/S. naso/S. brasiliensis and the other, S. rastrifer/S. stellifer/Stellifer sp. B, which is closer to Ophioscion than the former clade. The O. punctatissimus populations from the northern and southern Brazilian coast were also highly divergent in both nuclear (0.8% for rhodopsin and 0.9% for RAG-1) and mitochondrial sequences (2.2% for 16S rRNA and 7.3% for COI), which we conclude is consistent with the presence of two distinct species. The morphological similarities of the members of the Stellifer group is reinforced by the molecular data from both the present study and previous analyses, which have questioned the taxonomic status of the Stellifer group. If, on the one hand, the group is in fact composed of four genera (Stellifer, Ophioscion, Odontoscion, and Bairdiella), one of the two Stellifer clades should be reclassified as a new genus. However, if the close relationship and the reduced genetic divergence found within the group is confirmed in a more extensive study, including representatives of additional taxa, this, together with the morphological evidence, would support downgrading the whole group to a single genus. Obviously, these contradictory findings reinforce the need for a more systematic taxonomic revision of the Stellifer group as a whole.