Miracle-dz/UniFAR-FTUs huggingface dataset:
Clients' perspectives on therapy termination

Abstract We used consensual qualitative research to analyze interviews with 12 clients about their termination from psychotherapy. Those who had positive termination experiences reported a strong therapeutic relationship and positive outcomes of therapy. They terminated primarily for logistical or financial reasons; their termination, post-termination plans, and feelings about termination were discussed in advance with their therapist, as was their growth in therapy, leading to mostly positive effects of the termination. In contrast, those who had problematic terminations reported a mixed therapeutic relationship and mixed outcomes of therapy. They usually terminated abruptly because of a therapeutic rupture, and thus termination was rarely planned and discussed in advance, rendering it a negative experience. Implications of these findings are addressed.
Origins and Diversification of a Complex Signal Transduction System in Prokaryotes

The bacterial chemotaxis system evolved from simpler regulatory proteins that primarily control transcription. Evolution and Classification of Bacterial Chemotaxis With the availability of whole-genome and proteome data, it is now possible to investigate questions related to the evolution of signaling systems. By analyzing 450 prokaryotic proteomes, Wuichet and Zhulin identified central and auxiliary components of the prokaryotic chemotaxis system and then grouped chemotaxis systems in various species into 19 classes. Additionally, their analysis revealed two previously unknown kinds of signal transducers that may be links between the complex chemotaxis system and the simple two-component transcription regulatory system from which the chemotaxis system is likely to have evolved. The molecular machinery that controls chemotaxis in bacteria is substantially more complex than any other signal transduction system in prokaryotes, and its origins and variability among living species are unknown. We found that this multiprotein “chemotaxis system” is present in most prokaryotic species and evolved from simpler two-component regulatory systems that control prokaryotic transcription. We discovered, through genomic analysis, signaling systems intermediate between two-component systems and chemotaxis systems. Evolutionary genomics established central and auxiliary components of the chemotaxis system. While tracing its evolutionary history, we also developed a classification scheme that revealed more than a dozen distinct classes of chemotaxis systems, enabling future predictive modeling of chemotactic behavior in unstudied species.
Fluidic operational amplifier for mock circulatory systems

For the development of cardiovascular devices and the study of the dynamics of blood flow through the cardiovascular system, hardware fluidic models are commonly used to minimize animal experiments and clinical trials. These systems, called "mock circulatory systems" (MCS) are also critical for development of ventricular assist devices (VADs). The passive and active elements in these systems are frequently "hard-plumbed" and are difficult to modify in experimental studies. Therefore we propose a novel fluidic operational amplifier comprised of a high-gain feedback-controlled gear pump. With pressure being the analog of voltage, design with the fluidic op-amp is analogous to electrical op-amp circuit design. Initial simulation results demonstrate that the device may be programmed for use in mock circulatory systems to emulate the function of the energy sources (the ventricles) or passive networks (hemodynamic loads).
Natural Single-Nucleotide Polymorphisms in the 3′ Region of the HIV-1 pol Gene Modulate Viral Replication Ability

