Miracle-dz/UniFAR-FTUs huggingface dataset:
The Feasibility and Acceptability of Groups for Pain Management in Methadone Maintenance Treatment

Objectives:Effective and safe pain management interventions in methadone maintenance treatment are needed. Methods:We examined the feasibility (ie, single-session attendance) and acceptability (ie, patient satisfaction and booster session attendance) of cognitive-behavioral therapy–informed groups for pain management—Coping With Pain, Relaxation Training, Group Singing, and Mindful Walking. Pre- and postsession measures were collected. Results:A total of 349 (out of a census of approximately 800) methadone-maintained patients attended at least 1 of the groups. Group satisfaction was high. Booster session attendance was numerically lower in Mindful Walking (14%) than in the other groups (at least 40%). Repeat attendance at Coping With Pain was associated with reduced characteristic pain intensity and depression, whereas repeat attendance at Relaxation Training was associated with decreased anxiety. Conclusions:Coping With Pain, Relaxation Training, and Group Singing are transportable, affordable, adaptable, and tolerated well by patients with pain and show promise as components of a multimodal pain management approach in methadone maintenance treatment.
Comparative Phylogeography Reveals Cryptic Diversity and Repeated Patterns of Cladogenesis for Amphibians and Reptiles in Northwestern Ecuador

Comparative phylogeography allow us to understand how shared historical circumstances have shaped the formation of lineages, by examining a broad spectrum of co-distributed populations of different taxa. However, these types of studies are scarce in the Neotropics, a region that is characterized by high diversity, complex geology, and poorly understood biogeography. Here, we investigate the diversification patterns of five lineages of amphibians and reptiles, co-distributed across the Choco and Andes ecoregions in northwestern Ecuador. Mitochondrial DNA and occurrence records were used to determine the degree of geographic genetic divergence within species. Our results highlight congruent patterns of parapatric speciation and common geographical barriers for distantly related taxa. These comparisons indicate similar biological and demographic characteristics for the included clades, and reveal the existence of two new species of Pristimantis previously subsumed under P. walkeri, which we describe herein. Our data supports the hypothesis that widely distributed Chocoan taxa may generally experience their greatest opportunities for isolation and parapatric speciation across thermal elevational gradients. Finally, our study provides critical information to predict which unstudied lineages may harbor cryptic diversity, and how geology and climate are likely to have shaped their evolutionary history.
Impact of a Structured Prenatal Counseling on Anxiety Level among Women Undergoing Amniocentesis

Background: Although amniocentesis is a common obstetric procedure, it is usually accompanied with higher level of anxiety related to anticipated pain, possible harm to pregnancy and testing results. Aim: The aim of the study was to examine the impact of a structured prenatal counseling on anxiety level among women undergoing amniocentesis. Design: Non-equivalent pre-post test Quasi experimental research design was utilized. Sample: A convenient sample of 32 pregnant women undergoing amniocentesis was recruited through a period of one year (24 in study group) and (8 in control group). Setting: The study was conducted in two settings; Fetal Medicine Unit at El-Manial University Hospital and Fetal Medicine and Diagnosis Unit at the National Research Center, in Cairo, Egypt. Tools: Maternal assessment interviewing schedule, state/trait anxiety inventory (STAI), Miller Behavioral Style Scale (MBSS), pre/post comprehension questionnaire and counseling satisfaction scale (CSS) were used for data collection. Results: The results showed that anxiety scores were decreased significantly immediately after application of counseling in the study group (t=19.88, p= 0.000) while anxiety scores did not show significant decrease two weeks after application of counseling (t= 0.353, p= 0. 727). As regards difference between study and control group there were significant difference in anxiety scores immediately after counseling (t= 8.84, p= 0.000) while no significant difference was found two weeks after counseling (t= 1.257, p= 0.218). Conclusion: The study concluded that application of pre-amniocentesis counseling decreased anxiety levels immediately before undergoing the procedure and has a little effect on the anxiety scores in the waiting period for the testing results. Recommendation: The study recommended that informative counseling should be included in the routine nursing care for women undergoing amniocentesis
Study of Volume, Weight and Size of Normal Pancreas, Spleen and Kidney in Adults Autopsies

