Miracle-dz/UniFAR-FTUs huggingface dataset:
Nurses’ application of the components of family nursing conversations in home health care: a qualitative content analysis

Aim The purpose of this study was to describe how nurses apply the components of family nursing conversations in their home healthcare practice. Method A qualitative content analysis with a deductive approach was conducted. Home healthcare nurses conducted family nursing conversations with families from their practice. Families were selected based on three nursing diagnoses: risk of caregiver role strain, caregiver role strain or interrupted family processes. Nurses audio‐recorded each conversation and completed a written reflection form afterwards. Transcripts of the audio‐recorded conversations were analysed in Atlas.ti 8.0 to come to descriptions of how nurses applied each component. Nurses’ reflections on their application were integrated in the descriptions. Results A total of 17 conversations were audio‐recorded. The application of each component was described as well as nurses’ reflections on their application. Nurses altered or omitted components due to their clinical judgment of families’ needs in specific situations, due to needs for adjustment of components in the transfer from theory to practice or due to limited skill or self‐confidence. Conclusion All of the components were applied in a cohesive manner. Nurses’ application of the components demonstrates that clinical judgment is important in applying them. Further training or experience may be required to optimise nurses’ skill and self‐confidence in applying the components. This study demonstrates the applicability of the family nursing conversations components in home health care, allowing exploration of the working mechanisms and benefits of family nursing conversations for families involved in long‐term caregiving in future studies.
Revisiting Video Saliency Prediction in the Deep Learning Era

Predicting where people look in static scenes, a.k. a visual saliency, has received significant research interest recently. However, relatively less effort has been spent in understanding and modeling visual attention over dynamic scenes. This work makes three contributions to video saliency research. First, we introduce a new benchmark, called DHF1K (Dynamic Human Fixation 1K), for predicting fixations during dynamic scene free-viewing, which is a long-time need in this field. DHF1K consists of 1K high-quality elaborately-selected video sequences annotated by 17 observers using an eye tracker device. The videos span a wide range of scenes, motions, object types and backgrounds. Second, we propose a novel video saliency model, called ACLNet (Attentive CNN-LSTM Network), that augments the CNN-LSTM architecture with a supervised attention mechanism to enable fast end-to-end saliency learning. The attention mechanism explicitly encodes static saliency information, thus allowing LSTM to focus on learning a more flexible temporal saliency representation across successive frames. Such a design fully leverages existing large-scale static fixation datasets, avoids overfitting, and significantly improves training efficiency and testing performance. Third, we perform an extensive evaluation of the state-of-the-art saliency models on three datasets : DHF1K, Hollywood-2, and UCF sports. An attribute-based analysis of previous saliency models and cross-dataset generalization are also presented. Experimental results over more than 1.2K testing videos containing 400K frames demonstrate that ACLNet outperforms other contenders and has a fast processing speed (40 fps using a single GPU). Our code and all the results are available at https://github.com/wenguanwang/DHF1K.
Evidence accumulation is biased by motivation: A computational account

To make good judgments people gather information. An important problem an agent needs to solve is when to continue sampling data and when to stop gathering evidence. We examine whether and how the desire to hold a certain belief influences the amount of information participants require to form that belief. Participants completed a sequential sampling task in which they were incentivized to accurately judge whether they were in a desirable state, which was associated with greater rewards than losses, or an undesirable state, which was associated with greater losses than rewards. While one state was better than the other, participants had no control over which they were in, and to maximize rewards they had to maximize accuracy. Results show that participants’ judgments were biased towards believing they were in the desirable state. They required a smaller proportion of supporting evidence to reach that conclusion and ceased gathering samples earlier when reaching the desirable conclusion. The findings were replicated in an additional sample of participants. To examine how this behavior was generated we modeled the data using a drift-diffusion model. This enabled us to assess two potential mechanisms which could be underlying the behavior: (i) a valence-dependent response bias and/or (ii) a valence-dependent process bias. We found that a valence-dependent model, with both a response bias and a process bias, fit the data better than a range of other alternatives, including valence-independent models and models with only a response or process bias. Moreover, the valence-dependent model provided better out-of-sample prediction accuracy than the valence-independent model. Our results provide an account for how the motivation to hold a certain belief decreases the need for supporting evidence. The findings also highlight the advantage of incorporating valence into evidence accumulation models to better explain and predict behavior.
Baseline Frontoparietal Task-Related BOLD Activity as a Predictor of Improvement in Clinical Symptoms at 1-Year Follow-Up in Recent-Onset Psychosis.

