Miracle-dz/UniFAR-FTUs huggingface dataset:
Complementary and Alternative Medicine and Mental Health Care: Shared Challenges

Many of the challenges facing complementary and alternative medicine (CAM) professionals today are the same ones faced by professionals in the mental health care field. Compelling evidence for this overlap can be seen in the utilization statistics on CAM for those suffering from mental disorders. Several major studies have shown that mental health issues such as depression and anxiety are among the main reasons that people use CAM. For example, in Eisenberg et al.’s (1993) classic study, anxiety and depression ranked third and fourth, respectively, among problems for which people had used an alternative therapy. Unutzer et al. (2000) found that major depression and panic disorder were especially highly associated with CAM use and that overall, 21% of users of CAM met diagnostic criteria for at least one mental disorder, compared with 13% of nonusers. In fact, Kessler et al. (2001) found that the majority of Americans with anxiety or depression use some form of CAM to treat these conditions and that Americans are much more likely to use CAM to treat mental health issues than they are to use conventional approaches. This prompts the question: Are CAM usage statistics so high because mainstream approaches to mental health care are not acceptable to people? Many critics of conventional mental health care have made this claim. The survey data, however, prove them incorrect. It is not the case that most users of CAM dislike conventional approaches; rather, they simply like CAM more, because it is more congruent with their value system (Astin, 1998). CAM’s phenomenal rise can be attributed almost entirely to consumer enthusiasm. The White House Commission on Complementary and Alternative Medicine (2002) Policy Report released last year acknowledged that the driving force behind the prominence of CAM today is consumer demand. The commissioners who prepared the report expressed concerns about this, however, and called for policy making in CAM to be driven not by consumer demand but rather by scientific research on safety and efficacy. Research can provide a more objective evaluation of CAM therapies, they pointed out. It is hoped that with objective information gained from proper trials, we should be able to depoliticize the policy-making process and minimize the effect of interest-group politics on policy making. When you have as we do more than $30 billion a year spent on CAM in this country, there are sure to be interest groups involved. With that much money at stake, the discussion is going to get heated.
Challenges of feedback provision in the workplace: A qualitative study of emergency medicine residents and teachers

Abstract Background: Feedback is an effective pedagogical tool in clinical teaching and learning, but is often perceived as unsatisfactory. Little is known about the effect of a busy clinical environment on feedback-giving and -seeking behaviors. This study aims to determine the perceptions and challenges of feedback provision in a busy clinical setting, exemplified by an emergency department (ED). Methods: A qualitative semi-structured interview study design was employed. Thirty-six participants (18 attending physicians, 18 residents) were purposively sampled from three EDs in northern Taiwan between August 2015 and July 2016. Interviews were recorded, transcribed, and analyzed thematically. Results: Three major themes were identified with illustrative quotes: (1) the balance between patient safety and providing feedback, (2) variability in feedback, and (3) influential factors, barriers and enablers. Conclusions: In real practice, clinical duties competed with the impulse to provide feedback. The variety and complexity of feedback extended beyond style and content. Clinical and contextual factors – some of which may be presented as barriers – influenced how, when and whether a teacher or learner decided to give or seek feedback.
The Effect of Hearing Aid Noise Reduction on Listening Effort in Hearing-Impaired Adults

Objectives: The purpose of the present study was to evaluate the effect of a noise-reduction (NR) algorithm on the listening effort hearing-impaired participants expend on a speech in noise task. Design: Twelve hearing-impaired listeners fitted with behind-the-ear hearing aids with a fast-acting modulation–based NR algorithm participated in this study. A dual-task paradigm was used to measure listening effort with and without the NR enabled in the hearing aid. The primary task was a sentence-in-noise task presented at fixed overall speech performance levels of 76% (moderate listening condition) and 50% (difficult listening condition) correct performance, and the secondary task was a visual-tracking test. Participants also completed measures of working memory (Reading Span test), and processing speed (Digit Symbol Substitution Test) ability. Results: Participants’ speech recognition in noise scores did not significantly change with the NR algorithm activated in the hearing aid in either listening condition. The NR algorithm significantly decreased listening effort, but only in the more difficult listening condition. Last, there was a tendency for participants with faster processing speeds to expend less listening effort with the NR algorithm when listening to speech in background noise in the difficult listening condition. Conclusions: The NR algorithm reduced the listening effort adults with hearing loss must expend to understand speech in noise.
Services quality for people with rheumatoid arthritis: Iranian patients' perspective