Aims: 1) To establish the volume, weight and size of a normal pancreas, spleen and kidney in 114 adult male autopsies; 2) To investigate the relationship between the volume, weight, and size of the pancreas, spleen, and kidney with body mass index (BMI), body surface area (BSA), age, height, and weight. Methods: The normal pancreas, spleen, and kidney volume, weight, and size retrospectively gathered from 114 forensic autopsy cases between the ages of 25 and 88 years. The pancreas, spleen, and kidney volume, weight, and size were available. The parameters used for statistical correlation were the age, height, body weight, BMI, and BSA of the deceased. Results: The volume, weight, and size of all the organs were shown in correlation with the deceased’s height, body weight, BMI, and BSA but not age. The organ volume, weight, and size showed a better statistical correlation with the BSA, BMI, and body weight than the height. Conclusions: The normal reference ranges for organ volume, weight, and size given in this study can serve as a standard to judge atrophy or hypertrophy of organs in post-mortem diagnosis.
A comparison of successful and unsuccessful attempts in maximal bench pressing.

PURPOSE This study was designed to compare the differences in EMG and kinematics between successful and unsuccessful attempts in bench pressing at one repetition maximum (1RM) in recreational weight-trained subjects. We hypothesized that failure occurs during the sticking period (the period during which there is a temporary reduction in movement velocity). METHODS Eleven male subjects (age = 21.9 +/- 1.8 yr, mass = 80.0 +/- 11.2 kg, height = 1.79 +/- 0.08 m) with at least 1 yr of bench press training experience participated in this study. They performed attempts at 1RM and 1RM + 2.5 kg in bench press during which kinematics and muscle activity were recorded. One successful attempt and one unsuccessful attempt were used for further analysis. RESULTS Both attempts showed the same sticking period, but only half of the failures occurred during that period. The main differences in the kinematics occurred during the sticking period. Muscle activity, in contrast, showed the same pattern in both attempts and only differed during the downward and the start of the upward movement of the lift. CONCLUSIONS The sticking period occurs in both successful and unsuccessful attempts in maximal bench press. However, failure does not always occur during the sticking period.
Modulation of Staphylococcus aureus Biofilm Matrix by Subinhibitory Concentrations of Clindamycin

ABSTRACT Staphylococcus aureus biofilms are extremely difficult to treat. They provide a protected niche for the bacteria, rendering them highly recalcitrant toward host defenses as well as antibiotic treatment. Bacteria within a biofilm are shielded from the immune system by the formation of an extracellular polymeric matrix, composed of polysaccharides, extracellular DNA (eDNA), and proteins. Many antibiotics do not readily penetrate biofilms, resulting in the presence of subinhibitory concentrations of antibiotics. Here, we show that subinhibitory concentrations of clindamycin triggered a transcriptional stress response in S. aureus via the alternative sigma factor B (σB) and upregulated the expression of the major biofilm-associated genes atlA, lrgA, agrA, the psm genes, fnbA, and fnbB. Our data suggest that subinhibitory concentrations of clindamycin alter the ability of S. aureus to form biofilms and shift the composition of the biofilm matrix toward higher eDNA content. An understanding of the molecular mechanisms underlying biofilm assembly and dispersal in response to subinhibitory concentrations of clinically relevant antibiotics such as clindamycin is critical to further optimize antibiotic treatment strategies of biofilm-associated S. aureus infections.
Excavations at the Marco Gonzalez Site, Ambergris Cay, Belize, 1986

