Miracle-dz/UniFAR-FTUs huggingface dataset:
The problem with “problem behaviors”: a systematic review of the association between individual patient behavioral and psychological symptoms and caregiver depression and burden within the dementia patient–caregiver dyad

ABSTRACT Background: Behavioral and psychological symptoms of dementia (BPSDs) are routinely cited as important predictors of caregiver burden and depression. Although BPSDs include a wide variety of patient behaviors, they are routinely grouped together as one construct to differentiate them from cognitive symptoms of dementia. Determining the specific BPSDs that result in increased depression and burden for caregivers may elucidate the stress process for caregivers and facilitate the development of effective interventions for caregivers. Methods: We conducted a systematic review of English-language articles published from 1990 to 2010 to determine whether there are known symptoms or symptom clusters which exert undue negative impact on caregiver depression and burden. Additionally, we review systems used for classifying BSPD symptom clusters and determine whether there have been any mechanisms studied by which individual BPSD symptoms negatively affect caregivers. Finally, we examine how the role of timing of symptoms has been examined within the literature. Results: Thirty-five original research articles examined the impact of an individual behavior symptom on caregiver burden or depression/depressive symptoms. The studies had no consistent system for categorizing symptoms. Although depression, aggression, and sleep disturbances were the most frequently identified patient symptoms to impact negatively on caregivers, a wide range of symptoms was associated with caregiver burden and depression. Conclusions: The evidence is not conclusive as to whether some symptoms are more important than others. The studies reviewed were largely exploratory relative to the differential impact of individual BPSDs and did not focus on testing causal mechanisms by which specific symptoms exert more impact on caregiver mental health than others. Future research may benefit from the re-conceptualization of BPSDs from the perspective of their impact on the caregiver to examine hypothesis-driven differences among BPSD symptom clusters.
Outdoor-indoor angular power spectrum prediction

Theory of normal mode propagation in a LOS street scenario is extended to include propagation into buildings through coupling to a diffuse indoor field. Previous work reported the approach led to close agreement with signal strength measurements. Here it is found that the method reproduces signal directions for direct and reflected signal components, while also predicting angle spread for each.
REDUCTION OF ANISOMETROPIA & AMBLYOPIA IN A NON-FIXATING EYE FOLLOWING ESOTROPIA SURGERY &V ISION THERAPY

This is the case of a 28-month-old child who presented to us with anisometropia, amblyopia and a partially accommodative esotropia. The latter condition was subsequently surgically altered, resulting in a consecutive exotropia. The patient’s anisometropia decreased following a regimen of full spectacle correction, occlusion (direct patching) and vision therapy. The reduction of anisometropia coincided with the improvement of binocularity and visual acuity. A discussion of the relationship among the development of anisometropia, amblyopia, esotropia and consecutive exotropia is presented.
DESIGN OF A GAS-SOLID FLUIDIZED BED REACTOR AT HIGH TEMPERATURE AND HIGH PRESSURE

Numerous processes of refining and petro chemistry involve multiphase fluids at extreme conditions, and are realized in agitated reactors or in fluidized beds. The use of high temperature and/or high pressure during conversion and handling of high viscosity materials and/or viscosity ratios results in extreme processing conditions for which the multiphase process hydrodynamics are completely unknown. Subsequently, with only a few studies at high temperature and almost none at high temperature and high pressure, general and reliable design criteria for the use of extreme conditions are scarce and therefore are of immediate interest to Total, the industrial partner of this research chair. The aim of this work is to review and compare the already published models on fluidization at ambient and extreme conditions with emphasis on the information necessary for designing gassolid reactors. Consequently, a detailed design of a fluidized bed reactor that would allow flexible operation at high temperature and high pressure at several gas velocities will be conducted in order to serve for the future development of new hydrodynamic models. In order to illustrate the need for this laboratory scale reactor, the effect of using extreme operating conditions (high temperature, pressure and velocity) on fluidization and more specifically bubble size were demonstrated. Three bubble size correlations were chosen: the first for being respectively modeled at high pressure and velocity, the second for being modeled at high temperature and the third for being one of the most commonly used models in design books. None of these correlations provided acceptable values beyond their designated range. Furthermore, the impact of bubble diameter on mass transfer, reaction conversion, entrainment and the transport disengaging height (TDH) were studied through the application of each of these bubble size models. By doing so, several discrepancies between the obtained results and the expected trends were highlighted. Using entrainment plots, TDH was found to be independent of bubble size and vary with temperature, pressure and velocity, which is contrary to several existing correlations. Moreover, at high velocities, despite obtaining a large TDH value both graphically and by using the existing models, the overall changes in the total flux are negligible which would imply that sizing the freeboard accordingly, as suggested by most design books, might not be profitable.
Definite and undetermined forensic diagnoses of suicide among immigrants in Sweden