Background: Service quality (SQ) refers primarily to how the care received is perceived and is influenced by the physical, social, and cultural context and nonhealth aspects of care, such as access, respect, and confidentiality. This study aimed to assess SQ for people with rheumatoid arthritis (RA) from the patients' perspective. Subjects and Methods: A cross-sectional study was conducted with 172 people with RA who received care from specialist clinics of Isfahan University of medical sciences in 2013. SQ was measured using comprehensive quality measurement in healthcare_service quality (CQMH_SQ) questionnaire. Questionnaire content validity was reviewed and confirmed by 10 experts and its reliability was confirmed based on Cronbach's alpha index (α =0. 803). A measure of SQ was derived by combining the relative importance and actual performance. Data analyzed using the SPSS-17 statistical package. Results: Study findings indicate average SQ score were 7.91 (0.87) and demonstrated which aspects of SQ took a weak score in total SQ for people with RA. Confidentiality and choice of care provider achieved the highest and availability of support group had the lowest scores SQ scores. Participants with good control of their disease had higher scores (P = 0.042) and SQ score customer quality score have positive relationship with increasing each year in elapsed time of diagnosis (P = 0. 028). Conclusions: According to average score of customer quality, study findings indicate that patient and provider participation in quality improvement activities can be used as an effective solution and also needs for focus on such aspect of health care quality that were more important for consumer, also dimension have worst quality such as availability of support group.
Exploring the relationship between examiners’ memories for performances, domain separation and score variability

Abstract Background: OSCE examiners’ scores are variable and may discriminate domains of performance poorly. Examiners must hold their observations of OSCE performances in “episodic memory” until performances end. We investigated whether examiners vary in their recollection of performances; and whether this relates to their score variability or ability to separate disparate performance domains. Methods: Secondary analysis was performed on data where examiners had: 1/scored videos of OSCE performances showing disparate student ability in different domains; and 2/performed a measure of recollection for an OSCE performance. We calculated measures of “overall-score variance” (the degree individual examiners’ overall scores varied from the group mean) and “domain separation” (the degree to which examiners separated different performance domains). We related these variables to the measure of examiners’ recollection. Results: Examiners varied considerably in their recollection accuracy (recognition beyond chance −5% to +75% for different examiners). Examiners’ recollection accuracy was weakly inversely related to their overall score accuracy (R = −0.17, p < 0.001) and related to their ability to separate domains of performance (R = 0.25, p < 0.001). Conclusions: Examiners vary substantially in their memories for students’ performances which may offer a useful point of difference to study processing and integration phases of judgment. Findings could have implication for the utility of feedback.
Lobular carcinoma of the breast with extracellular mucin: New variant of mucin‐producing carcinomas?

The presence of mucin in infiltrating lobular carcinomas has been described as occurring exclusively in an intracytoplasmic location. To the best of the authors' knowledge, infiltrating lobular carcinoma displaying extracellular mucin has not been described in the literature. Herein is presented a case of lobular carcinoma with extracellular mucin in a 60‐year‐old female patient, who also had a contralateral ductal carcinoma of the cribriform type. Histologically the tumor had the classical appearance of infiltrating lobular carcinoma with signet ring cells and ‘Indian file’ infiltration of the stroma as well as pools of extracellular mucin. It is of great importance to appropriately classify breast carcinomas as ductal or lobular in origin due to the different treatment, prognosis, and clinical behavior of these lesions. The present finding opens the door for discussion of the current knowledge concerning histological variants of lobular carcinoma and should alert pathologists to the fact that the presence of extracellular mucin in an otherwise classical infiltrating lobular carcinoma does not preclude this diagnosis.
Gastric secretagogue action of Cryptolepis sanguinolenta in the perfused stomach of anesthetized rats

