Miracle-dz/UniFAR-FTUs huggingface dataset:
Tapering Clonazepam in Patients With Panic Disorder After at Least 3 Years of Treatment

High-potency benzodiazepines, such as clonazepam, are frequently used in the treatment of panic disorder (PD) because of their rapid onset of action and good tolerability. However, there is concern about their potential to cause withdrawal symptoms. We aimed to develop a protocol for safely tapering off clonazepam in patients with PD who had been receiving treatment for at least 3 years. A specific scale for judging withdrawal was also developed, the Composite Benzodiazepine Discontinuation Symptom Scale. We selected 73 patients with PD who had been asymptomatic for at least 1 year and who wished to discontinue the medication. The trial consisted of a 4-month period of tapering and an 8-month follow-up period. The dosage of clonazepam was decreased by 0.5 mg per 2-week period until 1 mg per day was reached, followed by a decrease of 0.25 mg per week. The mean dosage at the start of tapering was 2.7 ± 1.2 mg/d. In total, 51 (68.9%) of the patients were free of the medication after the 4 months of tapering according to the protocol, and 19 (26.0%) of the patients needed another 3 months to be free of medication. Clonazepam discontinuation symptoms were mostly mild and included mainly: anxiety, shaking/trembling/tremor, nausea/vomiting, insomnia/nightmares, excessive sweating, tachycardia/palpitations, headache, weakness, and muscle aches. The improvement in PD and general well-being was maintained during both the taper and follow-up phases. Clonazepam can be successfully discontinued without any major withdrawal symptoms if the dose is reduced gradually. We recommend reducing the dosage of clonazepam after intermediate-term use by 0.25 mg/wk.
Amisulpride Overdose Is Frequently Associated With QT Prolongation and Torsades de Pointes

This study aimed to describe the effects of the antipsychotic amisulpride in overdose, including the frequency of QT prolongation and torsades de pointes. Cases of amisulpride overdose (>1 g) were recruited from 2 state poison centers and a tertiary toxicology unit over 5 years. A 1-page clinical research form was used to collect clinical information. Copies of all electrocardiograms were obtained. Electrocardiogram parameters (QRS and QT intervals) were manually measured as previously described, and plots of QT-heart rate (HR) pairs were compared with the QT nomogram. There were 83 patients with amisulpride overdoses with a median age of 29 years (interquartile range [IQR], 23-40 years), and 42 (51%) were female. The median dose ingested was 6 g (IQR, 3-13 g, range, 1.2-120 g). The median HR was 66 beats/min (IQR, 60-81 beats/min). Bradycardia occurred in 20 cases (24%), and hypotension in 19 (23%). From 440 electrocardiograms (average of 5 per case; range, 1-15), an abnormal QT-HR pair occurred in 61 cases (73%). Torsades de pointes developed in 6 cases (7%), with doses of 4, 4.6, 18, 24, 32, and 80 g. The patient taking 32 g died after a cardiac arrest. Widened QRS did not occur except transient rate-dependent bundle-branch block in 3 cases. There were significant associations of bradycardia, hypokalemia, and hypocalcaemia, with QT prolongation and torsades de pointes. Central nervous system effects were uncommon with coma in 7 cases, seizures in 2, and dystonic reactions in 2. Amisulpride overdose commonly causes QT prolongation, bradycardia, and hypotension. Torsades de pointes occurred commonly enough to suggest that amisulpride is highly cardiotoxic in overdose.
Brief Tone Detection and Discrimination Tests in Clinical Audiology with Emphasis on their use in Central Nervous System Lesions

