Miracle-dz/UniFAR-FTUs huggingface dataset:
Reimbursement Restriction and Moderate Decrease in Benzodiazepine Use in General Practice

PURPOSE To limit misuse and save costs, on January 1, 2009, benzodiazepines were excluded from the Dutch reimbursement list when used as anxiolytic, hypnotic, or sedative. This study aims to assess the impact of this reimbursement restriction on benzodiazepine use in patients with newly diagnosed anxiety or sleeping disorder in general practice. METHODS Was conducted a retrospective observational database study deriving data on diagnoses and prescriptions from the electronic health records–based Netherlands Information Network of General Practice (LINH). We looked for patients aged 18 years and older with an incident diagnosis of sleeping disturbance (International Classification of Primary Care code: P06) or anxiety (P74, P01) between January 2008 and December 2009. Incidence of these diagnoses, benzodiazepine use, and initiation of selective serotonin reuptake inhibitor (SSRI) treatment was compared between 2008 and 2009. RESULTS In total, we identified 13,596 patients with an incident diagnosis of anxiety (3,769 in 2008 and 3,710 in 2009) or sleeping disorder (3,254 in 2008 and 2,863 in 2009). The proportion of patients being prescribed a benzodiazepine after a diagnosis was lower in 2009 than in 2008 for both anxiety (30.1% vs 33.7% P <.05) and sleeping disorder (59.1% vs 67.0%, P <.05), as was the proportion of patients with more than 1 benzodiazepine prescription for both anxiety (36.4% vs 42.6%, P <.05) and sleeping disorder (35.0% vs 42.6%, P <.05). We found no increase in the use of alternative treatment for anxiety with SSRIs. CONCLUSIONS The reimbursement restriction has led to a moderate decrease in the number of incident diagnoses and initiation of benzodiazepine use in patients with newly diagnosed anxiety or sleeping disorder. This finding indicates that in settings where no such reimbursement opportunities exist, physicians have room to reduce benzodiazepine prescribing.
The uses and implications of standards in general practice consultations

Quality standards play an increasingly important role in primary care through their inscription in various technologies for improving professional practice. While ‘hard’ biomedical standards have been the most common and debated, current quality development initiatives increasingly seek to include standards for the ‘softer’ aspects of care. This article explores the consequences of both kinds of quality standards for chronic care consultations. The article presents findings from an explorative qualitative field study in Danish general practice where a standardized technology for quality development has been introduced. Data from semi-structured interviews and observations among 17 general practitioners were analysed using an iterative analytical approach, which served to identify important variations in the uses and impacts of the technology. The most pronounced impact of the technology was observed among general practitioners who strictly adhered to the procedural standards on the interactional aspects of care. Thus, when allowed to function as an overall frame for consultations, those standards supported adherence to general recommendations regarding which elements to be included in chronic disease consultations. However, at the same time, adherence to those standards was observed to narrow the focus of doctor–patient dialogues and to divert general practitioners’ attention from patients’ personal concerns. Similar consequences of quality standards have previously been framed as manifestations of an inherent conflict between principles of patient-centredness and formal biomedical quality standards. However, this study suggests that standards on the ‘softer’ aspects of care may just as well interfere with a clinical approach relying on situated and attentive interactions with patients.
Spinal Metastases: The Obvious, the Occult, and the Impostors

Spines from 832 deceased patients with a terminal diagnosis of malignant neoplasm were examined grossly, microscopically and radiographically for evidence of tumor. Gross tumor and bone destruction or sclerosis were reliable signs of obvious metastases. Occult lesions visualized on gross sagittal sections but not detectable radiographically occurred in 26% of spines with confirmed metastatic deposits. Vertebral collapse was not a reliable indicator of metastases. Collapse was not caused by neoplasm in 22% of cases. Overall, metastases were found in 36% of patients dying from neoplastic disease. Although most metastases are obvious, occult lesions not visible radiographically occur. Collapsed vertebra may be impostors simulating metastatic disease.
Sonographically Guided Ilioinguinal Nerve Block

Objective. The aim of this study was to describe a sonographically guided ilioinguinal nerve block in adults. Methods. We developed a useful step‐by‐step technique of sonographically guided ilioinguinal nerve block based on visualization of abdominal muscles, fascial planes, and the branch of the deep circumflex iliac artery. Results. We performed 9 sonographic examinations with subsequent blockade of the ilioinguinal nerve. All injections resulted in a clinically successful sensory block. Conclusions. This technique is reliable and reproducible. The block is achievable by a low‐volume local anesthetic injection. Visualization of the intestines and blood vessels in the abdominal wall may help prevent an inadvertent injury.
Dermatophytes and host defence in cutaneous mycoses.

