Miracle-dz/UniFAR-FTUs huggingface dataset:
Moving from efficacy to effectiveness in cognitive behavioral therapy for psychosis: a randomized clinical practice trial.

OBJECTIVE Randomized controlled trials have attested the efficacy of cognitive behavioral therapy (CBT) in reducing psychotic symptoms. Now, studies are needed to investigate its effectiveness in routine clinical practice settings. METHOD Eighty patients with schizophrenia spectrum disorders who were seeking outpatient treatment were randomized to a specialized cognitive behavioral intervention for psychosis (CBTp; n = 40) or a wait list (n = 40). The CBTp group was assessed at baseline, posttreatment, and 1-year follow-up. The wait list group was assessed at baseline, after a 4-month waiting period, at posttreatment, and after 1 year. The primary outcome measure was the Positive and Negative Syndrome Scale (PANSS). RESULTS The CBTp group showed significant improvement over the wait list group for the total PANSS score at posttreatment-postwaiting. CBTp was also superior to the wait list group in regard to the secondary outcomes positive symptoms, general psychopathology, depression, and functioning, but not in regard to negative symptoms. The number of dropouts during the treatment phases was low (11.3%). Participants perceived the treatment as helpful (98%) and considered themselves improved (92%). Significant pre- and posttreatment effect sizes varied between 0.77 for general psychopathology and 0.38 for delusional conviction. The positive effects of treatment could be maintained at 1-year follow-up, although the number of patients who had deteriorated was higher than at postassessment. CONCLUSIONS Large proportions of patients in clinical practice settings benefit from CBTp. The efficacy of CBTp can be generalized to clinical practice despite the differences in patients, therapists, and deliverance.
Binary Large Object-Based Approach for QR Code Detection in Uncontrolled Environments

Quick Response QR barcode detection in nonarbitrary environment is still a challenging task despite many existing applications for finding 2D symbols. The main disadvantage of recent applications for QR code detection is a low performance for rotated and distorted single or multiple symbols in images with variable illumination and presence of noise. In this paper, a particular solution for QR code detection in uncontrolled environments is presented. The proposal consists in recognizing geometrical features of QR code using a binary large object- (BLOB-) based algorithm with subsequent iterative filtering QR symbol position detection patterns that do not require complex processing and training of classifiers frequently used for these purposes. The high precision and speed are achieved by adaptive threshold binarization of integral images. In contrast to well-known scanners, which fail to detect QR code with medium to strong blurring, significant nonuniform illumination, considerable symbol deformations, and noising, the proposed technique provides high recognition rate of 80%–100% with a speed compatible to real-time applications. In particular, speed varies from 200 ms to 800 ms per single or multiple QR code detected simultaneously in images with resolution from 640 × 480 to 4080 × 2720, respectively.
The complete mitochondrial genome of Odontesthes sp. (Atheriniforms, Atherinopsidae)

Abstract In this study, the complete mitochondrial genome of Odontesthes sp. has been studied first. The genome is 16,528 bp in length and contains 13 protein-coding genes, 22 tRNA genes, 2 ribosomal RNA genes and 1 putative control region. The mitochondrial genome of Odontesthes sp. had common features about gene arrangement and tRNA structures compared with those of other teleost fishes. The overall base composition of Odontesthes sp. is T 27.3%, C 29.4%, A 26.0% and G 17.3%, with a slight A + T bias of 53.3%. Meanwhile, the conserved motif 5′-GCCGG-3′ was determined in the origin of light-strand replication of Odontesthes sp. The mitochondrial genome of this species would play an important role in the phylogenetics of Atherinopsidae.
Wheelchair martial arts practitioners have similar bone strength, sitting balance and self-esteem to healthy individuals

smfong@hku.hk This is an Open-Access article distributed under the terms of t he Creative Commons Attribution Non-Commercial License (http:// creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.Copyright © 2014 Korean Academy of Physical Therapy Rehabilitation Science
Effect of Antihypertensive Therapy on Serum Lipids in Newly Diagnosed Essential Hypertensive Men