Background : Cryptolepis sanguinolenta has been reported to have antimalarial and antidiabetic effects. Aim : The gastric secretagogue action of ethanolic extract of Cryptolepis sanguinolenta stem was studied in rat model to evaluate its possible role in gastric acid secretion. Food intake and weight gain were also observed. Materials and Methods : The animals used were divided into four groups. The control received 2 ml of distilled water, while treated groups received 50, 150, and 250 mg/kgbw of Cryptolepis sanguinolenta extract per oral respectively daily for 21 days. Results : Cryptolepis sanguinolenta caused dose-dependent increase in gastric acid secretion. This secretagogue effect was augmented by histamine. Cryptolepis sanguinolenta also significantly increased food intake, body weight gain, and the sizes and number of gastric parietal cells. Conclusion : The results suggest that Cryptolepis sanguinolenta is ulcerogenic, and the gastric secretagogue action is histamine-mediated. This effect could be attributed to the presence of cryptolepine, the major bioactive agent, and other alkaloids present in the botanical. Keywords : Cryptolepis sanguinolenta , body weight, food intake, gastric acid, ulcer
Automatic change detection in high-resolution remote-sensing images by means of level set evolution and support vector machine classification

In this article, we propose a method for change detection in high-resolution remote-sensing images by means of level set evolution and support vector machine (SVM) classification, which combined both the pixel-level method and the object-level method. Both pixel-based change features and object-based ones are extracted to improve the discriminability between the changed class and the unchanged class. At the pixel level, the change detection problem is formulated as a segmentation issue using level set evolution in the difference images. At the object level, potential training samples are selected from the segmentation results without manual intervention into the SVM classifier. Thereafter, the final changes are obtained by combining the pixel-based changes and the object-based changes. A chief advantage of our approach is being able to select appropriate samples for SVM classifier training. Furthermore, our proposed method helps improve the accuracy and the degree of automation. We systematically evaluate it with various Satellite Pour l’Observation de la Terre (SPOT) 5 images and aerial images. Experimental results demonstrate the accuracy of our proposed method.
Intrinsically Disordered Proteins and Desiccation Tolerance: Elucidating Functional and Mechanistic Underpinnings of Anhydrobiosis

Over 300 years ago the father of microscopy, Antonie van Leeuwenhoek, observed dried rotifers (tiny animals) “coming back to life” upon rehydration. Since then, scientists have been fascinated by the enduring mystery of how certain organisms survive losing essentially drying out completely. Historically sugars, such as the disaccharide trehalose, have been viewed as major functional mediators of desiccation tolerance. However, some desiccation tolerant organisms do not produce this sugar, hinting that additional mediators, and potentially novel mechanisms exist. It has become apparent that a common theme among such organisms is the production and use of intrinsically disordered proteins (IDPs) to mediate survival in this dry state. However, the basic biology of these proteins – which unlike globular proteins lack persistent three‐dimensional structure – is poorly understood, as are the functional mechanisms utilized by these enigmatic proteins that allow them to mediate desiccation tolerance. We purpose that probing the biochemical and biophysical nature of stress‐related IDPs will provide mechanistic insights into these fascinating proteins.
Aggressive progression of breast cancer with microscopic pulmonary emboli possessing a stem cell‐like phenotype independent of its origin