Department of Communication Disorders and Kresge Hearing Research Laboratory of the South, Louisiana State University Medical Center, New Orleans, Louisiana Since the initial investigation by Hughes (1946) on the relationship between hearing threshold and the duration of sounds, a number of researchers (Harris, et al., 1958; Wright, 1968a, 1968b; Hattler and Northern, 1970; Martin and Wofford, 1970; Sanders, et al., 1971; Gengel and Watson, 1971) have proposed the use of brief tone audiometry as a clinical procedure for differentiating between cochlear and retrocochlear neural lesions. Most of these investigations have been concerned with the hearing phenomenon commonly referred to as temporal integration or temporal summation. This phenomenon refers to the observation that, in normal listeners, as the temporal duration of a tone pulse is progressively decreased below a value of approximately 200 msec, the intensity required to maintain its audibility must be continuously increased (Garner, 1947; deVries, 1948; Plomp, 1961). These studies have shown that for durations less than about 200 msec, there is approximately a 10 dB change in threshold for a change of one log unit of duration. In contrast to the large number of studies on the relationships between signal duration and threshold sensitivity, a second relatively unexplored area of brief tone investigation with which the present author (Cranford, 1979b; Cranford et al., 1982) has been recently involved concerns the relationship between tonal duration and the size of the frequency difference limen. In the present article the current status of both areas of brief tone investigation will be reviewed, with major emphasis on evaluating the possible clinical utility of each approach with respect to site of lesion testing. The format of this article will be to review, in sequence, those studies that have focused on studying the effects of lesions at successively higher levels of the auditory nervous system, beginning at the cochlea and ending at the auditory cortex.
Retrospective Analysis of Suicidality in Patients Treated With the Antidepressant Desvenlafaxine

The objective of this analysis was to assess the risk of increased suicidal thoughts and behavior (suicidality) with desvenlafaxine (administered as desvenlafaxine succinate) in patients with major depressive disorder (MDD). Data from 9 double-blind, 8-week studies in outpatients with MDD were analyzed retrospectively. Patients were randomly assigned to desvenlafaxine (n = 1834) or placebo (n = 1116). Adverse events (AEs) related to suicidality were identified by searching the AE database for text strings possibly related to suicidality; false positives were excluded. Narratives for each case were prepared and blinded for review. Events were classified according to the Columbia Classification Algorithm of Suicide Assessment. Odds ratios were calculated; &khgr;2 tests were used to compare treatment groups. Occurrence of emerging or worsening suicidality, based on the 17-item Hamilton Rating Scale for Depression suicide item, was compared for desvenlafaxine and placebo using &khgr;2 tests. In all, 17 (0.93%) of 1834 patients receiving desvenlafaxine and 8 (0.72%) of 1116 receiving placebo reported possible suicidality-related AEs. Events were relatively evenly distributed across treatment groups. One patient randomly assigned to desvenlafaxine treatment died of completed suicide during the on-therapy period. There were no significant differences between groups in the risk for any class of suicide-related events, including completed suicide or suicide attempt. Odds of emergence or worsening of suicidality 17-item (Hamilton Rating Scale for Depression suicide item) did not differ significantly between treatment groups. No evidence of a signal for increased suicidality was detected in adult patients treated with desvenlafaxine in short-term MDD trials. As suicidal events were extremely rare, a true increased risk cannot be ruled out.
Co-existence of Poisson and non-Poisson processes in ordered parallel multilane pedestrian traffic

We show that non-Poisson and Poisson processes can coexist in ordered parallel multilane pedestrian traffic, in the presence of lane switching which asymmetrically benefits the switchers and nonswitchers. Pedestrians join at the tail end of a queue and transact at the opposite front end. Their aim is to complete a transaction within the shortest possible time, and they can transfer to a shorter queue with probability ps. Traffic is described by the utilization parameter U = λ〈ts〉/N, where λ is the average rate of pedestrians entering the system, 〈ts〉 is the average transaction time, and N is the number of lanes. Using an agent-based model, we investigate the dependence of the average completion time 〈tc〉 with variable K = 1 + (1 − U)−1 for different N and 〈ts〉 values. In the absence of switching (ps = 0), we found that 〈tc〉 ∝ Kτ, where τ ≈ 1 regardless of N and 〈ts〉. Lane switching (ps = 1) reduces 〈tc〉 for a given K, but its characteristic dependence with K differs for nonswitchers and switchers in the same traffic system. For the nonswitchers, 〈tc〉 ∝ Kτ, where τ < 1. At low K values, switchers have a larger 〈tc〉 that also increases more rapidly with K. At large K, the increase rates become equal for both. For nonswitchers, the possible tc values obey an exponentially decaying probability density function p(tc). The switchers on the other hand, are described by a fat-tailed p(tc) implying that a few are penalized with tc values that are considerably longer than any of those experienced by nonswitchers. © 2006 Wiley Periodicals, Inc. Complexity 11: 35–42, 2006
Posttraumatic Stress and General Distress Among Parents of Children Surviving a Brain Tumor

