Miracle-dz/UniFAR-FTUs huggingface dataset:
Occupation-based intervention in hand injury rehabilitation: Experiences of occupational therapists in Malaysia

Abstract Introduction: In a previous study consensus was sought from Malaysian occupational therapists of occupation-based intervention (OBI) that was perceived as a means and an end. Occupation as a means refers to occupational and purposeful tasks as a therapeutic agent while occupation as an end refers to occupation as an outcome of intervention. The purpose of this follow-up study was to describe the occupational therapists’ experiences of providing OBI in hand injury rehabilitation in Malaysia. Methods: Sixteen occupational therapists with more than five years of experience in hand rehabilitation were individually interviewed on their experiences of using OBI in practice. Data were thematically analysed using interpretative phenomenological analysis. Results: Definition of “Occupation as a means”, and “Occupation as an end” was broadened after data analysis of interviews to include two new themes: “Rewarding yet challenging” and “Making OBI a reality”. Occupational therapists had positive experiences with OBI and perceived that occupation as a means and an end can be merged into a single therapy session when the occupational therapists use an occupation that is therapeutic. Conclusion: Although occupation as a means and as an end have different purposes, when the ultimate goal is to enhance the clients’ maximum level of functioning both can be used for successful rehabilitation of hand injuries.
Comparison of the cardiovascular effects of equipotent anesthetic doses of sevoflurane alone and sevoflurane plus an intravenous infusion of lidocaine in horses.

OBJECTIVE To compare cardiovascular effects of sevoflurane alone and sevoflurane plus an IV infusion of lidocaine in horses. Animals-8 adult horses. PROCEDURES Each horse was anesthetized twice via IV administration of xylazine, diazepam, and ketamine. During 1 anesthetic episode, anesthesia was maintained by administration of sevoflurane in oxygen at 1.0 and 1.5 times the minimum alveolar concentration (MAC). During the other episode, anesthesia was maintained at the same MAC multiples via a reduced concentration of sevoflurane plus an IV infusion of lidocaine. Heart rate, arterial blood pressures, blood gas analyses, and cardiac output were measured during mechanical (controlled) ventilation at both 1.0 and 1.5 MAC for each anesthetic protocol and during spontaneous ventilation at 1 of the 2 MAC multiples. RESULTS Cardiorespiratory variables did not differ significantly between anesthetic protocols. Blood pressures were highest at 1.0 MAC during spontaneous ventilation and lowest at 1.5 MAC during controlled ventilation for either anesthetic protocol. Cardiac output was significantly higher during 1.0 MAC than during 1.5 MAC for sevoflurane plus lidocaine but was not affected by anesthetic protocol or mode of ventilation. Clinically important hypotension was detected at 1.5 MAC for both anesthetic protocols. CONCLUSIONS AND CLINICAL RELEVANCE Lidocaine infusion did not alter cardiorespiratory variables during anesthesia in horses, provided anesthetic depth was maintained constant. The IV administration of lidocaine to anesthetized nonstimulated horses should be used for reasons other than to improve cardiovascular performance. Severe hypotension can be expected in nonstimulated horses at 1.5 MAC sevoflurane, regardless of whether lidocaine is administered.
Measuring ultrashort laser pulses in the time-frequency domain using frequency-resolved optical gating

We summarize the problem of measuring an ultrashort laser pulse and describe in detail a technique that completely characterizes a pulse in time: frequency-resolved optical gating. Emphasis is placed on the choice of experimental beam geometry and the implementation of the iterative phase-retrieval algorithm that together yield an accurate measurement of the pulse time-dependent intensity and phase over a wide range of circumstances. We compare several commonly used beam geometries, displaying sample traces for each and showing where each is appropriate, and we give a detailed description of the pulse-retrieval algorithm for each of these cases.
Pigeons Flexibly Time or Count on Cue

In Experiment 1, pigeons were presented with a sequence of light flashes and cued to peck a key for reward either after a fixed time or after a fixed number of flashes. Curves that showed the rate of key pecking over time within trials indicated that peak rates of response were reached near the fixed time on timing-cued trials and near the fixed number of flashes on counting-cued trials. In Experiment 2, the key cue was shifted from timing to counting or from counting to timing midway through a trial. The peak times reached after the cue change indicated that pigeons kept track of time while cued to count but did not count while cued to time. These findings suggest a basic asymmetry in the dual-mode model of timing and counting.
Signal Transduction by the Chemokine Receptor CXCR3

