Miracle-dz/UniFAR-FTUs huggingface dataset:
Psychological health in patients with ALS is maintained as physical function declines

Abstract Although quality of life (QoL) in patients with ALS has been shown to be independent of physical function and to be maintained over time, the status of psychological health over the disease course has not been studied using an ALS-specific instrument. It is also uncertain how three common interventions – antidepressants, percutaneous endoscopic gastrostomy (PEG), and non-invasive ventilatory support (NIPPV) – influence psychological health. We performed a retrospective review of the Negative Emotion subscale (NES) score, a measure of psychological health within the ALS-Specific QoL Instrument. Analysis of 72 patients over three months, and of a subset of 48 over six months, showed stability of psychological health despite a decline in the ALS Functional Rating Scale-Revised to 88.4% of baseline at three months and 82.6% at six months. NES did not change after antidepressants, PEG, or NIPPV, although there was a suggestion of improvement with antidepressants in a subgroup. In conclusion, as with overall QoL, psychological health of ALS patients as measured with an ALS-specific instrument does not decline as physical function is lost. Supports found in a multidisciplinary ALS clinic may influence expectations, facilitate response shift, and stabilize psychological health while masking the independent effects of specific interventions.
Impact of a collaborative interprofessional learning experience upon medical and social work students in geriatric health care

Abstract Interprofessional collaborative practice is increasingly recognized as an essential model in health care. This study lends preliminary support to the notion that medical students (including residents) and social work students develop a broader understanding of one another’s roles and contributions to enhancing community-dwelling geriatric patients’ health, and develop a more thorough understanding of the inherent complexities and unique aspects of geriatric health care. Wilcoxon Signed Rank Tests of participants’ scores on the Index of Interdisciplinary Collaboration (IIC) indicated the training made significant changes to the students’ perception of interprofessional collaboration. Qualitative analysis of participants’ statements illustrated (1) benefits of the IPE experience, including complementary roles in holistic interventions; and (2) challenges to collaboration. The findings suggest that interprofessional educational experiences have a positive impact upon students’ learning and strategies for enhanced care of geriatric patients.
Clinical significance of adverse outcomes of placental abruption developing at home

Abstract We reviewed the obstetric records of 40 singleton deliveries complicated by placental abruption which developed at patients’ homes after 24 weeks’ gestation. Of the 40 cases complicated by placental abruption which developed at home, 13 cases (33%) were defined as showing adverse outcomes (5 cases of IUFD and 8 cases of UA pH < 7.0). The rate of patients who complained of abdominal pain without bleeding was higher in the adverse outcome group than in the control group (p = 0.02). The average time interval between the onset and hospital (or clinic) visit in the adverse outcome group was longer than in the control group (p = 0.03). Adverse outcomes due to placental abruption which developed at home were associated with the symptom of pain without bleeding and a long time interval between the onset and hospital (or clinic) visit.
The carrot or the stick: individual adaption against varying institutional arrangements

This study employs a unique household-level data-set to investigate the effectiveness of various waste separation policies under consideration of local socioeconomic contexts. Our results confirm previous findings that most demographic factors are generally not statistically significant. The findings suggest that waste separation knowledge, social capital, free provision of sortable containers and community collecting recyclables are positively associated with household involvement in waste separation. More importantly, while an increase in the garbage fee motivates non-sorting households to separate their waste into two categories of recyclables and non-recyclables, it also crowds out households’ preexisting motivations for sorting waste into three or more categories. The introduction of a garbage fee indeed substitutes rather than complements free provision of sortable containers and community collection of recyclables. Apart from actively fostering the creation of social capital, local authorities should, therefore, comprehensively design a compatible policy mix to adjust and optimize current management schemes for enhancing waste management practices.
The role of extra-foveal processing in 3D imaging

The field of medical image quality has relied on the assumption that metrics of image quality for simple visual detection tasks are a reliable proxy for the more clinically realistic visual search tasks. Rank order of signal detectability across conditions often generalizes from detection to search tasks. Here, we argue that search in 3D images represents a paradigm shift in medical imaging: radiologists typically cannot exhaustively scrutinize all regions of interest with the high acuity fovea requiring detection of signals with extra-foveal areas (visual periphery) of the human retina. We hypothesize that extra-foveal processing can alter the detectability of certain types of signals in medical images with important implications for search in 3D medical images. We compare visual search of two different types of signals in 2D vs. 3D images. We show that a small microcalcification-like signal is more highly detectable than a larger mass-like signal in 2D search, but its detectability largely decreases (relative to the larger signal) in the 3D search task. Utilizing measurements of observer detectability as a function retinal eccentricity and observer eye fixations we can predict the pattern of results in the 2D and 3D search studies. Our findings: 1) suggest that observer performance findings with 2D search might not always generalize to 3D search; 2) motivate the development of a new family of model observers that take into account the inhomogeneous visual processing across the retina (foveated model observers).
Barriers and facilitators to medication adherence: a qualitative study with general practitioners