Microscopic pulmonary tumor embolism is difficult to diagnose. Herein is presented the case of a patient who suffered from acute dyspnea and breast cancer on the right side. Two weeks after the breast cancer diagnosis the patient began to experience dyspnea. After 2 weeks of dyspnea, the patient died without an accurate diagnosis of dyspnea. Autopsy indicated massive microscopic pulmonary emboli of the breast cancer. Immunohistochemistry showed that most of the cancer cells in the primary site were negative for estrogen receptors, progesterone receptors Her2/neu oncogene (triple negative), and stem cell‐like markers (OCT3/4, NANOG2, CD44, CD24, aldehyde dehydrogenase 1 (ALDH1)). The breast cancer cells in the lung (the metastasized site), however, were triple negative, but were enriched in stem cell‐like markers (OCT3/4+, NANOG2+, CD44+/CD24−/low, ALDH1+). This is a significant case report indicating that vascular emboli themselves contain the essential molecular signature of ‘stemness’ independent of the origin.
Epidemiological factors influencing IVF outcome: Evidence from the Yale IVF program

Summary Age, BMI, lifestyle, menstrual status and obstetric history can modulate the endocrine system and, therefore, have been hypothesised to play a role in in-vitro fertilisation (IVF) outcome. We designed a retrospective study, set in a medical school hospital. We evaluated the medical files of 297 infertile women who underwent laparoscopy and consecutive IVF-ET treatment in the Yale IVF unit between 1996 and 2002. The study group consisted of 151 women who conceived after IVF-ET and the control group of 146 women who underwent 288 IVF-ET cycles without pregnancy. The main outcome measure was the impact of epidemiological factors on the IVF outcome. There was no association between IVF outcome and race, BMI, age at menarche, length of cycle, duration and amount of flow, menstrual symptoms, other medical problems, medical history of allergies, and family history of endometriosis and cancer. We found that the degree of smoking and alcohol use was not a factor when comparing women with and without pregnancy after IVF (34.5% vs 29.5%, and 33.7% vs 27%, respectively). The rate of duration of infertility tended to be lower in pregnant women (35.9±23.4 months) vs (42.3±30.2) non-pregnant women. As expected, we also confirmed the inverse association between the age of women and IVF outcome. Overall, body attributes, lifestyle, family history, menstrual and reproductive factors were not related to IVF-ET outcome.
Understanding Trauma: Integrating Biological, Clinical and Cultural Perspectives

T edited volume emerged from a series of workshops and conferences organized by the Foundation for Psychocultural Research. The intention of the three editors was to bring together a wide-ranging group of experts in neuroscience, behavioral science, and anthropology who could commonly address the subject of traumatic experience in order to undertake a creative exchange and make “significant steps toward the integration of diverse models and levels of explanation. ” To achieve this goal, the book is divided into three sections. The first section focuses on neurobiological perspectives of trauma and is largely concerned with basic science and thus is likely to present the most significant challenge to readers without a biological orientation. Recognizing the tendency of basic science research to rapidly outdate itself, the editors state that “some of the material presented in this section will no longer be cutting edge by the time this book appears in print. ” The second section explores some clinical issues surrounding the treatment of traumatized individuals, with contributions from several notable figures in the world of traumatic stress studies. The focus of the third section is on cultural perspectives of trauma and the ways in which any comprehensive understanding of the subject must explore the cultural context and collective meaning—and memory—of any event. The contributors to this section are mainly anthropologists, who view the subject through the lens of their field experiences. Although the stated goal of the volume is one of integration, a multiauthored book makes this task a challenging one, so the editors attempt to Jeffrey L. Geller, M.D., M.P.H. , Editor
An Investigation on Performance of Significance Analysis of Microarray (SAM) for the Comparisons of Several Treatments with one Control in the Presence of Small‐variance Genes