Hepatic stellate cells (HSC) and glomerular mesangial cells (MC) are tissue-specific pericytes involved in tissue repair, a process that is regulated by members of the chemokine family. In this study, we explored the signal transduction pathways activated by the chemokine receptor CXCR3 in vascular pericytes. In HSC, interaction of CXCR3 with its ligands resulted in increased chemotaxis and activation of the Ras/ERK cascade. Activation of CXCR3 also stimulated Src phosphorylation and kinase activity and increased the activity of phosphatidylinositol 3-kinase and its downstream pathway, Akt. The increase in ERK activity was inhibited by genistein and PP1, but not by wortmannin, indicating that Src activation is necessary for the activation of the Ras/ERK pathway by CXCR3. Inhibition of ERK activation resulted in a decreased chemotactic and mitogenic effect of CXCR3 ligands. In MC, which respond to CXCR3 ligands with increased DNA synthesis, CXCR3 activation resulted in a biphasic stimulation of ERK activation, a pattern similar to the one observed in HSC exposed to platelet-derived growth factor, indicating that this type of response is related to the stimulation of cell proliferation. These data characterize CXCR3 signaling in pericytes and clarify the relevance of downstream pathways in the modulation of different biologic responses.
Energetics of walking in elderly people: factors related to gait speed.

BACKGROUND Slow walking speed in elderly people predicts increased morbidity and mortality. We examined factors that may be associated with decreased habitual walking speed in older men and women. METHODS Older (range: 60-88 years, mean = 72.5 years) men (n = 25) and women (n = 24) were recruited. The Short Physical Performance Battery, body composition, VO(₂peak) on a treadmill, VO₂ and rated perceived exertion during 10 minutes of walking at habitual gait speed and at a walking speed of 0.9 m/s, muscle strength, and level of physical activity were measured. RESULTS VO(₂peak) was strongly related to habitual gait speed (r = .744, p < .001) and remained significant even after controlling for age, muscle strength, and gender. Compared with the tertile of fastest walkers (mean gait speed, 1.37 ± 0.04 m/s), the tertile of slowest walkers (0.87 ± 0.02 m/s) were older (p < .001), shorter (p = .026), had lower lean body mass (p = .011), lower strength ( p < .001), less self-reported daily physical activity (p = .102), and higher relative (to VO(₂peak)) intensity during walking at their habitual speed (65.3% ± 3.9% vs 54.3% ± 2.1% of VO(₂peak), p = . 013). CONCLUSIONS VO(p₂eak) was strongly associated with habitual walking speed, suggesting that as aerobic capacity declines with age, the exertion associated with habitual gait speed increases. A slowing of walking speed may be a response to increased perception of exertion. The extent to which exercise training affects habitual gait speed and fatigue is not clear.
Reliability, validity and factorial dimensions of the Interactive Observation Scale for Psychiatric Inpatients

The Interactive Observation Scale for Psychiatric Inpatients (IOSPI) is characterized by the necessity of interaction between the rater and the patient during the evaluation process. The reliability, validity and factor structure of the IOSPI were evaluated by using a total of 186 sets of ratings accomplished by 2 nursing aides on 34 adult psychiatric inpatients submitted to weekly evaluations during the 3 first weeks of hospitalization. The patients were observed by the 2 nursing aides simultaneously during the morning shift (5 h). In the afternoon of the same day, they were interviewed by two psychiatrists who filled in separately the Brief Psychiatric Rating Scale (BPRS). Factor analysis of the 16 IOSPI items revealed 5 distinct clusters of items, which represented higher‐order constructs of social interest, psychomotor agitation, psychoticism, neatness and irritability. It was found that the IOSPI has significant interrater reliability, estimated by an intraclass correlation coefficient of total score and factor score. The total scores of the IOSPI showed a significant correlation with the total scores of the BPRS, meeting the criteria of concurrent validity. The criteria of predictive validity were also met, since the patients who could be discharged presented IOSPI scores significantly lower than the patients who could not be discharged. In conclusion, the IOSPI met the requirements of an evaluation scale and can stimulate therapeutic attitudes of the nursing staff by its characteristics of interactive observation.
Searching for Evidence about Health Education and Health Behavior Interventions