Background General practitioners (GPs) manage the drug therapies of people with chronic diseases, and poor adherence to medication remains a major challenge. Objective This qualitative study examined GPs’ insights into non-adherence and ways of overcoming this problem. Methods We ran four focus groups comprising 16 GPs at the Kirkkonummi Health Centre (Southern Finland). Interviews were audiotaped, transcribed verbatim and analysed by inductive content analysis. Main results The two main themes in the discussions with the GPs were non-adherence in the care of chronic disease and increased need for medicine information. The medication management challenges identified were related to: patient-specific factors, the healthcare system, characteristics of drug therapies and the function and role of healthcare professionals as a team. To improve the situation, the GPs offered a number of solutions: improved coordination of care, better patient education and IT systems as well as enhanced interprofessional involvement in the follow-up of patients. Discussion and conclusions With an ageing population, the GPs were increasingly confronted with non-adherence in the care of chronic diseases. They had mostly a positive attitude towards organising care in a more interprofessional manner. To support medication adherence and self-management, the GPs appreciated pharmacists’ assistance especially with patients with polypharmacy and chronic diseases.
Preliminary studies for the development of intranasal nanoemulsion containing CNS agent: emphasizing the utilization of cut and weigh method

Abstract Context: The selection of excipients and preformulation strategy plays a vital role for the development of nanoemulsion, due to anatomical and physiological challenges posed by nasal cavity. Objective: This attempt is focused on the selection and optimization of excipients for the development of a nanoemulsion system for intranasal delivery. Materials and methods: Excipients were selected on the basis of solubility of active drug, compatibility interactions and nasal irritancy. Surfactant and co-surfactant combination and their ratio were finalized on the basis of nanoemulsion region obtained from constructed phase diagrams with Capmul MCM as oil phase. A validated cut and weigh method was employed for the optimization of different phase diagrams with respect to nanoemulsion region. Results and discussion: The solubility of drug in Capmul MCM, Labrasol, and Transcutol-P was found to be superior with numeric values of 79.50 ± 1.68 mg/ml, 51.10 ± 1.39 mg/ml, and 36.60 ± 0.85 mg/ml, respectively. On the basis of phase diagram analysis, Labrasol and Transcutol-P in 3:1 ratio provides greater nanoemulsion region of 65.28 ± 0.18%. The validation of cut and weigh method revealed that there was no significant statistical difference (P > 0.05) with a %RSD value of 2.38 for intersheet variation. Conclusion: The results of validation studies for cut and weigh method suggests that it can be effectively used as an optimization method for the selection of nanoemulsion composition.
A novel planar contiguous diplexer DC-67-100 GHz using Organic Liquid Crystal Polymer (LCP)

This article describes a novel contiguous, planar Suspended Stripline (SSL) diplexer covering up to 100 GHz, implemented using Organic Liquid Crystal Polymer (LCP) for the first time. The diplexer design enables sharp & symmetrical roll-off. The lowpass and highpass channels cover ultra-wide bandwidth of DC-66 GHz and 66-100 GHz respectively. The synthesis, design and simulation of the diplexer is done using closed form analytical model in AWR's iFilter and optimized using 3D simulation.
Achieving Excellence in Practice: A Model for Continuing Education for Nurse Practitioners

Purpose To provide a continuing education (CE) model that will meet varied needs of nurse practitioners by incorporating the variable of years of experience in practice setting. Data sources An empirical study conducted over a period of approximately 10 months, from Fall 2002 to Spring 2003 in one of the southeastern states. Conclusions A model has been developed to plan and deliver CE education programs based on the changing CE needs of NPs as they gain experience and expertise. Implications for practice Results of this study may be used to guide providers to develop and offer CE programs based on the CE needs of NPs related to length of time in clinical practice, general issues of practice, and specialty practice area needs.
Energy-efficient control of rate and power in DS-CDMA systems

The quality of service in direct-sequence code-division multiple access (DS-CDMA) can be controlled by a suitable selection of processing gain and transmission powers. In this paper, distributed control of rate and power for best effort data services is considered. In particular, we elaborate on the problem of how to control the transmission rates for maximizing system throughput while simultaneously minimizing the transmission powers. We assume a practical scenario, where every user has a finite set of discrete transmission rates and propose a simple heuristic rate allocation scheme, greedy rate packing (GRP), applicable in both up- and downlink. The scheme can be interpreted as a practical form of water-filling, in the sense that high transmission rates are allocated to users having high link gains and low interference. We show that under certain conditions, GRP will give maximum throughput and that it can be extended to guarantee a minimum data rate while maximizing network excess capacity. We suggest and analyze a distributed power control algorithm to control the intercell interference when GRP is applied to a multicellular system. Numerical results show that the proposed transmission scheme can significantly decrease the power levels while maintaining high throughput.
Prevalence of BK virus replication among recipients of solid organ transplants.

