Miracle-dz/UniFAR-FTUs huggingface dataset:
Music Therapy and Therapeutic Alliance in Adult Mental Health: A Qualitative Investigation

Therapeutic alliance has been consistently linked to therapeutic outcome. Although music therapists often emphasize the role of music for developing therapeutic alliance when treating adults in mental health settings, there is a lack of research into how the therapeutic alliance is developed. The purpose of this exploratory interpretivist investigation was to understand how music therapists develop therapeutic alliance with adults in mental health settings. The investigator conducted semi-structured interviews with eight music therapists who worked with adults in health settings. Participants had between 1 and 29 years of clinical experience in various types of inpatient mental health facilities conducting both group-based and individual treatment, represented diverse philosophical orientations, and used a variety of interventions. Emerging themes and subthemes were identified though thematic analysis and member checking and trustworthiness used to verify results. Due to the clear differences in how participants described techniques to develop therapeutic alliance, 8 emerging themes, supported by 14 subthemes, were divided into music and non-music factors. As therapeutic alliance represents a crucial aspect of treatment and is linked to outcome, music therapy clinicians can use emerging themes and subthemes to help guide their interactions to expediently establish and augment therapeutic alliance with adults in mental health settings. Implications for clinical practice, limitations, and suggestions for future research are provided.
Extended infusion of β-lactams for bloodstream infection in patients with liver cirrhosis: an observational multicenter study.

METHODS The BICRHOME study was a prospective, multicenter study enrolling 312 cirrhotic patients with BSI. In this secondary analysis we selected patients receiving TZP or carbapenems as adequate empiric treatment. The 30-day mortality of patients receiving C/EI or intermittent infusion of TZP or carbapenems was assessed with Kaplan-Meier curves, Cox-regression model and estimation of the average treatment effect (ATE) using propensity score matching. RESULTS Overall, 119 patients received TZP or carbapenems as empiric treatment. Patients who received C/EI had a significantly lower mortality rate (16% vs 36%, P=0.047). In a Cox-regression model, the administration of C/EI was associated with a significantly lower mortality [HR 0.41(95% CI 0.11-0.936), P=0.04] when adjusted for severity of illness, and an ATE of 25.6% reduction in 30-day mortality risk (95% CI 18.9-32.3, P<0.0001) estimated with propensity score matching. A significant reduction of 30-day mortality was also observed in the subgroups of patients with sepsis [HR 0.21 (95%CI 0.06-0.74), P=0.015)], acute-on-chronic liver failure [HR 0.29 (95%CI 0.03-0.99] and a MELD score ≥ 25 [HR 0.26 (95%CI 0.08-0.92), P=0.048)]. At competing risk analysis, C/EI of beta-lactams was associated with a significantly higher rates of hospital discharge [SHR (95%CI): 1.62 (1.06-2.47); P=0.026]. CONCLUSION C/EI of beta-lactams in cirrhotic patients with BSI may improve outcomes and facilitate earlier discharge.
Obesity‐induced MBD2_v2 expression promotes tumor‐initiating triple‐negative breast cancer stem cells

Obesity is a risk factor for triple‐negative breast cancer (TNBC) incidence and poor outcomes, but the underlying molecular biology remains unknown. We previously identified in TNBC cell cultures that expression of epigenetic reader methyl‐CpG‐binding domain protein 2 (MBD2), specifically the alternative mRNA splicing variant MBD variant 2 (MBD2_v2), is dependent on reactive oxygen species (ROS) and is crucial for maintenance and expansion of cancer stem cell‐like cells (CSCs). Because obesity is coupled with inflammation and ROS, we hypothesized that obesity can fuel an increase in MBD2_v2 expression to promote the tumor‐initiating CSC phenotype in TNBC cells in vivo. Analysis of TNBC patient datasets revealed associations between high tumor MBD2_v2 expression and high relapse rates and high body mass index (BMI). Stable gene knockdown/overexpression methods were applied to TNBC cell lines to elucidate that MBD2_v2 expression is governed by ROS‐dependent expression of serine‐ and arginine‐rich splicing factor 2 (SRSF2). We employed a diet‐induced obesity (DIO) mouse model that mimics human obesity to investigate whether obesity causes increased MBD2_v2 expression and increased tumor initiation capacity in inoculated TNBC cell lines. MBD2_v2 and SRSF2 levels were increased in TNBC cell line‐derived tumors that formed more frequently in DIO mice relative to tumors in lean control mice. Stable MBD2_v2 overexpression increased the CSC fraction in culture and increased TNBC cell line tumor initiation capacity in vivo. SRSF2 knockdown resulted in decreased MBD2_v2 expression, decreased CSCs in TNBC cell cultures, and hindered tumor formation in vivo. This report describes evidence to support the conclusion that MBD2_v2 expression is induced by obesity and drives TNBC cell tumorigenicity, and thus provides molecular insights into support of the epidemiological evidence that obesity is a risk factor for TNBC. The majority of TNBC patients are obese and rising obesity rates threaten to further increase the burden of obesity‐linked cancers, which reinforces the relevance of this report.
Toxin and Genome Evolution in a Drosophila Defensive Symbiosis