Dermatophytosis is the infection of keratinized tissues such as hair, nails and the stratum corneum of the skin by dermatophyte fungi. These fungi are onygenalean anamorphs and anamorphic species belonging to the genera Trichophyton, Microsporum and Epidermophyton. An important characteristic of the dermatophytes as parasites is their restriction to the dead keratinized tissues, except in rare cases where the patient is immunosuppressed. In contrast to many fungi, including normally non-pathogenic species, which can invade systemically in severely immunocompromised (e.g. neutropenic) patients, dermatophytes appear to be unable to cause systemic infection in this population. Thus, these fungi appear to have an unique interaction with the immune system. A better understanding of this interaction will contribute significantly to our knowledge of mammalian host defences.
It's all in the parameters: a critical analysis of some well-known negative studies on low-level laser therapy.

OBJECTIVE Scientific studies include references to historical studies on low-level laser therapy (LLLT) in general and to old studies on the specific subject in particular. Some studies are quoted often. It is fair to take a second look at these, since few people seem to have read them carefully, and others have read them only in the abstract form. This paper critically reviews the parameter pitfalls found in many of the classic "negative" studies. SUMMARY BACKGROUND DATA A study of 1,200 papers on LLLT has resulted in 85 positive and 35 negative double-blind studies. The negative studies have been scrutinized carefully in an effort to pinpoint possible reasons for the failures. In the following, the majority are double-blind studies, but some non-blinded and animal studies have been included to give typical examples of pitfalls.
Value creation and supply risk reduction in purchasing : Effects of purchasing involvement and a proactive market orientation Working paper

In the current study, we explain how involvement and proactivity of purchasing professionals in the sourcing process affect sourcing project outcomes, in terms of value creation and supply risk reduction. The results of this paper are obtained from quantitative research within a large, private, European financial institution. Data was collected from the company’s sourcing projects database, complemented by in depth and structured interviews with key stakeholders within the organization. Our quantitative data were analyzed using PLS-SEM. Our research results demonstrate that early involvement, responsibility and proactivity of purchasing professionals in sourcing projects are important drivers of supply risk reduction and value creation outcomes. More specifically, our results indicate that proactivity mediates the effect of purchasing involvement on value creation. The present study empirically establishes the importance of purchasing professionals’ role in sourcing projects to realize supply risk reduction and value creation.
ENDOPARASITES OF HARES (LEPUS TIMIDUS L. AND L. EUROPAEUS PALLAS) IN FINLAND

Intestinal and lung parasites of 85 mountain hares (Lepus timidus) and 24 European hares (L. europaeus) were examined. The species of parasites found in both hare species were Trichostrongylus retortaeformis Zeder, 1800; Mosgovoyia pectinata Goeze, 1782 and Protostrongylus pulmonalis Froelich, 1802. Eimeria semisculpta Madsen, 1938 and E. townsendi Carvalho, 1943 were found only in the European hares and Eimeria leporis Nieschulz, 1923 and Dicrocoelium dendriticum Rudolphi, 1819 only in the mountain hares. Ninety-five percent of the mountain hares and 88% of the European hares were infected with parasites. Mountain hares were more commonly infected with P. pulmonalis and D. dendriticum while European hares were more commonly infected with Eimeria spp. and T. retortaeformis. Young mountain hares were more often infected with M. pectinata and adult mountain hares with P. pulmonalis. The management technique of winter-feeding did not increase significantly the percentage of infected animals. Dicrocoelium dendriticum was found only in hares from islands where sheep had grazed during the summers. The absence of cysticerci of Taenia pisiformis Bloch, 1780 in this survey may be a reflection of improved hygiene practices instituted by hunters.
Ray of Hope

