Miracle-dz/UniFAR-FTUs huggingface dataset:
The treatment of schizophrenia: Can we raise the standard of care?

Objective: There is evidence that over time health outcomes of people with schizophrenia are deteriorating rather than improving both in terms of mortality rate and levels of morbidity, even in Australia where service resourcing is substantial. Our objective was to examine the evidence of whether poor outcomes reflect decreases in treatment effectiveness and, if so, what are the barriers to improving standards of care. This review will argue that the confidence of clinicians to diagnose schizophrenia early, and provide assertive and long-term care, may be being undermined by a series of controversies in the published literature and discrepancies in clinical practice guidelines. Method: A critical review was conducted of the evidence regarding six issues of high clinical relevance to the treatment of schizophrenia formulated as questions: (1) Is schizophrenia a progressive disease? (2) Does relapse contribute to disease progression and treatment resistance? (3) When should the diagnosis of schizophrenia be made? (4) Should maintenance antipsychotic medication be discontinued in fully remitted first-episode patients? (5) Do antipsychotic medications cause deleterious reductions in cortical grey matter volumes? and (6) Are long-acting injectable antipsychotics more effective in reducing relapse rate compared to oral formulations? Results: There is reliable evidence for schizophrenia being a progressive disease with emergent treatment resistance in most cases, that relapse contributes to this treatment resistance, that maintenance antipsychotic medication should not be discontinued in remitted first-episode patients, that antipsychotic medication does not appear to cause deleterious grey matter volume changes, that maintenance antipsychotic medication reduces the mortality rate in schizophrenia and that long-acting injectable antipsychotics are more effective in preventing relapse than oral formulations. Conclusion: There is an urgent need to re-engineer the early management of schizophrenia and to routinely evaluate this type of innovation within practice-based research networks. A proposal for an assertive treatment algorithm is included.
Subject to qualification: Weakening links between job roles and qualifications in Australian manufacturing enterprise agreements

This article examines job classifications in enterprise agreements from the Australian manufacturing industry, focusing on the recognition of formal qualifications. It follows earlier research that found the strength and frequency of references to qualifications vary considerably between modern awards, with manufacturing industry awards having some of the strongest connections. A representative sample of 350 agreements (13.5% of the total) made under the Fair Work Act between 2010 and 2013 was analysed. Analysis revealed that linkages between formal qualifications and job classification structures are less common in enterprise agreements than in relevant modern awards. However, the overall effects of enterprise bargaining on recognition of employees' qualifications are complex. We find that, one way or another, the award classification structure continues to apply in 47.1% of enterprise agreements. Through logistic regression, we explore factors influencing the use of formal qualifications as part of job classifications, with a particular focus on whether this extends beyond the licensing requirements of tradespeople (Certificate III). Our finding that three factors – workplace size, award coverage and union coverage – significantly affect enterprise bargaining outcomes is likely to be generalisable beyond this study's focus on job classifications to many other important terms in enterprise agreements.
Seeing the Forest and the Trees: How a Systems Perspective Informs Paradox Research

Paradox theory has fundamentally changed how researchers think about organizational tensions by emphasizing their oppositions and their interdependencies. Yet, most paradox studies focus on salient, perceived tensions, ignoring latent, nested tensions and their complex interconnections. This partial view is rooted in the paradox literature focusing on the epistemological realm (actors’ perception of tensions) while disregarding the ontological realm (tensions’ underlying reality). The focus on the epistemological aspects of the tensions impedes researchers from moving to more intricate insights into paradox, which could help address the realities of complex issues, such as wicked problems. We propose a systems perspective on paradox that discriminates the epistemological understandings from the ontological realities of tensions. By revealing the ontology of tensions, the underlying complexity becomes empirically interpretable. We illustrate the power of this perspective by offering two research strategies that can help researchers and organizations apprehend paradoxes grounded in systems.
Continuous infusion of calcium gluconate in 5% albumin is safe and prevents most hypocalcemic reactions during therapeutic plasma exchange

