Miracle-dz/UniFAR-FTUs huggingface dataset:
bCCM enhances retrieval of serial contextual but not of serial spatial memory in mice

The effects of inverse agonists of the c-aminobutyric acid (GABA)/benzodiazepine receptors such as b-carboline-3carboxylate (bCCM) on retrieval processes have not been studied extensively. This study investigates the effects in mice of an acute bCCM injection on retrieval of previously acquired serial discriminations, involving distinct contextual cues (Contextual Serial Discrimination, CSD) or identical cues (Serial Spatial Discrimination, SSD) in a four-hole board. Animals submitted to CSD were also evaluated for emotional reactivity in an elevated-plus maze. In both the CSD and the SSD tasks, mice were injected with saline before the learning session began. Twenty-four hours later, mice were replaced on the hole-board following a single dose of saline or bCCM (0.5mg/kg or 1.5mg/kg) injected 20min before testing. The highest dose of bCCM improved performance of the first discrimination in the contextual task but not in the spatial task. Moreover, the higher dose of bCCM produced anxiety-like reactivity in an elevated-plus maze, and scores of ‘anxiety’ were positively correlated with memory scores. Overall, the data show that the bCCM enhancement of memory processes depends on: (1) the cues associated with the to-be-remembered information; and (2) the emotional effects of the drug. Behavioural Pharmacology 15:123–131 c 2004 Lippincott Williams & Wilkins.
Neurologic Critical Clinical and Psychological Effects of Early Mobilization in Patients Treated in a Neurologic ICU: A Comparative Study*

and were more likely to be discharged home ( p = 0.033) compared with preintervention patients. Conclusions: A neurologic ICU early mobility protocol increased highest neurologic ICU mobility and discharge home and decreased length of stay, but did not improve quality metrics or psychological profile. ( Crit Care Med 2015; 43:865–873)
Cyclazocine: comparison to hydromorphone and interaction with cocaine

Kappa-opioid agonists produce neurobiological and behavioral effects opposite to those of cocaine and may be useful for the treatment of cocaine dependence. To evaluate the kappaand mu-agonist effects of cyclazocine and to test whether cyclazocine pretreatment would attenuate the effects of cocaine, healthy, male and female, experienced opiate and cocaine users (n=13) were enrolled in a two-phase study. In Phase 1, placebo, cyclazocine (0.2, 0.4 and 0.8mg) and the mu-agonist hydromorphone (5 and 15mg) were administered orally in six 4.5-hour sessions separated by at least 72h. In Phase 2, cocaine (100mg intranasal) was given 2h after oral pretreatment with cyclazocine (0, 0.1, 0.2, 0.4, 0.8 and 0mg, in that order) in each of six sessions conducted daily Monday to Friday and the following Monday. Physiological, subjective and behavioral measures were collected in each session. Nine participants completed Phase 1; eight completed Phase 2. Hydromorphone (15mg) produced prototypic mu-agonist effects. Cyclazocine exhibited only modest kappa-like effects. Cyclazocine also had only modest, non-dose-related effects on response to cocaine. However, cocaine effects were consistently lower on the last administration (cyclazocine 0mg pretreatment) following 4 days of cyclazocine pretreatment, compared to the first administration (0mg pretreatment). This finding is unlikely to be fully attributable to cocaine tolerance and is not accounted for by pharmacokinetic changes; plasma concentrations of cocaine were not altered by cyclazocine. This study is suggestive but not strongly supportive for the use of kappa-opiate drugs to diminish acute effects of cocaine administration or for the use of these kappa agonists in drug abuse treatment applications. Behavioural Pharmacology 15:91–102
Norm-Critical Potential in Undergraduate Nursing Education Curricula