Abstract Defenses conferred by microbial symbionts play a vital role in the health and fitness of their animal hosts. An important outstanding question in the study of defensive symbiosis is what determines long term stability and effectiveness against diverse natural enemies. In this study, we combine genome and transcriptome sequencing, symbiont transfection and parasite protection experiments, and toxin activity assays to examine the evolution of the defensive symbiosis between Drosophila flies and their vertically transmitted Spiroplasma bacterial symbionts, focusing in particular on ribosome-inactivating proteins (RIPs), symbiont-encoded toxins that have been implicated in protection against both parasitic wasps and nematodes. Although many strains of Spiroplasma, including the male-killing symbiont (sMel) of Drosophila melanogaster, protect against parasitic wasps, only the strain (sNeo) that infects the mycophagous fly Drosophila neotestacea appears to protect against parasitic nematodes. We find that RIP repertoire is a major differentiating factor between strains that do and do not offer nematode protection, and that sMel RIPs do not show activity against nematode ribosomes in vivo. We also discovered a strain of Spiroplasma infecting a mycophagous phorid fly, Megaselia nigra. Although both the host and its Spiroplasma are distantly related to D. neotestacea and its symbiont, genome sequencing revealed that the M. nigra symbiont encodes abundant and diverse RIPs, including plasmid-encoded toxins that are closely related to the RIPs in sNeo. Our results suggest that distantly related Spiroplasma RIP toxins may perform specialized functions with regard to parasite specificity and suggest an important role for horizontal gene transfer in the emergence of novel defensive phenotypes.
An open-label, interventional, single-center, prospective clinical study to evaluate the efficacy and safety of “AHPL/AYTAB/1514” in patients suffering from halitosis

Objectives: The main objective of the study was to assess the efficacy and safety of AHPL/AYTAB/1514 tablet in patients suffering from halitosis. Methodology: Fifty four patients were recruited in the study. Patients were advised to take maximum two tablets or at least one tablet four times a day (depending on tolerability of the drug) orally for 60 days. Patients were called for follow-up on day 15, 30, 45, 60, and 75. Data describing quantitative measures were expressed as mean ± standard deviation comparison of variables representing categorical data were performed using Chi-square test, Student's t-test, or Wilcoxon Sign Rank test. Results: At the end of the treatment, significant reduction in halitosis, gingivitis index, and dental plaque index was observed. Even after stoppage of treatment for 15 days after 60 days of treatment, there was no relapse in halitosis. Few patients experienced sore throat, cough, and common cold during the study, which were resolved with the treatment of AHPL/AYTAB/1514 tablet. No significant change in vital parameters and most of the safety laboratory parameters were observed. No staining on tooth was observed in any patient. Almost all patients showed excellent improvement as per global evaluation done by the physician and patient. Almost all patients showed excellent tolerability to the study drug. Few patients showed mild AE, which were resolved without stoppage of study drug. Conclusion: The study provides good evidence in support of the efficacy and safety of the AHPL/AYTAB/1514 tablet in halitosis.
Gait and Dynamic Balance Sensing Using Wearable Foot Sensors