ABSTRACT We previously showed that prototype macaque-tropic human immunodeficiency virus type 1 (HIV-1) acquired nonsynonymous growth-enhancing mutations within a narrow genomic region during the adaptation process in macaque cells. These adaptive mutations were clustered in the 3′ region of the pol gene, encoding a small portion of the C-terminal domain of integrase (IN). Mutations in HIV-1 IN have been reported to have pleiotropic effects on both the early and late phases in viral replication. cis-acting functions in the IN-coding sequence for viral gene expression have also been reported. We here demonstrated that the adaptive mutations promoted viral growth by increasing virion production with no positive effects on the early replication phase. Synonymous codon alterations in one of the adaptive mutations influenced virion production levels, which suggested nucleotide-dependent regulation. Indeed, when the single-nucleotide natural polymorphisms observed in the 3′ regions of 196 HIV-1/simian immunodeficiency virus (SIVcpz) pol genes (nucleotides [nt] 4895 to 4929 for HIV-1 NL4-3) were introduced into macaque- and human-tropic HIV-1 clones, more than half exhibited altered replication potentials. Moreover, single-nucleotide mutations caused parallel increases or decreases in the expression levels of viral late proteins and viral replication potentials. We also showed that the overall expression profiles of viral mRNAs were markedly changed by single-nucleotide mutations. These results demonstrate that the 3′ region of the HIV-1 pol gene (nt 4895 to 4929) can alter viral replication potential by modulating the expression pattern of viral mRNAs in a nucleotide-dependent manner. IMPORTANCE Viruses have the plasticity to adapt themselves under various constraints. HIV-1 can mutate and evolve in growth-restrictive cells by acquiring adaptive changes in its genome. We have previously identified some growth-enhancing mutations in a narrow region of the IN-coding sequence, in which a number of cis-acting elements are located. We now focus on the virological significance of this pol gene region and the mechanistic basis underlying its effects on viral replication. We have found several naturally occurring synonymous mutations within this region that alter viral replication potentials. The effects caused by these natural single-nucleotide polymorphisms are linked to the definite expression patterns of viral mRNAs. We show here that the nucleotide sequence of the pol gene (nucleotides 4895 to 4929 for HIV-1 NL4-3) plays an important role in HIV-1 replication by modulating viral gene expression.
Prognostic Significance of Nonobstructive Left Main Coronary Artery Disease in Women Versus Men: Long-Term Outcomes From the CONFIRM (Coronary CT Angiography Evaluation For Clinical Outcomes An International Multicenter) Registry

Background— Patients with obstructive (≥50% stenosis) left main (LM) coronary artery disease (CAD) are at high risk for adverse events; prior studies have also documented worse outcomes among women than men with severe multivessel/LM CAD. However, the prognostic significance of nonobstructive (1%–49% stenosis) LM CAD, including sex-specific differences, has not been previously examined. Methods and Results— In the long-term CONFIRM (Coronary CT Angiography Evaluation For Clinical Outcomes: An International Multicenter) registry, patients underwent elective coronary computed tomographic angiography for suspected CAD and were followed for 5 years. After excluding those with obstructive LM CAD, 5166 patients were categorized as having normal LM or nonobstructive LM (18% of cohort). Cumulative 5-year incidence of death, myocardial infarction, or revascularization was higher among patients with nonobstructive LM than normal LM in both women and men: women (34.3% versus 15.4%; P<0.0001); men (24.6% versus 18.2%; P<0.0001). A significant interaction existed between sex and LM status for the composite outcome (P=0.001). In multivariable Cox regression, the presence of nonobstructive LM plaque increased the risk for the composite outcome in women (adjusted hazard ratio, 1.48; P=0.005) but not in men (adjusted hazard ratio, 0.98, P=0.806). In subgroup analysis, women with nonobstructive LM CAD had a nearly 80% higher risk for events than men with nonobstructive LM CAD (adjusted hazard ratio, 1.78; P=0.017); sex-specific interactions were not observed across other patterns (eg, location or extent) of nonobstructive plaque. Conclusion— Nonobstructive LM CAD was frequently detected on coronary computed tomographic angiography and strongly associated with adverse events among women. Recognizing the sex-specific prognostic significance of nonobstructive LM plaque may augment risk stratification efforts.
Healthcare quality and moderators of patient satisfaction: testing for causality.

PURPOSE The purpose of this article is to present a comprehensive structural equation based service quality and patient satisfaction model taking into account the patient's condition before and after discharge. The authors aim to test for causality in a sample of patients from United Arab Emirates public hospitals. DESIGN/METHODOLOGY/APPROACH Data were collected using questionnaires completed by adults discharged (n = 244) from UAE public hospitals. The proposed model consists of five main constructs. Three represent service quality: quality of care (four variables); process and administration (four variables) and information (four variables). There is also one construct that represents patient's status (two variables--health status before admission and after discharge). Finally, there is one construct that represents patient's satisfaction with care (two variables--general and relative satisfaction). Structural equation modeling and LISREL using maximum likelihood estimation was used to test hypothesized model(s)/parameters(s) derived deductively from the literature. FINDINGS The structural equation modeling representation provides a comprehensive picture that allows healthcare constructs and patient satisfaction causality to be tested. The goodness-of-fit statistics supported the healthcare quality-patient status-satisfaction model. ORIGINALITY/VALUE The model has been found to capture attributes that characterize healthcare quality in a developing country and could represent other modern healthcare systems. Also, it can be used to evaluate other healthcare practices from patients' viewpoints. The study highlights the importance of healthcare quality as patient satisfaction predictors by capturing other effects such as patient status.
Variability of Emaravirus Species Associated with Sterility Mosaic Disease of Pigeonpea in India Provides Evidence of Segment Reassortment