Does bright lighting seem more desirable when people feel hopeless? Common parlance such as “ray of hope” depicts an association between hope and the perception of brightness. Building on research in embodied cognition and conceptual metaphor, we examined whether incidental emotion of hopelessness can affect brightness perception, which may influence people’s preference for lighting. Across four studies, we found that people who feel hopeless judge the environment to be darker (Study 1). As a consequence, hopeless people expressed a greater desire for ambient brightness and higher wattage light bulbs (Studies 2 and 3). Study 4 showed the reversal of the effect—being in a dimmer (vs. brighter) room induces greater hopelessness toward the perceived job search prospects. Taken together, these results suggest that hopeless feeling seems to bias people’s perceptual judgment of ambient brightness, which may potentially impact their electricity consumption.
The lobular expression of the rat asialoglycoprotein receptor is regulated at the posttranscriptional level

Abstract: The purpose of this study was to define the distribution of the asialoglycoprotein receptor (ASGP‐R) main peptide, rat hepatic lectin (RHL)‐1, within the rat liver lobule and to investigate its possible modulation in physiological states characterised by marked changes of receptorial expression. In particular, we chose livers from rats partially hepatectomised or at the end of pregnancy, as models, respectively, of decreased or increased expression of the ASGP‐R, and used the in situ hybridisation and immunocytochemistry techniques to analyse in parallel the lobular distributions of RHL‐1 mRNA and protein. In normal rat liver, although the RHL‐1 mRNA was homogeneously distributed, the RHL‐1 peptide was predominantly localised on the surface of pericentral hepatocytes with a gradient of expression towards the periportal zone. This gradient of expression of RHL‐1 peptide was reduced in regenerating livers, in which the positive stain was restricted to a few layers of cells around the central vein. In contrast, livers at the end of pregnancy showed an overall increase of the peptide with a concomitant flattening of the gradient across the liver plate. In all the conditions, we never observed important changes in the pattern of expression of the specific mRNA. These findings indicate that the distribution of ASGP‐R is heterogeneous across the liver lobule, with a pattern of expression prevalently modulated at the posttranscriptional level.
DegU co‐ordinates multicellular behaviour exhibited by Bacillus subtilis

Unicellular organisms use a variety of mechanisms to co‐ordinate activity within a community and accomplish complex multicellular processes. Because some of the processes that are exhibited by one species can be physiologically incompatible, it raises the question of how entry into these different pathways is regulated. In the Gram‐positive bacterium Bacillus subtilis, genetic competence, swarming motility, biofilm formation, complex colony architecture and protease production are all regulated by the response regulator DegU. DegU appears to integrate environmental signals and co‐ordinate multicellular behaviours that are subsequently manifested at different levels of DegU phosphorylation. Data are presented which indicate that: (i) swarming motility is activated by very low levels of DegU∼P that can be generated independently from its cognate sensor kinase DegS; (ii) complex colony architecture is activated by low levels of DegU∼P that are produced in a DegS‐dependent manner to activate transcription of yvcA, a novel gene required for complex colony architecture; and (iii) high levels of DegU∼P inhibit complex colony architecture and swarming motility but are required prior to the activation of exoprotease production. A model is proposed to explain why such a system may have evolved within B. subtilis to control these multicellular processes through a single regulator.
A system dynamics approach to technology interaction including cyclic behaviour

This paper is an extension of previous research on the simulation of three competing technologies that interact. Some exploration into cyclic behaviour of a modified version of the three technology system is attempted. Technology is considered in this research as a result of innovation, a rate dependent process that may include several non-linearities due to interaction with the environment. Technology growth patterns can be traced in a number of ways. Using bibliometrics as a research data source is one interesting way to trace these technology growth patterns very effectively. In this research the existence of cyclic behaviour in two real life technologies is illustrated using bibliometrics. In this paper a technology system consisting of three interacting technologies is treated and modeled in a coupled manner where the interacting dynamics is described by the Lotka-Volterra system of differential equations. The effect of interaction between the technologies and the period of cyclic behaviour is illustrated parametrically. Furthermore the possible uncertain diffusion effect in one of the technologies is also addressed in this research using a Monte Carlo multivariate simulation technique and a system dynamics approach. The research method is exploratory and case based. This method has been shown before to be useful especially early on in research projects.
Antihepatotoxicity of Ricinus communis (L.) Against Ketoconazole Induced Hepatic Damage