One of multiple testing problems in drug finding experiments is the comparison of several treatments with one control. In this paper we discuss a particular situation of such an experiment, i.e., a microarray setting, where the many‐to‐one comparisons need to be addressed for thousands of genes simultaneously. For a gene‐specific analysis, Dunnett's single step procedure is considered within gene tests, while the FDR controlling procedures such as Significance Analysis of Microarrays (SAM) and Benjamini and Hochberg (BH) False Discovery Rate (FDR) adjustment are applied to control the error rate across genes. The method is applied to a microarray experiment with four treatment groups (three microarrays in each group) and 16,998 genes. Simulation studies are conducted to investigate the performance of the SAM method and the BH‐FDR procedure with regard to controlling the FDR, and to investigate the effect of small‐variance genes on the FDR in the SAM procedure. (© 2008 WILEY‐VCH Verlag GmbH & Co. KGaA, Weinheim)
Changing trends in the laparoscopic management of ectopic pregnancy in a London district general hospital: 7-years experience

Summary We set out to evaluate the effect of a programme introduced in January 2003 to make operative laparoscopy the standard surgical treatment for women requiring surgery for ectopic pregnancy. This was a retrospective and prospective clinical data analysis performed at The Whipps Cross University Hospital in London, with a comparison of data taken before and after the introduction of the programme. A total of 116 women who had surgical management for ectopic pregnancy from January 2000 to December 2002 and 313 women who had surgery for ectopic pregnancy between January 2003 and December 2006 took part in the study. A programme was started in January 2003 to make operative laparoscopy the surgical management of choice. The main outcome measure was the proportion of women requiring surgery who had operative laparoscopy in the two study periods. The χ2-test was used to determine if there was any statistically significant difference between proportions. A difference was deemed statistically significant if p < 0.05. The results showed that there was a progressive rise in the proportion of ectopic pregnancies managed by operative laparoscopy following the change in January 2003. A total of 34% of women were managed laparoscopically between 2000 and 2002, increasing to 90% between 2003 and 2006. This difference was statistically significant (p < 0.001). In 2006, some 96% of women requiring surgery were managed by laparoscopic surgery. The findings of this study indicate that it is possible to implement changes which increase and sustain a high rate of laparoscopic surgery for women with ectopic pregnancy requiring surgery in a district general hospital setting.
Auditory and Audiovisual Close Shadowing in Post-Lingually Deaf Cochlear-Implanted Patients and Normal-Hearing Elderly Adults

Objectives: The goal of this study was to determine the effect of auditory deprivation and age-related speech decline on perceptuo–motor abilities during speech processing in post-lingually deaf cochlear-implanted participants and in normal-hearing elderly (NHE) participants. Design: A close-shadowing experiment was carried out on 10 cochlear-implanted patients and on 10 NHE participants, with two groups of normal-hearing young participants as controls. To this end, participants had to categorize auditory and audiovisual syllables as quickly as possible, either manually or orally. Reaction times and percentages of correct responses were compared depending on response modes, stimulus modalities, and syllables. Results: Responses of cochlear-implanted subjects were globally slower and less accurate than those of both young and elderly normal-hearing people. Adding the visual modality was found to enhance performance for cochlear-implanted patients, whereas no significant effect was obtained for the NHE group. Critically, oral responses were faster than manual ones for all groups. In addition, for NHE participants, manual responses were more accurate than oral responses, as was the case for normal-hearing young participants when presented with noisy speech stimuli. Conclusions: Faster reaction times were observed for oral than for manual responses in all groups, suggesting that perceptuo–motor relationships were somewhat successfully functional after cochlear implantation and remain efficient in the NHE group. These results are in agreement with recent perceptuo–motor theories of speech perception. They are also supported by the theoretical assumption that implicit motor knowledge and motor representations partly constrain auditory speech processing. In this framework, oral responses would have been generated at an earlier stage of a sensorimotor loop, whereas manual responses would appear late, leading to slower but more accurate responses. The difference between oral and manual responses suggests that the perceptuo–motor loop is still effective for NHE subjects and also for cochlear-implanted participants, despite degraded global performance.