In this preliminary study we examined both posttraumatic stress and general distress among parents of children diagnosed with a brain tumor. Participants included 28 parents of children diagnosed with a brain tumor who completed self-report measures of posttraumatic stress, general distress, coping, and illness uncertainty. Findings revealed that participants reported high levels of posttraumatic stress and general distress. Greater levels of emotion-focused coping and perceived uncertainty were associated with a higher frequency of both posttraumatic stress symptoms and general distress. However, perceived uncertainty was the strongest predictor of both indexes of distress. Emotion-focused coping predicted general distress, but not posttraumatic stress symptom severity. Overall, parents of children surviving a brain tumor appear to be at risk for both posttraumatic stress and general distress. Uncertainty in illness may constitute a primary risk factor for adjustment problems. CHILDREN’S HEALTH CARE, 30(3), 169–182 Copyright © 2001, Lawrence Erlbaum Associates, Inc.
A technique for resection of invasive tumors involving the trigone area of the bladder in dogs: preliminary results in two dogs.

OBJECTIVE To describe a surgical technique for resection of the entire bladder neck, including the trigone and proximal urethra in dogs with invasive tumors causing life-threatening urinary tract obstruction. STUDY DESIGN Clinical case reports. ANIMALS Dogs (n=2) with bladder tumors. METHODS Circumferential excision of the bladder neck and proximal urethra with preservation of the neurovascular pedicles was performed to remove a rhabdomyosarcoma (dog 1) and a transitional cell carcinoma (dog 2) involving the trigone and bladder neck that were causing urinary tract obstruction. Reconstruction of the bladder and proximal urethra included bilateral ureteroneocystostomy. Adjuvant chemotherapy was administered postoperatively to both dogs. RESULTS Postoperatively, dogs 1 and 2 were continent after 7 and 17 days, respectively, and regained normal urinary function after resolution of a transient pollakiuria. Dog 1 had no evidence of local or regional recurrence; however, a large solitary pulmonary metastatic lesion was diagnosed 8 months later. The dog was euthanatized despite a lack of clinical signs. Dog 2 had at least 1 metastatic lesion in the abdominal wall 6 months later and was euthanatized at 580 days because of renal failure. CONCLUSION En-bloc removal of the bladder neck and proximal urethra with preservation of the dorsal vascular and nervous pedicles, although a technically challenging procedure, can be performed without associated urinary incontinence or bladder wall necrosis. CLINICAL RELEVANCE In dogs with invasive bladder tumors causing life-threatening urinary tract obstruction, resection of the bladder neck and proximal urethra should be considered as a promising surgical alternative to urinary diversion.
Does habitual body avoidance and checking behavior influence the decrease of negative emotions during body exposure in eating disorders?

Abstract The aim of the present study was to assess whether habitual body avoidance and body-checking behavior influences the decrease of negative emotions during body exposure. Twenty-one eating-disordered female participants completed the Body Image Avoidance Questionnaire and the Body Checking Questionnaire. On another day, a 40-min body exposure session was conducted under standardized conditions. Every 10 min, negative emotions were assessed. It was shown that the extent of decrease in negative emotions during the body exposure session could be predicted by a lower degree of body checking. Results indicate that habitual checking behavior seems to negatively influence the effect of body exposure. Therefore, an adaptation of body exposure to patients with a higher degree of body-checking behavior might be promising.
Short form of the revised vanderbilt therapeutic alliance scale: Development, reliability, and validity