While therapeutic plasma exchanges (TPEs) performed with 5% albumin are considered safe, concerns regarding venous access and hypocalcemic toxicity remain. We reviewed the frequency of complications during TPEs performed with 5% albumin supplemented with calcium gluconate and potassium chloride for a 5 year period in our institution. Eighty‐four adult patients (46 males and 38 females) underwent 581 plasma exchanges during the study period. The most common indications were myasthenia gravis (37%), acute inflammatory demyelinating polyradiculoneuropathy (31%), and chronic inflammatory demyelinating polyneuropathy (13%). All procedures used 2.2% ACD‐A delivered at a calculated average rate of 0.26 mg/kg/min, which led to a mean dose of citrate per TPE of 2.18 ± 0.48 g or 27.8 ± 5.24 mg/kg of body weight. Venous access difficulties occurred in 85 procedures (14.6%), but most TPEs were completed successfully. Hypotension and citrate toxicity were seen in <5% of the TPEs and were mostly reversible. Only 17 exchanges (3%) had to be aborted because of the loss of venous access (n = 9), hypocalcemic toxicity (n = 3), hypotension (n = 2), panic attacks (n = 2), and one atypical reaction due to the interaction with an angiotensin converting enzyme inhibitor. Comparison between pre‐ and post‐TPE potassium levels showed a statistically significant mean decrease of 7%, from 4.1 mequiv/l to 3.8 mequiv/l (P < 0.0001). We attribute the low rate of hypocalcemia to our practice of adding calcium and potassium to the replacement fluid and suggest that this method could become standard of care. J. Clin. Apheresis, 2007. © 2007 Wiley‐Liss, Inc.
COMPARISON OF EFFICACY AND SAFETY OF GLARGINE AND DETEMIR INSULIN IN THE MANAGEMENT OF INPATIENT HYPERGLYCEMIA AND DIABETES.

OBJECTIVE Glargine and detemir insulin are the two most commonly prescribed basal insulin analogues for the ambulatory and inpatient management of diabetes. The efficacy and safety of basal insulin analogues in the hospital setting has not been established. METHODS This observational study compared differences in glycemic control and outcomes in non-intensive care unit patients with blood glucose (BG) >140 mg/dL who were treated with glargine or detemir, between January 1, 2012, and September 30, 2015, in two academic centers. RESULTS Among 6,245 medical and surgical patients with hyperglycemia, 5,749 received one or more doses of glargine, and 496 patients received detemir during the hospital stay. There were no differences in the mean daily BG (glargine, 182 ± 46 mg/dL vs. detemir, 180 ± 44 mg/dL; P = .70). There were no differences in mortality, hospital complications, or re-admissions between groups (all, P>.05). After adjusting for potential confounders, there was no statistically significant difference in hypoglycemia rates between treatment groups. Patients treated with detemir required higher total daily basal insulin doses (0.27 ± 0.16 units/kg/day vs. 0.22 ± 0.15 units/kg/day; P<.001). Glargine-treated patients had statistically longer length of stay; however, this difference may not be clinically relevant (6.8 ± 7.4 days vs. 6.0 ± 6.3 days; P<.001). CONCLUSION Our study indicates that treatment with glargine and detemir results in similar inpatient glycemic control in general medicine and surgery patients. Detemir treatment was associated with higher daily basal insulin dose and number of injections. A prospective randomized study is needed to confirm these findings. ABBREVIATIONS BG = blood glucose BMI = body mass index CI = confidence interval eGFR = estimated glomerular filtration rate HbA1c = glycated hemoglobin ICD-9 = International Classification of Diseases, ninth revision ICU = intensive care unit IQR = interquartile range LOS = length-of-stay OR = odd ratio.
Emptying effect of massage on parotid gland radioiodine content