Abstract Excavations at the small site of Marco Gonzalez at the tip of an offshore cay, for coral island, off the northern coast of Belize yielded evidence of occupation from early in the Christian era to perhaps as late as the beginning of the Spanish contact period, ca. A.C. 1544. During the community's apogee, ca. A.C. 1150–1300, its material culture closely resembled that of the Postclassic center of Lamanai on the New River Lagoon in northern Belize. The resemblance suggests that other cultural links also tied the two communities to each other. The data add significantly to a growing body of information on Maya use of the cays; they also extend our understanding of southern lowlands Postclassic developments and of Lamanai's role therein.
Growth Plate Forces in the Adolescent Human Knee: A Radiographic and Mechanical Study of Epiphyseal Staples

The purpose of this study was to quantify the forces produced by the growth plates of the adolescent human proximal tibia and distal femur. The postoperative deformations of staples used to treat genu valgum were correlated with similar staple deformations produced by mechanical testing. Staple deformation was measured in sequential radiographs of 35 knees in 20 patients. Mechanical tests were performed on new staples to determine the force necessary to bend the staples to the observed displacements. Based on deformation at final examination, the static equivalent loads exerted at the joint centerline by the growth plates of the proximal tibia and distal femur were 0.5 kN per physis. The estimated corresponding stress was 1 MPa. These results indicated that successful lower limb hemiepiphysiodesis suppressed a longitudinally directed, centrally applied compressive force on the order of body weight.
The Role of Antibiotics after Surgical Treatment of Simple Hand Infections: A Prospective Pilot Study

ABSTRACT Background: Manifested hand infections are usually treated by sufficient debridement and drainage followed by splinting and elevation of the corresponding upper extremity. The role of antibiotics in the postoperative prognosis of hand infections is contradictory. Methods: Three groups of 30 patients each with subcutaneous or subfascial localized hand infections without infiltration of tendons, joints, or bones, have been treated in a different way regarding the use of antibiotics postoperatively. Group 1 was treated with systemic cephalosporins as well as locally inserted Gentamycin bead chains in the wound after debridement. Group 2 was only treated locally with Gentamycin bead chains but no systemic antibiots, while Group 3 did not receive any antibiotics at all. Results: No substantial differences could be observed between the three patient groups regarding the convalescence in terms of duration of splinting and recovery of hand function in relation to hand mobility as assessed by the sum of finger-palm distance and to the disabilities of the arm, shoulder, and hand score. Conclusions: The use of antibiotics after surgical treatment of simple hand infections seems to be unnecessary.
Use of the International Classification of Diseases (ICD‐9‐CM) to Identify Hospitalizations for Mechanical Low Back Problems in Administrative Databases

Large administrative databases are increasingly valuable tools for health care research. Although increased access to these databases provides valuable opportunities to study health care utilization, costs and outcomes and valid and comparable results require explicit and consistent analytic methods. Algorlthms for identifying surgical and nonsurgical hospitalizations for “mechanical” low back problems in automated databases are described. Sixty-six ICD-9-CM diagnosis and 15 procedure codes that could be applied to patients with mechanical low back problems were identified. Twenty-seven diagnosis and two procedure codes identify hospitalizations for problems definitely in the lumbar or lumbosacral region. Exclusion criteria were developed to eliminate nonmechanical causes of low back pain, such as malignancies, infections, and major trauma. The use of the algorithms is illustrated using national hospital discharge data.
Public sector e-procurement: a study of benefits from e-markets in the local government sector

Procuring goods and services through e-markets can have profound effects on organisations in terms of the benefits e-markets deliver to them. In the local government sector, the adoption and implementation of electronic government initiatives to increase the effectiveness of how public services are delivered and the need to address inefficiencies in their procurement function have been two of the key drivers of e-market adoption. Although a number of studies have looked at some of the prospective and realised benefits e-markets offer organisations in the private sector, to date, few studies have examined the procurement benefits that public sector organisations gain from e-market participation. This exploratory study uses an e-market procurement benefits framework to examine the types of benefits local authorities gain from procuring through e-markets that operate in the local government sector. E-markets were found to provide a number of benefits to local authorities that correspond to the operational, m.
Global asymptotics of the discrete Chebyshev polynomials