The effect of antihypertensives on serum lipids in newly diagnosed male essential hypertensive patients was studied. The participants (n = 99) were randomly allocated to receive amlodipine, atenolol, enalapril, hydrochlorothiazide, and a combination of amlodipine and atenolol. Lipid parameters were estimated before and after 8 weeks of therapy. The atenolol and thiazide group showed a significant increase in triglycerides (TGs) and very-low-density lipoprotein cholesterol (VLDL-C). High-density lipoprotein cholesterol (HDL-C) and HDL-C to low-density lipoprotein cholesterol (LDL-C) ratio were significantly increased and TC to HDL-C ratio was significantly decreased in the amlodipine and amlodipine— atenolol combination groups. In the enalapril group, we found a significant reduction in TC, TGs, VLDL-C, nonHDL-C, and TG to HDL-C ratio after treatment. It can be concluded from the present study that some drugs have beneficial effects on the lipid status, whereas others adversely affect the lipid status in hypertension.
Anatomy of a Choice: Deciding on Assisted Living or Nursing Home Care in Oregon

This study, based on interviews with 1,215 assisted living and nursing home residents and family members in Oregon, compares assisted living residents and their family proxies with their nursing home counterparts regarding preferences for long-term care settings and circumstances and decisions surrounding their move. Analyses showed some differences between reported preferences of assisted living and nursing home groups, with the former placing more emphasis on control over private space and the latter on rehabilitation. There were also many similarities, however, especially in the views of residents themselves rather than those of their family proxies. For example, high value given by both groups to help with care from staff, decisions on how much care, and private rooms indicate policy planners and providers should take into account such preferences and develop a hybrid of positively valued features in both assisted living and nursing homes.
Risk factors for surgical site infection following spine surgery: efficacy of intraoperative saline irrigation.

OBJECT The purpose of this study was to identify risk factors for surgical site infection after spine surgery, noting the amount of saline used for intraoperative irrigation to minimize wound contamination. METHODS The authors studied 223 consecutive spine operations from January 2006 through December 2006 at our institute. For a case to meet inclusion criteria as a site infection, it needed to require surgical incision and drainage and show positive intraoperative cultures. Preoperative and intraoperative data regarding each patient were collected. Patient characteristics recorded included age, sex, and body mass index (BMI). Preoperative risk factors included preoperative hospital stay, history of smoking, presence of diabetes, and an operation for a traumatized spine. Intraoperative factors that might have been risk factors for infection were collected and analyzed; these included type of procedure, estimated blood loss, duration of operation, and mean amount of saline used for irrigation per hour. Data were subjected to univariate and multivariate logistic regression analyses. RESULTS The incidence of surgical site infection in this population was 6.3%. According to the univariate analysis, there was a significant difference in the mean duration of operation and intraoperative blood loss, but not in patient age, BMI, or preoperative hospital stay. The mean amount of saline used for irrigation in the infected group was less than in the noninfected group, but was not significantly different. In the multivariate analysis, sex, advanced age (> 60 years), smoking history, and obesity (BMI > 25 kg/m(2)) did not show significant differences. In the analysis of patient characteristics, only diabetes (patients receiving any medications or insulin therapy at the time of surgery) was independently associated with an increased risk of surgical site infection (OR 4.88). In the comparison of trauma and elective surgery, trauma showed a significant association with surgical site infection (OR 9.42). In the analysis of surgical factors, a sufficient amount of saline for irrigation (mean > 2000 ml/hour) showed a strong association with the prevention of surgical site infection (OR 0.08), but prolonged operation time (> 3 hours), high blood loss (> 300 g), and instrumentation were not associated with surgical site infection. CONCLUSIONS Diabetes, trauma, and insufficient intraoperative irrigation of the surgical wound were independent and direct risk factors for surgical site infection following spine surgery. To prevent surgical site infection in spine surgery, it is important to control the perioperative serum glucose levels in patients with diabetes, avoid any delay of surgery in patients with trauma, and decrease intraoperative contamination by irrigating > 2000 ml/hour of saline in all patients.
Who Pays What for Primary Health Care? Patterns and Determinants of the Fees Paid by Patients in a Mixed Public-Private Financing Model