Abstract This study presents the development and psychometric properties of a five-item version of the revised Vanderbilt Therapeutic Alliance Scale (VTAS-R Short Form). A total of 255 alliance ratings, derived from therapy sessions from 86 cases of family therapy for substance-abusing adolescents, were used to generate two separate subsamples. The first subsample was used to develop the five-item form and the second subsample to estimate the measure's reliability and concurrent and predictive validity. The VTAS-R Short Form evidenced high internal consistency, was highly correlated with the full-length VTAS-R, and predicted treatment completion and adolescents’ days of cannabis use at 3 months follow-up. The findings suggest that the VTAS-R Short Form is a reliable and valid alternative to the full-length form.
Structural changes in counselor trainee intention use and clients’ session evaluation

Abstract Profile analysis and Pathfinder Network Analysis (Schvaneveldt, 1990) were used to examine changes in procedural knowledge and procedural structural knowledge, respectively, of 32 counselor trainees and to examine convergence in their procedural knowledge and procedural structural knowledge with the procedural knowledge structure of 42 experienced counselors. Procedural knowledge was derived from the pattern and level of intention use (Hill & O'Grady, 1985) in a pre- and posttraining counseling session. Procedural structural knowledge was derived from the co-occurrence of the intentions used in these two counseling sessions. Only counselor trainees’ structure of intention use changed from pre- to posttraining, becoming more similar to the structure of intention use of the experienced counselors. At both pre- and posttraining, when trainees’ structure of intention use was more similar to that of experienced counselors, their clients rated counseling sessions as smoother (pre- and posttraining) and deeper (posttraining only). The use of knowledge structures as a criterion for assessing the effectiveness of counseling skills training is discussed.
A primer on meta-analysis of correlation coefficients: The relationship between patient-reported therapeutic alliance and adult attachment style as an illustration

Abstract The aim of this article is twofold: to offer an introduction to meta-analysis using correlation coefficients to facilitate greater understanding of meta-analytic findings and to guide those interested in conducting meta-analyses. The authors review calculations for a weighted average effect size, the statistical significance of this effect, a test of homogeneity, confidence intervals, and file drawer analysis. They provide a running example of the relationship between patient-reported therapeutic alliance and adult attachment style. Results (k = 12, N = 581.17, weighted average r = .17, p < .0001, 95% confidence interval=.13–.21) indicated a positive, statistically significant relationship, suggesting that greater attachment security is associated with stronger therapeutic alliances, whereas greater attachment insecurity is associated with weaker therapeutic alliances. File drawer results suggested that some caution is warranted in terms of the size of the effect.
Risk evaluation of diabetes mellitus by relation of chaotic globals to HRV

This study's aim is to analyze heart rate dynamics in subjects with diabetes by measures of heart rate variability HRV. The correlation of chaotic global parameters in the two cohorts is able to assess the probability of cardiac failure and other dynamical diseases. Adults 46 were divided into two equal groups. The autonomic evaluation consisted of measuring HRV for 30 min in supine position in absence of any physical, sensory, or pharmacological stimuli. Chaotic global parameters are able to statistically determine which series of electrocardiograph interpeak intervals in short time-series are diabetic and which are not. The chaotic forward parameter that applies all three parameters is suggested to be the most appropriate and robust algorithm. This was decided after tests for normality; followed by one-way analysis of variance ANOVA1; P<0.09 and Kruskal-Wallis technique P<0.03. Principal component analysis implied two components represent 99.8% of total variance. Therefore, diabetes is a disease which reduces the chaotic response and, as such may be termed a dynamical condition such as are cardiac arrest, asthma, and epilepsy. © 2014 Wiley Periodicals, Inc. Complexity 20: 84-92, 2015
The effect of choice between test anxiety treatment options on treatment outcomes