OBJECTIVE The early course of illness in psychotic disorders is highly variable, and predictive biomarkers of treatment response have been lacking. Trial and error remains the basis for care in early psychosis, and poor outcomes are common. Early prediction of nonimprovement in response to treatment could help identify those who would benefit from alternative and/or supplemental interventions. The goal of this study was to evaluate the ability of functional MRI (fMRI) measures of cognitive control-related brain circuitry collected at baseline to predict symptomatic response in patients after 1 year. METHODS Patients with recent-onset (<2 years) psychotic disorders (N=82) in early psychosis specialty care were classified as improvers (>20% improvement in total score on the Brief Psychiatric Rating Scale [BPRS] at 1-year follow-up compared with baseline) or as nonimprovers. Behavioral (d' context) and fMRI (proactive control-associated activation in a priori frontoparietal regions of interest) measures of cognitive control were then evaluated on their ability to predict BPRS improvement using linear and logistic regression. RESULTS Cognitive control-associated measures significantly predicted BPRS improvement and improver status, with 70% positive predictive value, 60% negative predictive value, and 66% accuracy. Only the fMRI-based measure (and not the behavioral measure) significantly predicted status. CONCLUSIONS These results suggest that frontoparietal activation during cognitive control performance at baseline significantly predicts subsequent symptomatic improvement during early psychosis specialty care. Potential implications for fMRI-based personalized patient treatment are discussed.
Neuropeptide B stimulates insulin secretion and expression but not proliferation in rat insulin‑producing INS‑1E cells.

Neuropeptide B (NPB) regulates food intake, body weight and energy homeostasis by interacting with NPBW1/NPBW2 in humans and NPBW1 in rodents. NPB and NPBW1 are widely expressed in the central nervous system and peripheral tissues including pancreatic islets. Although previous studies have demonstrated a prominent role for NPB and NPBW1 in controlling glucose and energy homeostasis, it remains unknown as to whether NPB modulates pancreatic β‑cell functions. Therefore, the aim of the present study was to investigate the effects of NPB on insulin expression and secretion in vitro. Furthermore, the role of NPB in the modulation of INS‑1E cell growth, viability and death was examined. Gene expression was assessed by reverse transcription‑quantitative PCR. Cell proliferation and viability were determined by BrdU or MTT tests, respectively. Apoptotic cell death was evaluated by relative quantification histone‑complexed DNA fragments (mono‑and oligonucleosomes). Insulin secretion was studied using an ELISA test. Protein phosphorylation was assessed by western blot analysis. NPB and NPBW1 mRNA was expressed in INS‑1E cells and rat pancreatic islets. In INS‑1E cells, NPB enhanced insulin 1 mRNA expression via an ERK1/2‑dependent mechanism. Furthermore, NPB stimulated insulin secretion from INS‑1E cells and rat pancreatic islets. By contrast, NPB failed to affect INS‑1E cell growth or death. We conclude that NPB may regulate insulin secretion and expression in INS‑1E cells and insulin secretion in rat pancreatic islets.
Structure of the Cdc48 segregase in the act of unfolding an authentic substrate