Remote monitoring of gait performance offers possibilities for objective evaluation and tackling impairment in motor ability, gait, and balance in populations, such as elderly, stroke, multiple sclerosis, and Parkinson’s. This requires a wearable and unobtrusive system capable of estimating ambulatory gait and balance measures, such as the extrapolated center of mass (XCoM) and dynamicmargin of stability. These estimations require the knowledge of 3-D forces and moments (F&M) and accurate foot positions. Though an existing ambulatory gait and balance system (AGBS) consisting of 3-D F&M sensors and inertial measurement units can be used for the purpose, it is bulky and conspicuous. Resistive pressure sensorswere investigated as an alternative to the onboard 3-D F&M sensors. Subject-specific regression models were built to estimate 3-D F&M from 1-D plantar pressures. The model was applicable for different walking speeds. Different pressure sensor configurations were studied to optimize the system complexity and accuracy. Using resistive sensors only under the toe and heel, we were able to estimate the XCoM with a mean absolute rms error of 2.2 ±0.3 cm in the walking direction while walking at a preferred speed, when compared to the AGBS. For the same case, the XCoM was classified as ahead or behind the base of support correctly at 97.7±1.7%. In conclusion, this paper shows that pressure sensors, minimally under the heel and toe, offer a lightweight and inconspicuous alternative for F&M sensing, toward estimating ambulatory gait and dynamic balance.
Fluoxetine triggers selective apoptosis in inflammation‐induced proliferating (Ki‐67high) thymocytes

Inappropriate functioning of the immune system is observed during sustained systemic inflammation, which might lead to immune deficiencies, autoimmune disorders and cancer. Primary lymphoid organs may progress to a deregulated proliferative state in response to inflammatory signals in order to intensify host defense mechanisms and exacerbate an inflammatory niche. Fluoxetine, a selective serotonin reuptake inhibitor, has recently been projected as an anti‐inflammatory agent. This study had been designed to evaluate the potential novel role of fluoxetine in reversing inflammation‐induced immune dysfunction. Lipopolysaccharide (LPS) administration in Swiss albino mice potentiated a systemic inflammatory response, along with increased proliferation of thymocytes and peripheral blood mononuclear cells, as evident from increased Ki‐67 expression. The proliferative changes in the immune system were mainly associated with increased phosphorylation of PI3k, AKT and IκB along with elevated NFκB‐p65 nuclear translocation. The Ki‐67high thymocytes obtained from LPS administered mice demonstrated significantly low p53 nuclear activity, which was established to be mediated by NFκB through reduced nuclear translocation of p53 during LPS‐induced proliferative conditions, thereby blocking p53‐dependent apoptosis. Fluoxetine supplementation not only reversed the proinflammatory condition, but also induced selective apoptosis in the proliferation‐dictated Ki‐67high thymocytes possibly by modulating the hypothalamus–pituitary–adrenal axis and inducing glucocorticoid receptor activation and apoptosis in these proliferation‐biased immune cells, authenticating a novel antiproliferative role of an established drug.
Hippo Deficiency Leads to Cardiac Dysfunction Accompanied by Cardiomyocyte Dedifferentiation During Pressure Overload