The New Zealand government introduced a Primary Health Care Strategy (PHCS) in 2001 aimed at improving access to primary health care, improving health, and reducing inequalities in health. The Strategy represented a substantive increase in health funding by government and a move from a targeted to a universal funding model. This paper uses representative national survey data to examine the distribution of fees paid for primary health care by different individuals under the mixed public-private financing model in place prior to the introduction of PHCS. Using multivariate regression analysis, we find that fees do vary, with people who might be expected to have greater needs paying less. However, apart from people with diabetes, there is no direct link between self-reported health status and fees paid. The findings indicate that a mixed public-private financing model can result in a fee structure which recognises differences across different population groups. The findings also provide a baseline against which changes in funding brought about by the PHCS can be evaluated.
DETECTING ADVERSE DRUG REACTIONS IN THE NURSING HOME SETTING USING A CLINICAL EVENT MONITOR

Adverse drug reactions (ADRs) are the most clinically significant and costly medication-related problems in nursing homes (NH), and are associated with an estimated 93,000 deaths a year and as much as $4 billion of excess healthcare expenditures. Current ADR detection and management strategies that rely on pharmacist retrospective chart reviews (i.e., usual care) are inadequate. Active medication monitoring systems, such as clinical event monitors, are recommended by many safety organizations as an alternative to detect and manage ADRs. These systems have been shown to be less expensive, faster, and identify ADRs not normally detected by clinicians in the hospital setting. The main research goal of this dissertation is to review the rationale for the development and subsequent evaluation of an active medication monitoring system to automate the detection of ADRs in the NH setting. This dissertation includes three parts and each part has its own emphasis and methodology centered on the main topic of better understanding of how to detect ADRs in the NH setting.The first paper describes a systematic review of pharmacy and laboratory signals used by clinical event monitors to detect ADRs in hospitalized adult patients. The second paper describes the development of a consensus list of agreed upon laboratory, pharmacy, and Minimum Data Set signals that can be used by a clinical event monitor to detect potential ADRs. The third paper describes the implementation and pharmacist evaluation of a clinical event monitor using the signals developed by consensus.The findings in the papers described will help us to better understand, design, and evaluate active medication monitoring systems to automate the detection of ADRs in the NH setting. Future research is needed to determine if NH patients managed by physicians who receive active medication monitoring alerts have more ADRs detected, have a faster ADR management response time, and result in more cost-savings from a societal perspective, compared to usual care.
Feasibility of Cardiovascular Magnetic Resonance to Assess the Orifice Area of Aortic Bioprostheses

Background—Prosthetic orifice area, usually calculated by transthoracic echocardiography (TTE) or transesophageal echocardiography (TEE), provides important information regarding the hemodynamic performance of aortic bioprostheses. However, both TTE and TEE have limitations; therefore accurate and reproducible determination of the orifice area often remains a challenge. The present study aimed to investigate the feasibility of cardiovascular magnetic resonance (CMR) to assess the orifice areas of aortic bioprostheses. Methods and Results—CMR planimetry of the orifice area was performed in 65 patients (43/22 stented/stentless prostheses; mean time since implantation, 3.1±2.8 years; mean orifice area [TTE], 1.70±0.43 cm2; 62 normally functioning prostheses, 2 severe stenoses, and 1 severe regurgitation) in an imaging plane perpendicular to the transprosthetic flow using steady-state free-precession cine imaging under breath-hold conditions on a 1.5-T MR system. CMR results were compared with TTE (continuity equation, n=65) and TEE (planimetry, n=31). CMR planimetry was readily feasible in 80.0%; feasible with limitation in 15.4% because of stent, flow, and sternal wire artifacts; and impossible in 4.6% because of flow artifacts. Correlations of the orifice areas by CMR with TTE (r=0.82) and CMR with TEE (r=0.92) were significant. The average difference between the methods was −0.02±0.24 cm2 (TTE) and 0.05±0.15 cm2 (TEE). Agreement was present for stented and stentless devices and independent of orifice size. Intraobserver and interobserver variabilities of CMR planimetry were 6.7±5.4% and 11.5±7.8%. Conclusions—The assessment of aortic bioprostheses with normal orifice areas by CMR is technically feasible and provides orifice areas with a close correlation to echocardiography and low observer dependency.
On Checking an Adder