Protein unfolding, one substrate at a time Ubiquitin marks proteins for degradation by the proteasome. However, many substrates cannot be directly degraded because they are well folded or are located in cell membranes or in multimeric complexes. These proteins are first unfolded by the Cdc48 adenosine triphosphatase (ATPase), which forms a hexameric assembly that pulls polypeptides through its central pore. Twomey et al. determined structures of Cdc48 at an initiation stage of substrate processing. Surprisingly, a ubiquitin molecule in the substrate-linked polyubiquitin chain could be unfolded simply by binding to the Cdc48 complex. A segment of the unfolded ubiquitin inserts into the ATPase ring and initiates substrate unfolding. This explains why Cdc48 can deal with a broad range of substrates—even ones that are folded. Cooney et al. report the cryo–electron microscopy structure of Cdc48 in complex with an authentic substrate. In contrast to previously reported Cdc48 structures, an asymmetric spiraling assembly wraps around the extended substrate polypeptide. Thus, Cdc48 uses a hand-over-hand mechanism of translocation, which supports a common mechanism for protein substrate unfolding for AAA+ ATPases. Science, this issue p. eaax1033, p. 502 Cryo-EM structures of native Cdc48 complexes reveal a conserved mechanism of substrate translocation by AAA+ ATPases. The cellular machine Cdc48 functions in multiple biological pathways by segregating its protein substrates from a variety of stable environments such as organelles or multi-subunit complexes. Despite extensive studies, the mechanism of Cdc48 has remained obscure, and its reported structures are inconsistent with models of substrate translocation proposed for other AAA+ ATPases (adenosine triphosphatases). Here, we report a 3.7-angstrom–resolution structure of Cdc48 in complex with an adaptor protein and a native substrate. Cdc48 engages substrate by adopting a helical configuration of substrate-binding residues that extends through the central pore of both of the ATPase rings. These findings indicate a unified hand-over-hand mechanism of protein translocation by Cdc48 and other AAA+ ATPases.
Subjectively and Objectively Measured Sleep Predict Differing Aspects of Cognitive Functioning in Adults.

OBJECTIVE To examine associations between subjectively-reported sleep and objectively-measured sleep (i.e., actigraphy) with different domains of cognitive functioning, and determine whether age may moderate these associations. METHOD In this cross-sectional study, a total of 489 participants (mean age = 45.4 years; SD = 18.8) completed a self-reported sleep measure and one week of actigraphy. Participants also completed a battery of cognitive tests measuring episodic memory, social cognition, executive functioning, and complex cognition (i.e., reasoning, visuospatial, and language abilities). RESULTS Multiple regression analyses revealed that greater objective sleep quality and longer onset latencies were both associated with better performance on measures of conceptual flexibility. In contrast, subjective sleep quality was not associated with performance in any cognitive domain after accounting for objective sleep variables. Age moderated sleep-cognition relationships in differing ways based on cognitive domain and facet of sleep assessed. For example, whereas poorer subjective sleep quality was associated with poorer complex cognition in younger, but not older adults, poorer objective sleep quality was associated with poorer conceptual flexibility in older, but not younger adults. CONCLUSIONS Objectively-measured and self-reported sleep are associated with differing aspects of executive functioning, with the latter related to executive functioning broadly and the former associated with conceptual flexibility in particular. Age moderates sleep-cognition relationships differentially depending on the method by which sleep quality and quantity are measured.
Emotion Recognition in Kindergarten Children

Background/Aims: Recognition and understanding of emotions are essential skills in nonverbal communication and in everyday social functioning. These are already evident in infancy. We aimed to compare how young children recognize facial emotional expressions from static faces versus vocal emotional expressions from speech prosody. Methods: Participants were 313 kindergarten children (162 girls, mean age = 51.01, SD 9.65 months; range 36–72). The design consisted of a visual and an auditory block (with 45 randomized trials each). Children were seated in front of a 14-inch laptop monitor and received visual stimuli (photos of faces) or auditory stimuli (spoken sentences) via loudspeakers. Results: Recognizing emotions from looking at static faces was found to be easier compared to interpreting emotions transmitted by speech prosody alone. The ability to interpret emotions from both faces and speech prosody increased with age. It was easier to identify a “happy” emotion from a facial expression than an “angry” or “sad” one, whereas a “sad” emotion could be more easily recognized from speech prosody alone than facial imagery alone. Girls were significantly better than boys in identifying “sad” facial expressions. Conclusion: The results of the study are discussed in terms of educational implications for nonverbal communication.
Randomized control trial of adenoma detection rate in Endocuff‐assisted colonoscopy versus transparent hood‐assisted colonoscopy