A total of 707 cases of violent death (suicide, undetermined mode or accident) occurring in 1990 were investigated at the Department of Forensic Medicine in Stockholm. The catchment area of the Department includes about 1.9 million people. Fourteen percent of the population in the area are immigrants. The largest single immigrant group was the 91,015 Finnish‐born inhabitants, who represented 33% of the overall immigrant population. Thirty percent of all undetermined deaths and 20% of the suicides were among people born outside Sweden. A significant overrepresentation of the largest immigrant group (Finnish‐born) was found in both the definite and undetermined suicide categories. There was also an overall overrepresentation of immigrants among the undetermined cases and a trend towards overrepresentation among definite suicides. Also, there was a significant overall overrepresentation of immigrants in the total cases of undetermined and definite suicide. Some psychosocial factors found predominant among the immigrant sample were social isolation, low social class and poor social network. The findings in this study indicates that immigrant status should be considered as a risk factor for suicide in Sweden. Previous reports on the high suicide rates among immigrants in Australia, Canada, Great Britain and the United States suggest that the overrepresentation of immigrants found in our study could represent a worldwide epidemiological trend related to voluntary and forced migration. Possible hypotheses that could explain this phenomenon are discussed.
Is Roux‐en‐Y choledochojejunostomy an independent risk factor for nonanastomotic biliary strictures after liver transplantation?

Biliary reconstruction using Roux‐en‐Y choledochojejunostomy has been suggested as a risk factor for the development of nonanastomotic biliary strictures (NAS) after liver transplantation. Roux‐en‐Y reconstruction, however, is preferentially used in patients transplanted for primary sclerosing cholangitis (PSC), and the disease itself is also associated with a higher incidence of NAS. The aim of this study was to determine whether Roux‐en‐Y reconstruction is really an independent risk factor for NAS. A series of 486 consecutive adult liver transplants were studied. Biliary reconstruction in patients transplanted for PSC was either by Roux‐en‐Y choledochojejunostomy or by duct‐to‐duct anastomosis, depending on the quality of the recipient's extrahepatic bile duct. Univariate and multivariate statistical analyses were used to identify risk factors for the development of NAS. The overall incidence of NAS was 16.5% (80/486). In univariate analyses, the following variables were significantly associated with NAS: PSC as the indication for transplantation, type of biliary reconstruction (Roux‐en‐Y versus duct‐to‐duct), and postoperative cytomegalovirus infection. After multivariate logistic regression analysis, PSC as the indication for transplantation (odds ratio, 2.813; 95% confidence interval, 1.624‐4.875; P < 0.001) and postoperative cytomegalovirus infection (odds ratio, 2.098; 95% confidence interval, 1.266‐3.477; P = 0.004) remained as independent risk factors for NAS. Biliary reconstruction using Roux‐en‐Y choledochojejunostomy was not identified as an independent risk factor for NAS. In conclusion, the association between Roux‐en‐Y choledochojejunostomy and NAS observed in previous studies can be explained by the more frequent use of Roux‐en‐Y reconstruction in patients with PSC. Roux‐en‐Y reconstruction itself is not an independent risk factor for NAS. Liver Transpl 15:924–930, 2009. © 2009 AASLD.
Activated protein C resistance and factor V Leiden: a review.

CONTEXT Factor V Leiden (FVL) is the most common heritable cause of venous thrombosis. It is caused by a single nucleotide substitution resulting in an R506Q missense mutation, resulting in factor V resistance to activated protein C (APC) inactivation. Carriers of FVL have an increased susceptibility to venous thrombosis, which is further increased in the presence of other genetic or environmental risk factors. OBJECTIVE To review the biology, clinical findings, laboratory detection methods, and screening recommendations for patients with the FVL mutation. DATA SOURCES PubMed review of published literature and online information. CONCLUSIONS FVL remains an important heritable cause of hypercoagulability since its discovery more than 10 years ago. Clinical suspicion should be high in cases of unexplained venous thrombosis. APC resistance and FVL mutation can be diagnosed with high sensitivity and specificity with use of clotting time-based functional assays and genetic assays, respectively, allowing for evidence-guided clinical decision making regarding the benefit of long-term anticoagulation.
Systematic review of research into frequent callers to crisis helplines

Summary We conducted a systematic review of research into callers making multiple calls to crisis helplines. Two databases were searched, identifying 561 articles from 1960 until 2012, of which 63 were relevant. Twenty-one articles from 19 separate studies presented empirical data about callers making multiple calls to crisis helplines. Of the 19 studies, three were intervention studies, five were surveys of callers and 11 were call record audits. Most studies were conducted in the USA and defined frequent callers as people making two or more calls. Frequent callers were more likely to be male and unmarried compared to other callers. There were no reported differences between frequent callers and other callers with regard to age, mental health conditions or suicidality. Three studies tested interventions designed to better manage frequent callers. These studies, even though small, reported reductions in the number of calls made by frequent callers. Suggested techniques for responding to frequent callers included: limiting the number and duration of calls allowed, assigning a specific counsellor, implementing face to face contact, the service initiating contact with the caller instead of waiting for callers to contact the service, providing short term anxiety and depression treatment programmes by telephone, and creating a specific management plan for each frequent caller. Future work requires robust study design methods using larger sample sizes and validated measurements.
GDNF and its receptor component Ret in injured human nerves and dorsal root ganglia