Evidence is fundamental to science, but finding the right evidence in health education and health behavior (HEHB) is often a challenge. The authors discuss some of the controversies about the types of evidence that should be considered acceptable in HEHB, the tension between the use of qualitative versus quantitative data, the need for measures of important but neglected constructs, and interpretation of data from experimental and nonexperimental research. This article discusses some of the challenges to the use of evidence and describes a number of strategies and some forces encouraging the use of evidence-based interventions. Finally, the authors suggest ways to improve the practice and dissemination of evidence-based HEHB. Ultimately, if evidencebased interventions are not disseminated, the interventions will not achieve their potential. The goal should be to develop more effective interventions and disseminate them to improve the public’s health.
Classification of posterior polymorphous corneal dystrophy as a corneal ectatic disorder following confirmation of associated significant corneal steepening.

IMPORTANCE The identification of steep corneal curvatures in a significant percentage of patients with posterior polymorphous corneal dystrophy (PPCD) confirms this previously reported association and suggests a role for the ZEB1 protein in keratocyte function. OBJECTIVE To determine whether PPCD is characterized by significant corneal steepening. DESIGN, SETTING, AND PARTICIPANTS Cross-sectional study at university-based and private ophthalmology practices of 38 individuals (27 affected and 11 unaffected) from 23 families with PPCD. EXPOSURE Slitlamp examination and corneal topographic imaging were performed for individuals with PPCD and unaffected family members. Saliva or blood samples were obtained from each individual for DNA isolation and ZEB1 sequencing. Corneal ZEB1 expression was measured using immunohistochemistry. MAIN OUTCOMES AND MEASURES Percentage of individuals affected with PPCD and controls with an average keratometric value greater than 48.0 diopters (D) in each eye; the mean keratometric value averaged for both eyes of individuals with PPCD and controls; and the correlation of ZEB1 mutation with keratometric value. RESULTS ZEB1 coding region mutations were identified in 7 of the 27 affected individuals. Ten of the 38 individuals (26.3%) had average keratometric values greater than 48.0 D OU: 10 of 27 individuals with PPCD (37.0%; 6 of 7 individuals with ZEB1 mutations [85.7%] and 4 of 20 individuals without ZEB1 mutations [20.0%]) and 0 of 11 unaffected individuals (P = .04 for unaffected vs affected individuals; P = .004 for individuals with PPCD with vs without ZEB1 mutation). The mean keratometric value of each eye of affected individuals (48.2 D) was significantly greater than that of each eye of unaffected family members (44.1 D) (P = .03). Affected individuals with ZEB1 mutations demonstrated a mean keratometric value of 53.3 D, which was significantly greater than that of affected individuals without ZEB1 mutations (46.5 D; P = .004). Fluorescence immunohistochemistry demonstrated ZEB1 expression in keratocyte nuclei. CONCLUSIONS AND RELEVANCE Abnormally steep corneal curvatures are identified in 37% of all individuals with PPCD and 86% of affected individuals with PPCD secondary to ZEB1 mutations. ZEB1 is present in keratocyte nuclei, suggesting a role for ZEB1 in keratocyte function. Therefore, ZEB1 may play a role in both corneal stromal and endothelial development and function, and PPCD should be considered both an endothelial dystrophy and an ectatic disorder.
BOB.1/OBF.1 Deficiency Affects Marginal-Zone B-Cell Compartment