2 Abstract: Since chronic hepatic diseases stand as one of the foremost health troubles worldwide, with liver cirrhosis and drug induced liver injury leading to death in western and developing countries. Treatment of liver diseases with plant-derived compounds which are accessible and do not require laborious pharmaceutical synthesis seems highly attractive. The present study was carried out to screen and evaluate the hepatoprotective activity of ethanolic leaf extracts of Ricinus communis (L.) at a dose of 100 mg / kg body weight against Ketoconazole (Phytoral) induced liver damage in mice. The degree of protection was measured by performing various liver function tests. Results indicated that ethanolic extracts of Ricinus communis (L.) at a dose of 100 mg / kg body weight exhibited relative significant reduction in hepatic enzymes of treated mice The results of the present investigation confirms the traditional uses of this plant as a potential hepatoprotective agent. The present study revealed that Ricinus communis Linn. could be formulated as a drug of choice since this medicinal herb is easily available in southern India.
Evaluation of five primitive reflexes in 240 young adults

The clinical implication of a positive primitive reflex is a controversial issue. Primitive reflexes are believed to signify frontal lobe damage or upper motor neuron disease,1 and generally are thought to indicate cortical disinhibition.2 Attempts to elicit these reflexes are regarded as standard in the physical examination of patients with suspected dementia and are reportedly useful in the clinical assessment and diagnosis of multiple sclerosis, Parkinson's disease, Alzheimer's disease, schizophrenia, hydrocephalus, and frontal lobe lesions.2,3 Due to the correlation between higher Centers for Disease Control (CDC) HIV stages and the presence of multiple primitive reflexes, primitive reflex testing has been suggested as part of the standard neurologic examination. The use of primitive reflexes as markers for cerebral dysfunction in neurologically asymptomatic HIV-positive patients adds new import to the understanding of primitive reflex prevalences.4,5 The goal of this project was to establish a reference for a positive primitive reflex response seen …
Natural variation in GL1 and its effects on trichome density in Arabidopsis thaliana

The ultimate understanding of how biological diversity arises, is maintained, and lost depends on identifying the genes responsible. Although a good deal has been discovered about gene function over the past few decades, far less is understood about gene effects, that is, how natural variation in a gene contributes to natural variation in phenotypes. Trichome density in Arabidopsis thaliana is an ideal trait for studies of natural molecular and phenotypic variation, as trichome initiation is genetically well‐characterized and trichome density is highly variable in and among natural populations. Here, we show that variation at GLABRA1 (GL1), an R2R3 MYB transcription factor gene, which has a role in trichome initiation, has qualitative and likely quantitative effects on trichome density in natural accessions of A. thaliana. Specifically, we characterize four independent loss‐of‐function alleles for GL1, each of which yields a glabrous phenotype. Further, we find that a pattern of common polymorphisms confined to the GL1 locus is associated with quantitative variation for trichome density. While mutations resulting in a glabrous phenotype are primarily coding changes, the pattern resulting in quantitative variation spans both coding and regulatory regions. These data show that GL1 is an important source of trichome density variation within A. thaliana and, along with recent reports, suggest that the TTG1 epidermal cell fate pathway generally may be the key molecular genetic source of natural trichome density variation and an important model for the study of molecular evolution.
Slow vertical saccades in motor neuron disease: Correlation of structure and function