In this paper, we study the asymptotics of the discrete Chebyshev polynomials tn (z, N) as the degree grows to infinity. Global asymptotic formulas are obtained as n \rightarrow \infty, when the ratio of the parameters n/N = c is a constant in the interval (0, 1). Our method is based on a modified version of the Riemann-Hilbert approach first introduced by Deift and Zhou.
Is There a Case in Favour of Predictive Genetic Testing in Young Children?

Genetic testing has brought the ability to predict the onset of diseases many years before symptoms appear and the use of such predictive testing is now widespread. The medical fraternity has met the application of this practice to children with caution. The justification for their predominantly prohibitive stance has revolved around the lack of a readily identifiable medical benefit in the face of potential psychological harms to the child. We argue that predictive testing can have important psychosocial benefits and that the interests of the child have been construed too narrowly. Proponents of a prohibitive stance also argue that testing in childhood breaches the child's future right to make the same decision as an autonomous adult and to maintain this information as confidential. We argue that predictive genetic testing of children is not necessarily a violation of the child's future autonomy. Indeed, in some cases, such testing may facilitate the development of autonomy in the maturing child. We argue that parents are generally best placed to judge what is in their own child's overall interests, and that parental request for testing after appropriate genetic counselling should be respected unless there is clear evidence that the child will be harmed in an overall sense as a result of testing.
Behavioural Complexity in Eurasian Neanderthal Populations: a Chronological Examination of the Archaeological Evidence

Whether Neanderthals were capable of behaviours commonly held to be the exclusive preserve of modern humans — such as abstract thought, language, forward planning, art, reverence of the dead, complex technology, etc. — has remained a fundamental question in human evolutionary studies since their discovery more than a hundred years ago. A lack of quantitative data on Neanderthal symbolism and complex behaviour is a key obstacle to the resolution of this question, with temporal analyses usually confined to single regions or short time periods. Here we present an approach to the issue of symbolism and complex behaviours among Neanderthals that examines the frequency of key proxies for symbolic and complex behaviours through time, including burials, modified raw materials, use of pigments, use of composite technology and body modification. Our analysis demonstrates that the number and diversity of complex Neanderthal behaviours increases between 160,000 and 40,000 years ago. Whether this pattern derives from preservation factors, the evolution of cognitive and behavioural complexity, cumulative learning, or population size is discussed. We take the view that it is not the apparent sophistication of a single specific item, nor the presence or absence of particular types in the archaeological record that is important. Instead, we believe that it is the overall abundance of artefacts and features indicative of complex behaviours within the Neanderthal archaeological record as a whole that should provide the mark of Neanderthal capabilities and cultural evolutionary potential.
Does It Make a Difference? L2 Vocabulary Learning via Mobile and Conventional Mode

The present study investigated the significance of mobile learning (m-learning) of English vocabulary items through a traditional contrasted with a blended method of content representation. To achieve the goals, sixty semi-illiterate adults were evaluated for their knowledge of the English alphabet and then randomly placed in two groups: traditional (G1) and the blended group (G2). Next, they were presented thirty new English vocabulary items through the two methods. Also, the vocabulary items were taught with and without pictorial annotations. Upon the completion of teaching, the participants took the paper-and-pencil-based English Vocabulary Recognition and Recall (EVRR) test. The test results were subjected to the appropriate statistical analyses. The analysis demonstrated the supremacy of blended group's performance over the traditional group in vocabulary learning. Furthermore, the obtained results confirmed that pictorial annotations enhanced the learning of L2 vocabulary compared with non-annotated items. The results can provide some practical and theoretical implications for both teachers and learners.
Impact of the Insertion Speed of Cochlear Implant Electrodes on the Insertion Forces