The documents and literature that regulate nursing education are based on certain values and knowledge, and the underlying power in the curriculum raises the question of how health care professionals are molded during the course of their education. Norm criticism is a concept with its roots in critical pedagogy and gender and queer studies, emphasizing the origins as well as the consequences of marginalization, power, and knowledge of what is generally accepted as “normal” and “true. ” Norm criticism is used in this article to analyze the documents and literature underlying a nursing program in Sweden, which are shown to include a sometimes politically correct rhetoric, but one lacking a firm basis in social justice values.
Unmet Needs and Caregiver Burden Among Family Caregivers of Hospice Patients in South Korea

Family caregivers of hospice patients experience burden of care, various unmet needs, and emotional pain, especially in cultures where social responsibilities are imposed on families with terminally ill patients. This study investigated unmet needs and caregiving burden of hospice patients’ family caregivers in South Korea who care for patients as they are dying. A descriptive correlation study design queried 101 family caregivers of patients hospitalized in 4 urban hospice palliative care institutions. Data gathered between September 2015 and March 2016 were analyzed using descriptive statistics and correlations. A positive correlation emerged between unmet needs and burden of care. Many subdomains of unmet needs showed a significant positive correlation with burden of care: health and psychological problems, family and social support, information, religious and spiritual needs, and practical support needs. Unmet needs in South Korean family caregivers of hospitalized hospice patients aligned with a higher burden of care. Assessment and intervention for health and psychological problems, family and social support needs, and informational needs were discussed affiliated with culture, aiming to alleviate the unmet needs and burden of care in family caregivers of hospice patients.
Infusing Integrated Behavioral Health in an MSW Program: Curricula, Field, and Interprofessional Educational Activities

ABSTRACT An essential aspect of integrated care is the coordination of medical and behavioral health needs concurrently. This has sparked renewed emphasis on interprofessional (IP) education and practice. The impetus for IP efforts was crystalized in large part because of health care reforms, and federal funding to expand the behavioral health work force. Using an ecological systems perspective, this article describes how one school is preparing a new generation of MSW students to work in integrated behavioral health care using a three-pronged approach involving curricula, field education, and IP activities. Social work education must ensure that new and experienced professionals can (a) understand the profession’s role in IP health care settings, and (b) navigate an evolving and complex health care environment.
Resting Blood Flow in Patients With Critical Coronary Lesions

Background. Experimental data demonstrate the persistence of a transmural vasodilator reserve in the face of depressed resting myocardial perfusion. The present study was designed to determine whether resting myocardial hypoperfusion indicates exhausted coronary reserve (CR). Methods and Results. Fifteen patients with stable angina, isolated left anterior descending coronary artery (LAD) stenosis, and no previous myocardial infarction were evaluated by means of "'Tc human albumin microsphere scintigraphy. Regional myocardial perfusion and CR were assessed at baseline and after LAD papaverine (10-12 mg) by means of two microsphere injections in the left ventricle and compared with five normal subjects. Two 300-second scans were obtained with a mobile gamma camera positioned in the 700 left anterior oblique projection; actual microsphere distribution after papaverine was obtained by image subtraction. The two arterial input functions (basal and papaverine) were measured from the first-pass time-activity curves and validated with the reference arterial sample technique. From the comparison of circumferential profile analysis between patients and normal subjects, nine patients (group 1A) showed perfusion defects at rest (reduction of percent radioactivity below 2 SD of normal subjects) in the LAD territory, and the other six (group 1B) showed homogeneous perfusion. CR (papaverine/resting perfusion) was 3.8±0.2 and 1.51±0.27 in normal subjects and in ischemic patients, respectively (p<0.01). Despite resting hypoperfusion, group lA showed a papaverine-recruitable CR similar to that of group 1B (1.57±+0.33 and 1.43±0.16, respectively, p=NS). Conclusions. In patients with stable angina pectoris, isolated LAD stenosis, and no previous myocardial infarction, microsphere scintigraphy disclosed a high incidence of resting perfusion defects; in those patients, a residual CR was observed despite decreased resting blood flow. (Circulation 1993;87:330-344)
Meta analysis