Sterility mosaic disease (SMD) of pigeonpea is a serious constraint for cultivation of pigeonpea in India and other South Asian countries. SMD of pigeonpea is associated with two distinct emaraviruses, Pigeonpea sterility mosaic virus 1 (PPSMV-1) and Pigeonpea sterility mosaic virus 2 (PPSMV-2), with genomes consisting of five and six negative-sense RNA segments, respectively. The recently published genome sequences of both PPSMV-1 and PPSMV-2 are from a single location, Patancheru from the state of Telangana in India. However, here we present the first report of sequence variability among 23 isolates of PPSMV-1 and PPSMV-2, collected from ten locations representing six states of India. Both PPSMV-1 and PPSMV-2 are shown to be present across India and to exhibit considerable sequence variability. Variability of RNA3 sequences was higher than the RNA4 sequences for both PPSMV-1 and PPSMV-2. Additionally, the sixth RNA segment (RNA6), previously reported to be associated with only PPSMV-2, is also associated with isolates of PPSMV-1. Multiplex reverse transcription PCR (RT-PCR) analyses show that PPSMV-1 and PPSMV-2 frequently occur as mixed infections. Further sequence analyses indicated the presence of reassortment of RNA4 between isolates of PPSMV-1 and PPSMV-2.
AUDIT OF SURGICAL EMERGENCY AT LAHORE GENERAL HOSPITAL.

BACKGROUND Audit is a quality improvement process that seeks to improve patient care and outcomes through systematic review of care against explicit criteria and the review of change. Objective of this study was to report the patterns of admissions in our surgical emergency and the comparison of results with the available data. METHODS All the patients presented in the surgical emergency of Unit III from April to December 2014. Detail of all surgical patients admitted during the period was recorded from the emergency entry register maintained by the staff nurse. Demographic data, mode of admission, diagnosis and outcomes were recorded on a pro forma. RESULTS Total number of patients were 11140, out of which 5998 (53.8%) were males and 5142 (46%) were females, mostly were between 18-56 years of age. Emergency surgeries were performed in 650 of our cases whereas the rest of the patients were managed conservatively, treated at minor operation theatre (MOT), referred to their concerned emergencies or discharged. The most common presentation was road traffic accidents followed by trauma, urological emergencies and intestinal obstruction. Overall mortality was estimated as 1.5%. CONCLUSIONS Surgical audit should be made a regular practice to serve as an important and effective tool of accountibilty on clinical outcomes and self evaluation and in improving the quality of our health care system.
Campaigns and Cliques: Variations in Effectiveness of an Antismoking Campaign as a Function of Adolescent Peer Group Identity

Identity-based strategies have been suggested as a way to promote healthy behaviors when traditional approaches fall short. The truth® campaign, designed to reduce smoking in adolescents, is an example of a campaign that uses such a strategy to reach youth described as being outside the mainstream. This article examines the effectiveness of this strategy in promoting antitobacco company beliefs among youth. Survey data from 224 adolescents between 14 and 15 years of age were used to examine whether the truth® campaign was more or less effective at reaching and promoting antitobacco company beliefs among youth who identify with nonmainstream crowds (deviants and counterculture) versus those who identify with mainstream crowds (elites and academics). Analyses revealed that adolescents who identified as deviants and counterculture were more likely to have been persuaded by the truth® campaign. Social identity theory is used as a theoretical framework to understand these effects and to make recommendations for future health campaigns.
Ifosfamide, carboplatin and etoposide in children with poor-risk relapsed Wilms' tumor: a Children's Cancer Group report.