ABSTRACT Marginal-zone (MZ) B cells represent a first line of defense against particulate blood-borne antigens. Together with the B1 cells, they are responsible for the early response against type II T-independent antigens. The molecular pathways controlling the development of MZ B cells are only poorly understood. We found that these cells are virtually absent in mice deficient in the BOB.1/OBF.1 coactivator. Loss of these B cells was demonstrated by the lack of cells showing the appropriate cell surface phenotype but also by histological analyses and tri-nitro-phenol-Ficoll capturing. The lack of these cells is a B-cell-intrinsic defect, as shown by bone marrow complementation experiments. We also show that the expression of BOB.1/OBF.1 in peripheral B cells is required for the development of MZ B lymphocytes. Our analysis of BOB.1/OBF.1-deficient splenic B cells reveals alterations in cell motility, tumor necrosis factor receptor expression, and B-cell receptor (BCR) signaling. These changes could contribute to the loss of MZ B lymphocytes by altering the maturation of the cells. Interestingly, development of and BCR signaling in B1 B cells are completely normal in BOB.1/OBF.1 mutant mice.
Levobupivacaine 0.5% Provides Longer Analgesia After Sciatic Nerve Block Using the Labat Approach Than the Same Dose of Ropivacaine in Foot and Ankle Surgery

BACKGROUND: Levobupivacaine and ropivacaine are 2 left enantiomeric molecules frequently used for peripheral nerve blocks because of their safe clinical profile. Levobupivacaine is more lipophilic and theoretically more potent than ropivacaine, but clinical studies show conflicting results in terms of anesthetic and analgesic characteristics. We hypothesized that the pure S-enantiomer of bupivacaine provides longer-lasting analgesia than ropivacaine. METHODS: We compared the analgesic characteristics of 20 mL levobupivacaine versus 20 mL ropivacaine 0.5% in a posterior sciatic nerve block (Labat approach) for foot and ankle surgery. In a double-blind, randomized, prospective design, 80 patients received either substance. We assessed the onset, duration, and success of the block, and the need for rescue analgesia and technical or neurologic complications over 24 hours. RESULTS: The onset of sensory block (minutes) and the success rate were similar in levobupivacaine and ropivacaine groups (onset, 15 minutes [5–40 minutes] vs 15 minutes [5–60 minutes], respectively; success rate, 90% vs 92.5%). The average time for the first request of pain medication provided by 20 mL levobupivacaine 0.5% was significantly longer than with ropivacaine (1605 minutes [575–2400 minutes] vs 1035 minutes [590–1500 minutes], P < 0.001). The need for postoperative rescue analgesia was higher in the ropivacaine group (37 of 40 [92.5%] vs 30 of 40 [75%], P < 0.034). No complications were noted in either group at 24 hours. CONCLUSION: Twenty milliliters levobupivacaine 0.5% in posterior gluteal (Labat) sciatic nerve block provided longer-lasting analgesia after foot and ankle surgery compared with the same dose of ropivacaine.
Assessing demoralization and depression in the setting of medical disease.

OBJECTIVE The aim of this study was to assess the presence of demoralization and major depression in the setting of medical disease. METHOD 807 consecutive outpatients recruited from different medical settings (gastroenterology, cardiology, endocrinology, and oncology) were assessed according to DSM-IV criteria and Diagnostic Criteria for Psychosomatic Research, using semistructured research interviews. RESULTS Demoralization was identified in 245 patients (30.4%), while major depression was present in 135 patients (16.7%). Even though there was a considerable overlap between the 2 diagnoses, 59 patients (43.7%) with major depression were not classified as demoralized, and 169 patients (69.0%) with demoralization did not satisfy the criteria for major depression. CONCLUSIONS The findings suggest a high prevalence of demoralization in the medically ill and the feasibility of a differentiation between demoralization and depression. Further research may determine whether demoralization, alone or in association with major depression, entails prognostic and clinical implications.
Massive left atrial thrombus in a patient with rheumatic mitral stenosis and atrial fibrillation while anticoagulated with dabigatran.

Dabigatran is an oral direct thrombin inhibitor licensed for use by the Food and Drug Administration.1,2 This novel anticoagulant is effective and approved for prevention of stroke and systemic embolism in nonvalvular atrial fibrillation (AF) and prevention of venous thromboembolism in adults receiving elective total hip or knee replacement surgery.1,2 These images present a cautionary account of failed dabigatran anticoagulation in a patient with valvular AF: an indication for which its use has not been approved. A 50-year-old female with severe rheumatic mitral stenosis underwent open mitral valvotomy under cardiopulmonary bypass 25 years prior. On subsequent annual surveillance, she remained asymptomatic and her mitral stenosis remained moderate on echocardiography with a mean transmitral gradient of 8 mm Hg. Permanent AF was previously diagnosed 12 months earlier, and she was commenced on warfarin and metoprolol. She had stable anticoagulation monitoring, no bleeding complications, and normal renal function, but was needle-phobic with psychological …
Reduction of Inpatient Hospital Length of Stay in Lumbar Fusion Patients With Implementation of an Evidence-Based Clinical Care Pathway