Hypothesis: Objective of the present experimental research study was to examine the hypothesis that cochlear implant insertion speed can significantly affect the insertion forces. Background: Cochlear implant electrode insertion forces can influence the insertion trauma and the preservation of residual hearing. The effect of the electrode insertion speed on the insertion forces still remains unknown. Methods: Force measurements were performed while inserting human electrodes in an artificial scala tympani model at different speeds. For these measurements, an Instron 5542 Force Measurement System with a 10 N load cell and Nucleus 24 Contour Advance electrodes were used. Additionally, the insertion speed was measured through videos of 116 human implantations; these videos were recorded in our theaters and involved different surgeons and electrode types. Results: Progressive increase in insertion speed from 10 to 200 mm/min resulted in significant, proportional increase in the average insertion forces from 0.09 to 0.185 N and in the maximum forces from 0.18 to 0.42 N, respectively. The average insertion speed used in the theaters during human cochlear implantations was 96.5 mm/min (range, 42-165.2 mm/min) and depended on the electrode type and the surgeon. Conclusion: High insertion speeds cause significant increase of the forces. Cochlear implant surgeons should use low and stable speeds during the insertion. Insertion speed close to the average value used in the theaters should be applied on experimental models, to approximate human implantation conditions.
Population pharmacokinetics of lorazepam and midazolam and their metabolites in intensive care patients on continuous venovenous hemofiltration.

BACKGROUND The objective is to study the population pharmacokinetics of lorazepam and midazolam in critically ill patients with acute renal failure who are treated with continuous venovenous hemofiltration (CVVH). METHODS Twenty critically ill patients with acute renal failure on CVVH therapy were administered either lorazepam (n = 10) or midazolam (n = 10) by continuous infusion. CVVH was performed with an ultrafiltrate flow of 2 L/h with filtrate substitution in the predilution or postdilution mode. Blood flow through the 1.9-m 2 cellulose triacetate membrane filter was 180 mL/min. For 48 hours, multiple blood and ultrafiltrate samples were obtained for determination of concentrations of the drug and its metabolites. RESULTS The pharmacokinetics of lorazepam is described best by a 1-compartment model. No significant covariates were identified. Total-body clearance was 6.4 L/h, and volume of distribution was 376 L. Ultrafiltration clearance was 0.31 L/h, equivalent to approximately 5% of total clearance. Average degree of plasma protein binding was 82.9% for lorazepam, with a sieving coefficient of 0.16 +/- 0.03. For lorazepamglucuronide, degree of plasma protein binding was 39.5%, and sieving coefficient was 0.48 +/- 0.07. The pharmacokinetics of midazolam is described best by a 1-compartment model. No significant covariates were identified. Total-body clearance was 8.5 L/h, and volume of distribution was 157 L. Clearance by ultrafiltration was 0.055 L/h, equivalent to approximately 0.7% of total clearance. Average degree of plasma protein binding was 95.8%, with a sieving coefficient of 0.04 +/- 0.03. For the metabolite 1-hydroxymidazolamglucuronide, average degree of plasma protein binding was 43.4%, with a sieving coefficient of 0.45 +/- 0.06. CONCLUSION Neither lorazepam nor midazolam is removed efficiently by CVVH. CVVH contributes significantly to the removal of the glucuronide metabolites lorazepamglucuronide and 1-hydroxymidazolamglucuronide.
Urodynamic effects and safety of modified intravesical oxybutynin chloride in patients with neurogenic detrusor overactivity: 3 years experience

Abstract Background: Intravesical oxybutynin chloride with hydroxypropylcellulose (HPC) (modified intravesical oxybutynin) has been reported to be effective for treatment of overactive bladder. We reported the short‐term effects of modified intravesical oxybutynin previously. In the present article, we detail the results of a 3‐year follow‐up study of patients from our previous analysis and report the efficacy and side‐effects of modified intravesical oxybutynin.