BackgroundTo prevent salivary dysfunction in thyroid cancer patients who have undergone radioiodine ablation, massaging the parotid gland (PG) is presumed to be helpful for the removal of radioiodine. The purpose of this study was to evaluate the effect of PG massage in the removal of radioiodine from the PG. MethodsForty-four patients (female, 38; 49.1±11.0 years) who underwent total thyroidectomy followed by I-131 ablation were included in this prospective study. Three serial salivary gland scans were performed 2 h after administration of I-123 in thyroid hormone withdrawal status. The patients were divided into two groups. There was a 1-min (or 2-min) interval between the first and second scans for control, followed by the performance of PG massage for 1 min (or 2 min) between the second and third scans. Changes in uptakes were calculated between the first and second scans (control) and between the second and third scans (massage). ResultsThe mean change in uptake at the 1-min massage was 0.97±11.27%, whereas that at the 1-min control was 11.54±5.59% (P<0.001). The mean change in uptake at the 2-min massage was also significantly lower than that at the 2-min control (11.11±6.97 vs. −0.85±9.78%, P<0.001). However, no statistical difference was observed between the mean changes in uptake after 1- and 2-min massages (P=0.573). ConclusionPG massage reduced the radioiodine uptake in the PG, and the effect of PG massage for 1 min was comparable with that of PG massage for 2 min. PG massage can be applied to thyroid cancer patients who receive radioiodine therapy to reduce PG dysfunction.
Hydrosocial territories in the context of diverse and changing ruralities: the case of Cochabamba’s drinking water provision over time

ABSTRACT The article describes the history of drinking water provision of the city of Cochabamba, Bolivia, as an instructive case for analyzing the dynamic reconfiguration of hydrosocial territories and rural–urban relations over time. Cochabamba’s growing drinking water demand obliged the city to expand its access to water sources, involving diverse rural areas and groups of rural inhabitants. Using the concept of hydrosocial territories, the history of Cochabamba’s water solutions is explored, showing the need to analyze rural actors in a differentiated way in order to understand their (changing) role in the configuration of the hydrosocial territories.
Corporate Social Responsibility Information in Annual Reports in the EU—A Czech Case Study

The commitment of the European Union (EU) to Corporate Social Responsibility (CSR) is projected into EU law about annual reporting by businesses. Since EU member states further develop this framework by their own domestic laws, annual reporting with CSR information is not unified and only partially mandatory in the EU. Do all European businesses report CSR information and what public declaration to society do they provide with it? The two main purposes of this paper are to identify the parameters of this annual reporting duty and to study the CSR information provided by the 10 largest Czech companies in their annual statements for 2013–2017. Based on legislative research and a teleological interpretation, the current EU legislative framework with Czech particularities is presented and, via a case study exploring 50 annual reports, the data about the type, extent and depth of CSR is dynamically and comparatively assessed. It appears that, at the minimum, large Czech businesses satisfy their legal duty and e-report on CSR to a similar extent, but in a dramatically different quality. Employee matters and adherence to international standards are used as a public declaration to society more than the data on environmental protection, while social matters and research and development (R&D) are played down.
A role for muscarinic receptors or rho-kinase in hypertension associated rat bladder dysfunction?

PURPOSE Essential arterial hypertension is a frequent condition. Spontaneously hypertensive rats (SHRs) show bladder dysfunction similar to that seen in patients with overactive bladder. Since muscarinic receptors and rho-kinase have a key role in the regulation of bladder contractility, we determined whether alterations of either one might contribute to hypertension associated bladder dysfunction. MATERIALS AND METHODS The bladders of SHRs and normotensive Wistar Kyoto rats (WKYs) were compared in in vitro radioligand binding and contractility studies. RESULTS The mean total number of muscarinic receptors +/- SEM (181 +/- 14 vs 191 +/- 22 fmol/mg protein) and the relative roles of their subtypes were similar in SHRs and WKYs. Contractile responses to the muscarinic agonist carbachol (maximum effect 2.04 +/- 0.24 vs 2.05 +/- 0.14 mN/mm strip length and -log EC50 5.61 +/- 0.07 vs 5.64 +/- 0.04) and to KCl in a receptor independent manner were similar in the 2 strains. The M3 selective antagonist darifenacin inhibited carbachol responses much more potently than the M2 selective antagonist methoctramine but the potency of the 2 drugs was similar in each strain. The rho-kinase inhibitor Y27,632 attenuated carbachol induced contraction in a quantitatively similar manner in SHRs and WKYs. CONCLUSIONS An altered function of muscarinic receptor subtypes or rho-kinase does not appear to contribute to bladder dysfunction in SHRs.
Impact of arterial elastance as a measure of vascular load on left ventricular geometry in hypertension.