BACKGROUND BK virus (BKV) has been implicated as a cause of nephritis and graft loss in 2%-9% of kidney transplant recipients, but the prevalence among recipients of other solid organ transplants (SOTs) has not been well established. Our objective was to determine the prevalence of BKV infection for all types of SOT recipients at our medical center. METHODS A total of 156 consecutive SOT recipients were studied, of whom 49 received kidney transplants, 43 received heart transplants, and 64 received liver transplants. Samples were obtained a median of 559 days (range, 1-9481 days) after transplantation. Nested polymerase chain reaction was performed for detection of BKV DNA in urine and plasma specimens. RESULTS BKV was found in 19% of urine specimens and 6% of plasma specimens. The prevalence of viruria after kidney, heart, and liver transplantation was 26.5%, 25.5%, and 7.8%, respectively. BKV viremia was detected in 12.2% of kidney transplant recipients and 7% of heart transplant recipients. Mean creatinine levels were higher in patients with BKV viruria or viremia (1.9 and 3.5 mg/dL, respectively) than in patients with no BKV replication (1.3 mg/dL). Independent factors related to impaired renal function were renal transplantation (odds ratio [OR], 14.4); BKV replication, including viruria or viremia (OR, 3.3); and mycophenolate use (OR, 2.6). CONCLUSION BKV is common in all types of SOT recipients, particularly those who have received heart or kidney transplants.
Children’s active trips to school: a review and analysis

This paper provides a review of academic articles in English and some in Spanish, concerning active trips (walking and cycling) to school. It was found that decision on transport mode to travel to school can be rather complex, which is affected by environmental, social, economic, and geographical factors. Experiences from existing programmes and policies highlight the importance of complementing engineering approaches with education to increase active trips and to improve safety. ‘Proactive trips’ programmes should consider parental concerns and time constraints. Active trips provide benefits for children and parents, yet an attendant risk of being involved in traffic accident exists. There is a notable dearth of research into children’s active trips to school (ATS) for tropical environments, and analysis of the economic impact of ATS is minimal. Practices highlighted in this paper can be implemented in countries with conducive active trips infrastructure such as Singapore.
External cephalic version with an amniotic fluid index ⩽10: A systematic review

Objective. To review the literature and evaluate the role of the amniotic fluid index (AFI) on the success of an external cephalic version (ECV). Study design. A computerized search of MEDLINE and Cochrane databases were conducted using ‘breech’, ‘version’, ‘external cephalic version’, ‘amniotic fluid’, and ‘amniotic fluid index’. References from the identified publications were manually searched to identify additional relevant articles. Articles from 1987 to 2004 were included. Results. Of the initial 33 articles discovered, only three remained after exclusions. These articles used different AFI ranges for ‘borderline’ or ‘low–normal’ fluid measurements and therefore could not be combined for analysis. All three studies demonstrated a lower success rate of ECV with lower amniotic fluid volume estimates (AFI 5–8, <10, or <8.6), although none reached statistical significance. Conclusion. Due to limited and dissimilar data, it is impossible to define the lower AFI threshold for an unsuccessful ECV compared with the success of a normal AFI. Although not statistically significant, an AFI <10 may correlate with lower success rates for an ECV.
A Novel Monothiol Glutaredoxin (Grx4) from Escherichia coli Can Serve as a Substrate for Thioredoxin Reductase*

Glutaredoxins are ubiquitous proteins that catalyze the reduction of disulfides via reduced glutathione (GSH). Escherichia coli has three glutaredoxins (Grx1, Grx2, and Grx3), all containing the classic dithiol active site CPYC. We report the cloning, expression, and characterization of a novel monothiol E. coli glutaredoxin, which we name glutaredoxin 4 (Grx4). The protein consists of 115 amino acids (12.7 kDa), has a monothiol (CGFS) potential active site and shows high sequence homology to the other monothiol glutaredoxins and especially to yeast Grx5. Experiments with gene knock-out techniques showed that the reading frame encoding Grx4 was essential. Grx4 was inactive as a GSH-disulfide oxidoreductase in a standard glutaredoxin assay with GSH and hydroxyethyl disulfide in a complete system with NADPH and glutathione reductase. An engineered CGFC active site mutant did not gain activity either. Grx4 in reduced form contained three thiols, and treatment with oxidized GSH resulted in glutathionylation and formation of a disulfide. Remarkably, this disulfide of Grx4 was a direct substrate for NADPH and E. coli thioredoxin reductase, whereas the mixed disulfide was reduced by Grx1. Reduced Grx4 showed the potential to transfer electrons to oxidized E. coli Grx1 and Grx3. Grx4 is highly abundant (750–2000 ng/mg of total soluble protein), as determined by a specific enzyme-link immunosorbent assay, and most likely regulated by guanosine 3′,5′-tetraphosphate upon entry to stationary phase. Grx4 was highly elevated upon iron depletion, suggesting an iron-related function for the protein.
The role of reproductive factors and use of oral contraceptives in the aetiology of breast cancer in women aged 50 to 74 years