Transparent hood‐assisted colonoscopy (TAC) has been reported to improve the cecal insertion rate and adenoma detection rate (ADR). An endoscopic cap (Endocuff) with two rows of soft wings was recently developed to improve ADR, by flattening the mucosal folds during withdrawal. This randomized prospective control study aimed to compare ADR between Endocuff‐assisted colonoscopy (EAC) and TAC.
Exercise testing criteria to diagnose lower extremity peripheral artery disease assessed by computed-tomography angiography

Background The sensitivity and specificity of exercise testing have never been studied simultaneously against an objective quantification of arterial stenosis. Aims were to define the sensitivity and specificity of several exercise tests to detect peripheral artery disease (PAD), and to assess whether or not defined criteria defined in patients suspected of having a PAD show a difference dependent on the resting ABI. Methods In this prospective study, consecutive patients with exertional limb pain referred to our vascular center were included. All patients had an ABI, a treadmill exercise-oximetry test, a second treadmill test (both 10% slope; 3.2km/h speed) with post-exercise pressures, and a computed-tomography-angiography (CTA). The receiver-operating-characteristic curve was used to define a cut-off point corresponding to the best area under the curve (AUC; [CI95%]) to detect arterial stenosis ≥50% as determined by the CTA. Results Sixty-three patients (61+/-11 years-old) were included. Similar AUCs from 0.72[0.63–0.79] to 0.83[0.75–0.89] were found for the different tests in the overall population. To detect arterial stenosis ≥50%, cut-off values of ABI, post-exercise ABI, post-exercise ABI decrease, post-exercise ankle pressure decrease, and distal delta from rest oxygen pressure (DROP) index were ≤0.91, ≤0.52, ≥43%, ≥20mmHg and ≤-15mmHg, respectively (p<0.01). In the subset of patients with an ABI >0.91, cut-off values of post-exercise ABI decrease (AUC = 0.67[0.53–0.78]), and DROP (AUC = 0.67[0.53–0.78]) were ≥18.5%, and ≤-15mmHg respectively (p<0.05). Conclusion Resting ABI is as accurate as exercise testing in patients with exertional limb pain. Specific exercise testing cut-off values should be used in patients with normal ABI to diagnose PAD.
Association between pulmonary function and left ventricular volume and function in duchenne muscular dystrophy

Introduction: Duchenne muscular dystrophy (DMD) is characterized by absence of the subsarcolemmal protein dystrophin, present in skeletal muscles and cardiomyocytes. We hypothesized that progressive respiratory and left ventricular (LV) insufficiencies in DMD could be parallel and interrelated phenomena. Methods: We conducted a retrospective chart review of 27 patients with DMD. Our primary objective was to compare the rates of decline between pulmonary function test (PFT) measures (forced expiratory volume in the first second, forced vital capacity, peak expiratory flow rate, maximal inspiratory/expiratory pressure) and echocardiographic estimates of LV end‐diastolic volume and LV ejection fraction. Results: The rates of decline/year of PFTs and LV estimates were not significantly different. Pulmonary function test measures of ventilatory efficiency and strength had strong intercorrelations. Pulmonary function tests and LV estimates had weak but statistically significant correlations. Discussion: A comparable rate of decline in PFTs and LV indices in DMD provides evidence for concurrently progressive deterioration in respiratory and LV functions. Muscle Nerve, 2019
Establishing key criteria to define and compare models of specialist palliative care: A mixed-methods study using qualitative interviews and Delphi survey