Background The incidence of brain metastases in patients with breast cancer is approximately 10%–16%, and survival after diagnosis of brain metastases is usually short. This study was designed to evaluate the risk factors associated with brain metastases in advanced breast cancer patients, with a view to help predict patient groups with high risk of brain metastases. Methods In total, 295 patients with advanced breast cancer were evaluated. All patients were pathologically confirmed and metastatic lesions were confirmed pathologically or by imaging. All patients were examined at least once every 6 months with head CT or MRI. Patients showing symptoms underwent immediate inspection, and brain metastatic lesions were confirmed by head CT and/or MRI. Results At a median follow-up of 12 months from the occurrence of metastases, brain metastases had occurred in 49 patients (16.6%). In our univariate analysis, variables significantly related to increased risk of brain metastases were hormone receptor-negative tumors, epidermal growth factor receptor 2 (HER2)-positive tumors, and multiple distant metastases. Patients with dominant tumor sites in soft tissue, or defined as Luminal A subtype, tended to have a lower risk of brain metastases than patients with visceral metastases, Luminal B subtype, triple-negative subtype or HER2-enriched subtype tumors. Conclusions Our results strongly suggest that factors such as Luminal B, triple-negative, and HER2-enriched subtypes are high risk factors for brain metastases. These data, therefore, provide pivotal clinical evidence towards a comprehensive understanding of the risk factors of brain metastases in advanced breast cancer patients. Chin Med J 2013;126 (7): 1269-1275
Study of cardiovascular responses to sustained handgrip and change in posture in Type II diabetes mellitus patients

Background: In India, more than 50% of patients with Type II diabetes have poor glycemic control and these patients suffer from complications of diabetes. One of the major complications of diabetes is impaired cardiovascular autonomic reflexes. Postural tachycardia index, blood pressure (BP) response to sustained handgrip (SHG), and BP response to standing these tests are used to assess cardiovascular autonomic responses. Aims and Objectives: This study was done to assess cardiovascular responses to SHG and change in posture in Type II diabetes mellitus patients. Materials and Methods: A total of 90 participants were selected out, of which 30 participants had uncontrolled diabetes, 30 had controlled diabetes, and remaining were 30 age- and gender-matched healthy controls. Postural tachycardia index, BP response to SHG, and BP response to standing were measured using Physiopac-8: Computerized 8-channel biopotential acquisition system and Omron Intellisense M3 BP monitor. Data obtained were analyzed statistically. Results: Postural tachycardia index values were significantly lower in uncontrolled diabetes patient group as compared to controlled diabetes patient group and healthy control group. The value of BP response to sustained handgrip in uncontrolled diabetes patient group was significantly lower as compared to healthy controls ( P < 0.01), whereas no statistically significant difference observed between uncontrolled and controlled diabetes patient groups ( P = 0.35). The value of BP response to standing was significantly higher in uncontrolled diabetes patient group as compared healthy controls ( P < 0.01), there is a progressive increase in value of fall of BP to standing from healthy control group to uncontrolled diabetes patient group. Value of fall in BP is more in both controlled and uncontrolled diabetes patient group compared to controls but value is greater in patients with uncontrolled diabetes. Conclusion: Poor glycemic control leads to impairment of cardiovascular response to change in posture and SHG in Type II diabetes mellitus patients.
Low-dose diazepam primes motivation for alcohol and alcohol-related semantic networks in problem drinkers