BACKGROUND The outcome of children with relapsed Wilms' tumor is poor, especially with poor-risk factors such as unfavorable histology, early recurrence, previous three-drug therapy, relapse not confined to lungs and abdominal relapse following abdominal radiotherapy. We report the overall response rate, progression-free survival and overall survival of 11 children with relapsed and poor-risk Wilms' tumor following ifosfamide/carboplatin/etoposide (ICE) chemotherapy. PATIENTS AND METHODS ICE therapy consisted of ifosfamide 1800 mg/m2/day (on day 0-4), carboplatin 400 mg/m2/day (on day 0-1) and etoposide 100 mg/m2/day (on day 0-4). The median age at diagnosis was 39 months (range from 13 months to 16 years) and the median time to relapse after initial diagnosis was 9 months (range 4-72 months). All but one patient had at least one poor prognostic feature, with eight patients showing three or four. RESULTS After ICE chemotherapy the number of patients showing a complete response (CR) was three (27%) and a partial response (PR) was six (55%). The overall response rate (CR+PR) was 82%. Five of the six patients with a PR subsequently achieved a CR with further therapy. The 3-year event-free survival and overall survival were 63.6 +/- 14.5%. CONCLUSIONS The response rate in children with relapsed and poor-risk Wilms' tumor is >80% with ICE re-induction chemotherapy followed by post-ICE therapy. The optimal approach for post-ICE consolidation therapy has yet to be determined.
Brief Report: Anal Cancer in the HIV-Positive Population: Slowly Declining Incidence After a Decade of cART

Abstract:We surveyed trends in incidence (1995–2012) and risk factors for anal cancer in the Dutch HIV-positive population. After an initial increase with a peak incidence in 2005–2006 of 114 [95% confidence interval (CI): 74 to 169] in all HIV+ patients and 168 (95% CI: 103 to 259) in HIV+ men who have sex with men (MSM), a decline to 72 (95% CI: 43 to 113) and 100 (95% CI: 56 to 164), respectively, was seen in 2011–2012. Low nadir CD4, alcohol use, and smoking were significantly associated with anal cancer in MSM. In conclusion, anal cancer remains a serious problem in predominantly HIV+ MSM. However, it seems that incidence rates are leveling off.
Power harvesting with PZT ceramics

Piezoelectric materials have been proposed as embedded power source, which are capable of converting mechanical energy into electrical energy. However, power generated from a piezoelectric material usually comes with poor characteristics such as high voltage, low current and high impedance. In order to drive the embedded sensor circuit, piezoelectric power needs to be characterized and regulated. In this paper, we present an analysis on the power generation characteristics of the stiff lead zirconate titanate (PZT) ceramics and its equivalent circuit. It is then verified by simulation and experimental results. Since a single PZT element may not meet the needs of real-world embedded applications, we present experiments and analysis using four identical PZTs. Finally, we outline an application where PZT elements are used for power generation in a Total Knee Replacement (TKR) implant.
New Trends in Aryl Hydrocarbon Receptor Biology

Traditionally considered as a critical intermediate in the toxic and carcinogenic response to dioxin (2,3,7,8-tetrachlorodibenzo-p-dioxin, TCDD), the Aryl hydrocarbon/Dioxin receptor (AhR) has proven to be also an important regulator of cell physiology and organ homeostasis. AhR has become an interesting and actual area of research mainly boosted by a significant number of recent studies analyzing its contribution to the proper functioning of the immune, hepatic, cardiovascular, vascular and reproductive systems. At the cellular level, AhR establishes functional interactions with signaling pathways governing cell proliferation and cell cycle, cell morphology, cell adhesion and cell migration. Two exciting new aspects in AhR biology deal with its implication in the control of cell differentiation and its more than likely involvement in cell pluripotency and stemness. In fact, it is possible that AhR could help modulate the balance between differentiation and pluripotency in normal and transformed tumor cells. At the molecular level, AhR regulates an increasingly large array of physiologically relevant genes either by traditional transcription-dependent mechanisms or by unforeseen processes involving genomic insulators, chromatin dynamics and the transcription of mobile genetic elements. AhR is also closely related to epigenetics, not only from the point of view of target gene expression but also with respect to its own regulation by promoter methylation. It is reasonable to consider that deregulation of these many functions could have a causative role, or at least contribute to, human disease. Consequently, several laboratories have proposed that AhR could be a valuable tool as diagnostic marker and/or therapeutic target in human pathologies. An additional point of interest is the possibility of regulating AhR activity by endogenous non-toxic low weight molecules agonist or antagonist molecules that could be present or included in the diet. In this review, we will address these molecular and functional features of AhR biology within physiological and pathological contexts.
A Passivity-Based Approach for Stable Patient–Robot Interaction in Haptics-Enabled Rehabilitation Systems: Modulated Time-Domain Passivity Control