OBJECTIVE Effective arterial elastance (Ea), integrating the pulsatile component of left ventricular (LV) afterload, is an estimate of aortic input impedance. We evaluated relationships of Ea with left ventricular anatomy and function in essential hypertension. DESIGN A cross-sectional analysis in 81 normotensive and 174 untreated hypertensive individuals enrolled in a referral hypertension centre. METHODS Using echocardiography we determined left ventricular mass index (LVMI), relative wall thickness (RWT), stroke volume (SV), endocardial (FSe) and midwall (FSm) fractional shortening and total peripheral resistance (TPR). Carotid pressure waveforms were obtained by arterial tonometry, and end-systolic pressure (Pes) was measured at the dicrotic notch. Ea index (EaI) was calculated as Pes/(SV index); LV elastance (Ees) was estimated as Pes/LV end-systolic volume, and ventriculo-arterial coupling was evaluated by the Ea/Ees ratio. RESULTS EaI was higher in hypertensives than in normotensives (3.02 +/- 0.63 versus 2.40 +/- 0.52 mmHg/l per m2; P< 0.0001). Using the 95% upper confidence limit in normotensives, hypertensives were divided in two groups with normal or elevated EaI. The 38 hypertensives with elevated EaI had higher RWT (0.41 +/- 0.06 versus 0.37 +/- 0.05), lower LVMI (87.5 +/- 18.5 versus 96.8 +/- 19.3 g/m2), higher TPR (2247 +/- 408 versus 1658 +/- 371 dynes/cm s(-5)) and lower FSe and FSm (35 +/- 5 versus 39 +/- 5 and 16 +/- 2 versus 18 +/- 2%; all P< 0.05) than patients with normal EaI. Ea/Ees ratio was increased and cardiac output was reduced in hypertensives with elevated EaI. CONCLUSIONS High values of EaI identify a minority of hypertensive patients characterized by elevated TPR, left ventricular concentric remodelling, depressed left ventricular systolic function and impaired ventriculo-arterial coupling.
Swarms, Phase Transitions, and Collective Intelligence (Paper 1); and A Nonequilibrium Statistical Field Theory of Swarms and Other Spatially Extended Complex Systems (Paper 2)

(Paper 1) A spacially extended model of the collective behavior of a large number of locally acting organisms is proposed in which organisms move probabilistically between local cells in space, but with weights dependent on local morphogenetic substances, or morphogens. The morphogens are in turn effected by the passage of an organism. The evolution of the morphogens, and the corresponding flow of the organisms constitutes the collective behavior of the group. Such models have various types of phase transitions and self-organizing properties controlled both by the level of the noise, and other parameters. The model is then applied to the specific case of ants moving on a lattice. The local behavior of the ants is inspired by the actual behavior observed in the laboratory, and analytic results for the collective behavior are compared to the corresponding laboratory results. It is hoped that the present model might serve as a paradigmatic example of a complex cooperative system in nature. In particular swarm models can be used to explore the relation of nonequilibrium phase transitions to at least three important issues encountered in artificial life. Firstly, that of emergence as complex adaptive behavior. Secondly, as an exporation of continuous phase transitions in biological systems. Lastly, to derive behavioral criteria for the evolution of collective behavior in social organisms. (Paper 2) A class of models with applications to swarm behavior as well as many other types of spatially extended complex biological and physical systems is studied. Internal fluctuations can play an active role in the organization of the phase structure of such systems. Consequently, it is not possible to fully understand the behavior of these systems without explicitly incorporating the fluctuations. In particular, for the class of models studied here the effect of internal fluctuations due to finite size is a renormalized {\it decrease} in the temperature near the point of spontaneous symmetry breaking. We briefly outline how these models can be applied to the behavior of an ant swarm.
Signal through gp130 Activated by Soluble Interleukin (IL)‐6 Receptor (R) and IL‐6 or IL‐6R/IL‐6 Fusion Protein Enhances Ex Vivo Expansion of Human Peripheral Blood‐Derived Hematopoietic Progenitors