Considerable research with animals indicates that the GABA–benzodiazepine (BZ) system plays a key role in alcohol reinforcement. However, only limited research appears to have assessed this issue directly in humans. The present study investigated whether low-dose diazepam would cross-prime motivation for alcohol in problem drinkers. Twelve male problem drinkers (Alcohol Dependence Scale; ADS score Z9) received oral diazepam (5mg) and placebo, in a counterbalanced manner on separate sessions. There were three measures of primed motivation for alcohol: self-reported desire for alcohol, consumption of placebo beer in an ostensible taste test procedure, and automatically executed vocal reading responses to Alcohol versus Neutral words on a computer-based task. Diazepam significantly increased beer consumption, and produced a marginally significant increase in reported desire for alcohol. On the reading task, diazepam significantly decreased response latency to Alcohol words relative to Neutral words. Latency to Alcohol words correlated significantly with beer consumption under the drug. Moreover, response latency to Alcohol words under the drug also predicted ADS scores. Thus, severity of dependence was directly linked with vulnerability to a BZ priming effect on motivation for alcohol. These findings provide direct evidence that the GABA–BZ system plays an important role in alcohol reinforcement in problem drinkers. Behavioural Pharmacology 15:503–512 c 2004 Lippincott Williams & Wilkins.
The everyday lives of older adults with visual impairment: An occupational perspective

Introduction In order to live in a world created for the sighted, older adults with visual impairment must adapt to complete vision-dependent activities that require reading, writing, and object identification. The objective of this study was to explore the occupational lives of three older adults with visual impairment. Method A qualitative study with four interviews each and two observation sessions each was conducted with older adults with visual impairment. Data were analyzed by participant and across participants using open, axial, and selective coding. Codes were refined throughout the process yielding the themes of the study. Results Three themes emerged from the analysis: an occupational life of doing, an occupational life rich with well-being, and an occupational life filled with motivation for independence. Participants were highly motivated to complete their occupations and activities independently. Participation in activities in the home and community environments provided participants with life satisfaction and happiness. Through problem-solving skills, adaptations, and support of family and friends, participants successfully completed their desired occupations. Conclusion This study highlights the importance of motivation and support to facilitate participation in occupations in the home and community environments.
There is a Role for Nonbronchoscopic Lavage for Investigating Alveolar Inflammation in Acute Respiratory Distress Syndrome

To the Editor: Perkins et al. recently compared nonbronchoscopic lavage with bronchoscopic bronchoalveolar lavage in a randomized, prospective crossover trial (1). They showed in 41 patients suffering from or at risk for acute respiratory distress syndrome (ARDS) that nonbronchoscopic lavage is not comparable to bronchoscopic bronchoalveolar lavage and concluded that nonbronchoscopic lavage cannot be used as an alternative to bronchoscopic bronchoalveolar lavage for assessing changes in the alveolar compartment of patients with ARDS. Certainly, their Bland and Altman analysis showed poor comparability, and nonbronchoscopic lavage was unable to differentiate between patients with ARDS and those at risk for ARDS. Without a doubt, nonbronchoscopic lavage is at best a combination of alveolar and bronchial lavage, but as such it may still be used as an alternative for bronchoscopic bronchoalveolar lavage. Indeed, very recently it was demonstrated that plasminogen activator inhibitor-1 (PAI-1) in alveolar fluid samples obtained by nonbronchoscopic lavage can identify patients with witnessed aspiration at risk for progression to ARDS (2). The study by Perkins et al. compared nonbronchoscopic lavage with bronchoscopic bronchoalveolar lavage at a single time point; they did not perform repeated nonbronchoscopic lavage, which has been shown to be a useful approach in predicting development of ventilator-associated pneumonia (3, 4), as well as in following changes in several pathways of pulmonary inflammation (5), including coagulation and fibrinolysis (6, 7). Data from several studies in which repeated nonbronchoscopic lavage was performed in patients with ARDS are pending. Although it is less accurate than bronchoscopic bronchoalveolar lavage, nonbronchoscopic lavage has several clear benefits over bronchoscopic bronchoalveolar lavage (8): it is faster and does not require a bronchoscope or experienced bronchoscopist. In addition, (repeated) nonbronchoscopic lavages are safe to perform, also in severely ill patients (3). This may especially hold true in the context of studies: primum non nocere applies not only for treatment but also for research.
Enhanced sensitivity to the antinociceptive effects of kappa opioids in naltrexone-treated rats: dose- and time-dependent effects