Rationale: The Hippo pathway plays an important role in determining organ size through regulation of cell proliferation and apoptosis. Hippo inactivation and consequent activation of YAP (Yes-associated protein), a transcription cofactor, have been proposed as a strategy to promote myocardial regeneration after myocardial infarction. However, the long-term effects of Hippo deficiency on cardiac function under stress remain unknown. Objective: We investigated the long-term effect of Hippo deficiency on cardiac function in the presence of pressure overload (PO). Methods and Results: We used mice with cardiac-specific homozygous knockout of WW45 (WW45cKO), in which activation of Mst1 (Mammalian sterile 20-like 1) and Lats2 (large tumor suppressor kinase 2), the upstream kinases of the Hippo pathway, is effectively suppressed because of the absence of the scaffolding protein. We used male mice at 3 to 4 month of age in all animal experiments. We subjected WW45cKO mice to transverse aortic constriction for up to 12 weeks. WW45cKO mice exhibited higher levels of nuclear YAP in cardiomyocytes during PO. Unexpectedly, the progression of cardiac dysfunction induced by PO was exacerbated in WW45cKO mice, despite decreased apoptosis and activated cardiomyocyte cell cycle reentry. WW45cKO mice exhibited cardiomyocyte sarcomere disarray and upregulation of TEAD1 (transcriptional enhancer factor) target genes involved in cardiomyocyte dedifferentiation during PO. Genetic and pharmacological inactivation of the YAP-TEAD1 pathway reduced the PO-induced cardiac dysfunction in WW45cKO mice and attenuated cardiomyocyte dedifferentiation. Furthermore, the YAP-TEAD1 pathway upregulated OSM (oncostatin M) and OSM receptors, which played an essential role in mediating cardiomyocyte dedifferentiation. OSM also upregulated YAP and TEAD1 and promoted cardiomyocyte dedifferentiation, indicating the existence of a positive feedback mechanism consisting of YAP, TEAD1, and OSM. Conclusions: Although activation of YAP promotes cardiomyocyte regeneration after cardiac injury, it induces cardiomyocyte dedifferentiation and heart failure in the long-term in the presence of PO through activation of the YAP-TEAD1-OSM positive feedback mechanism.
Estimating disease prevalence from drug utilization data using the Random Forest algorithm

Abstract Background Aggregated claims data on medication are often used as a proxy for the prevalence of diseases, especially chronic diseases. However, linkage between medication and diagnosis tend to be theory based and not very precise. Modelling disease probability at an individual level using individual level data may yield more accurate results. Methods Individual probabilities of having a certain chronic disease were estimated using the Random Forest (RF) algorithm. A training set was created from a general practitioners database of 276 723 cases that included diagnosis and claims data on medication. Model performance for 29 chronic diseases was evaluated using Receiver-Operator Curves, by measuring the Area Under the Curve (AUC). Results The diseases for which model performance was best were Parkinson’s disease (AUC = .89, 95% CI = .77–1.00), diabetes (AUC = .87, 95% CI = .85–.90), osteoporosis (AUC = .87, 95% CI = .81–.92) and heart failure (AUC = .81, 95% CI = .74–.88). Five other diseases had an AUC >. 75: asthma, chronic enteritis, COPD, epilepsy and HIV/AIDS. For 16 of 17 diseases tested, the medication categories used in theory-based algorithms were also identified by our method, however the RF models included a broader range of medications as important predictors. Conclusion Data on medication use can be a useful predictor when estimating the prevalence of several chronic diseases. To improve the estimates, for a broader range of chronic diseases, research should use better training data, include more details concerning dosages and duration of prescriptions, and add related predictors like hospitalizations.
Neuronal correlates of delay discounting in healthy subjects and its implication for addiction: an ALE meta-analysis study

ABSTRACT Background: Delay discounting (DD) describes the phenomenon of devaluing future rewards in favor of immediate rewards. Increased DD is a key behavioral marker of addiction, and has been suggested as a target for interventions to alleviate addiction symptoms (e.g., preference for immediate drug use over larger-and-later rewards, and relapses) in patients with substance use disorders (SUD). Objectives: Performed a meta-analysis on neuroimaging results of DD regarding specific contrasts in healthy participants. Reviewed the results of existing patient studies in light of the meta-analyses results. Methods: We conducted activation likelihood estimation meta-analyses on DD neuroimaging studies (25 studies, n = 583; 354 males and 229 females) regarding six analytic strategies. Results: The meta-analyses revealed various subdivisions of the cortical-basal ganglia circuits that are associated with different aspects of DD in healthy subjects. By comparing the meta-analyses results and patients’ studies regarding each contrast, we highlighted three brain regions that may underlie excessive DD in patients. Decreased left inferior frontal gyrus (IFG) activity was related to less preference for delayed choices; reduced ventral striatum (VS) activity was associated with impaired valuation processes; and declined anterior cingulate cortex (ACC)/medial prefrontal cortex (mPFC) activity was associated with alterations in processing difficult choices. Conclusions: We propose that neuromodulation (e.g. deep brain simulation) or behavioral interventions (e.g. episodic future imagination) targeting these key brain regions (IFG, VS, ACC/mPFC) may be effective for improving DD function in patients with SUD, enhancing valuations of future rewards and helping to resist the temptation of immediate drug use.
Thoracoscopy: Advances and Increasing Role for Interventional Pulmonologists