This study was designed to investigate the effects of a combination of soluble interleukin (sIL)‐6 receptor (R) and IL‐6 on the ex vivo expansion of human peripheral blood (PB)‐derived hematopoietic progenitor cells in a short‐term serum‐free liquid suspension culture system, using PB‐derived CD34+IL‐6R+/– cells as a target. In combination with stem cell factor (SCF), IL‐3, and sIL‐6R/IL‐6, the expansion efficiency (EE) for granulocyte/macrophage colony‐forming unit (CFU‐GM) reached a peak level on day 10 of incubation. On the other hand, the EE for erythroid burst (BFU‐E) and mixed colony‐forming unit (CFU‐Mix) reached a peak level on day 7 of incubation. Among the cytokine combinations tested, SCF + IL‐3 + sIL‐6R/IL‐6 + flt3 ligand (FL) most effectively expanded CFU‐GM and CFU‐Mix. The maximum EEs for CFU‐GM and CFU‐Mix were 208‐fold and 42‐fold, respectively. While the EE for BFU‐E was 70‐90‐fold in the presence of SCF + IL‐3 + sIL‐6R/IL‐6, FL significantly augmented the EE for CFU‐GM and CFU‐Mix. In contrast, thrombopoietin (TPO) significantly augmented the EE for CFU‐Mix. Interestingly, in combination with IL‐3 and SCF, newly generated IL‐6R/IL‐6 fusion protein (FP) expanded PB‐derived BFU‐E and CFU‐Mix twice more effectively than a combination of sIL‐6R and IL‐6. These results demonstrated that human PB‐derived committed progenitors were effectively expanded in vitro using sIL‐6R/IL‐6 or FP, in combination with IL‐3, SCF and/or FL or TPO, and that FP may transduce a stronger intracellular signal than a combination of sIL‐6R and IL‐6.
Secretion of human interleukin 2 by recombinant Mycobacterium bovis BCG

The human interleukin 2 (huIL-2) gene was introduced into Mycobacterium bovis BCG by using the integrative vector pMV306. To express and secrete huIL-2 from BCG, two different plasmids, CI and CII, were made. In CI, the huIL-2-encoding region was under the control of the alpha-antigen promoter of BCG; in CII, the expression of huIL-2 was regulated by the heat shock protein 60 promoter. A signal peptide sequence isolated from the naturally secreted alpha-antigen of BCG was inserted between the promoter and huIL-2-encoding region to facilitate secretion. Both huIL-2 expression plasmids were integrated into the BCG genome when introduced into the BCG Pasteur strain by electroporation. Approximately 150 U of huIL-2 was secreted into the medium of a BCG-CII culture, while the BCG-CI cells secreted approximately one-sixth of that amount. When the IL-2-expressing BCG strain BCG-CII was injected intravenously into BALB/c mice, the number of BCG cells in the spleens of these mice was significantly less than the number in the control mice. The decreased number of IL-2-expressing BCG cells is likely due to the augmentation of the host immune response by the secreted huIL-2, although the exact mechanism is not known.
Patterns of Functional Loss Among Older People: A Prospective Analysis

Objective: Patterns of capability loss and disability onset among older people were investigated prospectively. Background: With aging, the gap between personal capability and environmental demand becomes wider, resulting in higher levels of disability in daily activities. Methods: Data from a longitudinal, population-based study were obtained for analysis, which recruited a representative sample of 13,004 people aged 65 years and older from five sites in Great Britain. Participants completed a baseline interview during 1990 to 1994 and follow-up interviews after 1, 2, 3, 6, 8, and 10 years. Those who reported full vision, hearing, thinking, locomotion, reaching, and dexterity ability as well as no disability in cooking, housework, shopping, and transportation at baseline were included in a survival analysis. Results: Locomotion was the first ability to be lost, followed by reaching, thinking, hearing, vision, and dexterity. Age at onset of disability was earliest for shopping, then housework, transportation, and cooking. Women were consistently younger at capability loss and disability onset than men except in terms of hearing and cooking. Conclusion: These findings suggest that capabilities required for product and service interaction follow a hierarchical pattern of loss, which has practical implications for design. Although interventions to reduce disability in the older population are likely to require changes that address more than one demand, capabilities lost early in old age should take precedence over those lost later. Application: A potential application of this research is in the development of an overall design strategy to enhance older people’s ability to live independently.