It is widely known that a computer adder can be checked by a completely independent circuit using check symbols that are residues of the numbers modulo some base. This paper describes such a residue checking system and shows, moreover, that independent adding and checking circuits are possible only with systems of this type. The discussion includes a method of handling residue-class check symbols when overflow occurs.
A cost analysis of the Honduras community-based integrated child care program (Atencion Integral a la Ninez-Comunitaria, AIN-C)

The Honduras AIN-C (Atencion Integral a la Ninez-Comunitaria) Program is a preventive health and nutrition program of the Honduras Ministry of Health that relies on volunteers to help mothers and communities pro-actively monitor and maintain the adequate growth of young children. A 2000 experimental-design based evaluation found that the program achieved near-universal coverage and was effective in improving mothers' child-rearing knowledge, attitudes and practices, including feeding practices and appropriate care-giving and care-seeking practices for children with diarrhea and acute respiratory illness. The program is widely regarded as a model. This study was undertaken to provide the first comprehensive estimates of the cost of AIN-C, with the goal of providing a program and financial planning tool for Honduras, as well as other countries interested in implementing an AIN-C Program. Expressed in mid-2002 U.S. dollars, the study found: (1) the long-term, annual, recurrent cost per child less than two participating in the program is US$6.82, (2) the long-term, annual, incremental budget requirements per child less than two participating in the program is $4.00, (3) the long-term, annual recurrent cost per capita is $0.44, and the cost of an AIN-C monthly growth monitoring and counseling session per child is 11 percent of the cost of a traditional MOH, facility-based growth and development consultation per child.
Short- and midterm reproducibility of apparent diffusion coefficient measurements at 3.0-T diffusion-weighted imaging of the abdomen.

PURPOSE To test the hypothesis that there is no significant variability in apparent diffusion coefficients (ADCs) at assessment of the short- and midterm reproducibility of ADC measurements in a healthy population. MATERIALS AND METHODS Twenty healthy male volunteers were enrolled in this prospective institutional review board-approved study after they provided written informed consent. A 3.0-T magnetic resonance (MR) system was used to perform five axial diffusion-weighted (DW) abdominal acquisitions (session 1). A mean of 147 days +/- 20 (standard deviation) later, 16 of the 20 volunteers were imaged again with use of the same protocol and MR system (session 2). The mean ADCs for three regions of interest (ROIs) in five anatomic locations (right hepatic lobe, spleen, and head, body, and tail of pancreas) were calculated. The coefficient of variation (CV, equal to standard deviation divided by mean) was calculated for each subject, session, and anatomic location. The ADC and CV data were then analyzed by using repeated-measures analysis of variance. RESULTS There were significant differences (P < .001) in mean ADCs among the five anatomic locations. There were no significant differences in ADCs among the various repeated sequence acquisitions or the three ROIs. There were no significant differences in ADCs between imaging sessions 1 and 2. ADCs were fairly stable over the midterm within a given individual. Finally, there were no significant differences in resulting CVs between the imaging sessions or anatomic locations. The mean CV for ADC measurement reproducibility was 14% (95% confidence interval: 13%, 15%). CONCLUSION The mean CV for short- and midterm ADC reproducibility was 14% at abdominal DW imaging. Treatment effects of less than approximately 27% (change in ADC divided by pretreatment ADC) will not be clinically detectable with confidence with one acquisition in a single individual.
Pembrolizumab Exposure–Response Assessments Challenged by Association of Cancer Cachexia and Catabolic Clearance