Background: Specialist palliative care services have various configurations of staff, processes and interventions, which determine how care is delivered. Currently, there is no consistent way to define and distinguish these different models of care. Aim: To identify the core components that characterise and differentiate existing models of specialist palliative care in the United Kingdom. Design: Mixed-methods study: (1) semi-structured interviews to identify criteria, (2) two-round Delphi study to rank/refine criteria, and (3) structured interviews to test/refine criteria. Setting/participants: Specialist palliative care stakeholders from hospice inpatient, hospital advisory, and community settings. Results: (1) Semi-structured interviews with 14 clinical leads, from eight UK organisations (five hospice inpatient units, two hospital advisory teams, five community teams), provided 34 preliminary criteria. (2) Delphi study: Round 1 (54 participants): thirty-four criteria presented, seven removed and seven added. Round 2 (30 participants): these 34 criteria were ranked with the 15 highest ranked criteria, including setting, type of care, size of service, diagnoses, disciplines, mode of care, types of interventions, ‘out-of-hours’ components (referrals, times, disciplines, mode of care, type of care), external education, use of measures, bereavement follow-up and complex grief provision. (3) Structured interviews with 21 UK service leads (six hospice inpatients, four hospital advisory and nine community teams) refined the criteria from (1) and (2), and provided four further contextual criteria (team purpose, funding, self-referral acceptance and discharge). Conclusion: In this innovative study, we derive 20 criteria to characterise and differentiate models of specialist palliative care – a major paradigm shift to enable accurate reporting and comparison in practice and research.
A Spatial Analysis of Preventable Hospitalization for Ambulatory Care Sensitive Conditions and Regional Characteristics in South Korea

Hospitalization rates for ambulatory care sensitive conditions (ACSCs) can indicate the accessibility of a community’s primary care. We examined regional variation in ACSC hospitalization rates and identified associated factors. ACSC hospitalization rates in the 232 districts in 2013 ranged from 4.08 to 101.53 per 1000 adults. Spatial analysis showed that none of the 24 highest rate districts were located near Seoul, whereas 80% of the 45 lowest rate districts were, suggesting health care inequality between people living near Seoul and in other areas. Regression analysis showed significantly higher ACSC hospitalization rates in districts with higher elderly (β = 0.94) and low-income populations (β = 2.25), more remote areas (β = 0.29), and more hospital beds (β = 0.03). The number of primary care clinics was negatively associated with ACSC hospitalization (β = −1.37). For these variables, geographically weighted regression analysis provided local regression coefficients, useful for developing region-specific strategies to reduce ACSC hospitalization.
Cost-effectiveness and satisfaction following arthroscopic rotator cuff repair.

AIMS The aim of this study was to investigate the influence of age on the cost-effectiveness of arthroscopic rotator cuff repair. PATIENTS AND METHODS A total of 112 patients were prospectively monitored for two years after arthroscopic rotator cuff repair using the Disabilities of the Arm, Shoulder and Hand questionnaire (DASH), the Oxford Shoulder Score (OSS), and the EuroQol five-dimension questionnaire (EQ-5D). Complications and use of healthcare resources were recorded. The incremental cost-effectiveness ratio (ICER) was used to express the cost per quality-adjusted life-year (QALY). Propensity score-matching was used to compare those aged below and above 65 years of age. Satisfaction was determined using the Net Promoter Score (NPS). Linear regression was used to identify variables that influenced the outcome at two years postoperatively. RESULTS A total of 92 patients (82.1%) completed the follow-up. Their mean age was 59.5 years (sd 9.7, 41 to 78). There were significant improvements in the mean DASH (preoperative 47.6 vs one-year 15.3; p < 0.001) and OSS scores (26.5 vs 40.5; p < 0.001). Functional improvements were maintained with no significant change between one and two years postoperatively. The mean preoperative EQ-5D was 0.54 increasing to 0.81 at one year (p < 0.001) and maintained at 0.86, two years postoperatively. There was no significant difference between those aged below or above 65 years of age with regards to postoperative shoulder function or EQ-5D gains. Smoking was the only characteristic that significantly adversely influenced the EQ-5D at two years postoperatively (p = 0.005). A total of 87 were promoters and five were passive, giving a mean NPS of 95 (87/92). The total mean cost per patient was £3646.94 and the mean EQ-5D difference at one year was 0.2691, giving a mean ICER of £13 552.36/QALY. At two years, this decreased further to £5694.78/QALY. This was comparable for those aged below or above 65 years of age (£5209.91 vs £5525.67). Smokers had an ICER that was four times more expensive. CONCLUSION Arthroscopic rotator cuff repair results in excellent patient satisfaction and cost-effectiveness, regardless of age. Cite this article: Bone Joint J 2019;101-B:860-866.