GLIAL cell line-derived neurotrophic factor (GDNF) is trophic to motor and sensory neurones in animal models. GDNF mRNA is up-regulated in Schwann cells after peripheral nerve injury in rats. We have quantified and localized GDNF and its receptor component Ret, for the first time in any species, in injured human peripheral nerves and dorsal root ganglia (DRG) avulsed from the spinal cord. Significantly higher levels of GDNF were found in nerve distal to the site of the injury than in proximal or intact nerve, and in avulsed DRG than in post-mortem control DRG. GDNF immunostaining was seen in Schwann cells and in DRG neurones, especially of small and medium size, with significantly increased numbers of medium sized sensory neurones immunore-active for GDNF after avulsion. Ret immunoreactivity was restricted to DRG neurones and axons, with no significant changes in numbers of positive DRG cells after injury. Our findings suggest that GDNF may play a role in injured human nerves and sensory ganglia, particularly in medium sized sensory neurones.
Interpopulation variation in HIV testing promptness may introduce bias in HIV incidence estimates using the serologic testing algorithm for recent HIV seroconversion

Objectives The serologic testing algorithm for recent HIV seroconversion (STARHS) calculates incidence using the proportion of testers who produce a level of HIV antibody high enough to be detected by ELISA but low enough to suggest recent infection. The validity of STARHS relies on independence between dates of HIV infection and dates of antibody testing. When subjects choose the time of their own test, testing may be motivated by risky behaviour or symptoms of infection and the criterion may not be met. This analysis was conducted to ascertain whether estimates of incidence derived using STARHS were consistent with estimates derived using a method more robust against motivated testing. Methods A cohort-based incidence estimator and two STARHS methods were applied to identical populations (n=3821) tested for HIV antibody at publicly funded sites in Seattle. Overall seroincidence estimates, demographically stratified estimates and incidence rate ratios were compared across methods. The proportion of low-antibody testers among HIV-infected individuals was compared with the proportion expected given their testing histories. Results STARHS estimates generally exceeded cohort-based estimates. Incidence ratios derived using STARHS between demographic strata were not consistent across methods. The proportion of HIV-infected individuals with lower antibody levels exceeded that which would be expected under independence between infection and testing. Conclusions Incidence estimates and incidence rate ratios derived using methods that rely on the changing antibody level over the course of HIV infection may be vulnerable to bias when applied to populations who choose the time of their own testing.
Conducting a user-centered information needs assessment: the Via Christi Libraries' experience.

PURPOSE The research sought to provide evidence to support the development of a long-term strategy for the Via Christi Regional Medical Center Libraries. METHODS An information needs assessment was conducted in a large medical center serving approximately 5,900 physicians, clinicians, and nonclinical staff in 4 sites in 1 Midwestern city. Quantitative and qualitative data from 1,295 self-reporting surveys, 75 telephone interviews, and 2 focus groups were collected and analyzed to address 2 questions: how could the libraries best serve their patrons, given realistic limitations on time, resources, and personnel, and how could the libraries best help their institution improve patient care and outcomes? RESULTS Clinicians emphasized the need for "just in time" information accessible at the point of care. Library nonusers emphasized the need to market library services and resources. Both clinical and nonclinical respondents emphasized the need for information services customized to their professional information needs, preferences, and patterns of use. Specific information needs in the organization were identified. DISCUSSION/CONCLUSIONS The results of this three-part, user-centered information needs assessment were used to develop an evidence-based strategic plan. The findings confirmed the importance of promoting library services in the organization and suggested expanded, collaborative roles for hospital librarians.
Novel intelligent soft computing techniques for location prediction in mobility management

Voice and data services are provided by cellular networks to the users with mobility. To bring services to the mobile users, the cellular network is capable of tracking the locations of the users, and allowing user movement during the conversations. With the growing number of mobile users, global connectivity, and the small size of cells, location management is one of the most critical issues regarding these networks. The objective of a dynamic location management system is to maintain a low paging cost in the communication system. As the data associated with the communication system is a purely non-stationary, therefore soft-computing approach this time playing major roles for achieving the real objective of the location management system. In this research article, an attempt has been made to apply PPN (Polynomial Perceptron Network) for development of an intelligent location management system. In this work a comparison of several locations management techniques are performed under identical terminal mobility model and network characteristics. From the simulation result it is seen that MLP (Multilayer Perceptron) has better performance than PPN network, however PPN network takes very less CPU time comparing with MLP system.
EXPERIMENTAL AUTOIMMUNE MYASTHENIA GRAVIS: CELLULAR AND HUMORAL IMMUNE RESPONSES *