Purpose: To investigate the relationship of pembrolizumab pharmacokinetics (PK) and overall survival (OS) in patients with advanced melanoma and non–small cell lung cancer (NSCLC). Patients and Methods: PK dependencies in OS were evaluated across three pembrolizumab studies of either 200 mg or 2 to 10 mg/kg every 3 weeks (Q3W). Kaplan–Meier plots of OS, stratified by dose, exposure, and baseline clearance (CL0), were assessed per indication and study. A Cox proportional hazards model was implemented to explore imbalances of typical prognostic factors in high/low NSCLC CL0 subgroups. Results: A total of 1,453 subjects were included: 340 with pembrolizumab-treated melanoma, 804 with pembrolizumab-treated NSCLC, and 309 with docetaxel-treated NSCLC. OS was dose independent from 2 to 10 mg/kg for pembrolizumab-treated melanoma [HR = 0.98; 95% confidence interval (CI), 0.94–1.02] and NSCLC (HR = 0.98; 95% CI, 0.95–1.01); however, a strong CL0–OS association was identified for both cancer types (unadjusted melanoma HR = 2.56; 95% CI, 1.72–3.80 and NSCLC HR = 2.64; 95% CI, 1.94–3.57). Decreased OS in subjects with higher pembrolizumab CL0 paralleled disease severity markers associated with end-stage cancer anorexia-cachexia syndrome. Correction for baseline prognostic factors did not fully attenuate the CL0–OS association (multivariate-adjusted CL0 HR = 1.64; 95% CI, 1.06–2.52 for melanoma and HR = 1.88; 95% CI, 1.22–2.89 for NSCLC). Conclusions: These data support the lack of dose or exposure dependency in pembrolizumab OS for melanoma and NSCLC between 2 and 10 mg/kg. An association of pembrolizumab CL0 with OS potentially reflects catabolic activity as a marker of disease severity versus a direct PK-related impact of pembrolizumab on efficacy. Similar data from other trials suggest such patterns of exposure–response confounding may be a broader phenomenon generalizable to antineoplastic mAbs. See related commentary by Coss et al., p. 5787
FoxO1 and FoxM1 Transcription Factors Have Antagonistic Functions in Neonatal Cardiomyocyte Cell-Cycle Withdrawal and IGF1 Gene Regulation

Rationale: In the mammalian heart, cardiomyocytes withdraw from the cell cycle and initiate hypertrophic growth soon after birth, but the transcriptional regulatory mechanisms that control these neonatal transitions are not well-defined. Objective: Forkhead family transcription factors have been implicated as positive (forkhead box [Fox] transcription factor M1) and negative (FoxO1 and FoxO3) regulators of cardiomyocyte proliferation prenatally, but their regulatory interactions and functions in neonatal cell-cycle withdrawal have not been reported previously. Potential regulators of Fox activity, including the metabolic indicator AMP-activated protein kinase (AMPK), and Fox transcriptional targets (p21, p27, insulin-like growth factor 1 [IGF1]) also were examined. Methods and Results: In cultured neonatal rat cardiomyocytes, AMPK activates FoxOs, and AMPK inhibition is sufficient to induce cell proliferation. In vivo, combined loss of FoxO1 and FoxO3 specifically in cardiomyocytes leads to delayed cell-cycle withdrawal and increased expression of IGF1 and FoxM1. Conversely, cardiomyocyte-specific loss of FoxM1 results in decreased neonatal cardiomyocyte cell proliferation, decreased expression of IGF1, and increased expression of cell-cycle inhibitors p21 and p27. IGF1 is a direct downstream target of cardiac Fox transcription factors, which is negatively regulated by FoxOs and positively regulated by FoxM1, dependent on AMPK activation status. Conclusions: These data support a regulatory mechanism whereby the balance of FoxO and FoxM1 transcription factors integrates metabolic status, mediated by AMPK, and cell-cycle regulation, through competitive regulation of target genes, including IGF1, in neonatal cardiomyocytes.
Health care-seeking behaviour for child illnesses among rural mothers in South Africa: a pilot study

The aim of this study was to examine the health care-seeking behaviour of mothers when their children under five years suffer from common childhood illnesses such as diarrhoea, fever, cough and worms. Opsomming Die doel van die navorsing was om moeders met siek kinders se gesondheidsgedrag na te vors. Die fokus was op die moeders se pogings om mediese hulp vir hul kinders te bekom. *Please note: This is a reduced version of the abstract. Please refer to PDF for full text.