It is unclear whether age at menarche is causally involved in breast‐cancer aetiology, or serves a correlate of other early‐life exposures. Other aspects of reproductive life, including cycle length and regularity, climacteric symptoms, reproductive history and oral contraceptive use, are also incompletely investigated. We examined these issues in a population‐based case‐control study, including 3,016 women aged 50 to 74 years with invasive breast cancer, and 3,263 controls of similar age. Mailed questionnaires and telephone interviews were used to collect information on menstrual and reproductive characteristics as well as use of oral contraceptives. We found a statistically significant negative association between increasing age at menarche and breast‐cancer risk in women born before 1925 but not after. Length of the menstrual cycle at age 30 seemed to be adversely related to breast‐cancer risk, with OR for women with cycle lengths <24 days and >30 days being 0.76 and 1.18, as compared with women with a cycle length of 28 days. There was a strong trend of decreasing breast‐cancer risk with increasing parity (OR per borne child 0.85, 95% CI 0.80–0.90). Lactation, menopausal symptoms or past use of oral contraceptives did not appear associated with breast‐cancer risk. Our findings provide some evidence of a role of environmental correlates of early menarche in breast‐cancer aetiology, and underline the importance of childbirth, especially early in life, in the prevention of breast cancer. Our data are not readily compatible with an important influence of former oral contraceptive use on post‐menopausal breast‐cancer risk. Int. J. Cancer 80:231–236, 1999. © 1999 Wiley‐Liss, Inc.
SH2-Kinase Linker Mutations Release Hck Tyrosine Kinase and Transforming Activities in Rat-2 Fibroblasts*

Biochemical and structural studies of Src and related kinases demonstrate that two intramolecular interactions suppress kinase activity. These interactions involve binding of the SH2 domain to a phosphotyrosine residue in the C-terminal tail and association of the SH3 domain with a polyproline type II helix formed by amino acids linking the SH2 and kinase domains. Recent studies have shown that high affinity interaction of the SH3 domain of Hck with the human immunodeficiency virus type I Nef protein activates Hck tyrosine kinase and biological activities, suggesting a mechanism that involves disruption of the SH3-linker interaction. To test the role of this interaction in the regulation of Hck kinase activity in living cells, we substituted alanines for prolines 225 and 228 in the linker region and observed that the resulting mutant (Hck-2PA) demonstrated strong transforming activity in a Rat-2 fibroblast focus-forming assay. Hck-2PA also exhibited elevated tyrosine kinase activity in terms of autophosphorylation, endogenous substrate phosphorylation, and in anin vitro kinase assay. The transforming and kinase activities of Hck-2PA were remarkably similar to those observed with a Hck mutant activated by Phe substitution of the conserved tail Tyr residue and with wild-type Hck following co-expression with human immunodeficiency virus Nef. Introduction of the 2PA and tail mutations into a single Hck expression construct did not increase kinase or transforming activity relative to the individual mutations. These data provide new evidence that SH3-linker interaction may represent the dominant mechanism controlling Hck tyrosine kinase activity in vivo.
Schema Therapy for Personality Disorders: a Qualitative Study of Patients’ and Therapists’ Perspectives

Background: Several studies have evaluated the (cost) effectiveness of schema therapy for personality disorders, but little research has been done on the perspectives of patients and therapists. Aim: The present study aims to explore patients’ and therapists’ perspectives on schema therapy. Method: Qualitative data were collected through in-depth semi-structured interviews with 15 patients and a focus group of 8 therapists. A thematic analysis was performed. Results: Most patients and therapists agreed that helpful aspects in schema therapy were the highly committed therapeutic relationship, the transparent and clear theoretical model, and the specific schema therapy techniques. About unhelpful aspects, several patients and some therapists shared the opinion that 50 sessions was not enough. Furthermore, patients lacked clear advance information about the possibility that they might temporarily experience stronger emotions during therapy and the possibility of having telephone contact outside session hours. They missed practical goals in the later stage of therapy. With regard to imagery, patients experienced time pressure and they missed a proper link between the past and the present. For therapists, it was hard to manage the therapeutic relation, to get used to a new kind of therapy and to keep the treatment focused on personality problems. Conclusions: Patients and therapists found some aspects of the schema therapy protocol helpful. Their views about which aspects are unhelpful and their recommendations need to be taken into consideration when adjusting the protocol and implementing schema therapy.