We studied eye movements and brainstem pathology in 2 patients with slow vertical saccades and autopsy‐proven amyotrophic lateral sclerosis (ALS). In both patients, the main ocular motor finding was supranuclear vertical gaze impairment with slow vertical saccades. The second patient had difficulty opening his eyes on command, with preserved spontaneous eyelid opening. Postmortem examination in both patients demonstrated cell loss in the rostral interstitial nucleus of the medial longitudinal fasciculus (riMLF) and substantia nigra, along with histopathological findings consistent with ALS. The extent of the pathological changes in the riMLF corelated well with the degree of functional impairment as reflected in the slow vertical saccades. We suggest that motor neuron disease with early involvement of vertical saccades represents a distinct clinicopathological entity.
On Rearrangeability of Multirate Clos Networks

Chung and Ross [SIAM J. Comput. , 20 (1991), pp. 726--736] conjectured that the multirate three-stage Clos network C(n,2n-1,r) is rearrangeable in the general discrete bandwidth case; i.e., each connection has a weight chosen from a given finite set {p1, p2,. ,pk} where $1 \geq p_1 > p_2 > \cdots > p_k > 0$ and pi is an integer multiple of pi, denoted by $p_k \mid p_i$, for $1 \leq i \leq k-1$. In this paper, we prove that multirate three-stage Clos network C(n,2n-1,r) is rearrangeable when each connection has a weight chosen from a given finite set {p1, p2,. ,pk} where $1 \geq p_1 > p_2 > \cdots > p_{h} > 1/2 \geq p_{h+1} > \cdots > p_k > 0$ and ph+2 | ph+1,ph+3 |ph+2,. ,pk | ph+1. We also prove that C(n,2n-1,r) is two-rate rearrangeable and $C(n, \lceil \frac{7n}{3} \rceil, r)$ is three-rate rearrangeable.
Report of the Eye Bank Association of America Medical Advisory Board Subcommittee on Fungal Infection After Corneal Transplantation

Purpose: To investigate the incidence of fungal infections after corneal transplantation to determine whether storage media supplementation with an antifungal should be considered. Methods: Adverse reactions reported to the Eye Bank Association of America through the online adverse reaction reporting system between January 1, 2007, and December 31, 2010, were reviewed to identify cases of recipient fungal infection. Data were collected regarding the donor, the donor cornea, recovery and processing, and mate culture and clinical course of the recipients. Results: Thirty-one cases of culture-proven fungal keratitis (n = 14) and endophthalmitis (n = 17) were reported out of 221,664 corneal transplants performed using corneal tissue distributed by domestic eye banks (1.4 cases per 10,000 transplants performed). Although the annual incidence of postkeratoplasty fungal infection has not increased significantly since 2005, a trend toward an increasing rate of fungal infection has been observed. Fungal infections were more commonly reported after endothelial keratoplasty procedures (0.022%) than penetrating keratoplasty procedures (0.012%), but the difference was not statistically significant (P = 0.076). Additionally, no association was found between fungal infection after endothelial keratoplasty and whether the lamellar tissue cut was performed by the surgeon or the eye bank technician. Seventy-three percent (16 of 22) of the fungal cultures performed on the mate corneas were positive, with infection developing in 67% (10 of 15) of recipient eyes (endophthalmitis in 6 eyes and keratitis in 4 eyes). Conclusions: Although a nonsignificant increasing trend in the rate of fungal infection has been observed over the past 6 years, it is not sufficiently compelling to pursue antifungal supplementation of donor storage media.
Pathological Aspects of a Subclinical Marek's Disease Case in Free-Range Chickens

The present report aims at describing the occurrence of Marek's Disease (MD) in a free range poultry farm based on macroscopic and microscopic lesions. For this purpose, seven free-range chickens were evaluated by gross and microscopic examination. Tumor lesions were observed in the liver and ovary, in addition of enlarged kidney and spleen, skin thickening and whitish lesions in streak form in the breast muscle. Fragments of the affected organs were collected and placed in 10% formalin for processing by the usual histopathology techniques, and stained with hematoxylin-eosin. Under microscopic evaluation, we observed pleomorphic populations of neoplastic lymphoreticular cells with pyknotic nuclei in the same organs, all compatible with MD. The macroscopic and microscopic lesions presented in this study were consistent with MD, meaning that the MD virus is present in the rearing environment of the studied chicken farm.