Study Design. Quality improvement with before and after evaluation of the intervention. Objective. To improve lumbar spine postoperative care and quality outcomes through a series of Lean quality improvement events designed to address root causes of error and variation. Summary of Background Data. Lumbar spine fusion procedures are common, but highly variable in process of care, outcomes, and cost. Methods. We implemented a standardized lumbar spine fusion clinical care pathway through a series of Lean quality improvement events. The pathway included an evidence-based electronic order set; a patient visual tool; and multidisciplinary communication, and was designed to delineate expectations for patients, staff, and providers. To evaluate the effectiveness of the intervention, we performed a quality improvement study with before and after evaluation of consecutive patients from January 2012 to September 2014. Outcomes were hospital length of stay and quality measures before and after the April 1, 2013 intervention. Data were analyzed with chi-square and t tests for before and after comparisons, and were explored graphically for temporal trends with statistical process control charts. Results. Our study population was 458 patients (mean 65 years, 65% women). Length of stay decreased from 3.9 to 3.4 days, a difference of 0.5 days (CI 0.3, 0.8, P < 0.001). Discharge disposition also improved with 75% (183/244) being discharged to home postintervention versus 64% (136/214) preintervention (P = 0.002). Urinary catheter removal also improved (P = 0.003). Patient satisfaction scores were not significantly changed. Conclusion. Applying Lean methods to produce standardized clinical pathways is an effective way of improving quality and reducing waste for lumbar spine fusion patients. We believe that quality improvements of this type are valuable for all spine patients, to provide best care outcomes at lowest cost. Level of Evidence: 4
Features, Projections, and Representation Change for Generalized Planning

Generalized planning is concerned with the characterization and computation of plans that solve many instances at once. In the standard formulation, a generalized plan is a mapping from fea- ture or observation histories into actions, assuming that the instances share a common pool of features and actions. This assumption, however, excludes the standard relational planning domains where actions and objects change across instances. In this work, we extend the standard formulation of generalized planning to such domains. This is achieved by projecting the actions over the features, resulting in a common set of abstract actions which can be tested for soundness and completeness, and which can be used for generating general policies such as “if the gripper is empty, pick the clear block above x and place it on the table” that achieve the goal clear(x) in any Blocksworld instance. In this policy, “pick the clear block above x” is an abstract action that may represent the action Unstack(a, b) in one situation and the action Unstack(b, c) in another. Transformations are also introduced for computing such policies by means of fully observable non-deterministic (FOND) planners. The value of generalized representations for learning general policies is also discussed.
Mineral Nutrient Acquisition and Response by Plants Grown in Saline Environments

Plants acquire mineral nutrients from their native soil environments. Most crop plants are glycophytes and have evolved under conditions of low soil salinity. Consequently, they have developed mechanisms for absorbing, transporting, and utilizing mineral nutrients in nonsaline soils. Under saline conditions, which are characterized by low nutrient-ion activities and extreme ratios of Na / Ca , Na /K , Mg /Ca , and Cl /NO3 , nutritional disorders can develop and crop growth and quality may be reduced. This is not surprising, since under saline conditions, Na and/or Cl often exceed macronutrient concentrations by one or two orders of magnitude and even more in the case of micronutrients. Halophytes, native to saline environments, may also develop nutrient disorders despite their remarkable ability to absorb nutrients selectively from soil solutions dominated by Na and Cl . Nutrient imbalance can develop in salt-stressed plants in different ways. It may result from the effect of salinity on nutrient availability, uptake, transport, or partitioning within the plant or may be caused by physiological inactivation of a given nutrient resulting in an increase in the plant’s internal requirement for that essential element. It is likely that salinity may affect one or more of these processes at the same time, but whether or not this imbalance results in loss of crop yield or quality depends on its severity, which is influenced by a number of environmental factors. Nutrient availability and uptake by plants grown in saline environments is related to (a) the activity of the nutrient ion in the soil solution which depends on pH, pE (the negative log of