Abstract Evidence regarding the effect of clients' choice of treatment on treatment outcome is inconsistent. This possible effect was examined by presenting participants with two treatments of test anxiety: advanced muscle relaxation and changing of internal dialogue. Clients (N=73) were allocated to three groups: choice (participants chose their preferred treatment), no choice (participants were assigned to their preferred treatment but were led to believe they couldn't choose the treatment they were assigned to), and wait-list control (participants received no treatment until the end of the study). There was a significant linear pattern, with the choice group performing better than the no-choice group with no feeling of control, which in turn performed better than the control group. Limitations and suggestions for future research are discussed.
An adaptive neuro-fuzzy inference system for islanding detection in wind turbine as distributed generation

This article proposes a new integrated diagnostic system for islanding detection by means of a neuro-fuzzy approach. Islanding detection and prevention is a mandatory requirement for grid-connected distributed generation DG systems. Several methods based on passive and active detection scheme have been proposed. Although passive schemes have a large non-detection zone NDZ, concern has been raised on active method due to its degrading power-quality effect. Reliably detecting this condition is regarded by many as an ongoing challenge as existing methods are not entirely satisfactory. The main emphasis of the proposed scheme is to reduce the NDZ to as close as possible and to keep the output power quality unchanged. In addition, this technique can also overcome the problem of setting the detection thresholds inherent in the existing techniques. In this study, we propose to use a hybrid intelligent system called ANFIS the adaptive neuro-fuzzy inference system for islanding detection. This approach utilizes rate of change of frequency ROCOF at the target DG location and used as the input sets for a neuro-fuzzy inference system for intelligent islanding detection. This approach utilizes the ANFIS as a machine learning technology and fuzzy clustering for processing and analyzing the large data sets provided from network simulations using MATLAB software. To validate the feasibility of this approach, the method has been validated through several conditions and different loading, switching operation, and network conditions. The proposed algorithm is compared with the widely used ROCOF relays and found working effectively in the situations where ROCOF fails. Simulation studies showed that the ANFIS-based algorithm detects islanding situation accurate than other islanding detection algorithms. © 2014 Wiley Periodicals, Inc. Complexity 21: 10-20, 2015
The Effects of Kinesio Ankle Taping on Postural Stability in Semiprofessional Rugby Union Players

[Purpose] Kinesio taping has been postulated to reduce injuries by improving proprioception. To date there remain few studies that have assessed the impact of Kinesio taping on postural stability and by inference proprioception in team sports. The aim of this study was to establish if bilateral application of Kinesio taping of the ankles would improve postural stability in rugby union players. [Subjects] The participants were 31 healthy semiprofessional rugby players (age 19.57 ± 0.76 y; body mass 91.87 ± 11.81 kg; stature 1.82 ± 0.08 m). [Methods] Postural stability was measured using an experimental crossover study design. [Results] Significant improvements in overall stability, anterior-posterior stability, and medial-lateral stability were observed under the taped versus non-taped conditions. A secondary finding was that differences in postural stability may be associated with playing position, in that backline players exhibited significantly better overall stability under the non-taped condition compared with forward players. [Conclusion] These results suggest that Kinesio taping may enhance postural stability in a position-dependant manner in semiprofessional rugby players. From a mechanistic point of view, these findings may help to explain why Kinesio taping may be beneficial; however, the impact that the tape may have in contributing towards the prevention of ankle injuries is yet to be established.
Efficacy of two versions of emotion-focused therapy for resolving child abuse trauma

Abstract This study evaluated and compared emotion-focused therapy for trauma (EFTT) with imaginal confrontation (IC) of perpetrators (n=20) and EFTT with empathic exploration (EE) of trauma material (n=25). Clients were women and men with histories of different types of childhood maltreatment (emotional, physical, and sexual abuse; emotional neglect). Clients were randomly assigned to treatment condition. Outcome measures assessed symptom distress, self and interpersonal problems, and abuse resolution. Results indicated statistically and clinically significant improvements on eight measures at posttest, maintenance of gains at follow-up, and no statistically significant differences between conditions. There were higher rates of clinically significant change in IC and a lower attrition rate for EE (7% vs. 20%). More severe personality pathology negatively influenced some dimensions of outcome, particularly in EE.