The purpose of the present study was to examine sensitivity to the antinociceptive effects of kappa opioids during chronic treatment with the nonselective opioid antagonist naltrexone. In a warm-water tail-withdrawal procedure, rats were restrained and the latencies to remove their tails from water maintained at 50 and 558C were recorded. Prior to chronic treatment, spiradoline, U50,488 and ( – )-pentazocine produced dose-dependent increases in tail-withdrawal latencies at both 50 and 558C. Chronic treatment with 3.0mg/kg naltrexone twice daily (b.i.d.) failed to alter sensitivity to the antinociceptive effects of spiradoline when tested 24h following naltrexone administration. When the maintenance dose of naltrexone was increased to 30mg/kg b.i. d. , sensitivity to the effects of spiradoline was reduced when tested 24h after naltrexone administration, but enhanced when tested 48 h after naltrexone administration. Enhanced sensitivity was also observed to the antinociceptive effects of U50,488 and ( – )-pentazocine when tested 48 h after chronic treatment with 30mg/kg naltrexone. After termination of chronic treatment, sensitivity to the antinociceptive effects of spiradoline, U50,488 and ( – )-pentazocine returned to that originally observed prior to naltrexone treatment. These data indicate that chronic naltrexone treatment enhances sensitivity to the antinociceptive effects of kappa opioids, and that this effect is both dose and time dependent. Behavioural Pharmacology 14:641–647 c 2003 Lippincott Williams & Wilkins.
Treatment of vitamin D deficiency and the outcome in cardiac surgery

Crit Care Med 2012 Vol. 40, No. 7 cost-effective way to obtain a better picture of what happens inside patients’ lungs during spontaneous breathing trials. Ultrasound has other uses in weaning as well. Kim et al (10) recently showed the high value of ultrasound in detecting reduced diaphragmatic function in patients undergoing weaning. Although many intensivists seem reluctant to incorporate ultrasound into routine practice, this noninvasive imaging technique is in many ways a better alternative to plain radiograph images and is likely to become the stethoscope of the future. Despite the extensive research into the factors that influence the success of weaning, we still lack robust studies showing the real clinical impact of different factors on outcomes. As recently recommended by the Outcome Research Strategy, we need to develop a comprehensive algorithm that provides clinicians with a structured approach to weaning that offers a clearly better outcome for our patients (11–13). While we expectantly wait for such studies, why not peek inside your patient’s lungs? Rafael Fernandez, MD Department of Intensive Care Hospital Sant Joan de Deu – Fundació Althaia Manresa, Spain
Age and sex differences in presentation of symptoms among patients with acute coronary disease: the REACT trial

BackgroundThere are few data on possible age and sex differences in presentation of symptoms for patients with acute coronary disease. ObjectiveTo investigate demographic differences in presentation of symptoms at the time of hospital presentation for acute myocardial infarction (AMI) and unstable angina. MethodsThe medical records of patients who presented with chest pain and who also had diagnoses of AMI (n = 889) or unstable angina (n = 893) on discharge from 43 hospitals were reviewed as part of data collection activities of the Rapid Early Action for Coronary Treatment trial based in 10 pair‐matched communities throughout the USA. ResultsDyspnea (49%), arm pain (46%), sweating (35%), and nausea (33%) were commonly reported by men and women of all ages in addition to the presenting complaint of chest pain. After we had controlled for various characteristics through regression modeling, older persons with AMI were significantly less likely than were younger persons to complain of arm pain and sweating, and men were significantly less likely to report vomiting than were women. Among persons with unstable angina, arm pain and sweating were reported significantly less often by elderly patients. Nausea and back, neck, and jaw pain were more common complaints of women. ConclusionsResults of this study suggest that there are differences between symptoms at presentation of men and women, and those in various age groups, hospitalized with acute coronary disease. Clinicians should be aware of these differences when diagnosing and managing patients suspected to have coronary heart disease.