In this paper, a novel passivity-based technique is proposed to 1) analyze and 2) guarantee the stability of haptics-enabled robotic/telerobotic systems when there is a possibility of having a source of nonpassivity (namely, a nonpassive environment) in addition to the conventional nonpassive component in teleoperation systems (namely, a delayed communication channel). The need for the proposed technique is motivated by safe and optimal implementation of the haptics-enabled robotic, cloud-based, and remote rehabilitation systems. The objective of the controller proposed in this paper is to perform minimum alteration to the system transparency, in a dynamic and patient-specific manner, by utilizing quantifiable biomechanical capability of the user’s limb (i.e., excess of passivity) in dissipating interactive energies to guaranteeing human–robot interaction safety, in the context of the strong passivity theorem. The proposed controller is named modulated time-domain passivity control (M-TDPC) approach and is a new member of the family of the state-of-the-art TDPC techniques. Simulations and experimental results are presented in support of the proposed technique and the developed theory.
Training Feedforward Neural Networks with Standard Logistic Activations is Feasible

Training feedforward neural networks with standard logistic activations is considered difficult because of the intrinsic properties of these sigmoidal functions. This work aims at showing that these networks can be trained to achieve generalization performance comparable to those based on hyperbolic tangent activations. The solution consists on applying a set of conditions in parameter initialization, which have been derived from the study of the properties of a single neuron from an information-theoretic perspective. The proposed initialization is validated through an extensive experimental analysis.
Validity of fractional exhaled nitric oxide and small airway function indices in diagnosis of cough-variant asthma

ABSTRACT Objective: Fractional exhaled nitric oxide (FeNO) is a non-invasive method used to reveal the eosinophilic inflammation of airway and to diagnose and manage asthma. The use of FeNO measurement or its combination with the small airway function in differentiating CVA patients from chronic cough patients is unexplored. Methods: From December 2012 to June 2016, patients with chronic non-productive cough for more than 8 weeks based on physician's opinion were subjected to FeNO, pulmonary function, and bronchial hyperresponsiveness (BHR) tests. Receiver operating characteristic (ROC) curves were obtained to evaluate the clinical value of FeNO and small airways indices in CVA diagnosis. The optimal cutoff point for the level of FeNO was also determined. Results: The FeNO value in the CVA group was significantly higher than that in the non-cough-variant asthma (NCVA) group [42(41) parts per billion (ppb) vs. (16(11) ppb), P < 0.05]. The area under the ROC curve was estimated to be 0.874 for FeNO. An optimal cutoff point of 25 ppb had respective sensitivity and specificity values of 81.3% and 84.0% in differentiating CVA patients from NCVA patients. The CVA group showed small airway dysfunction, and the small airway resistance was significantly higher than in the NCVA group. The area under the ROC curve of FeNO combined with maximal midexpiratory flow (MEF) (% predicted) was 0.883, and that combined with MEF50 (% predicted) was 0.886. Conclusions: The measurement of FeNO is a non-invasive, reproducible, and sensitive method of differentiating CVA patients from NCVA patients. A combination of the level of FeNO (25 ppb) and the abnormal small airway function suggested higher CVA possibility, thereby resulting in a rapid diagnosis. Unnecessary treatments are avoided. This finding provides a new perspective for the management of patients with CVA.