Abstract Thoracoscopy is an increasingly common procedure that provides significant clinical information and therapeutic applications. The procedure allows the physician to biopsy the parietal pleura under direct visualization with high accuracy. In addition, one can drain pleural fluid, place a chest tube in a precise location, and perform poudrage pleurodesis. Medical thoracoscopy (MT) is carried out in the operating room or procedure suite under moderate sedation with spontaneous ventilation. In comparison, video-assisted thoracoscopic surgery (VATS) is performed under general anesthesia with single lung ventilation and through multiple ports in the operating room. MT is less invasive, has a comparable diagnostic yield, and may be better tolerated in high-risk patients. The indications, complications, and advances in thoracoscopy will be discussed in this article. In the era of rapidly evolving therapeutics for lung cancer, immune-modulation and ever-increasing risks of immunosuppression, MT will evolve and continue to play a pivotal role in the evaluation and research of pleuropulmonary diseases.
Relationship between activities specific balance confidence (ABC) scale with age and falls on elderly in Wanasraya Nursing Home Denpasar

Falls are a major health problem for elderly. Apart from the direct injuries resulting from falls, other long-term consequences may include disability, fear of falling, and loss of independence, which can have serious effects on people’s health and quality of life. These risk factors are categorized into two distinct groups: intrinsic and extrinsic factors. Psychological factors, more commonly referred to the “fear of falling syndrome”, have been linked to significant reductions of daily activities in fallers resulting in a loss of independence. The Activities-Specific Balance Confidence (ABC) scale was used to measure confidence in carrying out specific activities without falling or becoming unsteady. We conduct an analytic cross-sectional study to determine the association between ABC scale with age and falls in elderly. Elderly, age over 60 years, at Wanasraya nursing home Denpasar on January 2015 recruited to this study. All subjects were asked questionnaire of ABC scale and history of falls. Health status was taken from physical examination and medical records. Data were analyzed using SPSS. There were 52 elderly consisted of 26 (50%) men, 26 (50%) women, age range 61 – 90 years, mean 71.6 ± 6.5 years, and 17.3% of them have history of falls. Total ABC scale mean were significantly difference between women and men (81.2 ± 14.1 vs 90 ± 12. 8; p < 0. 05) and between faller and non-faller (73.5 ± 13.6 vs 88.2 ± 12.9; p = 0.01). The ABC scale with cut off 82.9% has significantly association with falls; p = 0.01; prevalence ratio = 7.0; 95%CI 1.6 – 49.8. As a conclusion we found lower total ABC scale has significantly association with falls in elderly.
Influence of a Multimodal and Multimodal-Aerobic Therapy Concept on Health-Related Quality of Life in Breast Cancer Survivors

Context: Cancer-related fatigue (CRF) is one of the most burdensome symptoms in breast cancer survivors (BCSs), accompanied by reduced health-related quality of life (HRQOL). Objectives: This study investigated the influence of a multimodal therapy (MT; psychoeducation, eurythmy therapy, painting therapy, and sleep education/restriction), or a combination therapy (CT; MT plus aerobic training [AT]) on HRQOL in BCS with chronic CRF in comparison with AT alone. Methods: One hundred and twenty-six BCSs with CRF were included in a pragmatic comprehensive cohort study and allocated either per randomization or by preference to MT, CT, or AT. The EORTC QLQ-C30 core questionnaire was used to measure HRQOL. All analyses on HRQOL parameters were done in an explorative intention. Results: Patients were assigned to MT (n = 44), CT (n = 54), or AT (n = 28). CT was significantly superior to AT after 10 weeks of intervention (T1) in improving physical function. MT was found to have significant superiority over AT at T1 and T2 for physical functioning, emotional functioning, insomnia, and financial problems as well as role functioning, cognitive, social functioning, and fatigue 6 months later (T2). Conclusion: A multimodal approach appears to be a suitable concept for BCS with chronic CRF. A confirmatory study with larger samples should demonstrate the superiority of MT and adapted CT in HRQOL compared with the current treatment AT found in these explorative analyses.