Rats inoculated intradermally with eel acetylcholine receptor protein(AChR) with adjuvants developed autoimmunity to skeletal muscle AChR. This is evidenced clinically as two episodes of experimental autoimmune myasthenia gravis (EAMG), an acute phase that occurs early (8 days) and is transient, and a chronic phase (30 days) that is usually progressive. Positive delayed cutaneous reactivity appeared at day 4 and serum antibody to eel AChR was detectable by day 7 postinoculation. After day 25 the titer of antibody to syngeneic muscle AChR rose abruptly. Antibody to muscle AChR sedimented as 7S. Lymph node cells from rats sensitized to AChR were capable of transferring EAMG to normal recipients. Thymectomy after the onset of EAMG had no effect. Early treatment in vivo with antithymocyte serum suppressed acute but not chronic phase EAMG. Experiments combining thymectomy, x-irradiation and reconstitution with distinct populations of lymphocytes indicated athat thymus-derived lymphocytes are required for induction of EAMG and antibody to AChR. These data suggest that both cellular and humoral responses to AChR, either sequentially or in combination, contribute to the pathogenesis of EAMG.
Autonomic neural regulation of immunity

The ‘cytokine theory of disease’ states that an overproduction of cytokines can cause the clinical manifestations of disease. Much effort has been expended to determine how cytokines are regulated in normal health. Transcriptional, translational and other molecular control mechanisms protect the host from excessive cytokine production. A recent discovery revealed an unexpected pathway that inhibits macrophage cytokine production. The inflammatory reflex is a physiological pathway in which the autonomic nervous system detects the presence of inflammatory stimuli and modulates cytokine production. Afferent signals to the brain are transmitted via the vagus nerve, which activates a reflex response that culminates in efferent vagus nerve signalling. Termed the ‘cholinergic anti‐inflammatory pathway’, efferent activity in the vagus nerve releases acetylcholine (ACh) in the vicinity of macrophages within the reticuloendothelial system. ACh can interact specifically with macrophage α7 subunits of nicotinic ACh receptors, leading to cellular deactivation and inhibition of cytokine release. This ‘hard‐wired’ connection between the nervous and immune systems can be harnessed therapeutically in animal models of inflammatory disease, via direct electrical stimulation of the vagus nerve, or through the use of cholinergic agonists that specifically activate the macrophage α7 subunit of the ACh receptor. Autonomic dysfunction has been associated with human inflammatory diseases including rheumatoid arthritis, diabetes and sepsis; whether this dysfunction results from the inflammatory component of these diseases, or is actually an underlying cause, is now less clear. The description of the cholinergic anti‐inflammatory now brings to the fore several new therapeutic strategies for inflammatory disease, and suggests that many of these diseases may actually be diseases of autonomic dysfunction.
Characterization of a rat model with site‐specific bone metastasis induced by MDA‐MB‐231 breast cancer cells and its application to the effects of an antibody against bone sialoprotein

Metastasis into the skeleton is a serious complication of certain neoplastic diseases such as breast, prostate and lung cancer, but the reasons for this osteotropism are poorly understood. Our aim was to establish a physiologically relevant animal model that is characterized by osteolytic lesions confined to the hind leg of nude rats. For this purpose, we injected 1×105 MDA‐MB‐231 human breast cancer cells transfected with GFP into the superficial epigastric artery, which is an anastomosing vessel between the femoral and iliac arteries. As assessed with the aid of X‐rays, computed tomography and immunohistochemisty, osteolytic lesions occurred exclusively in the femur, tibia and fibula of the animals. The tumor take rate was 93% in a series of 96 rats and the increase in lesion size was observed up to 110 days after tumor cell inoculation. When applying this animal model to the effects of an antibody against bone sialoprotein (BSP), a significantly reduced osteolytic lesion size was observed after preincubation of cells (2 hr, 600 μg/ml anti‐BSP) prior to intra‐arterial tumor cell injection resulting in 19 T/C% at day 60 after tumor implantation (p < 0.05). In addition, the osteolytic lesion size was also significantly reduced after s.c. treatment of the animals with the antibody (20 mg/kg anti‐BSPx3 within 5 days after tumor implantation), resulting in 30 T/C% at day 60 after tumor cell implantation (p < 0.05). In conclusion, the novel rat model for site‐specific osteolytic lesions provides in vivo evidence that preincubation of MDA‐MB‐231GFP cells and treatment of rats after tumor implantation with an antibody against BSP significantly reduces the size of lytic lesions in bone. © 2005 Wiley‐Liss, Inc.